title: Controlled release of vancomycin from thin sol-gel films on implant surfaces successfully controls osteomyelitis.
abstract: Peri-prosthetic infection remains a serious complication of joint replacement surgery. Herein, we demonstrate that a vancomycin-containing sol-gel film on Ti alloy rods can successfully treat bacterial infections in an animal model. The vancomycin-containing sol-gel films exhibited predictable release kinetics, while significantly inhibiting S. aureus adhesion. When evaluated in a rat osteomyelitis model, microbiological analysis indicated that the vancomycin-containing sol-gel film caused a profound decrease in S. aureus number. Radiologically, while the control side showed extensive bone degradation, including abscesses and an extensive periosteal reaction, rods coated with the vancomycin-containing sol-gel film resulted in minimal signs of infection. MicroCT analysis confirmed the radiological results, while demonstrating that the vancomycin-containing sol-gel film significantly protected dense bone from resorption and minimized remodeling. These results clearly demonstrate that this novel thin sol-gel technology can be used for the targeted delivery of antibiotics for the treatment of periprosthetic as well as other bone infections.
authors.affiliation: Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA. Christopher.Adams@jefferson.edu
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Adams
authors.forename: Valentin
authors.initials: V
authors.lastname: Antoci
authors.forename: Gerald
authors.initials: G
authors.lastname: Harrison
authors.forename: Payal
authors.initials: P
authors.lastname: Patal
authors.forename: Terry A
authors.initials: TA
authors.lastname: Freeman
authors.forename: Irving M
authors.initials: IM
authors.lastname: Shapiro
authors.forename: Javad
authors.initials: J
authors.lastname: Parvizi
authors.forename: Noreen J
authors.initials: NJ
authors.lastname: Hickok
authors.forename: Shula
authors.initials: S
authors.lastname: Radin
authors.forename: Paul
authors.initials: P
authors.lastname: Ducheyne
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics*; D015519:Bone Density; D001858:Bone Nails / Q000382:microbiology; D001862:Bone Resorption / Q000000981:diagnostic imaging; D020099:Coated Materials, Biocompatible; D004195:Disease Models, Animal; D005269:Femur / Q000382:microbiology / Q000601:surgery; D005782:Gels; D010012:Osteogenesis; D010019:Osteomyelitis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011859:Radiography; D051381:Rats; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging / Q000188:drug therapy; D013211:Staphylococcus aureus / Q000187:drug effects; D014025:Titanium; D014640:Vancomycin / Q000493:pharmacokinetics*
chemical_list: D000900:Anti-Bacterial Agents; D020099:Coated Materials, Biocompatible; D005782:Gels; D014640:Vancomycin; D014025:Titanium