Treatment of contaminated bone defects with clindamycin-reconstituted bone xenograft-composites

Contaminated or infected bone defects and osteomyelitis after trauma are frequently encountered in clinical practice. It is difficult to make a successful bone graft and control infection at the same time. To find a better method to resolve this dilemma, we prepared a novel clindamycin-reconstituted bone xenograft-composite (C-RBX-C) that comprised of crude bBMP (bovine bone morphogenetic protein), clindamycin, and cancellous bone scaffold, and investigated the morphology, biocompatibility, antibiotic release profile and osteoinductive potential of this composite. The ultrastructure of C-RBX-C was evaluated by scanning electron microscopy; the biocompatibility and osteoinductive potential were assessed by testing ectopic implants. The antibiotic release profile was evaluated using a disc-diffusion assay. Finally, this composite was used to repair a Staphylococcus aureus contaminated bone defect in a rabbit model. 16 weeks after the implantation of C-RBX-C, the radial defect had been completely recuperated, with significantly better formation of lamellar bone and recanalization of the marrow cavity, than in the controls (scaffolds without clindamycin or bBMP). These results demonstrate that our novel composite, with its concomitant osteoinductive and antibiotic properties, has significant potential for the treatment of contaminated or infected bone defects and osteomyelitis.