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Antibiotic-Loaded Polymer-Calcium Phosphate Scaffold for Treating Orthopedic Device-Related Infection in a Rabbit

T Buchholz1, C Siverino1, T F Moriarty1

  • 1AO Research Institute Davos, Davos, Switzerland.

Journal of Biomedical Materials Research. Part A
|April 29, 2025
PubMed
Summary
This summary is machine-generated.

A novel 3D-printed, antibiotic-releasing calcium phosphate scaffold (CPS) shows promise for single-stage treatment of orthopedic device-related infections (ODRI), reducing infection rates and promoting bone healing.

Keywords:
Staphylococcus aureusorthopedic device‐related infectionradius defect modelsingle‐stage revision

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Area of Science:

  • Biomaterials Science
  • Orthopedic Surgery
  • Infectious Diseases

Background:

  • Orthopedic device-related infections (ODRI) often require complex two-stage surgical revisions.
  • Current treatments involve antibiotic-loaded polymethyl methacrylate (PMMA) spacers, which are burdensome and may not prevent recurrence.
  • A single-stage solution combining infection eradication and bone regeneration is highly desirable.

Purpose of the Study:

  • To evaluate the efficacy of a novel 3D-printed, antibiotic-loaded, osteoconductive calcium phosphate scaffold (CPS) in a rabbit model of infected segmental bone defect.
  • To compare the performance of CPS with traditional PMMA spacers and empty defects in treating ODRI.

Main Methods:

  • A 5-mm segmental radius defect model was created in rabbits and inoculated with Staphylococcus aureus.
  • After 4 weeks, defects were treated with empty control, PMMA with gentamicin, rifampicin-loaded CPS, or vancomycin-loaded CPS.
  • Systemic antibiotics were administered in most groups; one CPS group received only local antibiotics.
  • Outcomes were assessed via quantitative bacteriology and histopathology at 8 weeks post-revision.

Main Results:

  • Antibiotic-loaded scaffolds (PMMA-Gentamicin and CPS-Rifampicin) with systemic antibiotics reduced bacterial counts compared to controls.
  • PMMA-Gentamicin significantly reduced Colony Forming Units (CFUs) (p=0.0486) and lowered infection rates from 80% to 50%.
  • CPS-Vancomycin without systemic antibiotics showed a lower infection rate but comparable CFUs to controls, indicating local antibiotics alone are insufficient.

Conclusions:

  • While PMMA-Gentamicin offered superior infection eradication, it lacks bone reconstruction capabilities.
  • Antibiotic-loaded CPS demonstrated a reduction in infection rates and offers the potential for bone healing in a single stage.
  • Further research into optimized antibiotic-loaded CPS formulations is warranted for effective ODRI management.