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Calcium-Based, Antibiotic-Loaded Bone Substitute as an Implant Coating: A Pilot Clinical Study
N Logoluso1, L Drago2, E Gallazzi1
1Department of Reconstructive Surgery of Osteo-articular Infections C.R.I.O. Unit, I.R.C.C.S. Galeazzi Orthopaedic Institute, Milano, Italy.
Journal of Bone and Joint Infection
|May 23, 2017
Summary
This pilot study shows a calcium-based bone substitute loaded with gentamicin or vancomycin is safe for coating cementless joint implants. It effectively prevented infection recurrence in 95% of patients, offering a promising new strategy for orthopedic surgery.
Area of Science:
- Orthopaedic Surgery
- Biomaterials Science
- Infectious Diseases
Background:
- Implant-related infections are a significant challenge in orthopaedic surgery, necessitating effective preventative strategies.
- Current antibacterial coatings for orthopaedic implants are limited in clinical application despite extensive preclinical research.
- Developing novel methods to prevent bacterial adhesion and biofilm formation on implants is crucial.
Purpose of the Study:
- To evaluate the short-term safety of a calcium-based, antibiotic-loaded bone substitute as an antibacterial coating for cementless joint prostheses.
- To assess the efficacy of this coating in preventing infection recurrence and implant loosening.
Main Methods:
- A prospective, observational pilot study included 20 patients undergoing two-stage revision surgery for peri-prosthetic joint infection.
- Cerament G or Cerament V (gentamicin or vancomycin-loaded calcium sulphate/hydroxyapatite bone substitute) was applied to the stem surface of hip or knee revision prostheses.
- Patients were monitored clinically, in laboratory tests, and radiographically for a minimum of 12 months post-surgery.
Main Results:
- At 12-month follow-up, 19 out of 20 patients (95%) showed no recurrence of infection.
- No signs of radiographic loosening of the prosthesis stem were observed in any patient.
- No adverse events were associated with the use of the antibiotic-loaded bone substitute coating.
Conclusions:
- This pilot study demonstrates the short-term safety of using a calcium-based, antibiotic-loaded bone substitute as a surface coating on cementless prosthetic implants.
- The findings suggest a potential new approach to protect orthopaedic implants from bacterial adhesion using resorbable, osteoconductive antibiotic carriers.
- Larger studies with longer follow-up periods are needed to confirm these promising results.
