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A Novel Method to Determine the Longitudinal Antibacterial Activity of Drug-Eluting Materials
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Long acting anti-infection constructs on titanium.

Stefano Perni1, Hadil Faris Alotaibi2, Abdulla A Yergeshov3

  • 1School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK.

Journal of Controlled Release : Official Journal of the Controlled Release Society
|June 25, 2020
PubMed
Summary
This summary is machine-generated.

New coatings for uncemented joint implants release chlorhexidine to prevent peri-prosthetic joint infections (PJI). This non-antibiotic approach offers a promising solution against rising antibiotic resistance and improves patient outcomes.

Keywords:
ChlorhexidineJoint replacementMultilayers coatingPJITitanium

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Area of Science:

  • Biomaterials Science
  • Infectious Disease Research
  • Orthopedic Surgery

Background:

  • Peri-prosthetic joint infections (PJI) are a significant complication of joint replacement surgery.
  • Current prevention strategies primarily rely on antibiotic-loaded bone cement for cemented implants.
  • There is a critical need for effective antimicrobial solutions for uncemented prostheses, especially given rising antibiotic resistance.

Purpose of the Study:

  • To develop and evaluate a novel non-antibiotic antimicrobial coating for uncemented prosthesis to prevent PJI.
  • To investigate the sustained release of chlorhexidine from a multilayered coating on titanium surfaces.
  • To assess the efficacy and safety of the developed coating in vitro and in vivo.

Main Methods:

  • Fabrication of a multilayered functional coating on titanium surfaces using alginate and poly-beta-amino-esters embedding chlorhexidine.
  • In vitro assessment of chlorhexidine release kinetics over time.
  • In vitro and in vivo evaluation of the coating's biocompatibility with osteoblast and fibroblast cells.
  • Assessment of the coating's antimicrobial efficacy in reducing bacterial load and its impact on wound healing in an excisional wound model.

Main Results:

  • The functional coating demonstrated sustained release of chlorhexidine for nearly two months.
  • In vitro and in vivo studies confirmed the material's efficacy and safety.
  • The coatings did not adversely affect osteoblast and fibroblast cell growth.
  • Significant reduction in bacterial load and accelerated wound healing were observed in the excisional wound model.

Conclusions:

  • The developed multilayered functional coating provides a viable non-antibiotic antimicrobial solution for uncemented prosthetic devices.
  • This approach offers a promising strategy for preventing peri-prosthetic joint infections and combating antibiotic resistance.
  • The findings support the potential clinical application of these coatings in arthroplasty to improve patient safety and outcomes.