A New Type of Biphasic Calcium Phosphate Cement as a Gentamicin Carrier for Osteomyelitis

Abstract

Osteomyelitis therapy is a long-term and inconvenient procedure for a patient. Antibiotic-loaded bone cements are both a complementary and alternative treatment option to intravenous antibiotic therapy for the treatment of osteomyelitis. In the current study, the biphasic calcium phosphate cement (CPC), called α-TCP/HAP (α-tricalcium phosphate/hydroxyapatite) biphasic cement, was prepared as an antibiotics carrier for osteomyelitis. The developed biphasic cement with a microstructure of α-TCP surrounding the HAP has a fast setting time which will fulfill the clinical demand. The X-ray diffraction and Fourier transform infrared spectrometry analyses showed the final phase to be HAP, the basic bone mineral, after setting for a period of time. Scanning electron microscopy revealed a porous structure with particle sizes of a few micrometers. The addition of gentamicin in α-TCP/HAP would delay the transition of α-TCP but would not change the final-phase HAP. The gentamicin-loaded α-TCP/HAP supplies high doses of the antibiotic during the initial 24 hours when they are soaked in phosphate buffer solution (PBS). Thereafter, a slower drug release is produced, supplying minimum inhibitory concentration until the end of the experiment (30 days). Studies of growth inhibition of Staphylococcus aureus and Pseudomonas aeruginosa in culture indicated that gentamicin released after 30 days from α-TCP/HAP biphasic cement retained antibacterial activity.

Local Release of Antibiotics for Surgical Site Infection Management Using High-Purity Calcium Sulfate: An In Vitro Elution Study

“…A n area gaining increasing interest for treating bone and soft tissue infections is the controlled release and local delivery of antibiotics from suitable carriers [1][2][3][4][5][6]. The benefits of ''local release'' are substantial and include the ability to provide high local concentrations of antibiotic, many times the minimum inhibitory concentration (MIC) [7], with serum concentrations and associated toxicity remaining low [8][9][10].…”

Comparison of Bone Preserving and Radical Surgical Treatment in 32 Cases of Calcaneal Osteomyelitis

“…The superiority of CGS over PMMA beads has been proven in clinical and animal studies 15 , 16 , 17 . Also calcium phosphate cements have proved to be a viable carrier of local antimicrobial agent allowing prolonged release of gentamicin sulfate or tobramicin 18 , 19 . Depending on the extend of the infection within calcaneus and presence of skin defect, the spectrum of surgical procedures includes partial or total calcanectomy and lower leg amputation.…”

Modulating antibiotic release from reservoirs in 3D‐printed orthopedic devices to treat periprosthetic joint infection

“…Numerous studies have demonstrated the potential of bioceramics as a depot for antibiotic delivery. 15,16,[18][19][20][21][22][23] However, bioceramics have significantly weaker mechanical properties than PMMA, preventing their use in loadbearing implants, such as knee and hip spacers. Overall, current treatment options lack both the mechanical strength and elution kinetics to effectively treat bone infections while bearing highmechanical loads.…”