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Lyophilized allogeneic bone tissue as an antibiotic carrier
Débora C Coraça-Huber1, Christoph G Ammann2, Michael Nogler2
1Experimental Orthopaedics, Department of Orthopaedic Surgery, Medical University of Innsbruck, Innrain 36, 6020, Innsbruck, Austria. debora.coraca-huber@i-med.ac.at.
Cell and Tissue Banking
|September 16, 2016
Summary
Antibiotic-impregnated bone grafts, both fresh-frozen and lyophilized, effectively release gentamicin to inhibit bacterial growth. This makes them a recommended option for preventing bone infections during revision joint replacement surgery.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Infectious Disease
Background:
- Rising rates of primary joint replacements lead to increased revision surgeries due to bacterial infections.
- Non-cemented implants and antibiotic-eluting bone grafts show promise for long-term outcomes and infection control in revision arthroplasty.
Purpose of the Study:
- To evaluate the antibiotic release kinetics and efficacy of fresh-frozen and lyophilized allogeneic bone grafts impregnated with various antibiotics.
- To assess the suitability of these bone grafts as carriers for gentamicin and vancomycin in preventing periprosthetic joint infections.
Main Methods:
- Allogeneic bone chips (fresh-frozen and lyophilized) were impregnated with gentamicin sulfate, gentamicin palmitate, vancomycin, or calcium-based bone substitutes containing these antibiotics.
- Drug release tests and bacterial susceptibility assays using Bacillus subtilis, Staphylococcus aureus, and methicillin-resistant Staphylococcus aureus were performed.
Main Results:
- Gentamicin release rates from lyophilized and fresh-frozen bone grafts were comparable, likely due to similar bone microstructure.
- High gentamicin release occurred in the first two days, decreasing to a sustained low level over two weeks.
- Both bone graft types demonstrated the ability to deliver therapeutic gentamicin concentrations for bacterial inhibition.
Conclusions:
- Allogeneic bone grafts, particularly when impregnated with gentamicin, can effectively deliver therapeutic doses for bacterial inhibition, especially during the critical initial two weeks post-implantation.
- Lyophilized and fresh-frozen bone allografts are recommended as antibiotic carriers for the prophylaxis of bone infections in revision joint replacement surgery.
