Xie Zongping, Liu Xin, Jia Weitao, Zhang Changqing, Huang Wenhai, Wang Jianqiang
Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Jiaotong University, Shanghai, 200233, China.
J Control Release. 2009 Oct 15;139(2):118-26. doi: 10.1016/j.jconrel.2009.06.012. Epub 2009 Jun 21.
The effectiveness of a degradable and bioactive borate glass has been compared with the clinically used calcium sulfate in the treatment of osteomyelitis of rabbits, as a carrier for vancomycin. The bone infections were induced in the tibias of 65 rabbits by injecting methicillin-resistant Staphylococcus aureus (MRSA). After 3 weeks, these rabbits were distributed into 4 groups and treated by debridement. Pure borate glass (BG), vancomycin-loaded calcium sulfate (VCS) and vancomycin-loaded borate glass (VBG) were implanted into the infection sites of groups 2 to 4 respectively. After 8 weeks, the effectiveness of treatment was assessed radiographically, bacteriologically, and histopathologically. The results showed that the negative rates of MRSA examination for rabbits were 36.36%, 18.18%, 73.33% and 81.25% respectively for groups 1 to 4. Significant differences were observed radiographically, bacteriologically, and histopathologically between groups 1 and 4, groups 2 and 3, and between groups 2 and 4. The best result of treatment was observed in group 4. Radiographically, VBG was found to be mostly reabsorbed and replaced by lots of new bones, whereas, VCS was completely reabsorbed and replaced by modest new bones. Histopathologically, there were lots of newly formed bones around VBG without any foreign body response, and only modest new bones around VCS with obvious foreign body response. VBG proved to have excellent biocompatibility and to be very effective in eradicating osteomyelitis and simultaneously stimulating bone regeneration, avoiding the disadvantages of VCS.
一种可降解且具有生物活性的硼酸盐玻璃作为万古霉素的载体，已在兔骨髓炎治疗中与临床使用的硫酸钙进行了效果比较。通过注射耐甲氧西林金黄色葡萄球菌（MRSA）在65只兔的胫骨中诱发骨感染。3周后，将这些兔分为4组并进行清创治疗。分别将纯硼酸盐玻璃（BG）、载万古霉素硫酸钙（VCS）和载万古霉素硼酸盐玻璃（VBG）植入第2至4组的感染部位。8周后，通过影像学、细菌学和组织病理学评估治疗效果。结果显示，第1至4组兔MRSA检查阴性率分别为36.36%、18.18%、73.33%和81.25%。第1组和第4组、第2组和第3组以及第2组和第4组之间在影像学、细菌学和组织病理学方面观察到显著差异。第4组治疗效果最佳。影像学上，发现VBG大部分被重新吸收并被大量新骨替代，而VCS完全被重新吸收并被适量新骨替代。组织病理学上，VBG周围有大量新形成的骨组织且无任何异物反应，而VCS周围只有适量新骨且有明显异物反应。VBG被证明具有优异的生物相容性，在根除骨髓炎并同时刺激骨再生方面非常有效，避免了VCS的缺点。
