The immobilization of antibiotic-loaded polymeric coatings on osteoarticular Ti implants for the prevention of bone infections

Abstract

Implant-associated infections in orthopaedic surgeries are very critical as they may hinder bone healing, cause implant failure and even progress to osteomyelitis. Drug-eluting implants for local delivery of antibiotics at surgical sites are thought to be promising in preventing infections. Herein, the antibiotic vancomycin was encapsulated in a poly(ethylene glycol) (PEG)-based hydrogel film that was covalently bound to Ti implants and subsequently covered by a PEG-poly(lactic-co-caprolactone) (PEG-PLC) membrane. Additionally, crosslinked starch (CSt) was mixed with the hydrogel because its porous microstructure is able to inhibit hydrogel swelling and thus slow down drug release. The release behavior could be regulated by the drug loading and the coating thickness. The vancomycin-loaded Ti implants showed no initial burst release, offering a sustained drug release for nearly 3 weeks in vitro and more than 4 weeks in vivo. In a rabbit model of S. aureus infection, the implants with a 4 mg vancomycin loading significantly reduced the inflammatory reaction and exhibited a good antimicrobial capability. The immobilization of the antibiotic-loaded polymeric coatings on orthopaedic implants can offer a sustainable drug release with no initial burst release and maintain an effective concentration for a longer time, so it is expected to be an effective strategy to treat and prevent local bone infections.

Staphylococcus aureus Prosthetic Joint Infection Is Prevented by a Fluorine‐ and Phosphorus‐Doped Nanostructured Ti–6Al–4V Alloy Loaded With Gentamicin and Vancomycin

“…6). Our results are consistent with other in vitro studies, which used different antibiotic-loaded biomaterial such as alloys, [23][24][25][26]29,35 polymers, [40][41][42][43] and ceramics [44][45][46] efficiently against different staphylococci; but they are especially consistent with other in vivo studies, which used nanostructured titanium alloys loaded with gentamicin 47 and vancomycin 26 and demonstrated their infection-prevention efficacy against S. aureus. 26,47 However, the main difference between our study and theirs stems from differences in the therapeutic approach: unlike the aforementioned studies, our method more closely emulates a clinical approach and is more capable of preventing the possible antibiotic-resistance associated with the local therapy.…”

Antibacterial Mesoporous Titania Films with Embedded Gentamicin and Surface Modified with Bone Morphogenetic Protein 2 to Promote Osseointegration in Bone Implants

“…However, there is a risk of bacterial colonization during the time bone tissue is being regenerated, which last several weeks, until the protective capsule is formed and especially after surgery when the osseointegration processes has started. To ensure the successful implant adaptation, a rational supply of antibiotics is needed and can be achieved by modifying the implant surface with antibiotics‐loaded polymer coatings such as polyelectrolyte multilayers, brushes, or hydrogels . However, the main challenge is to obtain a localized supply of the antibiotics with a two‐phase release profile.…”

Improving Hydrophilicity and Inducing Bone-Like Apatite Formation on PPBES by Polydopamine Coating for Biomedical Application

“…The modification of polymer surfaces is another area of academic research to improve bone–implant interfaces. Ti and hydroxyapatite (HA) have been coated on PEEK to improve the bone–implant interface [ 7 , 8 , 9 , 10 ]. The authors reported that Ti-coated polyarylether implants improve osteogenesis compared to uncoated implants.…”