RESUMO
BACKGROUND: Postoperative infection following total joint arthroplasty is thought to be one of the most serious and devastating complications. To develop an effective treatment for this complication, we tested a bioabsorbable antibacterial carrier that is made from novel cross-linked hyaluronic acid (HA) gel and gentamicin (GM). METHODS: Antibacterial activity of the carrier was evaluated by the agar diffusion test, direct contact test, in vivo mouse model, and in vivo rabbit osteomyelitis model. RESULTS: GM-containing HA gel suppressed bacterial growth both in vitro and in vivo. In the rabbit osteomyelitis model, beads coated with HA gel containing GM did not disturb bone ongrowth in the femoral stem. CONCLUSIONS: Our bioabsorbable carrier of antibiotic-containing HA gel is effective for prophylactic treatment or treatment of an actual deep infection following total joint arthroplasty.
Assuntos
Antibacterianos/farmacologia , Artroplastia de Quadril/instrumentação , Materiais Revestidos Biocompatíveis , Portadores de Fármacos , Gentamicinas/farmacologia , Ácido Hialurônico , Staphylococcus aureus/efeitos dos fármacos , Animais , Modelos Animais de Doenças , Géis , Prótese de Quadril , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Osteomielite/tratamento farmacológico , Osteomielite/microbiologia , Desenho de Prótese , Coelhos , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/isolamento & purificação , Infecção da Ferida Cirúrgica/tratamento farmacológico , Infecção da Ferida Cirúrgica/microbiologiaRESUMO
We have developed a novel bioabsorbable antibacterial carrier using hyaluronic acid (HA) gel for prevention and treatment of orthopedic infections. In this study, we investigated the in vivo antibacterial effects of two forms of this new material, an HA gel sponge and an HA gel film. A titanium cylinder was inserted into the intramedullary cavity of each rabbit femur, along with an HA gel sponge or HA gel film containing antibiotics. The HA gel sponge contained gentamycin, vancomycin, tobramycin, or minomycin. The HA gel film contained gentamycin or vancomycin. After 0, 7, and 14 days, the rabbit bone marrow was collected, and the antibacterial activity of the HA gel was determined by agar diffusion test. As a control, we used Septocoll, a commercially available antibacterial carrier. Both the HA gel sponge and HA gel film exhibited antibacterial activity. The present results indicate that HA gel containing antibiotics is a clinically useful bioabsorbable antibacterial carrier.
