Despite improvements in surgical techniques and implant designs in
orthopedic surgery, implantation-associated
infections are still a challenging problem for surgeons. The goal of this study was to evaluate the efficacy of a
norvancomycin-loaded, PDLLA-coated
stainless steel plate vs an uncoated
stainless steel plate in a rabbit model (n=50). The
norvancomycin was delivered from a biodegradable
poly(D,L-lactide) (PDLLA) coating of a
stainless steel plate. Intraoperatively, rabbit tibia fractures were contaminated with Staphylococcus aureus (10(5) colony forming units) after plate implantation. The implants were either uncoated or coated with PDLLA and
norvancomycin. In vivo drug release profiles showed that the
norvancomycin release rate was decreased by increasing the time. The
norvancomycin concentration in the tissue around the plate was higher than the minimum inhibitory concentration on the 14th day after implantation surgery. The animals were followed up for 28 days. Radiographic examinations were performed, and
C-reactive protein and erythrocyte sedimentation rate were determined.
Infection was evaluated by histological, microbiological, and radiological analysis. Eight of 25 rabbits (32%) implanted with the
norvancomycin-loaded, PDLLA-coated plates were infected. Twenty-three of 25 rabbits (92%) implanted with the uncoated plates were infected (P<.05). The
norvancomycin-loaded, PDLLA-coated plate may be used to treat
open fractures to reduce the incidence of early
infection.