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Adding functionality with additive manufacturing: Fabrication of titanium-based antibiotic eluting implants.

Sophie C Cox1, Parastoo Jamshidi2, Neil M Eisenstein3

  • 1School of Chemical Engineering, University of Birmingham, Edgbaston B15 2TT, UK.

Materials Science & Engineering. C, Materials for Biological Applications
|April 30, 2016
PubMed
Summary

Additive manufacturing enables new implant functions. Researchers created titanium implants with antibiotic reservoirs and channels, demonstrating effective delivery against common bone infection bacteria.

Keywords:
Additive manufacturingAntibioticCalcium phosphate cementDrug deliveryImplantSelective laser meltingTitanium

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Area of Science:

  • Biomaterials Engineering
  • Medical Device Design
  • Additive Manufacturing

Background:

  • Additive manufacturing (AM) offers design flexibility for patient-specific implants.
  • Current treatments for periprostrosthetic infections are limited.
  • AM can potentially integrate new functionalities into implants.

Purpose of the Study:

  • To investigate the potential of AM to create titanium implants with integrated antibiotic delivery capabilities.
  • To assess the mechanical properties and antibiotic release of a novel implant system.
  • To evaluate the antibacterial efficacy against common periprosthetic pathogens.

Main Methods:

  • Selective laser melting used to fabricate Ti-6Al-4V implants with reservoirs and pore channels.
  • Formulation of an injectable brushite calcium phosphate cement (CPC) as an antibiotic carrier for gentamicin.
  • Characterization of CPC mechanical strength, gentamicin release kinetics (UV-Vis spectroscopy), and implant porosity (micro-CT).
  • Assessment of antibacterial efficacy using agar diffusion assays against Staphylococcus aureus and Staphylococcus epidermidis.

Main Results:

  • AM successfully produced titanium implants with functional reservoirs and pore channels.
  • Gentamicin incorporation significantly improved CPC compressive strength (p=0.01).
  • Controlled release of gentamicin from CPC was observed, exceeding minimum inhibitory concentrations for target bacteria within 6 hours.
  • Implant pore channel orientation affected design reproducibility, injection back-pressure, and porosity.
  • Antibacterial efficacy demonstrated, with inhibition zone directionality influenced by pore channel orientation.

Conclusions:

  • Additive manufacturing can produce titanium-based antibiotic-eluting implants.
  • This technology presents a promising alternative to current strategies for managing periprosthetic infections.
  • The developed implant system shows potential for localized, sustained antibiotic delivery to combat implant-associated bacterial infections.