Porous orthopedic steel implant as an antibiotic eluting device: Prevention of post-surgical infection on an ovine model

Antimicrobial technology in orthopedic and spinal implants

“…Diagrams highlighting the principle design of fixation pins: A: Scheme of a drug releasing fixation pin. Note the permeation through the porous wall (arrows) [64] ; B: Scheme of implanted fixation pins, each capable of eluting local antibiotics around fixation site [65] . Figure 7 Interaction between surface roughness and bacterial adhesion [69] .…”

“…Initial in vivo testing by Gimeno et al [64] demonstrated that sheep infected with a biofilm-forming S. aureus strain showed no signs of infection of pre-placed tibia implants 7-9 d post introduction of S. aureus. Gimeno et al [65] subsequently proposed a design detailing fixation pins with tubular reservoirs for loading of antibiotics, allowing for more controlled release of the antibiotic based on number and size of release orifices ( Figure 6).…”

Silicon oxide based materials for controlled release in orthopedic procedures

“…The pins containing linezolid-loaded MSNs reduced the bacterial growth by two orders of magnitude when challenged with the S. aureus in vitro [123]. In a sheep tibia infection study [125], antibiotic-loaded implants were placed in the tibia of four sheep which were trans-surgically experimentally infected with a biofilm forming strain of S. aureus. After 7 and 9 days post infection, sheep did not show any evidence of infection as demonstrated by clinical, pathological and microbiological findings [125].…”

“…In a sheep tibia infection study [125], antibiotic-loaded implants were placed in the tibia of four sheep which were trans-surgically experimentally infected with a biofilm forming strain of S. aureus. After 7 and 9 days post infection, sheep did not show any evidence of infection as demonstrated by clinical, pathological and microbiological findings [125]. These results demonstrate the capability of such an antibiotic-loaded implant to prevent infection in orthopedic devices in vivo.…”

Novel anti-infective implant substrates: Controlled release of antibiofilm compounds from mesoporous silica-containing macroporous titanium

“…Up to now, very limited attention has been devoted to the application of drug delivery vehicles in the bulk of metallic implants. For example, porous titanium (Ti) or stainless steel cylinders have been described to serve as a reservoir for drug loaded gelatin sponges or packed beds of mesoporous silica particles, respectively [26][27][28]. Moreover, we have previously synthesized amorphous microporous silica inside an open porous Ti surface coating for the controlled release of chlorhexidine [29].…”