Use of Stimulan absorbable calcium sulphate beads in revision lower limb arthroplasty

Kallala, Rami; Harris, W. E.; Ibrahim, Mazin; Dipane, Matthew V.; McPherson, Edward J.

doi:10.1302/2046-3758.710.bjr-2017-0319.r1

Cited by 83 publications

(122 citation statements)

References 29 publications

(43 reference statements)

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“…The CaP@MSi and DOX-CaP@MSi were used in ratio of 38 and 12 wt%, respectively. The 12 wt% of DOX-CaP@MSi in the formulation corresponded to the 2 wt% content of drug similar to drug content in commercially available spherical granules (0.5-5 wt%) [21,22]. The microcrystalline cellulose (MCC; Avicel PH 101, Sigma-Aldrich) and ethyl cellulose (EC; Ethocel 20 cP, Dow Chemical) were used as the excipients (45 and 5 wt%, respectively).…”

Section: Formulation Of Drug Delivery Systemsmentioning

confidence: 98%

Biphasic composite of calcium phosphate-based mesoporous silica as a novel bone drug delivery system

Prokopowicz

Szewczyk

Skwira

et al. 2019

Drug Deliv. and Transl. Res.

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We reported the new biphasic composites of calcium phosphate and mesoporous silica material (CaP@MSi) in the form of powders and pellets as a potential bone drug delivery system for doxycycline hydrochloride (DOX). The CaP@MSi powders were synthesized by cationic surfactant-templating method. The effects of 10, 20, and 30% CaP content in the CaP@MSi powders on the molecular surface structure, the cytotoxicity against osteoblast cells in vitro, and the mineralization potential in simulated body fluid were investigated. The CaP@MSi characterized by the highest mineralization potential (30% CaP content) were used for DOX adsorption and pelletization process. The CaP which precipitated in the CaP@MSi composites was characterized as calcium-deficient with the Ca:P molar ratio between 1.0 and 1.2. The cytotoxicity assays demonstrated that the CaP content in MSi increases osteoblasts viability indicating the CaP@MSi (30% CaP content) as the most biocompatible. The combination of CaP and MSi was an effective strategy to improve the mineralization potential of parent material. Upon immersion in simulated body fluid, the CaP of composite converted into the bone-like apatite. The obtained pellets preserved the mineralization potential of CaP@MSi and provided the prolonged 5-day DOX release. The obtained biphasic CaP@MSi composites seem to have an application potential as bone-specific drug delivery system.

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Section: Formulation Of Drug Delivery Systemsmentioning

confidence: 98%

Biphasic composite of calcium phosphate-based mesoporous silica as a novel bone drug delivery system

Prokopowicz

Szewczyk

Skwira

et al. 2019

Drug Deliv. and Transl. Res.

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“…A study by Kallala et al analyzed the effectiveness of antibiotic loaded calcium sulphate beads in 755 patients who underwent hip or knee revision surgery for septic and aseptic causes: failures for septic causes were found in 4.5% of cases [32]. Even in this case, however, it was not possible to evaluate the prophylactic efficacy alone, since many of the patients treated were already suffering from PJIs.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic-Loaded Hydrogel Coating to Reduce Early Postsurgical Infections in Aseptic Hip Revision Surgery: A Retrospective, Matched Case-Control Study

et al. 2020

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Periprosthetic joint infections (PJIs) are a cause of frequent implant failure in revision hip replacement surgery. The purpose of this study is to evaluate the onset of early postoperative infections in patients who underwent hip surgery with cementless prostheses treated with an antibiotic loaded hydrogel on their surface, in addition to systemic prophylaxis, and compare them to a control group. The secondary objective was to evaluate the onset of any local and systemic adverse effects and interference with bone ingrowth processes and functional recovery. A retrospective observational study was conducted on patients who underwent revision hip surgery by performing a 1:1 match between patients treated with an antibiotic hydrogel (ALH) and the control patients. The incidence of PJIs was assessed with a minimum of six months follow-up. Seventeen patients treated with the ALH were compared with 17 patients from the control group. No PJIs were reported in the ALH group versus the six cases encountered in the control group (p < 0.0001). No significant differences were reported with regard to prosthetic osseointegration and functional results, nor were there side effects in the ALH group. Despite the low sample size, the use of on-site prophylaxis with ALH has proven effective and safe in reducing the risk of PJIs in patients with a high risk for infections. Further studies are needed to validate these results in other implant-related surgeries.

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“…The largest study evaluating complications of CSBs involved a cohort of 755 patients (7). A mean of 23.39 mL (with a range of 5 to 80 mL) of CSBs were used per patient.…”

Section: Discussionmentioning

confidence: 99%

Prolonged Hypercalcemia from Antibiotic-Eluting Calcium Sulfate Beads

Vora

Ali

2019

AACE Clinical Case Reports

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Objective: Calcium sulfate beads (CSBs) are biocompatible hydrophilic crystals that are used to deliver local antibiotics in periprosthetic joint infections. Hypercalcemia after placement of CSBs is uncommon and poorly understood. Methods: We present the case of a woman who presented with symptomatic hypercalcemia after placement of antibiotic-eluting CSBs. Results: A 58-year-old, Caucasian woman presented with altered mental status, respiratory failure, and septic shock 2 days after placement of antibiotic-eluting CSBs for a left prosthetic hip infection. Laboratory analysis revealed severe hypercalcemia at presentation. She had no known history of fractures, kidney stones, parathyroid, or calcium disorders. She was not on any medications that could induce hypercalcemia. She was treated with aggressive intravenous hydration and 8 doses of calcitonin. Due to impaired renal function, bisphosphonate was contraindicated. She subsequently became anuric with worsening renal failure and volume overload and the decision was made to initiate dialysis. She received 8 days of continuous renal replacement therapy followed by 2 sessions of hemodialysis which improved her serum calcium levels, mental status, and renal failure with no long-term complications. Conclusion: Hypercalcemia secondary to the placement of antibiotic-eluting CSBs is rare. Larger volumes of CSBs may contribute to hypercalcemia. In some cases, hypercalcemia can be severe and symptomatic as in the case of our patient. Serum calcium levels should be monitored frequently after placement of CSBs and managed as appropriate.

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Use of Stimulan absorbable calcium sulphate beads in revision lower limb arthroplasty

Cited by 83 publications

References 29 publications

Biphasic composite of calcium phosphate-based mesoporous silica as a novel bone drug delivery system

Biphasic composite of calcium phosphate-based mesoporous silica as a novel bone drug delivery system

Antibiotic-Loaded Hydrogel Coating to Reduce Early Postsurgical Infections in Aseptic Hip Revision Surgery: A Retrospective, Matched Case-Control Study

Prolonged Hypercalcemia from Antibiotic-Eluting Calcium Sulfate Beads

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