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Bone Remodeling

Bone Remodeling

Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.

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New method for antibiotic release from bone cement (polymethylmethacrylate): Redefining boundaries.

E Carbó-Laso¹, P Sanz-Ruiz², J C Del Real-Romero³

¹Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Gregorio Marañón, Madrid, España.

Revista Espanola De Cirugia Ortopedica Y Traumatologia (English Ed.)

|November 22, 2017

Summary

Microencapsulation of rifampicin in alginate preserves polymethylmethacrylate (PMMA) properties for bone cement spacers. This technique allows for effective antibiotic delivery to combat periprosthetic joint infections.

Keywords:

Cement spacers Espaciadores de cemento Infección periprotésica Microcapsules Microcápsulas Periprosthetic infection Polimetilmetacrilato Polymethylmethacrylate Rifampicin Rifampicina

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Area of Science:

Biomaterials Science
Polymer Chemistry
Infectious Disease Treatment

Background:

Rising antimicrobial resistance necessitates improved antibiotic delivery in orthopedic surgery.
Polymethylmethacrylate (PMMA) bone cement spacers are used for periprosthetic joint infections.
Rifampicin's efficacy is hindered by its negative impact on PMMA mechanical properties due to polymerization inhibition.

Purpose of the Study:

To develop a method for incorporating rifampicin into PMMA bone cement spacers.
To overcome rifampicin's inhibitory effect on PMMA polymerization using microencapsulation.
To create PMMA bone cement with preserved mechanical integrity for infection treatment.

Main Methods:

Synthesized rifampicin microcapsules using alginate and poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV).
Incorporated microcapsules into CMW®1 PMMA bone cement.
Evaluated mechanical properties: compression, hardness, and setting time.

Main Results:

Alginate microcapsules showed higher production, efficiency, and encapsulation yields.
PMMA with alginate or PHBV microcapsules exhibited significantly improved compression resistance compared to non-encapsulated rifampicin.
Setting time was reduced, and hardness with alginate microcapsules was comparable to the control.

Conclusions:

Alginate microencapsulation is a viable technique for incorporating rifampicin into PMMA.
This method preserves crucial mechanical properties of PMMA bone cement.
Enables intraoperative fabrication of effective rifampicin-eluting bone cement spacers for periprosthetic joint infection treatment.