title: A novel injectable borate bioactive glass cement as an antibiotic delivery vehicle for treating osteomyelitis.
abstract: BACKGROUND
  A novel injectable cement composed of chitosan-bonded borate bioactive glass (BG) particles was evaluated as a carrier for local delivery of vancomycin in the treatment of osteomyelitis in a rabbit tibial model.
  
  
  METHODS
  The setting time, injectability, and compressive strength of the borate BG cement, and the release profile of vancomycin from the cement were measured in vitro. The capacity of the vancomycin-loaded BG cement to eradicate methicillin-resistant Staphylococcus aureus (MRSA)-induced osteomyelitis in rabbit tibiae in vivo was evaluated and compared with that for a vancomycin-loaded calcium sulfate (CS) cement and for intravenous injection of vancomycin.
  
  
  RESULTS
  The BG cement had an injectability of >90% during the first 3 minutes after mixing, hardened within 30 minutes and, after hardening, had a compressive strength of 18 ± 2 MPa. Vancomycin was released from the BG cement into phosphate-buffered saline for up to 36 days, and the cumulative amount of vancomycin released was 86% of the amount initially loaded into the cement. In comparison, vancomycin was released from the CS cement for up 28 days and the cumulative amount released was 89%. Two months post-surgery, radiography and microbiological tests showed that the BG and CS cements had a better ability to eradicate osteomyelitis when compared to intravenous injection of vancomycin, but there was no significant difference between the BG and CS cements in eradicating the infection. Histological examination showed that the BG cement was biocompatible and had a good capacity for regenerating bone in the tibial defects.
  
  
  CONCLUSIONS
  These results indicate that borate BG cement is a promising material both as an injectable carrier for vancomycin in the eradication of osteomyelitis and as an osteoconductive matrix to regenerate bone after the infection is cured.
authors.affiliation: Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
authors.forename: Hao
authors.initials: H
authors.lastname: Ding
authors.affiliation: Department of Orthopedic Surgery, Liaocheng People's Hospital, Liaocheng, Shandong, People's Republic of China.
authors.forename: Cun-Ju
authors.initials: CJ
authors.lastname: Zhao
authors.affiliation: Institute of Bioengineering and Information Technology Materials, Tongji University, Shanghai, People's Republic of China.
authors.forename: Xu
authors.initials: X
authors.lastname: Cui
authors.affiliation: Institute of Bioengineering and Information Technology Materials, Tongji University, Shanghai, People's Republic of China.
authors.forename: Yi-Fei
authors.initials: YF
authors.lastname: Gu
authors.affiliation: Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
authors.forename: Wei-Tao
authors.initials: WT
authors.lastname: Jia
authors.affiliation: Department of Materials Science and Engineering, Missouri University of Science and Technology, Rolla, Missouri, United States of America.
authors.forename: Mohamed N
authors.initials: MN
authors.lastname: Rahaman
authors.affiliation: Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Institute of Bioengineering and Information Technology Materials, Tongji University, Shanghai, People's Republic of China.
authors.forename: Wen-Hai
authors.initials: WH
authors.lastname: Huang
authors.affiliation: Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
authors.forename: Chang-Qing
authors.initials: CQ
authors.lastname: Zhang
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D001672:Biocompatible Materials; D001881:Borates; D019245:Compressive Strength; D004195:Disease Models, Animal; D004337:Drug Carriers; D005898:Glass; D007700:Kinetics; D008422:Materials Testing; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D008826:Microbial Sensitivity Tests; D010019:Osteomyelitis / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D011817:Rabbits; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000473:pathology; D014640:Vancomycin / Q000008:administration & dosage
chemical_list: D000900:Anti-Bacterial Agents; D001672:Biocompatible Materials; D001881:Borates; D004337:Drug Carriers; D014640:Vancomycin