Suhardi V J, Bichara D A, Kwok Sjj, Freiberg A A, Rubash H, Malchau H, Yun S H, Muratoglu O K, Oral E
Harris Orthopaedic Laboratory, Massachusetts General Hospital, Boston, MA.
Department of Orthopaedic Surgery, Harvard Medical School.
Nat Biomed Eng. 2017;1. doi: 10.1038/s41551-017-0080. Epub 2017 Jun 13.
Despite advances in orthopedic materials, the development of drug-eluting bone and joint implants that can sustain the delivery of the drug and maintain the necessary mechanical strength in order to withstand loading has remained elusive. Here, we demonstrate that modifying the eccentricity of drug clusters and the percolation threshold in ultrahigh molecular weight polyethylene (UHMWPE) results in maximized drug elution and in the retention of mechanical strength. The optimized UHMWPE eluted antibiotic at a higher concentration for longer than the clinical gold standard antibiotic-eluting bone cement while retaining the mechanical and wear properties of clinically used UHMWPE joint prostheses. Treatment of lapine knees infected with with the antibiotic-eluting UHMWPE led to complete bacterial eradication and to the absence of detectable systemic effects. We argue that the antibiotic-eluting UHMWPE joint implant is a promising candidate for clinical trials.
尽管骨科材料取得了进展,但能够持续释放药物并保持必要机械强度以承受负荷的药物洗脱骨和关节植入物的开发仍然难以实现。在此,我们证明,改变药物簇的偏心率和超高分子量聚乙烯(UHMWPE)中的渗流阈值可实现药物洗脱最大化并保持机械强度。优化后的UHMWPE比临床金标准抗生素洗脱骨水泥更长时间地以更高浓度洗脱抗生素,同时保留了临床使用的UHMWPE关节假体的机械和磨损性能。用抗生素洗脱的UHMWPE治疗感染的兔膝关节导致细菌完全根除且未检测到全身效应。我们认为,抗生素洗脱UHMWPE关节植入物是临床试验的一个有前景的候选者。