Department of Materials Science and Engineering, Missouri University of Science and Technology, Rolla, MO 65409, USA.
Department of Orthopaedic Surgery, University of Missouri, Columbia, MO 65211, USA.
Mater Sci Eng C Mater Biol Appl. 2014 Aug 1;41:224-31. doi: 10.1016/j.msec.2014.04.055. Epub 2014 May 2.
Bacterial contamination of implanted orthopedic prostheses is a serious complication that requires prolonged systemic antibiotic therapy, major surgery to remove infected implants, bone reconstruction, and considerable morbidity. Local delivery of high doses of antibiotics using poly(methyl methacrylate) (PMMA) cement as the carrier, along with systemic antibiotics, is the standard treatment. However, PMMA is not biodegradable, and it can present a surface on which secondary bacterial infection can occur. PMMA spacers used to treat deep implant infections must be removed after resolution of the infection. Alternative carrier materials for antibiotics that could also restore deficient bone are therefore of interest. In this article, the development of bioactive glass-based materials as a delivery system for antibiotics is reviewed. Bioactive glass is osteoconductive, converts to hydroxyapatite, and heals to hard and soft tissues in vivo. Consequently, bioactive glass-based carriers can provide the combined functions of controlled local antibiotic delivery and bone restoration. Recently-developed borate bioactive glasses are of particular interest since they have controllable degradation rates coupled with desirable properties related to osteogenesis and angiogenesis. Such glasses have the potential for providing a new class of biomaterials, as substitutes for PMMA, in the treatment of deep bone infections.
植入式骨科假体的细菌污染是一种严重的并发症，需要长期全身抗生素治疗、去除感染植入物的大手术、骨重建和相当大的发病率。使用聚甲基丙烯酸甲酯 (PMMA) 水泥作为载体局部输送高剂量抗生素，并结合全身抗生素治疗，是标准治疗方法。然而，PMMA 不可生物降解，它可以提供一个表面，二次细菌感染可能会发生在这个表面上。用于治疗深部植入物感染的 PMMA 间隔物在感染得到解决后必须取出。因此，人们对可替代抗生素载体材料的兴趣，这些材料也可以修复缺损的骨骼。本文综述了将生物活性玻璃基材料开发为抗生素输送系统的研究进展。生物活性玻璃具有骨诱导性，可转化为羟基磷灰石，并在体内与硬组织和软组织愈合。因此，基于生物活性玻璃的载体可以提供控制局部抗生素释放和骨修复的综合功能。最近开发的硼酸盐生物活性玻璃尤其引人注目，因为它们具有可控制的降解率，同时具有与成骨和血管生成相关的理想特性。此类玻璃有可能作为 PMMA 的替代品，为深部骨感染的治疗提供一类新型生物材料。
