Biomedicines (May 2021)

Vancomycin-Loaded Collagen/Hydroxyapatite Layers Electrospun on 3D Printed Titanium Implants Prevent Bone Destruction Associated with <i>S. epidermidis</i> Infection and Enhance Osseointegration

  • Tomáš Suchý,
  • Lucie Vištejnová,
  • Monika Šupová,
  • Pavel Klein,
  • Martin Bartoš,
  • Yaroslav Kolinko,
  • Tereza Blassová,
  • Zbyněk Tonar,
  • Marek Pokorný,
  • Zbyněk Sucharda,
  • Margit Žaloudková,
  • František Denk,
  • Rastislav Ballay,
  • Štefan Juhás,
  • Jana Juhásová,
  • Eva Klapková,
  • Lukáš Horný,
  • Radek Sedláček,
  • Tomáš Grus,
  • Zdeněk Čejka,
  • Zdeněk Čejka,
  • Kateřina Chudějová,
  • Jaroslav Hrabák

DOI
https://doi.org/10.3390/biomedicines9050531
Journal volume & issue
Vol. 9, no. 5
p. 531

Abstract

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The aim of the study was to develop an orthopedic implant coating in the form of vancomycin-loaded collagen/hydroxyapatite layers (COLHA+V) that combine the ability to prevent bone infection with the ability to promote enhanced osseointegration. The ability to prevent bone infection was investigated employing a rat model that simulated the clinically relevant implant-related introduction of bacterial contamination to the bone during a surgical procedure using a clinical isolate of Staphylococcus epidermidis. The ability to enhance osseointegration was investigated employing a model of a minipig with terminated growth. Six weeks following implantation, the infected rat femurs treated with the implants without vancomycin (COLHA+S. epidermidis) exhibited the obvious destruction of cortical bone as evinced via a cortical bone porosity of up to 20% greater than that of the infected rat femurs treated with the implants containing vancomycin (COLHA+V+S. epidermidis) (3%) and the non-infected rat femurs (COLHA+V) (2%). The alteration of the bone structure of the infected COLHA+S. epidermidis group was further demonstrated by a 3% decrease in the average Ca/P molar ratio of the bone mineral. Finally, the determination of the concentration of vancomycin released into the blood stream indicated a negligible systemic load. Six months following implantation in the pigs, the quantified ratio of new bone indicated an improvement in osseointegration, with a two-fold bone ingrowth on the COLHA (47%) and COLHA+V (52%) compared to the control implants without a COLHA layer (27%). Therefore, it can be concluded that COLHA+V layers are able to significantly prevent the destruction of bone structure related to bacterial infection with a minimal systemic load and, simultaneously, enhance the rate of osseointegration.

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