带有抗生素的聚合物酸支架用于治疗骨科设备相关感染,在子细分骨缺陷模型中
T Buchholz1, C Siverino1, T F Moriarty1
1AO Research Institute Davos, Davos, Switzerland.
Journal of biomedical materials research. Part A
|April 29, 2025
概括
一种新的3D打印,释放抗生素的酸支架 (CPS) 显示出对骨科设备相关感染 (ODRI) 的单阶段治疗有希望,减少感染率并促进骨愈合.
科学领域:
- 生物材料科学 生物材料科学
- 整形外科手术 整形外科手术
- 传染性疾病 传染性疾病
背景情况:
- 骨科器械相关感染 (ODRI) 通常需要复杂的两阶段手术修订.
- 目前的治疗方法涉及带有抗生素的聚甲基甲酸 (PMMA) 间隔剂,这些是繁重的,可能无法防止复发.
- 一个结合感染根除和骨再生的单阶段解决方案是非常理想的.
研究的目的:
- 评估一种新的3D打印,充满抗生素的骨传导性酸支架 (CPS) 在受感染细分骨缺陷的子模型中的有效性.
- 为了比较CPS的性能与传统的PMMA间隔器和空缺缺陷在治疗ODRI.
主要方法:
- 在子中创建了一个5毫米细分半径缺陷模型,并用金黄色葡萄球菌接种.
- 在4周后,缺陷被用空对照,PMMA用 gentamicin,Rifampicin加载的CPS或Vancomycin加载的CPS治疗.
- 大多数组中都服用了全身抗生素;一个CPS组只服用局部抗生素.
- 结果通过定量细菌学和组织病理学在修订后8周评估.
主要成果:
- 与对照组相比,使用全身抗生素的充满抗生素的支架 (PMMA-Gentamicin和CPS-Rifampicin) 减少了细菌的数量.
- PMMA-Gentamicin显著减少了殖民地形成单位 (CFU) (p=0.0486) 并将感染率从80%降低到50%.
- 没有全身抗生素的CPS-Vancomycin显示出较低的感染率,但可与对照组相比较的CFU,表明仅局部抗生素是不够的.
结论:
- 虽然PMMA-Gentamicin提供了卓越的感染根除能力,但它缺乏骨重建能力.
- 充满抗生素的CPS显示了感染率的降低,并为骨在单个阶段的愈合提供了潜力.
- 为了有效的ODRI管理,需要对优化抗生素载CPS配方进行进一步的研究.
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