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A biodegradable gentamicin-hydroxyapatite-coating for infection prophylaxis in cementless hip prostheses
D Neut1, R J Dijkstra, J I Thompson
1Department of Biomedical Engineering (FB40), W.J. Kolff Institute, University of Groningen and University Medical Center Groningen, PO Box 196, 9700 AD Groningen, The Netherlands.d.neut@umcg.nl.
European Cells & Materials
|January 2, 2015
Summary
A new degradable coating for hip implants, poly (lactic-co-glycolic acid) (PLGA) with gentamicin, effectively prevents infection without hindering bone growth. This offers a promising prophylactic strategy for cementless prostheses.
Area of Science:
- Biomaterials Science
- Orthopedic Surgery
- Infectious Disease Prevention
Background:
- Cementless hip prostheses are susceptible to infection.
- Traditional cemented prostheses utilize gentamicin-loaded cements for prophylaxis.
- A novel coating is needed for cementless designs.
Purpose of the Study:
- To develop and evaluate a degradable, gentamicin-loaded poly (lactic-co-glycolic acid) (PLGA) coating for hydroxyapatite (HA)-coated cementless hip prostheses.
- To assess the coating's antibacterial efficacy and impact on bone ingrowth.
Main Methods:
- In vitro studies of antibiotic release and antibacterial activity against staphylococci.
- In vivo evaluation in rabbit models for infection prevention.
- Canine model to assess bone ingrowth with the coating.
Main Results:
- The PLGA-gentamicin-HA coating demonstrated rapid, high-burst release of gentamicin, with efficacy lasting up to 4 days, minimizing antibiotic resistance risk.
- The coating effectively killed gentamicin-sensitive and resistant staphylococci in vitro and prevented bacterial growth around implants in vivo.
- In rabbit models, PLGA-gentamicin-HA-coated pins significantly reduced infection rates compared to controls.
- Bone ingrowth was not compromised in canine models with the degradable coating.
Conclusions:
- The developed PLGA-gentamicin-HA coating is an effective prophylactic strategy against infection in cementless hip prostheses.
- The coating provides antibacterial benefits without negatively impacting osseointegration.
- This represents a significant advancement in preventing implant-related infections.
