Use of Antibiotic Loaded Biomaterials for the Management of Bone Prosthesis Infections: Rationale and Limits.


Journal

Current medicinal chemistry
ISSN: 1875-533X
Titre abrégé: Curr Med Chem
Pays: United Arab Emirates
ID NLM: 9440157

Informations de publication

Date de publication:
2019
Historique:
received: 31 05 2017
revised: 25 07 2017
accepted: 24 11 2017
pubmed: 1 12 2017
medline: 24 10 2019
entrez: 1 12 2017
Statut: ppublish

Résumé

Periprosthetic joint infection still represents a challenging issue for the orthopedic community. In the United States approximately a million joint arthroplasties are performed each year, with infection rates ranging from 1 to 2%: revisions has significant implications on health care costs and appropriate resource management. The use of locally applied antibiotics as a prophylaxis measure or as a component of the therapeutic approach in primary or revision surgery is finalized at eliminating any microorganism and strengthening the effectiveness of systemic therapy. The present review of clinical and preclinical in vivo studies tried to identify advantages and limitations of the materials used in the clinical orthopedic practice and discuss developed biomaterials, innovative therapeutic approaches or strategies to release antibiotics in the infected environment. A systematic search was carried out by two independent observers in two databases (www.pubmed.com and www.scopus.com) in order to identify pre-clinical and clinical reports in the last 10 years. 71 papers were recognized eligible: 15 articles were clinical studies and 56 in vivo studies. Polymethylmethacrylate was the pioneer biomaterial used to manage infections after total joint replacement. Despite its widespread use, several issues still remain debated: the methods to combine materials and antibiotics, the choice of antibiotics, releasing kinetics and antibiotics efficacy. In the last years, the interest was directed towards the selection of different antibiotics, loaded in association with more than only one class and biomaterials with special focus on delivery systems as implant surface coatings, hydrogels, ceramics, micro-carriers, microspheres or nanoparticles.

Sections du résumé

BACKGROUND BACKGROUND
Periprosthetic joint infection still represents a challenging issue for the orthopedic community. In the United States approximately a million joint arthroplasties are performed each year, with infection rates ranging from 1 to 2%: revisions has significant implications on health care costs and appropriate resource management. The use of locally applied antibiotics as a prophylaxis measure or as a component of the therapeutic approach in primary or revision surgery is finalized at eliminating any microorganism and strengthening the effectiveness of systemic therapy.
OBJECTIVE OBJECTIVE
The present review of clinical and preclinical in vivo studies tried to identify advantages and limitations of the materials used in the clinical orthopedic practice and discuss developed biomaterials, innovative therapeutic approaches or strategies to release antibiotics in the infected environment.
METHODS METHODS
A systematic search was carried out by two independent observers in two databases (www.pubmed.com and www.scopus.com) in order to identify pre-clinical and clinical reports in the last 10 years.
RESULTS RESULTS
71 papers were recognized eligible: 15 articles were clinical studies and 56 in vivo studies.
CONCLUSION CONCLUSIONS
Polymethylmethacrylate was the pioneer biomaterial used to manage infections after total joint replacement. Despite its widespread use, several issues still remain debated: the methods to combine materials and antibiotics, the choice of antibiotics, releasing kinetics and antibiotics efficacy. In the last years, the interest was directed towards the selection of different antibiotics, loaded in association with more than only one class and biomaterials with special focus on delivery systems as implant surface coatings, hydrogels, ceramics, micro-carriers, microspheres or nanoparticles.

Identifiants

pubmed: 29189125
pii: CMC-EPUB-87185
doi: 10.2174/0929867325666171129220031
doi:

Substances chimiques

Anti-Bacterial Agents 0
Biocompatible Materials 0

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

3150-3174

Informations de copyright

Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.

Auteurs

M Tschon (M)

Laboratory of Preclinical and Surgical Studies, IRCCS-Istituto Ortopedico Rizzoli, via di Barbiano 1/10, 40136, Bologna, Italy.

M Sartori (M)

Laboratory of Biocompatibility, Technological Innovations and Advanced Therapies, Istituto Ortopedico Rizzoli - RIT Department, via di Barbiano 1/10, 40136, Bologna, Italy.

D Contartese (D)

Laboratory of Preclinical and Surgical Studies, IRCCS-Istituto Ortopedico Rizzoli, via di Barbiano 1/10, 40136, Bologna, Italy.

G Giavaresi (G)

Laboratory of Preclinical and Surgical Studies, IRCCS-Istituto Ortopedico Rizzoli, via di Barbiano 1/10, 40136, Bologna, Italy.

N Nicoli Aldini (NN)

Laboratory of Preclinical and Surgical Studies, IRCCS-Istituto Ortopedico Rizzoli, via di Barbiano 1/10, 40136, Bologna, Italy.

M Fini (M)

Laboratory of Preclinical and Surgical Studies, IRCCS-Istituto Ortopedico Rizzoli, via di Barbiano 1/10, 40136, Bologna, Italy.

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Classifications MeSH