title: Review: emerging developments in the use of bioactive glasses for treating infected prosthetic joints.
abstract: Bacterial contamination of implanted orthopedic prostheses is a serious complication that requires prolonged systemic antibiotic therapy, major surgery to remove infected implants, bone reconstruction, and considerable morbidity. Local delivery of high doses of antibiotics using poly(methyl methacrylate) (PMMA) cement as the carrier, along with systemic antibiotics, is the standard treatment. However, PMMA is not biodegradable, and it can present a surface on which secondary bacterial infection can occur. PMMA spacers used to treat deep implant infections must be removed after resolution of the infection. Alternative carrier materials for antibiotics that could also restore deficient bone are therefore of interest. In this article, the development of bioactive glass-based materials as a delivery system for antibiotics is reviewed. Bioactive glass is osteoconductive, converts to hydroxyapatite, and heals to hard and soft tissues in vivo. Consequently, bioactive glass-based carriers can provide the combined functions of controlled local antibiotic delivery and bone restoration. Recently-developed borate bioactive glasses are of particular interest since they have controllable degradation rates coupled with desirable properties related to osteogenesis and angiogenesis. Such glasses have the potential for providing a new class of biomaterials, as substitutes for PMMA, in the treatment of deep bone infections.
authors.affiliation: Department of Materials Science and Engineering, Missouri University of Science and Technology, Rolla, MO 65409, USA. Electronic address: rahaman@mst.edu.
authors.forename: Mohamed N
authors.initials: MN
authors.lastname: Rahaman
authors.affiliation: Department of Orthopaedic Surgery, University of Missouri, Columbia, MO 65211, USA.
authors.forename: B Sonny
authors.initials: BS
authors.lastname: Bal
authors.affiliation: Institute of Bioengineering and Information Technology Materials, School of Materials Science and Engineering, Tongji University, Shanghai 200092, China.
authors.forename: Wenhai
authors.initials: W
authors.lastname: Huang
mesh_terms: D020341:Absorbable Implants; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000737:chemistry* / Q000494:pharmacology; D001419:Bacteria / Q000187:drug effects; D001672:Biocompatible Materials / Q000737:chemistry*; D001881:Borates / Q000737:chemistry; D004337:Drug Carriers / Q000737:chemistry; D005898:Glass / Q000737:chemistry*; D006801:Humans; D010019:Osteomyelitis / Q000188:drug therapy / Q000382:microbiology; D019904:Polymethyl Methacrylate / Q000737:chemistry
chemical_list: D000900:Anti-Bacterial Agents; D001672:Biocompatible Materials; D001881:Borates; D004337:Drug Carriers; D019904:Polymethyl Methacrylate
keywords: Antibiotic delivery; Bioactive glass; Borate glass; Joint infection; Osteomyelitis