Vancomycin powder in total joint replacement

Mancino, Fabio; Gant, Vanya; Meek, Dominic R. M.; Haddad, Fares S.

doi:10.1302/0301-620x.105b8.bjj-2023-0675

Cited by 4 publications

(2 citation statements)

References 64 publications

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“…With the increasingly evident trend of an aging population, the incidence of knee osteoarthritis (KOA) is gradually rising, and the importance of total joint replacement (TJR) is becoming more and more critical for middle-aged and elderly patients with KOA. − In TJR surgery, poly methyl methacrylate (PMMA) is a commonly used artificial joint fixation material, which has high compressive strength and elastic modulus, playing a crucial role in the orthopedic implantation process, such as supporting orthopedic implants and transmitting mechanical stress and loads between metal implants and host bone. − It is usually bonded to the host bone by mechanical anchoring. However, aseptic loosening of artificial joints is the most common middle- and late-stage (about 3–10 years) complication after joint replacement surgery, with possible mechanisms − including (i) PMMA lacks biological activity, and thus its failure to anchor to the host bone leads to prosthesis loosening; (ii) osteoporosis causes bone loss, leading to loosening of the PMMA and bone interface; and (iii) aseptic inflammation causes bone resorption, resulting in the failure of the PMMA anchoring function.…”

Section: Introductionmentioning

confidence: 99%

Intelligent and Bioactive Osseointegration of the Implanted Piezoelectric Bone Cement with the Host Bone Is Realized by Biomechanical Energy

Wang,

Luo,

Yang

et al. 2024

ACS Appl. Mater. Interfaces

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Poly methyl methacrylate (PMMA) bone cement is widely used in orthopedic surgeries, including total hip/knee arthroplasty and vertebral compression fracture treatment. However, loosening due to bone resorption is a common mid-tolate complication. Therefore, developing bioactive bone cement that promotes bone growth and integration is key to reducing aseptic loosening. In this study, we developed a piezoelectric bone cement comprising PMMA and BaTiO 3 with excellent electrobioactivity and further analyzed its ability to promote bone integration. Experiments demonstrate that the PMMA and 15 wt % BaTiO 3 cement generated an open-circuit voltage of 37.109 V under biomimetic mechanical stress, which effectively promoted bone regeneration and interfacial bone integration. In vitro experiments showed that the protein expression levels of ALP and RUNX-2 in the 0.65 Hz and 20 min group increased by 1.74 times and 2.31 times. In vivo experiments confirmed the osteogenic ability of PMMA and 15 wt % BaTiO 3 , with the increment of bone growth in the non-movement and movement groups being 4.67 and 4.64 times, respectively, at the second month after surgery. Additionally, Fluo-4 AM fluorescence staining and protein blotting experiments verified that PMMA and 15 wt % BaTiO 3 electrical stimulation promoted osteogenic differentiation of BMSCs by activating calcium-sensitive receptors and increasing calcium ion inflow by 1.41 times when the stimulation reached 30 min. Therefore, piezoelectric bioactive PMMA and 15 wt % BaTiO 3 cement has excellent application value in orthopedic surgery systems where stress transmission is prevalent.

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Section: Introductionmentioning

confidence: 99%

Intelligent and Bioactive Osseointegration of the Implanted Piezoelectric Bone Cement with the Host Bone Is Realized by Biomechanical Energy

Wang,

Luo,

Yang

et al. 2024

ACS Appl. Mater. Interfaces

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“…10%) as well as, to a lesser extent, from difficult-to-treat Gram-negative bacteria (<10%) including the pseudomonas strain. Periprosthetic joint surgeries are associated with a low but significant (1–2%) incidence of infection (PTI), but the associated morbidity and rehospitalization costs are very high [ 1 ]. Revision methods for treating such infections usually involve the surgical removal of the implant, debridement, and the insertion of an antibiotic drug-loaded “spacer” implant made from poly (methyl methacrylate) (PMMA) bone cement for up to six weeks.…”

Section: Introductionmentioning

confidence: 99%

Triple Encapsulation and Controlled Release of Vancomycin, Rifampicin and Silver from Poly (Methyl Methacrylate) or Poly (Lactic-Co-Glycolic Acid) Nanofibers

Jackson

2024

Bioengineering

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Although the incidence of infections in orthopedic surgeries, including periprosthetic surgeries, remains low at approximately 1–2%, the number of surgeries and the incidence of drug-resistant bacteria is increasing. The cost and morbidity associated with revision surgeries are huge. More effective drug combinations and delivery methods are urgently needed. In this paper, three anti-infective drugs (vancomycin, rifampicin, and silver sulfadiazine) have been jointly and effectively electrospun in thin (0.1 mm) flexible nanofiber mats of either poly (methyl methacrylate) (PMMA) or poly (lactic-co-glycolic acid) (PLGA). The inclusion of poly (ethylene glycol) (PEG) enabled optimal drug release with a reduced water contact angle for wetting. The controlled release of these three agents from 20% PEG (w/w to polymer)-blended PMMA or PLGA nanofiber mats may allow for the prophylactical prevention of implant-related infections or provide methods to treat orthopedic infections at the time of revision surgeries. These combinations of drugs provide excellent additive or synergistic antibiotic action against a broader spectrum of bacteria than each drug alone.

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Vancomicina en polvo en la prevención de la infección en artroplastia primaria de rodilla y cadera: estudio de casos y controles con 1.151 artroplastias

Paredes-Carnero,

Vidal-Campos,

Gómez-Suárez

et al. 2024

Revista Española de Cirugía Ortopédica y Traumatología

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Vancomycin powder in total joint replacement

Cited by 4 publications

References 64 publications

Intelligent and Bioactive Osseointegration of the Implanted Piezoelectric Bone Cement with the Host Bone Is Realized by Biomechanical Energy

Intelligent and Bioactive Osseointegration of the Implanted Piezoelectric Bone Cement with the Host Bone Is Realized by Biomechanical Energy

Triple Encapsulation and Controlled Release of Vancomycin, Rifampicin and Silver from Poly (Methyl Methacrylate) or Poly (Lactic-Co-Glycolic Acid) Nanofibers

Vancomicina en polvo en la prevención de la infección en artroplastia primaria de rodilla y cadera: estudio de casos y controles con 1.151 artroplastias

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