Vancomycin-Loaded Collagen/Hydroxyapatite Layers Electrospun on 3D Printed Titanium Implants Prevent Bone Destruction Associated with S. epidermidis Infection and Enhance Osseointegration.

The aim of the study was to develop an orthopedic implant coating in the form of vancomycin-loaded collagen/hydroxyapatite layers (COLHA+V) that combine the ability to prevent bone infection with the ability to promote enhanced osseointegration. The ability to prevent bone infection was investigated employing a rat model that simulated the clinically relevant implant-related introduction of bacterial contamination to the bone during a surgical procedure using a clinical isolate of Staphylococcus epidermidis. The ability to enhance osseointegration was investigated employing a model of a minipig with terminated growth. Six weeks following implantation, the infected rat femurs treated with the implants without vancomycin (COLHA+S. epidermidis) exhibited the obvious destruction of cortical bone as evinced via a cortical bone porosity of up to 20% greater than that of the infected rat femurs treated with the implants containing vancomycin (COLHA+V+S. epidermidis) (3%) and the non-infected rat femurs (COLHA+V) (2%). The alteration of the bone structure of the infected COLHA+S. epidermidis group was further demonstrated by a 3% decrease in the average Ca/P molar ratio of the bone mineral. Finally, the determination of the concentration of vancomycin released into the blood stream indicated a negligible systemic load. Six months following implantation in the pigs, the quantified ratio of new bone indicated an improvement in osseointegration, with a two-fold bone ingrowth on the COLHA (47%) and COLHA+V (52%) compared to the control implants without a COLHA layer (27%). Therefore, it can be concluded that COLHA+V layers are able to significantly prevent the destruction of bone structure related to bacterial infection with a minimal systemic load and, simultaneously, enhance the rate of osseointegration.

Surface Treatment of Acetabular Cups with a Direct Deposition of a Composite Nanostructured Layer Using a High Electrostatic Field.

A composite nanofibrous layer containing collagen and hydroxyapatite was deposited on selected surface areas of titanium acetabular cups. The layer was deposited on the irregular surface of these 3D objects using a specially developed electrospinning system designed to ensure the stability of the spinning process and to produce a layer approximately 100 micrometers thick with an adequate thickness uniformity. It was verified that the layer had the intended nanostructured morphology throughout its entire thickness and that the prepared layer sufficiently adhered to the smooth surface of the model titanium implants even after all the post-deposition sterilization and stabilization treatments were performed. The resulting layers had an average thickness of (110 ± 30) micrometers and an average fiber diameter of (170 ± 49) nanometers. They were produced using a relatively simple and cost-effective technology and yet they were verifiably biocompatible and structurally stable. Collagen- and hydroxyapatite-based composite nanostructured surface modifications represent promising surface treatment options for metal implants.