Biocompatibility of a Polymeric Implant for the Treatment of Osteomyelitis

We evaluated the biocompatibility of an injectable gelling polymeric device for the controlled release of gentamicin sulfate in the treatment of invasive bacterial infections in bone of male Wister rats. The biodegradable delivery carrier, poly(sebacic-co-ricinoleic-ester-anhydride), designated as p(SA:RA), was injected, with and without gentamicin, into the tibial canal. Rats were killed 3 weeks later. The tibiae were processed histologically, leaving the injectable polymer in situ. The local tissue reaction to the polymer with or without antibiotic consisted mainly of mild reactive fibroplasia/fibrosis and mild to moderate increased reactive bone formation. At this stage, no evidence for any active inflammatory response to the polymer was seen. Thus, the injection of p(SA:RA) was well tolerated and did not induce any signs of a progressive inflammatory reaction.

[1]  M. Griffith,et al.  PMMA Is Superior to Hydroxyapatite for Colony Reduction in Induced Osteomyelitis , 2007, Clinical orthopaedics and related research.

[2]  Yaron S Brin,et al.  Gentamicin extended release from an injectable polymeric implant. , 2007, Journal of controlled release : official journal of the Controlled Release Society.

[3]  B. Kocsis,et al.  Examination of a Novel, Specified Local Antibiotic Therapy through Polymethylmethacrylate Capsules in a Rabbit Osteomyelitis Model , 2006, Chemotherapy.

[4]  M. Hui,et al.  Development of Gentamicin Resistance After Gentamicin-PMMA Beads for Treatment of Foot Osteomyelitis: Report of Two Cases , 2005, Foot & ankle international.

[5]  Tomoyuki Sasaki,et al.  In vitro elution of vancomycin from calcium phosphate cement. , 2005, The Journal of arthroplasty.

[6]  Costerton Jw.  Biofilm theory can guide the treatment of device-related orthopaedic infections. , 2005 .

[7]  H. Aro,et al.  Comparison of 18F-FDG and 68Ga PET imaging in the assessment of experimental osteomyelitis due to Staphylococcus aureus , 2005, European Journal of Nuclear Medicine and Molecular Imaging.

[8]  A. Domb,et al.  Hydrolytic degradation of ricinoleic-sebacic-ester-anhydride copolymers. , 2005, Biomacromolecules.

[9]  V. Mendel,et al.  Therapy with gentamicin-PMMA beads, gentamicin-collagen sponge, and cefazolin for experimental osteomyelitis due to Staphylococcus aureus in rats , 2005, Archives of Orthopaedic and Trauma Surgery.

[10]  A. Domb,et al.  Poly(sebacic acid-co-ricinoleic acid) biodegradable carrier for paclitaxel: in vitro release and in vivo toxicity. , 2004, Journal of biomedical materials research. Part A.

[11]  Dennis Stephens,et al.  Polyanhydride implant for antibiotic delivery--from the bench to the clinic. , 2002, Advanced drug delivery reviews.

[12]  A. McLaren,et al.  The Effect of Sampling Method on the Elution of Tobramycin From Calcium Sulfate , 2002, Clinical orthopaedics and related research.

[13]  Chun Xing Li.  Poly(L-glutamic acid)--anticancer drug conjugates. , 2002, Advanced drug delivery reviews.

[14]  H. Chambers,et al.  The changing epidemiology of Staphylococcus aureus? , 2001, Emerging infectious diseases.

[15]  H. Busscher,et al.  Infection of orthopedic implants and the use of antibiotic-loaded bone cements: A review , 2001, Acta orthopaedica Scandinavica.

[16]  F. Korkusuz,et al.  In vivo application of biodegradable controlled antibiotic release systems for the treatment of implant-related osteomyelitis. , 2001, Biomaterials.

[17]  C Evora,et al.  Formulation of calcium phosphates/poly (d,l-lactide) blends containing gentamicin for bone implantation. , 2000, Journal of controlled release : official journal of the Controlled Release Society.

[18]  E. Witsø,et al.  Cancellous bone as an antibiotic carrier , 2000, Acta orthopaedica Scandinavica.

[19]  H. Busscher,et al.  Gentamicin release from polymethylmethacrylate bone cements and Staphylococcus aureus biofilm formation , 2000, Acta orthopaedica Scandinavica.

[20]  Hou Chunlin,et al.  Antibiotic loaded chitosan bar. An in vitro, in vivo study of a possible treatment for osteomyelitis. , 1999, Clinical orthopaedics and related research.

[21]  J. Calhoun,et al.  Adult posttraumatic osteomyelitis of the tibia. , 1999, Clinical orthopaedics and related research.

[22]  R. Rubin,et al.  The economic impact of Staphylococcus aureus infection in New York City hospitals. , 1999, Emerging infectious diseases.

[23]  G. Walenkamp,et al.  Osteomyelitis treated with gentamicin-PMMA beads: 100 patients followed for 1-12 years. , 1998, Acta orthopaedica Scandinavica.

[24]  Claude Carbón,et al.  Experimental models of bone and prosthetic joint infections. , 1997, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[25]  R. Skinner,et al.  Treatment of experimental osteomyelitis by surgical debridement and the implantation of bioerodable, polyanhydride‐gentamicin beads , 1997, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[26]  B. Nies,et al.  Antibiotic in vivo/in vitro release, histocompatibility and biodegradation of gentamicin implants based on lactic acid polymers and copolymers , 1995 .

[27]  P. Törmälä,et al.  Penetration of ciprofloxacin into bone: a new bioabsorbable implant. , 1995, Journal of investigative surgery : the official journal of the Academy of Surgical Research.

[28]  D. Robinson,et al.  Polylactide/polyglycolide antibiotic implants in the treatment of osteomyelitis. A canine model. , 1994, The Journal of bone and joint surgery. American volume.

[29]  D. M. Anger,et al.  The treatment of infected nonunions with gentamicin-polymethylmethacrylate antibiotic beads. , 1993, Clinical orthopaedics and related research.

[30]  W. Hayes,et al.  Bioerodible polyanhydrides for antibiotic drug delivery: In vivo osteomyelitis treatment in a rat model system , 1993, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[31]  J. Calhoun,et al.  In vitro and in vivo evaluation of antibiotic diffusion from antibiotic-impregnated polymethylmethacrylate beads. , 1992, Clinical orthopaedics and related research.

[32]  J. Jansen,et al.  Histologic evaluation of the osseous adaptation to titanium and hydroxyapatite-coated titanium implants. , 1991, Journal of biomedical materials research.

[33]  G. Stanek,et al.  In vitro properties of mixtures of fibrin seal and antibiotics. , 1983, Biomaterials.

[34]  M. Swartz,et al.  Osteomyelitis: a review of clinical features, therapeutic considerations and unusual aspects. , 1970, The New England journal of medicine.