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Formulation and characterization of a sortase a inhibitor-loaded PMMA bone cement
Yin-Yu Qi1,2, Lu-Yang Han1,2, Long-Xu Han1
1Bengbu Medical University, The Second People's Hospital of Hefei (Affiliated Hospital) Anhui 230011 China chujianj@mail.ustc.edu.cn xuyang@hfut.edu.cn.
RSC Advances
|September 19, 2025
Summary
A novel sortase A inhibitor (SrtA I)-loaded bone cement (SLBC) offers prolonged antibacterial activity against Staphylococcus aureus and MRSA. This biocompatible cement shows potential for managing prosthetic joint infections in total joint replacement.
Area of Science:
- Biomaterials Science
- Infectious Diseases
- Orthopedic Surgery
Background:
- Prosthetic joint infections are a significant complication of cemented total joint replacement (TJR).
- Current antibiotic-loaded bone cements have limitations in sustained antibacterial efficacy.
- Sortase A inhibitors offer a novel approach to combat bacterial infections.
Purpose of the Study:
- To develop and evaluate a novel sortase A inhibitor (SrtA I)-loaded bone cement (SLBC) for managing prosthetic joint infections.
- To compare the antibacterial efficacy and material properties of SLBC with conventional gentamicin-loaded bone cement (GS cement).
Main Methods:
- SLBC was formulated with 1-(3,4-dichlorophenyl)-3-(dimethylamino)propyl-1-one hydrochloride (AEEK1) as the SrtA I.
- Antibacterial duration against Staphylococcus aureus (S. aureus) and methicillin-resistant S. aureus (MRSA) was assessed.
- Quasi-static compressive strength, maximum polymerization temperature, and setting time were evaluated according to ISO 5833 standards.
- Biocompatibility and injectability were confirmed through in vitro and in vivo studies using porcine vertebrae.
Main Results:
- SLBC demonstrated a significantly prolonged effective antibacterial duration against both S. aureus and MRSA compared to GS cement.
- The mechanical properties (compressive strength, polymerization temperature, setting time) of SLBC met ISO 5833 standards and were comparable to GS cement.
- In vitro and in vivo studies confirmed the biocompatibility and easy injectability of SLBC into porcine vertebrae.
Conclusions:
- SLBC exhibits superior and prolonged antibacterial activity against key pathogens relevant to prosthetic joint infections.
- SLBC possesses favorable mechanical properties and biocompatibility, comparable to existing bone cements.
- SLBC shows significant potential as an effective therapeutic option for the management of prosthetic joint infections in cemented TJR.
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