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Kan YC, Guo R, Xu Y, Han LY, Bu WH, Han LX, Chu JJ. Investigating the in vitro antibacterial efficacy of composite bone cement incorporating natural product-based monomers and gentamicin. J Orthop Surg Res 2024; 19:169. [PMID: 38448971 PMCID: PMC10918884 DOI: 10.1186/s13018-024-04646-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/26/2024] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVE The objective of this study is to investigate the impact of four natural product extracts, namely, aloe-emodin, quercetin, curcumin, and tannic acid, on the in vitro bacteriostatic properties and biocompatibility of gentamicin-loaded bone cement and to establish an experimental groundwork supporting the clinical utility of antibiotic-loaded bone cements (ALBC). METHODS Based on the components, the bone cement samples were categorized as follows: the gentamicin combined with aloe-emodin group, the gentamicin combined with quercetin group, the gentamicin combined with curcumin group, the gentamicin combined with tannic acid group, the gentamicin group, the aloe-emodin group, the quercetin group, the curcumin group, and the tannic acid group. Using the disk diffusion test, we investigated the antibacterial properties of the bone cement material against Staphylococcus aureus (n = 4). We tested cell toxicity and proliferation using the cell counting kit-8 (CCK-8) and examined the biocompatibility of bone cement materials. RESULTS The combination of gentamicin with the four natural product extracts resulted in significantly larger diameters of inhibition zones compared to gentamicin alone, and the difference was statistically significant (P < 0.05). Except for the groups containing tannic acid, cells in all other groups showed good proliferation across varying time intervals without displaying significant cytotoxicity (P < 0.05). CONCLUSION In this study, aloe-emodin, quercetin, curcumin, and tannic acid were capable of enhancing the in vitro antibacterial performance of gentamicin-loaded bone cement against S. aureus. While the groups containing tannic acid displayed moderate cytotoxicity in in vitro cell culture, all other groups showed no discernible cytotoxic effects.
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Affiliation(s)
- Yu-Chen Kan
- Department of Orthopedics, The Second People's Hospital of Hefei, Hefei Hospital, Affiliated to Anhui Medical University, No. 246 of Heping Road, Yaohai District, Hefei, Anhui, 230011, China
- The Fifth Clinical Medical School of Anhui Medical University, Hefei, Anhui, 230032, China
| | - Rui Guo
- Department of Orthopedics, The Second People's Hospital of Hefei, Hefei Hospital, Affiliated to Anhui Medical University, No. 246 of Heping Road, Yaohai District, Hefei, Anhui, 230011, China
- The Fifth Clinical Medical School of Anhui Medical University, Hefei, Anhui, 230032, China
| | - Yang Xu
- School of Food and Biological Engineering, Hefei University of Technology, Hefei, Anhui, 230009, China
| | - Lu-Yang Han
- Department of Orthopedics, The Second People's Hospital of Hefei, Hefei Hospital, Affiliated to Anhui Medical University, No. 246 of Heping Road, Yaohai District, Hefei, Anhui, 230011, China
| | - Wen-Han Bu
- Department of Orthopedics, The Second People's Hospital of Hefei, Hefei Hospital, Affiliated to Anhui Medical University, No. 246 of Heping Road, Yaohai District, Hefei, Anhui, 230011, China
| | - Long-Xu Han
- Department of Orthopedics, The Second People's Hospital of Hefei, Hefei Hospital, Affiliated to Anhui Medical University, No. 246 of Heping Road, Yaohai District, Hefei, Anhui, 230011, China
| | - Jian-Jun Chu
- Department of Orthopedics, The Second People's Hospital of Hefei, Hefei Hospital, Affiliated to Anhui Medical University, No. 246 of Heping Road, Yaohai District, Hefei, Anhui, 230011, China.
- The Fifth Clinical Medical School of Anhui Medical University, Hefei, Anhui, 230032, 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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Clinical Applications of Poly-Methyl-Methacrylate in Neurosurgery: The In Vivo Cranial Bone Reconstruction. J Funct Biomater 2022; 13:jfb13030156. [PMID: 36135591 PMCID: PMC9504957 DOI: 10.3390/jfb13030156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 11/23/2022] Open
Abstract
Background: Biomaterials and biotechnology are becoming increasingly important fields in modern medicine. For cranial bone defects of various aetiologies, artificial materials, such as poly-methyl-methacrylate, are often used. We report our clinical experience with poly-methyl-methacrylate for a novel in vivo bone defect closure and artificial bone flap development in various neurosurgical operations. Methods: The experimental study included 12 patients at a single centre in 2018. They presented with cranial bone defects after various neurosurgical procedures, including tumour, traumatic brain injury and vascular pathologies. The patients underwent an in vivo bone reconstruction from poly-methyl-methacrylate, which was performed immediately after the tumour removal in the tumour group, whereas the trauma and vascular patients required a second surgery for cranial bone reconstruction due to the bone decompression. The artificial bone flap was modelled in vivo just before the skin closure. Clinical and surgical data were reviewed. Results: All patients had significant bony destruction or unusable bone flap. The tumour group included five patients with meningiomas destruction and the trauma group comprised four patients, all with severe traumatic brain injury. In the vascular group, there were three patients. The average modelling time for the artificial flap modelling was approximately 10 min. The convenient location of the bone defect enabled a relatively straightforward and fast reconstruction procedure. No deformations of flaps or other complications were encountered, except in one patient, who suffered a postoperative infection. Conclusions: Poly-methyl-methacrylate can be used as a suitable material to deliver good cranioplasty cosmesis. It offers an optimal dural covering and brain protection and allows fast intraoperative reconstruction with excellent cosmetic effect during the one-stage procedure. The observations of our study support the use of poly-methyl-methacrylate for the ad hoc reconstruction of cranial bone defects.
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