Gentamicin coating of plasma chemical oxidized titanium alloy prevents implant-related osteomyelitis in rats

被引：76

作者：

Diefenbeck, M. ^{[1
]}

Schrader, C. ^{[2
]}

Gras, F. ^{[1
]}

Mueckley, T. ^{[1
]}

Schmidt, J. ^{[2
]}

Zankovych, S. ^{[3
]}

Bossert, J. ^{[3
]}

Jandt, K. D. ^{[3
,4
]}

Voelpel, A. ^{[5
]}

Sigusch, B. W. ^{[5
]}

Schubert, H. ^{[6
]}

Bischoff, S. ^{[6
]}

Pfister, W. ^{[7
]}

Edel, B. ^{[7
]}

Faucon, M. ^{[8
]}

Finger, U. ^{[8
]}

机构：

[1] Univ Hosp Jena, Dept Trauma Hand & Reconstruct Surg, Erlanger Allee 101, D-07747 Jena, Germany

[2] Innovent Technol Dev, Prussingstr 27 B, D-07745 Jena, Germany

[3] Univ Jena, Fac Phys & Astron, Chair Mat Sci, Otto Schott Inst Mat Res OSIM, Lobdergraben 32, D-07743 Jena, Germany

[4] Univ Jena, Excellence Grad Sch Jena Sch Microbial Commun JSM, Neugasse 23, D-07743 Jena, Germany

[5] Univ Hosp Jena, Dept Conservat Dent & Periodontol, Alten Post 4, D-07743 Jena, Germany

[6] Univ Hosp Jena, Inst Expt Anim Sci & Anim Protect, Dornburger Str 23, D-07743 Jena, Germany

[7] Univ Klinikum Jena, Inst Med Microbiol, Erlanger Allee 101, D-07747 Jena, Germany

[8] Konigsee Implantate GmbH, OT Aschau Sand 4, D-07426 Allendorf, Germany

来源：

BIOMATERIALS | 2016年 / 101卷

关键词：

Plasma chemical oxidation; Titanium alloys; Implant-related infection; Animal model; Gentamicin coating; SDS; Tannic acid; TANNIC-ACID; INFECTION; BIOMATERIALS; PROPHYLAXIS; EFFICACY;

D O I：

10.1016/j.biomaterials.2016.05.039

中图分类号：

R318 [生物医学工程];

学科分类号：

0831 ;

摘要：

Implant related infection is one of the most feared and devastating complication associated with the use of orthopaedic implant devices. Development of anti-infective surfaces is the main strategy to prevent implant contamination, biofilm formation and implant related osteomyelitis. A second concern in orthopaedics is insufficient osseointegration of uncemented implant devices. Recently, we reported on a macroporous titanium-oxide surface (bioactive TiOB) which increases osseointegration and implant fixation. To combine enhanced osseointegration and antibacterial function, the TiOB surfaces were, in addition, modified with a gentamicin coating. A rat osteomyelitis model with bilateral placement of titanium alloy implants was employed to analyse the prophylactic effect of gentamicin-sodiumdodecylsulfate (SDS) and gentamicin-tannic acid coatings in vivo. 20 rats were randomly assigned to four groups: (A) titanium alloy; PBS inoculum (negative control), (B) titanium alloy, Staphylococcus aureus inoculum (positive control), (C) bioactive TiOB with gentamicin-SDS and (D) bioactive TiOB plus gentamicin-tannic acid coating. Contamination of implants, bacterial load of bone powder and radiographic as well as histological signs of implant-related osteomyelitis were evaluated after four weeks. Gentamicin-SDS coating prevented implant contamination in 10 of 10 tibiae and gentamicin-tannic acid coating in 9 of 10 tibiae (infection prophylaxis rate 100% and 90% of cases, respectively). In Group (D) one implant showed colonisation of bacteria (swab of entry point and roll-out test positive for S. aureus). The interobserver reliability showed no difference in the histologic and radiographic osteomyelitis scores. In both gentamicin coated groups, a significant reduction of the histological osteomyelitis score (geometric mean values: C = 0.111 +/- 0.023; D = 0.056 +/- 0.006) compared to the positive control group (B: 0.244 +/- 0.015; p < 0.05) was observed. The radiographic osteomyelitis scores confirmed these histological findings. (C) 2016 Elsevier Ltd. All rights reserved.

引用

页码：156 / 164

页数：9

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