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Salamanna F, De Luca A, Vandenbulcke F, Di Matteo B, Kon E, Grassi A, Ballardini A, Morozzi G, Raimondi L, Bellavia D, Costa V, Zaffagnini S, Fini M, Giavaresi G. Preliminary osteogenic and antibacterial investigations of wood derived antibiotic-loaded bone substitute for the treatment of infected bone defects. Front Bioeng Biotechnol 2024; 12:1412584. [PMID: 39055342 PMCID: PMC11270025 DOI: 10.3389/fbioe.2024.1412584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 06/17/2024] [Indexed: 07/27/2024] Open
Abstract
Introduction: The development of reliable treatments for infected or potentially infected bone loss resulting from open fractures and non-unions is extremely urgent, especially to reduce the prolonged courses of antimicrobial therapy to which affected patients are subjected. Numerous bone graft substitutes have been used over the years, but there are currently no effective solutions to treat critical bone loss, especially in the presence of infection. The present study evaluated the use of the biomorphic calcium phosphate bone scaffold b. Bone™, based on a next-generation resorbable biomimetic biomaterial, in bone reconstruction surgery in cases of infection. Methods: Using an "in vitro 3D bone fracture model" to predict the behavior of this drug delivery system during critical bone loss at an infected (or potentially infected) site, the effects of scaffolds loaded with gentamicin or vancomycin on the viability and differentiation capacity of human mesenchymal stem cells (hMSCs) were evaluated. Results: This scaffold, when loaded with gentamicin or vancomycin, exhibits a typical drug release curve that determines the inhibitory effects on the growth of Staphylococcus aureus, Enterococcus faecalis, and Escherichia coli, as well as relative biofilm formation. Discussion: The study demonstrates that b.bone scaffolds can effectively address key challenges in orthopedic surgery and patient care by inhibiting bacterial growth and biofilm formation through rapid, potent antibiotic release, reducing the risk of treatment failure due to resistance, and providing a promising solution for bone infections and improved patient outcomes. Future studies could explore the combination of different antibiotics on these scaffolds for more tailored and effective treatments against post-traumatic osteomyelitis pathogens.
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Affiliation(s)
- Francesca Salamanna
- Surgical Science and Technologies, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Angela De Luca
- Surgical Science and Technologies, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Filippo Vandenbulcke
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Milan, Italy
| | - Berardo Di Matteo
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Traumatology, Orthopaedics and Disaster Surgery, Sechenov University, Moscow, Russia
| | - Elizaveta Kon
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Milan, Italy
| | - Alberto Grassi
- 2nd Orthopedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | | | | | - Lavinia Raimondi
- Surgical Science and Technologies, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Daniele Bellavia
- Surgical Science and Technologies, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Viviana Costa
- Surgical Science and Technologies, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Stefano Zaffagnini
- 2nd Orthopedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Milena Fini
- Scientific Direction, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Gianluca Giavaresi
- Surgical Science and Technologies, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Cao L, Parvizi J, Zhang X, Liu X, Zijlstra WP, Tarabichi S. Editorial: Management of PJI/SSI after joint arthroplasty. ARTHROPLASTY 2024; 6:31. [PMID: 38840191 PMCID: PMC11155056 DOI: 10.1186/s42836-024-00256-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 04/30/2024] [Indexed: 06/07/2024] Open
Abstract
The management of periprosthetic joint infection (PJI) and surgical site infection (SSI) after joint arthroplasty poses a major challenge in orthopedic surgery. This Editorial provides an overview of the studies published in the special issue "Management of PJI/SSI after Joint Arthroplasty", summarizing the key findings from these studies, which cover a wide range of topics, including stringent preventive strategies, comprehensive diagnostic methods, and personalized treatment modalities. The authors concluded the editorial with their perspectives regarding the status quo of research in this field and future directions for research, such as the development of novel antibiotics, biofilm research, patient-specific risk factors, and the integration of technological advancements (such as machine learning and artificial intelligence) into clinical practice. The authors emphasized the need for continued research, interdisciplinary collaboration, and the application of innovative technologies to enhance patient outcomes and mitigate the burden of these infections on healthcare systems.
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Affiliation(s)
- Li Cao
- Department of Orthopedics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China.
| | - Javad Parvizi
- International Joint Center, Acibadem University Hospital, Istanbul, 34746, Turkey
| | - Xiaogang Zhang
- Department of Orthopedics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Xianzhe Liu
- Department of Orthopedic Surgery, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Wierd P Zijlstra
- Department of Orthopedic Surgery, Medical Center Leeuwarden, 8934 AD, Leeuwarden, the Netherlands
| | - Saad Tarabichi
- Rothman Orthopedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA, 19107, USA
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Liu D, Li H, Yang Y, Xu S, Zheng X, Liu J, Miyazaki T, Zhu Y. Preparation and characterizations of antibacterial poly(methyl methacrylate) bone cement via copolymerization with a quaternary ammonium monomer of dimethylaminotriclosan methacrylate. J Mech Behav Biomed Mater 2024; 151:106367. [PMID: 38194787 DOI: 10.1016/j.jmbbm.2023.106367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/30/2023] [Accepted: 12/31/2023] [Indexed: 01/11/2024]
Abstract
Poly (methyl methacrylate) (PMMA) bone cement relies on the loaded antibiotic to realize the antibacterial purpose. But the exothermic behavior during setting often makes temperature-sensitive antibiotics inactivated. It is necessary to develop new material candidates to replace antibiotics. In this study, a new quaternary ammonium methacrylate (QAM) monomer called dimethylaminetriclosan methacrylate (DMATCM) was designed by the quaternization between 2-(Dimethylamino)ethyl methacrylate and triclosan, then employed as the modifier to explore the feasibility of equipping bone cement with antibacterial activity, and to investigate the variations on the physical and biological performances brought by the substitution ratio of DMATCM to MMA. Results showed that DMATCM opened its C=C bonding to participate in the MMA polymerization, and the quaternary ammonium group helped it to perform broad-spectrum antibacterial property against both Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli. With an increased substitution ratio of DMATCM to MMA, the glass transition temperatures, the maximum exothermic temperatures, and the contact angles of bone cements declined, but the residual monomer contents, the fluid uptakes, and the setting times under Vical indentation increased. Long-term soaking made almost no changes to the weight loss and the mechanical properties of DMATCM-modified cements with lower substitution ratios of 0∼20%, and the activation rather enhanced the strengths of uncured AMBC-4 and AMBC-5 samples. Owing to more DMATCM exposed on the cement surface, the inhibition ring diameter produced by modified cement was improved to a maximum of 28.09 mm, and MC3T3-E1 cells performed the cell viabilities all beyond 70% and healthy adhesion after 72 h co-culturing. Taking all measured properties and ISO standards into account, the antibacterial bone cement under the ratio of 10% performed better, besides its good bactericidal effect, the other properties satisfied the requirements for clinical application.
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Affiliation(s)
- Dong Liu
- Faculty of Materials Science and Technology, Kunming University of Science and Technology, No. 68 Wenchang Road, Lianhua Campus, Kunming, Yunnan, 650093, China.
| | - Haoyang Li
- Faculty of Materials Science and Technology, Kunming University of Science and Technology, No. 68 Wenchang Road, Lianhua Campus, Kunming, Yunnan, 650093, China.
| | - Yunping Yang
- Spine Surgery Department, Affiliated Hospital of Yunnan University, No.176 Qingnian Road, Wuhua District, Kunming, Yunnan, 650021, China.
| | - Shan Xu
- Faculty of Materials Science and Technology, Kunming University of Science and Technology, No. 68 Wenchang Road, Lianhua Campus, Kunming, Yunnan, 650093, China.
| | - Xihao Zheng
- Faculty of Materials Science and Technology, Kunming University of Science and Technology, No. 68 Wenchang Road, Lianhua Campus, Kunming, Yunnan, 650093, China.
| | - Jinkun Liu
- Faculty of Materials Science and Technology, Kunming University of Science and Technology, No. 68 Wenchang Road, Lianhua Campus, Kunming, Yunnan, 650093, China.
| | - Toshiki Miyazaki
- Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, 2-4, Hibikino, Wakamatsu-ku, Kitakyushu-shi, 808-0196, Japan.
| | - Yan Zhu
- Faculty of Materials Science and Technology, Kunming University of Science and Technology, No. 68 Wenchang Road, Lianhua Campus, Kunming, Yunnan, 650093, China.
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Ghasemi F, Jahani A, Moradi A, Ebrahimzadeh MH, Jirofti N. Different Modification Methods of Poly Methyl Methacrylate (PMMA) Bone Cement for Orthopedic Surgery Applications. THE ARCHIVES OF BONE AND JOINT SURGERY 2023; 11:485-492. [PMID: 37674694 PMCID: PMC10479821 DOI: 10.22038/abjs.2023.71289.3330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 06/12/2023] [Indexed: 09/08/2023]
Abstract
In clinical practice, bone defects that occur alongside tumors, infections, or other bone diseases present significant challenges in the orthopedic field. Although autologous and allogeneic grafts are introduced as common traditional remedies in this field, their applications have a series of limitations. Various approaches have been attempted to treat large and irregularly shaped bone defects; however, their success has been less than optimal due to a range of issues related to material and design. However, in recent years, additive manufacturing has emerged as a promising solution to the challenge of creating implants that can be perfectly tailored to fit individual defects during surgical procedures. By fabrication of constructs with specific designs using this technique, surgeons are able to achieve much better outcomes for patients. Polymers, ceramics, and metals have been used as biomaterials in Orthopedic Surgery fields. Polymeric scaffolds have been used successfully in total joint replacements, soft tissue reconstruction, joint fusion, and as fracture fixation devices. The use of polymeric biomaterials, either in the form of pre-made solid scaffolds or injectable pastes that can harden in situ, shows great promise as a substitute for commonly used autografts and allografts. Polymethyl methacrylate (PMMA) is one of the most widely used polymer cement in orthopedic surgery. The present paper begins with an introduction and will then provide an overview of the properties, advantages/disadvantages, applications, and modifications of PMMA bone cement.
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Affiliation(s)
- Fatemeh Ghasemi
- Orthopedic Research Center, Mashhad University of Medical Science, Mashhad, Iran
- Bone and Joint Research Laboratory, Ghaem Hospital, Mashhad University of Medical Science, Mashhad, Iran
- Fatemeh Ghasemi and Afsaneh Jahani equally contributed as co-first author
| | - Afsaneh Jahani
- Orthopedic Research Center, Mashhad University of Medical Science, Mashhad, Iran
- Bone and Joint Research Laboratory, Ghaem Hospital, Mashhad University of Medical Science, Mashhad, Iran
- Department of Biomedical Engineering, Faculty of New Sciences and Technologies, Semnan University, Semnan, Iran
- Fatemeh Ghasemi and Afsaneh Jahani equally contributed as co-first author
| | - Ali Moradi
- Orthopedic Research Center, Mashhad University of Medical Science, Mashhad, Iran
- Bone and Joint Research Laboratory, Ghaem Hospital, Mashhad University of Medical Science, Mashhad, Iran
| | - Mohammad H. Ebrahimzadeh
- Orthopedic Research Center, Mashhad University of Medical Science, Mashhad, Iran
- Bone and Joint Research Laboratory, Ghaem Hospital, Mashhad University of Medical Science, Mashhad, Iran
| | - Nafiseh Jirofti
- Orthopedic Research Center, Mashhad University of Medical Science, Mashhad, Iran
- Bone and Joint Research Laboratory, Ghaem Hospital, Mashhad University of Medical Science, Mashhad, Iran
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