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Local gentamicin application does not interfere with bone healing in a rat model.

M Fassbender1, S Minkwitz, Z Kronbach

  • 1Julius Wolff Institute, Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. Mirja.fassbender@charite.de

Bone
|May 2, 2013
PubMed
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Local gentamicin application on intramedullary nails for bone infection prophylaxis does not hinder long-term bone healing. Studies show gentamicin-coated nails promote better bone healing outcomes compared to controls.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Infectious Disease Management

Background:

  • Local antibiotic delivery is crucial for treating and preventing bone infections.
  • Gentamicin-coated bone implants, like tibial nails, are used for fracture stabilization and infection prophylaxis.
  • The potential impact of locally applied gentamicin on bone healing requires thorough investigation.

Purpose of the Study:

  • To evaluate whether gentamicin locally delivered from polymeric coatings on intramedullary nails affects the bone healing process.
  • To compare bone healing in rats with osteotomy stabilized by gentamicin-coated versus non-coated intramedullary nails.

Main Methods:

  • Seventy-two female Sprague Dawley rats underwent osteotomy and intramedullary stabilization with Kirschner-wires (k-wires).

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  • K-wires were coated with either poly(d,l-lactide) (control) or 10% gentamicin incorporated into the polymer.
  • In vivo micro-computed tomography (μCT), mechanical torsional testing, and histological evaluation were performed at multiple time points post-osteotomy.

    • Main Results:

    • Micro-CT revealed increased tissue mineral density (TMD) over time in both groups.
    • Gentamicin-treated tibiae showed significantly better maximum load at day 84 compared to controls.
    • Histology indicated mineralized bridging in 2 of 5 calluses in the gentamicin group, with significantly more mineralized tissue observed compared to the control group.

    Conclusions:

    • Local gentamicin application via polymeric coatings on intramedullary nails does not impede long-term bone healing.
    • This method of local infection prophylaxis is effective and does not negatively impact bone healing processes.
    • Gentamicin-coated nails may even enhance bone healing outcomes in critical fracture cases.