Effectiveness of commercially-available antibiotic-impregnated implants

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Biomaterials Science

Background:

• Bone infections pose significant challenges in orthopedic surgery.
• Effective local antibiotic delivery is crucial for preventing implant-associated infections.

Purpose of the Study:

• To evaluate the efficacy of antibiotic-impregnated implants in preventing bone infection.
• To compare different formulations of tobramycin-impregnated implants.

Main Methods:

• A goat model of contaminated fracture was utilized.
• Four treatment groups were assessed: no treatment, hand-made tobramycin-impregnated polymethylmethacrylate (PMMA) beads, commercial tobramycin-impregnated calcium sulfate pellets, and commercial tobramycin-impregnated PMMA beads.
• Infection was induced using streptomycin-resistant Staphylococcus aureus.

Main Results:

• No evidence of infection was found in any antibiotic-treated group three weeks post-inoculation.
• All cultures from the untreated control group were positive for infection.
• Both hand-made and commercial tobramycin-impregnated implants demonstrated effectiveness.

Conclusions:

• Antibiotic-impregnated implants are effective in preventing bone infections.
• Both PMMA beads and calcium sulfate pellets provide effective local antibiotic delivery.
• Bioabsorbable calcium sulfate pellets offer an advantage by eliminating the need for a second removal surgery.