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

Abstract

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.

• Authors: M Diefenbeck, C Schrader, F Gras, T Mückley, J Schmidt, S Zankovych, J Bossert, K D Jandt, A Völpel, B W Sigusch, H Schubert, S Bischoff, W Pfister, B Edel, M Faucon, U Finger
• Journal: Biomaterials (Biomaterials) Vol. 101 Pg. 156-64 (09 2016) ISSN: 1878-5905 [Electronic] Netherlands
• PMID: 27294535 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2016 Elsevier Ltd. All rights reserved.

Chemical References

• Alloys
• Anti-Bacterial Agents
• Coated Materials, Biocompatible
• Gentamicins
• titanium dioxide
• Titanium

Topics

• Alloys (therapeutic use)
• Animals
• Anti-Bacterial Agents (therapeutic use)
• Bone and Bones (pathology)
• Coated Materials, Biocompatible (therapeutic use)
• Gentamicins (therapeutic use)
• Male
• Osseointegration
• Osteomyelitis (etiology, pathology, prevention & control)
• Prostheses and Implants (adverse effects)
• Rats
• Rats, Sprague-Dawley
• Staphylococcal Infections (etiology, pathology, prevention & control)
• Staphylococcus aureus (drug effects)
• Titanium (therapeutic use)