title: Vancomycin containing PLLA/β-TCP controls experimental osteomyelitis in vivo.
abstract: BACKGROUND
  Implant-related osteomyelitis (IRO) is recently controlled with local antibiotic delivery systems to overcome conventional therapy disadvantages. In vivo evaluation of such systems is however too little.
  
  
  OBJECTIVE
  We asked whether vancomycin (V)-containing poly-l-lactic acid/β-tricalcium phosphate (PLLA/β-TCP) composites control experimental IRO and promote bone healing in vivo.
  
  
  METHODS
  Fifty-six rats were distributed to five groups in this longitudinal controlled study. Experimental IRO was established at tibiae by injecting methicillin-resistant Staphylococcus aureus (MRSA) suspensions with titanium particles in 32 rats. Vancomycin-free PLLA/β-TCP composites were implanted into the normal and infected tibiae, whereas V-PLLA/β-TCP composites and coated (C)-V-PLLA/β-TCP composites were implanted into IRO sites. Sham-operated tibiae established the control group. Radiological and histological scores were quantified with microbiological findings on weeks 1 and 6.
  
  
  RESULTS
  IRO is resolved in the CV- and the V-PLLA/β-TCP groups but not in the PLLA/β-TCP group. MRSA was not isolated in the CV- and the V-PLLA/β-TCP groups at all times whereas the bacteria were present in the PLLA/β-TCP group. Radiological signs secondary to infection are improved from 10.9 ± 0.9 to 3.0 ± 0.3 in the V-PLLA/β-TCP group but remained constant in the PLLA/β-TCP group. Histology scores are improved from 24.7 ± 6.5 to 17.6 ± 4.8 and from 27.6 ± 7.9 to 32.4 ± 8.9 in the CV-PLLA/β-TCP and the V-PLLA/β-TCP groups, respectively. New bone was formed in all the PLLA/β-TCP group at weeks 1 and 6.
  
  
  CONCLUSIONS
  CV- and V-PLLA/β-TCP composites controlled experimental IRO and promoted bone healing.
  
  
  CONCLUSIONS
  CV- and V-PLLA/β-TCP composites have the potential of controlling experimental IRO and promoting bone healing.
authors.affiliation: Department of Biotechnology, Institute of Applied Sciences, Middle East Technical University, Çankaya, Ankara, 06800, Turkey. uysalberna@yahoo.com.
authors.forename: Berna
authors.initials: B
authors.lastname: Kankilic
authors.affiliation: Department of Histology and Embryology, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, 06100, Turkey. elif.bilgic@hacettepe.edu.tr.
authors.forename: Elif
authors.initials: E
authors.lastname: Bilgic
authors.affiliation: Department of Histology and Embryology, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, 06100, Turkey. petek@hacettepe.edu.tr.
authors.forename: Petek
authors.initials: P
authors.lastname: Korkusuz
authors.affiliation: Department of Sports Medicine, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, 06100, Turkey. feza.korkusuz@hacettepe.edu.tr.
authors.forename: Feza
authors.initials: F
authors.lastname: Korkusuz
mesh_terms: D000818:Animals; D001846:Bone Development / Q000187:drug effects; D000069343:Bone-Implant Interface / Q000382:microbiology*; D002130:Calcium Phosphates; D019344:Lactic Acid; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D010019:Osteomyelitis / Q000188:drug therapy / Q000517:prevention & control*; D011091:Polyesters; D011108:Polymers; D051381:Rats; D017207:Rats, Sprague-Dawley; D013203:Staphylococcal Infections / Q000517:prevention & control; D013977:Tibia / Q000601:surgery; D054457:Tissue Scaffolds; D014640:Vancomycin / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D002130:Calcium Phosphates; D011091:Polyesters; D011108:Polymers; C485817:beta-tricalcium phosphate; D019344:Lactic Acid; C033616:poly(lactide); D014640:Vancomycin