title: New PMMA-based composites for preparing spacer devices in prosthetic infections.
abstract: Even though the systemic antibiotic therapy is usually applied after prosthetic infections surgical treatments, it is unable to reach the infection site in sufficient concentrations to eradicate bacteria. Delivering antibiotics locally with the use of custom made device (spacer or nail coating) might eradicate or reduce the infection and the risk of recolonization, providing a very high concentration of antibiotic. PMMA-based (Mendec Spine) composites with BaSO(4) were enriched with β-tricalcium phosphate (Porosectan-TCP) or only a slightly higher BaSO(4) concentration (Porosectan-BaSO(4)) to obtain higher porosity. The aim of the study was to evaluate: (i) drug absorption capability and drug release kinetics in vitro soaking them with a combined solution of gentamicin and vancomycin, (ii) their in vitro and in vivo biocompatibility, and finally, (iii) they were tested preliminarily in an experimental model of bone infection. The simultaneous presence of β-TCP and BaSO(4) resulted in the formation of a texture of interconnecting channels with different diameters, from a few microns to several hundred microns, which totally filled the material. The porosity, determined by microcomputed tomography, was significantly higher in both tested plain composites (Porosectan-TCP: +17.3%; Porosectan-BaSO(4): +7.5%) in comparison to control composite material (Mendec Spine). The kinetics of antibiotic release from composites was rapid and complete, producing high drug concentrations for a short period of time. Both composites showed a good level of biocompatibility. The osteomyelitic model confirmed that both composites, soaked in antibiotic solution, were able to cure bone infection. These composites could be useful for preparing devices for prosthetic joint infections treatment also allowing the use of antibiotics solution at required concentrations.
authors.affiliation: Laboratory of Preclinical and Surgical Studies, Rizzoli Orthopaedic Institute IRCCS, via di Barbiano 1/10, 40136 Bologna, Italy. gianluca.giavaresi@ior.it
authors.forename: Gianluca
authors.initials: G
authors.lastname: Giavaresi
authors.forename: Elisa
authors.initials: E
authors.lastname: Bertazzoni Minelli
authors.forename: Maria
authors.initials: M
authors.lastname: Sartori
authors.forename: Anna
authors.initials: A
authors.lastname: Benini
authors.forename: Annapaola
authors.initials: A
authors.lastname: Parrilli
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Maltarello
authors.forename: Francesca
authors.initials: F
authors.lastname: Salamanna
authors.forename: Paola
authors.initials: P
authors.lastname: Torricelli
authors.forename: Roberto
authors.initials: R
authors.lastname: Giardino
authors.forename: Milena
authors.initials: M
authors.lastname: Fini
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D017609:Barium Compounds / Q000737:chemistry; D001672:Biocompatible Materials / Q000138:chemical synthesis* / Q000737:chemistry / Q000493:pharmacokinetics; D002478:Cells, Cultured; D004338:Drug Combinations; D016503:Drug Delivery Systems; D004864:Equipment and Supplies; D005839:Gentamicins / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008422:Materials Testing; D009262:Nails / Q000187:drug effects / Q000378:metabolism; D010019:Osteomyelitis / Q000188:drug therapy / Q000378:metabolism; D011108:Polymers / Q000138:chemical synthesis / Q000737:chemistry / Q000493:pharmacokinetics; D019904:Polymethyl Methacrylate / Q000138:chemical synthesis* / Q000737:chemistry; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000378:metabolism; D011817:Rabbits; D014640:Vancomycin / Q000008:administration & dosage
chemical_list: D000900:Anti-Bacterial Agents; D017609:Barium Compounds; D001672:Biocompatible Materials; D004338:Drug Combinations; D005839:Gentamicins; D011108:Polymers; D014640:Vancomycin; D019904:Polymethyl Methacrylate