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Aboona F, Bou-Akl T, Miller AJ, Fry M, Wu B, Pawlitz P, Ren W, Markel DC. Effects of Vancomycin/Tobramycin-Doped Ceramic Composite (Polyvinyl Alcohol Composite-Vancomycin/Tobramycin-Polymeric Dicalcium Phosphate Dihydrate) in a Rat Femur Model Implanted With Contaminated Porous Titanium Cylinders. J Arthroplasty 2024:S0883-5403(24)00424-8. [PMID: 38718912 DOI: 10.1016/j.arth.2024.04.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Periprosthetic joint infection (PJI) remains common and problematic. We hypothesized that using a bioceramic that provided rapid release of the antibiotics (vancomycin [VAN] or VAN and tobramycin [VAN and TOB]) from a polyvinyl-alcohol-composite (PVA) combined with a delayed and sustained antibiotic release from polymeric-dicalcium-phosphate-dihydrate (PDCPD) ceramic would inhibit S. aureus-associated implant infections. METHODS A total of 50 male Sprague Dawley rats were randomly divided into 5 groups-I: negative control; II: bacteria only; III: bacteria + saline wash; IV: bacteria + PVA-VAN-PDCPD, and V: bacteria + PVA-VAN-TOB-PDCPD. A porous titanium (Ti) implant was press-fit into the rat knee. S. aureus-containing broth was added into the joint space creating a PJI. After 1 week, the joints from groups III to V were washed with saline and the fluid collected for bacterial quantification. This was followed by saline irrigation treatment (groups III to V) and application of the antibiotic-loaded PVA-PDCPD bioceramic (groups IV and V). On day 21, joint fluid was collected, and the implants harvested for bacterial quantification. RESULTS No bacteria were isolated from the negative control (group I). The positive control (group II) was positive on both days 7 and 21. Bacteria were still present on day 21 in the fluid and implant in group III. Groups (IV and V) showed a decrease in the bacterial burden in the fluid and implant on day 21. There were significant differences in bacteria levels in the collected wash fluid and on the implant at day 21 between the saline wash (group III) and treatment groups (IV and V). CONCLUSIONS In this animal model of acute periprosthetic infection, treatment with PVA-VAN-PDCPD and PVA-VAN/TOB-PDCPD reduced bacterial load in the infected joint and the infected Ti implant. Application of PVA-VAN-PDCPD and/or PVA-VAN/TOB-PDCPD after saline irrigation could be used as an addition to the treatment of PJI.
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Affiliation(s)
- Fadi Aboona
- Section of Orthopaedic Surgery, Ascension-Providence Hospital, Southfield, Michigan
| | - Therese Bou-Akl
- Section of Orthopaedic Surgery, Ascension-Providence Hospital, Southfield, Michigan
| | - Adam J Miller
- Section of Orthopaedic Surgery, Ascension-Providence Hospital, Southfield, Michigan
| | - Mike Fry
- Section of Orthopaedic Surgery, Ascension-Providence Hospital, Southfield, Michigan
| | - Bin Wu
- Section of Orthopaedic Surgery, Ascension-Providence Hospital, Southfield, Michigan
| | - Paula Pawlitz
- Section of Orthopaedic Surgery, Ascension-Providence Hospital, Southfield, Michigan
| | - Weiping Ren
- Section of Orthopaedic Surgery, Ascension-Providence Hospital, Southfield, Michigan; Virotech Co., Inc., Troy, Michigan
| | - David C Markel
- Section of Orthopaedic Surgery, Ascension-Providence Hospital, Southfield, Michigan; The Core Institute, Novi, Michigan
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Markel DC, Dietz PR, Wu B, Chen L, Bou-Akl T, Shi T, Ren W. Repair of a rat calvaria defect with injectable strontium (Sr)-doped polyphosphate dicalcium phosphate dehydrate (P-DCPD) ceramic bone grafts. J Biomed Mater Res B Appl Biomater 2024; 112:e35388. [PMID: 38334714 DOI: 10.1002/jbm.b.35388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 01/07/2024] [Accepted: 01/27/2024] [Indexed: 02/10/2024]
Abstract
The trace element strontium (Sr) enhances new bone formation. However, delivering Sr, like other materials, in a sustained manner from a ceramic bone graft substitute (BGS) is difficult. We developed a novel ceramic BGS, polyphosphate dicalcium phosphate dehydrate (P-DCPD), which delivers embedded drugs in a sustained pattern. This study assessed the in vitro and in vivo performance of Sr-doped P-DCPD. In vitro P-DCPD and 10%Sr-P-DCPD were nontoxic and eluents from 10%Sr-P-DCPD significantly enhanced osteoblastic MC3T3 cell differentiation. A sustained, zero-order Sr release was observed from 10%Sr-P-DCPD for up to 70 days. When using this BGS in a rat calvaria defect model, both P-DCPD and 10% Sr-P-DCPD were found to be biocompatible and biodegradable. Histologic data from decalcified and undecalcified tissue showed that 10%Sr-P-DCPD had more extensive new bone formation compared with P-DCPD 12-weeks after surgery and the 10%Sr-P-DCPD had more organized new bone and much less fibrous tissue at the defect margins. The new bone was formed on the surface of the degraded ceramic debris within the bone defect area. P-DCPD represented a promising drug-eluting BGS for repair of critical bone defects.
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Affiliation(s)
- David C Markel
- Ascension Providence Hospital, Section of Orthopedic Surgery, Southfield, Michigan, USA
- Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA
| | - Paula R Dietz
- Ascension Providence Hospital, Section of Orthopedic Surgery, Southfield, Michigan, USA
| | - Bin Wu
- Ascension Providence Hospital, Section of Orthopedic Surgery, Southfield, Michigan, USA
| | - Liang Chen
- Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA
| | - Therese Bou-Akl
- Ascension Providence Hospital, Section of Orthopedic Surgery, Southfield, Michigan, USA
| | - Tong Shi
- Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA
| | - Weiping Ren
- Ascension Providence Hospital, Section of Orthopedic Surgery, Southfield, Michigan, USA
- Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA
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Dubus M, Scomazzon L, Ledouble C, Braux J, Beljebbar A, Van Gulick L, Baldit A, Gorin C, Alem H, Bouland N, Britton M, Schiavi J, Vaughan TJ, Mauprivez C, Kerdjoudj H. Hybrid Mineral/Organic Material Induces Bone Bridging and Bone Volume Augmentation in Rat Calvarial Critical Size Defects. Cells 2022; 11:cells11182865. [PMID: 36139439 PMCID: PMC9497222 DOI: 10.3390/cells11182865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/04/2022] [Accepted: 09/06/2022] [Indexed: 11/22/2022] Open
Abstract
In craniofacial bone defects, the promotion of bone volume augmentation remains a challenge. Finding strategies for bone regeneration such as combining resorbable minerals with organic polymers would contribute to solving the bone volume roadblock. Here, dicalcium phosphate dihydrate, chitosan and hyaluronic acid were used to functionalize a bone-side collagen membrane. Despite an increase in the release of inflammatory mediators by human circulating monocytes, the in vivo implantation of the functionalized membrane allowed the repair of a critical-sized defect in a calvaria rat model with de novo bone exhibiting physiological matrix composition and structural organization. Microtomography, histological and Raman analysis combined with nanoindentation testing revealed an increase in bone volume in the presence of the functionalized membrane and the formation of woven bone after eight weeks of implantation; these data showed the potential of dicalcium phosphate dihydrate, chitosan and hyaluronic acid to induce an efficient repair of critical-sized bone defects and establish the importance of thorough multi-scale characterization in assessing biomaterial outcomes in animal models.
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Affiliation(s)
- Marie Dubus
- Biomatériaux et Inflammation en Site Osseux (BIOS), Université de Reims Champagne Ardenne, EA 4691 Reims, France
- UFR d’Odontologie, Université de Reims Champagne Ardenne, 51100 Reims, France
| | - Loïc Scomazzon
- Biomatériaux et Inflammation en Site Osseux (BIOS), Université de Reims Champagne Ardenne, EA 4691 Reims, France
| | - Charlotte Ledouble
- Biomatériaux et Inflammation en Site Osseux (BIOS), Université de Reims Champagne Ardenne, EA 4691 Reims, France
- UFR d’Odontologie, Université de Reims Champagne Ardenne, 51100 Reims, France
- Pôle Médecine Bucco-Dentaire, Hôpital Maison Blanche, Centre Hospitalier Universitaire de Reims, 51100 Reims, France
| | - Julien Braux
- Biomatériaux et Inflammation en Site Osseux (BIOS), Université de Reims Champagne Ardenne, EA 4691 Reims, France
- UFR d’Odontologie, Université de Reims Champagne Ardenne, 51100 Reims, France
- Pôle Médecine Bucco-Dentaire, Hôpital Maison Blanche, Centre Hospitalier Universitaire de Reims, 51100 Reims, France
| | - Abdelilah Beljebbar
- BioSpecT EA 7506, Université de Reims Champagne Ardenne, 51100 Reims, France
- UFR de Pharmacie, Université de Reims Champagne Ardenne, 51100 Reims, France
| | - Laurence Van Gulick
- BioSpecT EA 7506, Université de Reims Champagne Ardenne, 51100 Reims, France
| | - Adrien Baldit
- Ecole Nationale d’Ingénieurs de Metz, CNRS, LEM3, Université de Lorraine, 57078 Metz, France
| | - Caroline Gorin
- URP2496, Pathologies, UFR Odontologie, Imagerie et Biothérapies Orofaciales et Plateforme Imagerie du Vivant, Université Paris Cité, 92120 Montrouge, France
- AP-HP, Services Médecines Bucco-Dentaire (GH Paris Sud-Sorbonne Université), 92120 Montrouge, France
| | - Halima Alem
- CNRS, IJL, Université de Lorraine, 54500 Nancy, France
| | - Nicole Bouland
- Service d’Anatomo-Pathologie, Université de Reims Champagne Ardenne, 51100 Reims, France
| | - Marissa Britton
- Biomechanics Research Centre (BioMEC), Biomedical Engineering, School of Engineering, College of Science and Engineering, National University of Ireland, H91 HX31 Galway, Ireland
| | - Jessica Schiavi
- Biomechanics Research Centre (BioMEC), Biomedical Engineering, School of Engineering, College of Science and Engineering, National University of Ireland, H91 HX31 Galway, Ireland
| | - Ted J. Vaughan
- Biomechanics Research Centre (BioMEC), Biomedical Engineering, School of Engineering, College of Science and Engineering, National University of Ireland, H91 HX31 Galway, Ireland
| | - Cédric Mauprivez
- Biomatériaux et Inflammation en Site Osseux (BIOS), Université de Reims Champagne Ardenne, EA 4691 Reims, France
- UFR d’Odontologie, Université de Reims Champagne Ardenne, 51100 Reims, France
- Pôle Médecine Bucco-Dentaire, Hôpital Maison Blanche, Centre Hospitalier Universitaire de Reims, 51100 Reims, France
| | - Halima Kerdjoudj
- Biomatériaux et Inflammation en Site Osseux (BIOS), Université de Reims Champagne Ardenne, EA 4691 Reims, France
- UFR d’Odontologie, Université de Reims Champagne Ardenne, 51100 Reims, France
- Correspondence:
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Markel DC, Todd SW, Provenzano G, Bou-Akl T, Dietz PR, Ren W. Mark Coventry Award: Efficacy of Saline Wash Plus Antibiotics Doped Polyvinyl Alcohol (PVA) Composite (PVA-VAN/TOB-P) in a Mouse Pouch Infection Model. J Arthroplasty 2022; 37:S4-S11. [PMID: 35248751 DOI: 10.1016/j.arth.2022.02.098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The efficacy of saline irrigation for treatment of periprosthetic infection (PJI) is limited by the presence of contaminated medical devices. This study evaluated treatment efficacy of locally placed polyvinyl alcohol (PVA)/bioceramic composite doped with vancomycin (PVA-VAN-P) or vancomycin and tobramycin (PVA-VAN/TOB-P) after saline irrigation in a mouse pouch infection model. METHODS Sutures were implanted into air pouches of BALB/cJ mice, then inoculated with Staphylococcus aureus. Mice were randomized into 6 groups (n = 6 each): (1) no bacteria; (2) bacteria without saline wash; (3) saline wash only; (4) saline wash + PVA-P; (5) saline wash + PVA-VAN-P, and (6) saline wash + PVA-VAN/TOB-P. After 7 days, pouches were washed with saline alone or with additional injection of 0.2 mL of the composites. Sacrifice occurred 14 days after the washout. Histology was performed on the pouch tissues and bacteria cultures on the washout fluid. RESULTS Bacterial culture (optical density) showed that infection persisted after saline irrigation (0.10 ± 0.14) but was effectively eradicated by the addition of PVA-VAN-P (0.05 ± 0.09) and PVA-VAN/TOB-P (0.002 ± 0.003, P < .05). These effects were confirmed by histology. Importantly, no residues of the PVA-P were detected in either the pouch washouts or pouch tissues. CONCLUSION PJI is common and problematic, and few innovations have changed clinical practice and/or outcome. Our data confirmed that the effect of saline irrigation was very limited in the presence of contaminated sutures. PVA-VAN/TOB-P was biodegradable, biocompatible, and effective in eradicating bacterial retention after saline irrigation. Application of PVA-VAN/TOB-P after saline irrigation could be an option for treatment of PJI and should be evaluated in future PJI animal models.
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Affiliation(s)
- David C Markel
- The CORE Institute, Novi, MI; Department of Biomedical Engineering, Wayne State University, Detroit, MI; Ascension Providence Hospital Orthopedic Research Laboratory, Southfield, MI
| | - Samuel W Todd
- Ascension Providence Hospital Orthopedic Research Laboratory, Southfield, MI
| | - Gina Provenzano
- Ascension Providence Hospital Orthopedic Research Laboratory, Southfield, MI
| | - Therese Bou-Akl
- Department of Biomedical Engineering, Wayne State University, Detroit, MI; Ascension Providence Hospital Orthopedic Research Laboratory, Southfield, MI
| | - Paula R Dietz
- Ascension Providence Hospital Orthopedic Research Laboratory, Southfield, MI
| | - Weiping Ren
- Ascension Providence Hospital Orthopedic Research Laboratory, Southfield, MI; Virotech Co., Inc., Troy, MI
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Ouyang Y, Zhang R, Chen H, Chen L, Xi W, Li X, Zhang Q, Yan Y. Novel, degradable, and cytoactive bone cements based on magnesium polyphosphate and calcium citrate. NEW J CHEM 2022. [DOI: 10.1039/d2nj01706g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Ideal bone-filling materials should be degradable and efficient for fast bone remodeling.
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Affiliation(s)
- Yalan Ouyang
- School of Chemical Engineering, Sichuan University, No. 24, Section 1, South First Ring Road, Chengdu 610065, P. R. China
| | - Rongguang Zhang
- School of Chemical Engineering, Sichuan University, No. 24, Section 1, South First Ring Road, Chengdu 610065, P. R. China
| | - Hong Chen
- College of Physics, Sichuan University, No. 24, Section 1, South First Ring Road, Chengdu 610065, P. R. China
| | - Lichao Chen
- School of Chemical Engineering, Sichuan University, No. 24, Section 1, South First Ring Road, Chengdu 610065, P. R. China
| | - Wenjing Xi
- College of Physics, Sichuan University, No. 24, Section 1, South First Ring Road, Chengdu 610065, P. R. China
| | - Xiaodan Li
- College of Physics, Sichuan University, No. 24, Section 1, South First Ring Road, Chengdu 610065, P. R. China
| | - Qiyi Zhang
- School of Chemical Engineering, Sichuan University, No. 24, Section 1, South First Ring Road, Chengdu 610065, P. R. China
| | - Yonggang Yan
- College of Physics, Sichuan University, No. 24, Section 1, South First Ring Road, Chengdu 610065, P. R. China
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Guardia A, Shi T, Bou-Akl T, Dietz P, Wu B, Ren W, Markel D. Properties of erythromycin-loaded polymeric dicalcium phosphate dehydrate bone graft substitute. J Orthop Res 2021; 39:2446-2454. [PMID: 33382124 DOI: 10.1002/jor.24979] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 12/27/2020] [Accepted: 12/28/2020] [Indexed: 02/04/2023]
Abstract
A self-setting, injectable polymeric dicalcium phosphate dehydrate bone graft substitute that is mechanically strong and has excellent cohesion was developed. We assessed the performance of erythromycin-loaded polymeric dicalcium phosphate dehydrate cement. Its properties include drug release, growth inhibition against Staphylococcus aureus and biocompatibility with osteoblastic MC3T3 cells. The impact of erythromycin loading on cement injectability, setting time, and mechanical strength were also evaluated. A sustained, low burst release of erythromycin was observed. Eluents collected from erythromycin-loaded cement showed a considerable zone of inhibition for up to 28 days. Direct contact of erythromycin-loaded cement discs with agar plate showed a similarly sizable zone of inhibition for up to 22 days. Degraded ceramic residues had strong zones of inhibition as well. While the erythromycin-loaded cement was injectable, a notable delay of the setting time was observed (49.2 ± 6.8 min) as compared with control (drug-free cement, 12.2 ± 2.6 min). A slight increase in compressive strength (60.83 ± 6.28 MPa) was observed in erythromycin-loaded cement as compared with control (59.41 ± 6.48 MPa). Erythromycin-loaded cement was biocompatible although reduced cell growth was observed in the presence of the cement eluent. We propose that the bactericidal efficacy of erythromycin-loaded cement was caused by the combined effects of erythromycin released and exposed on the contact surface of degrading ceramics. Our data may elucidate the future application of polymeric dicalcium phosphate dehydrate bone graft substitute for the treatment of orthopedic infections and opportunities to use other antibiotics and applications considering its comparable handling and mechanical strength to poly (methyl methacrylate) cements.
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Affiliation(s)
- Angelica Guardia
- Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA
| | - Tong Shi
- Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA
| | - Therese Bou-Akl
- Department of Orthopedics, Providence Hospital, Southfield, Michigan, USA
| | - Paula Dietz
- Department of Orthopedics, Providence Hospital, Southfield, Michigan, USA
| | - Bin Wu
- Department of Orthopedics, Providence Hospital, Southfield, Michigan, USA
| | - Weiping Ren
- Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA.,Department of Orthopedics, Providence Hospital, Southfield, Michigan, USA
| | - David Markel
- Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA.,Department of Orthopedics, Providence Hospital, Southfield, Michigan, USA
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Barua R, Daly-Seiler CS, Chenreghanianzabi Y, Markel D, Li Y, Zhou M, Ren W. Comparing the physicochemical properties of dicalcium phosphate dihydrate (DCPD) and polymeric DCPD (P-DCPD) cement particles. J Biomed Mater Res B Appl Biomater 2021; 109:1644-1655. [PMID: 33655715 DOI: 10.1002/jbm.b.34822] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 01/29/2021] [Accepted: 02/14/2021] [Indexed: 12/24/2022]
Abstract
We developed a new and injectable poly-dicalcium phosphate dihydrate (P-DCPD) forming cement. The key structural difference between P-DCPD and classical DCPD is that P-DCPD is composed of interconnected P-DCPD crystals by interlocking to the polyphosphate chains. In contrast, DCPD is composed of a package of DCPD crystals with weak mutual ionic bonding. The purpose of this continuing study was to compare the physicochemical properties between P-DCPD and DCPD cement particles. Data collected from SEM, X-ray diffraction, and Raman Spectroscopy approaches demonstrated that P-DCPD has a more stable chemical structure than DCPD as evidenced by much less transformation to hydroxyapatite (HA) during setting. Nanoindentation showed a similar hardness while the elastic modulus of P-DCPD is much lower than DCPD that might be due to the much less HA transformation of P-DCPD. P-DCPD has much lower zeta potential and less hydrophilicity than DCPD because of its entangled and interconnected polyphosphate chains. It is expected that superhydrophilic DCPD undergoes faster dissolution than P-DCPD in an aqueous environment. Another interesting finding is that the pH of eluent from P-DCPD is more neutral (6.6-7.1) than DCPD (5.5-6.5). More extensive experiments are currently underway to further evaluate the potential impacts of the different physiochemical performance observed of P-DCPD and DCPD cement particles on the biocompatibility, degradation behavior and bone defect healing efficacy both in vivo and in vitro.
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Affiliation(s)
- Rajib Barua
- Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA
| | - Conor S Daly-Seiler
- Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA
| | | | - David Markel
- Department of Orthopaedics, Providence Hospital, Southfield, Michigan, USA
| | - Yawen Li
- Department of Biomedical Engineering, Lawrence Technological University, Southfield, Michigan, USA
| | - Meng Zhou
- Department of Natural Sciences, Lawrence Technological University, Southfield, Michigan, USA
| | - Weiping Ren
- Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA
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Ren EJ, Guardia A, Shi T, Begeman P, Ren W, Vaidya R. A distinctive release profile of vancomycin and tobramycin from a new and injectable polymeric dicalcium phosphate dehydrate cement (P-DCPD). Biomed Mater 2021; 16:025019. [PMID: 33361554 DOI: 10.1088/1748-605x/abd689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A novel injectable polymeric dicalcium phosphate dehydrate (P-DCPD) cement was developed with superior mechanical strength and excellent cohesion. The purpose of this study was to assess the in vitro performance of P-DCPD loaded with vancomycin (VAN-P), tobramycin (TOB-P) and combination of both (VAN/TOB-P) (10%, w/w). There is a distinctive release profile between VAN and TOB. VAN-P showed decreased initial burst (<30% within 3 d) and sustained VAN release (76% in 28 d). In the presence of TOB (VAN/TOB-P), >90% of VAN was released within 3 d (p < 0.05). Slow and limited TOB release was observed both in TOB-P (<5%) and in TOB/VAN-P (<1%) over 28 d. Zone of inhibition (ZOI) of Staphylococcus aureus growth showed that eluents collected from VAN-P had stronger and longer ZOI (28 d) than that from TOB-P (14 d, p < 0.05). Direct contact of VAN-P, TOB-P and VAN/TOB-P cements displayed persistent and strong ZOI for >3 weeks. Interestingly, the cement residues (28 d after drug release) still maintained strong ZOI ability. P-DCPD with or without antibiotics loading were nontoxic and had no inferior impacts on the growth of osteoblastic MC3T3 cells. VAN-P and TOB-P were injectable. No significant influence on setting time was observed in both VAN-P (11.7 ± 1.9 min) and VAN/TOB-P (10.8 ± 1.5 min) as compared to control (12.2 ± 2.6 min). We propose that a distinctive release profile of VAN and TOB observed is mainly due to different distribution pattern of VAN and TOB within P-DCPD matrix. A limited release of TOB might be due to the incorporation of TOB inside the crystalline lattice of P-DCPD crystals. Our data supported that the bactericidal efficacy of antibiotics-loaded P-DCPD is not only depend on the amount and velocity of antibiotics released, but also probably more on the direct contact of attached bacteria on the degrading cement surface.
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Affiliation(s)
- E J Ren
- Department of Orthopaedic Surgery, Detroit Medical Center, Detroit, MI 48201, United States of America
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Antibacterial calcium phosphate composite cements reinforced with silver-doped magnesium phosphate (newberyite) micro-platelets. J Mech Behav Biomed Mater 2020; 110:103934. [DOI: 10.1016/j.jmbbm.2020.103934] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/04/2020] [Accepted: 06/13/2020] [Indexed: 11/23/2022]
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10
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Criado A, Yokhana S, Rahman T, McCarty S, Andrecovich C, Ren W, Yassir WK. Biomechanical strength comparison of pedicle screw augmentation using poly-dicalcium phosphate dihydrate (P-DCPD) and polymethylmethacrylate (PMMA) cements. Spine Deform 2020; 8:165-170. [PMID: 32030639 DOI: 10.1007/s43390-019-00022-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 08/25/2019] [Indexed: 12/01/2022]
Abstract
STUDY DESIGN A basic science, hypothesis-driven experimental study of the biomechanics of two bone cements in their ability to augment pedicle screws in bone foam. OBJECTIVE The purpose of our study was to compare the pullout and torque resistance of conventional pedicle screws (CPS) augmented with either polymethylmethacrylate (PMMA) or poly-dicalcium phosphate dihydrate (P-DCPD) cement in polyurethane foam blocks mimicking osteoporotic bone. P-DCPD cement has attractive safety characteristics such as non-exothermic curing and drug-eluting capacity. PMMA cement lacks these safety features yet is the current standard in pedicle screw augmentation. METHODS Standardized low-density polyurethane open-cell foam blocks were instrumented with conventional pedicle screws and categorized into three groups of six each. Group 1 was the control group and no cement was used. Groups 2 and 3 were augmented with PMMA and P-DCPD, respectively. An Instron machine applied an axial load to failure at a rate of 2 mm/min for 3 min and a torsional load to failure at a rate of 1°/s. Failure was defined by an evident drop in the load after maximum value. RESULTS Maximal pullout load for PMMA and P-DCPD was significantly greater than control (p < 0.0001). Interestingly, there was no significant difference in the pullout load to failure for the PMMA and P-DCPD groups. Analysis showed significant difference in torsional resistance between PMMA and P-DCPD, with PMMA having greater resistance (p = 0.00436). CONCLUSIONS No difference was observed between PMMA and P-DCPD in pullout load to failure conducted in low-density open-cell, rigid foam blocks. Although a significant difference did exist in our torque analysis, the clinical significance of such a load on a native spine is questionable. Further investigation is warranted for this promising compound that seems to be comparable in pullout resistance to PMMA and offers attractive safety features. LEVEL OF EVIDENCE Basic science, not applicable.
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Affiliation(s)
- Alberto Criado
- Department of Orthopedic Surgery, Detroit Medical Center, 4201 St Antoine St, Detroit, MI, 48201, USA
| | - Sanar Yokhana
- Department of Orthopedic Surgery, Detroit Medical Center, 4201 St Antoine St, Detroit, MI, 48201, USA
| | - Tahsin Rahman
- Wayne State University School of Medicine, 7733 Woodward Ave, Detroit, MI, 48202, USA.
| | - Scott McCarty
- Department of Orthopedic Surgery, Detroit Medical Center, 4201 St Antoine St, Detroit, MI, 48201, USA
| | - Christopher Andrecovich
- Department of Biomedical Engineering, Wayne State University, 818 W Hancock St, Detroit, MI, 48201, USA
| | - Weiping Ren
- Department of Biomedical Engineering, Wayne State University, 818 W Hancock St, Detroit, MI, 48201, USA
| | - Walid Khaled Yassir
- Department of Orthopedic Surgery, Detroit Medical Center, 4201 St Antoine St, Detroit, MI, 48201, USA
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Chehreghanianzabi Y, Barua R, Shi T, Yurgelevic S, Auner G, Markel DC, Ren W. Comparing the release of erythromycin and vancomycin from calcium polyphosphate hydrogel using different drug loading methods. J Biomed Mater Res B Appl Biomater 2019; 108:475-483. [DOI: 10.1002/jbm.b.34404] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/22/2019] [Accepted: 04/25/2019] [Indexed: 11/09/2022]
Affiliation(s)
| | - Rajib Barua
- Department of Biomedical EngineeringWayne State University Detroit Michigan
| | - Tong Shi
- Department of Biomedical EngineeringWayne State University Detroit Michigan
| | - Sally Yurgelevic
- Department of Biomedical EngineeringWayne State University Detroit Michigan
| | - Gregory Auner
- Department of Biomedical EngineeringWayne State University Detroit Michigan
| | - David C. Markel
- Department of OrthopedicsProvidence Hospital and Medical Center Southfield Michigan
| | - Weiping Ren
- Department of Biomedical EngineeringWayne State University Detroit Michigan
- Department of OrthopedicsProvidence Hospital and Medical Center Southfield Michigan
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12
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Shu Y, Zhou Y, Ma P, Li C, Ge C, Wang Y, Li Q, Yu K, Lu R, Zou X, Yin Y, Li J. Degradation in vitro and in vivo of β-TCP/MCPM-based premixed calcium phosphate cement. J Mech Behav Biomed Mater 2019; 90:86-95. [DOI: 10.1016/j.jmbbm.2018.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/28/2018] [Accepted: 10/01/2018] [Indexed: 01/04/2023]
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