Ceramic Biocomposites as Biodegradable Antibiotic Carriers in the Treatment of Bone Infections
<p class="p p-first" id="__p2">Local release of antibiotic has advantages in the treatment of chronic osteomyelitis and infected fractures. The adequacy of surgical debridement is still key to successful clearance of infection but local antibiotic carriers seem to afford gr...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Copernicus Publications
2017-01-01
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| Series: | Journal of Bone and Joint Infection |
| Online Access: | https://jbji.copernicus.org/articles/2/38/2017/jbji-2-38-2017.pdf |
| _version_ | 1818676587980128256 |
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| author | J. Ferguson M. Diefenbeck M. McNally |
| author_facet | J. Ferguson M. Diefenbeck M. McNally |
| author_sort | J. Ferguson |
| collection | DOAJ |
| description | <p class="p p-first" id="__p2">Local release of antibiotic has advantages in the treatment of chronic osteomyelitis and infected fractures. The adequacy of surgical debridement is still key to successful clearance of infection but local antibiotic carriers seem to afford greater success rates by targeting the residual organisms present after debridement and delivering much higher local antibiotic concentrations compared with systemic antibiotics alone. Biodegradable ceramic carriers can be used to fill osseous defects, which reduces the dead space and provides the potential for subsequent repair of the osseous defect as they dissolve away. A dissolving ceramic antibiotic carrier also raises the possibility of single stage surgery with definitive closure and avoids the need for subsequent surgery for spacer removal.</p><p id="__p3">In this article we provide an overview of the properties of various biodegradable ceramics, including calcium sulphate, the calcium orthophosphate ceramics, calcium phosphate cement and polyphasic carriers. We summarise the antibiotic elution properties as investigated in previous animal studies as well as the clinical outcomes from clinical research investigating their use in the surgical management of chronic osteomyelitis.</p><p id="__p4">Calcium sulphate pellets have been shown to be effective in treating local infection, although newer polyphasic carriers may support greater osseous repair and reduce the risk of further fracture or the need for secondary reconstructive surgery. The use of ceramic biocomposites to deliver antibiotics together with BMPs, bisphosphonates, growth factors or living cells is under investigation and merits further study.</p><p class="p p-last" id="__p5">We propose a treatment protocol, based on the Cierny-Mader classification, to help guide the appropriate selection of a suitable ceramic antibiotic carrier in the surgical treatment of chronic osteomyelitis.</p> |
| first_indexed | 2024-12-17T08:45:51Z |
| format | Article |
| id | doaj.art-20d80e4b2e494a57ac7e0637a73df98c |
| institution | Directory Open Access Journal |
| issn | 2206-3552 |
| language | English |
| last_indexed | 2024-12-17T08:45:51Z |
| publishDate | 2017-01-01 |
| publisher | Copernicus Publications |
| record_format | Article |
| series | Journal of Bone and Joint Infection |
| spelling | doaj.art-20d80e4b2e494a57ac7e0637a73df98c2022-12-21T21:56:12ZengCopernicus PublicationsJournal of Bone and Joint Infection2206-35522017-01-012385110.7150/jbji.17234Ceramic Biocomposites as Biodegradable Antibiotic Carriers in the Treatment of Bone InfectionsJ. Ferguson0M. Diefenbeck1M. McNally2The Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals Foundation NHS Trust, Oxford, United Kingdom.The Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals Foundation NHS Trust, Oxford, United Kingdom.The Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals Foundation NHS Trust, Oxford, United Kingdom.<p class="p p-first" id="__p2">Local release of antibiotic has advantages in the treatment of chronic osteomyelitis and infected fractures. The adequacy of surgical debridement is still key to successful clearance of infection but local antibiotic carriers seem to afford greater success rates by targeting the residual organisms present after debridement and delivering much higher local antibiotic concentrations compared with systemic antibiotics alone. Biodegradable ceramic carriers can be used to fill osseous defects, which reduces the dead space and provides the potential for subsequent repair of the osseous defect as they dissolve away. A dissolving ceramic antibiotic carrier also raises the possibility of single stage surgery with definitive closure and avoids the need for subsequent surgery for spacer removal.</p><p id="__p3">In this article we provide an overview of the properties of various biodegradable ceramics, including calcium sulphate, the calcium orthophosphate ceramics, calcium phosphate cement and polyphasic carriers. We summarise the antibiotic elution properties as investigated in previous animal studies as well as the clinical outcomes from clinical research investigating their use in the surgical management of chronic osteomyelitis.</p><p id="__p4">Calcium sulphate pellets have been shown to be effective in treating local infection, although newer polyphasic carriers may support greater osseous repair and reduce the risk of further fracture or the need for secondary reconstructive surgery. The use of ceramic biocomposites to deliver antibiotics together with BMPs, bisphosphonates, growth factors or living cells is under investigation and merits further study.</p><p class="p p-last" id="__p5">We propose a treatment protocol, based on the Cierny-Mader classification, to help guide the appropriate selection of a suitable ceramic antibiotic carrier in the surgical treatment of chronic osteomyelitis.</p>https://jbji.copernicus.org/articles/2/38/2017/jbji-2-38-2017.pdf |
| spellingShingle | J. Ferguson M. Diefenbeck M. McNally Ceramic Biocomposites as Biodegradable Antibiotic Carriers in the Treatment of Bone Infections Journal of Bone and Joint Infection |
| title | Ceramic Biocomposites as Biodegradable Antibiotic Carriers in the Treatment of Bone Infections |
| title_full | Ceramic Biocomposites as Biodegradable Antibiotic Carriers in the Treatment of Bone Infections |
| title_fullStr | Ceramic Biocomposites as Biodegradable Antibiotic Carriers in the Treatment of Bone Infections |
| title_full_unstemmed | Ceramic Biocomposites as Biodegradable Antibiotic Carriers in the Treatment of Bone Infections |
| title_short | Ceramic Biocomposites as Biodegradable Antibiotic Carriers in the Treatment of Bone Infections |
| title_sort | ceramic biocomposites as biodegradable antibiotic carriers in the treatment of bone infections |
| url | https://jbji.copernicus.org/articles/2/38/2017/jbji-2-38-2017.pdf |
| work_keys_str_mv | AT jferguson ceramicbiocompositesasbiodegradableantibioticcarriersinthetreatmentofboneinfections AT mdiefenbeck ceramicbiocompositesasbiodegradableantibioticcarriersinthetreatmentofboneinfections AT mmcnally ceramicbiocompositesasbiodegradableantibioticcarriersinthetreatmentofboneinfections |