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Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2014

Open Access 01-12-2014 | Research article

Vancomycin containing PLLA/β-TCP controls experimental osteomyelitis in vivo

Authors: Berna Kankilic, Elif Bilgic, Petek Korkusuz, Feza Korkusuz

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2014

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Abstract

Background

Implant-related osteomyelitis (IRO) is recently controlled with local antibiotic delivery systems to overcome conventional therapy disadvantages. In vivo evaluation of such systems is however too little.

Questions/purposes

We asked whether vancomycin (V)-containing poly-l-lactic acid/β-tricalcium phosphate (PLLA/β-TCP) composites control experimental IRO and promote bone healing in vivo.

Methods

Fifty-six rats were distributed to five groups in this longitudinal controlled study. Experimental IRO was established at tibiae by injecting methicillin-resistant Staphylococcus aureus (MRSA) suspensions with titanium particles in 32 rats. Vancomycin-free PLLA/β-TCP composites were implanted into the normal and infected tibiae, whereas V-PLLA/β-TCP composites and coated (C)-V-PLLA/β-TCP composites were implanted into IRO sites. Sham-operated tibiae established the control group. Radiological and histological scores were quantified with microbiological findings on weeks 1 and 6.

Results

IRO is resolved in the CV- and the V-PLLA/β-TCP groups but not in the PLLA/β-TCP group. MRSA was not isolated in the CV- and the V-PLLA/β-TCP groups at all times whereas the bacteria were present in the PLLA/β-TCP group. Radiological signs secondary to infection are improved from 10.9 ± 0.9 to 3.0 ± 0.3 in the V-PLLA/β-TCP group but remained constant in the PLLA/β-TCP group. Histology scores are improved from 24.7 ± 6.5 to 17.6 ± 4.8 and from 27.6 ± 7.9 to 32.4 ± 8.9 in the CV-PLLA/β-TCP and the V-PLLA/β-TCP groups, respectively. New bone was formed in all the PLLA/β-TCP group at weeks 1 and 6.

Conclusions

CV- and V-PLLA/β-TCP composites controlled experimental IRO and promoted bone healing.

Clinical relevance

CV- and V-PLLA/β-TCP composites have the potential of controlling experimental IRO and promoting bone healing.
Appendix
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Metadata
Title
Vancomycin containing PLLA/β-TCP controls experimental osteomyelitis in vivo
Authors
Berna Kankilic
Elif Bilgic
Petek Korkusuz
Feza Korkusuz
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2014
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-014-0114-3

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