Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA.
Department of Orthopedics, Providence Hospital, Southfield, Michigan, USA.
J Orthop Res. 2021 Nov;39(11):2446-2454. doi: 10.1002/jor.24979. Epub 2021 Jan 13.
A self-setting, injectable polymeric dicalcium phosphate dehydrate bone graft substitute that is mechanically strong and has excellent cohesion was developed. We assessed the performance of erythromycin-loaded polymeric dicalcium phosphate dehydrate cement. Its properties include drug release, growth inhibition against Staphylococcus aureus and biocompatibility with osteoblastic MC3T3 cells. The impact of erythromycin loading on cement injectability, setting time, and mechanical strength were also evaluated. A sustained, low burst release of erythromycin was observed. Eluents collected from erythromycin-loaded cement showed a considerable zone of inhibition for up to 28 days. Direct contact of erythromycin-loaded cement discs with agar plate showed a similarly sizable zone of inhibition for up to 22 days. Degraded ceramic residues had strong zones of inhibition as well. While the erythromycin-loaded cement was injectable, a notable delay of the setting time was observed (49.2 ± 6.8 min) as compared with control (drug-free cement, 12.2 ± 2.6 min). A slight increase in compressive strength (60.83 ± 6.28 MPa) was observed in erythromycin-loaded cement as compared with control (59.41 ± 6.48 MPa). Erythromycin-loaded cement was biocompatible although reduced cell growth was observed in the presence of the cement eluent. We propose that the bactericidal efficacy of erythromycin-loaded cement was caused by the combined effects of erythromycin released and exposed on the contact surface of degrading ceramics. Our data may elucidate the future application of polymeric dicalcium phosphate dehydrate bone graft substitute for the treatment of orthopedic infections and opportunities to use other antibiotics and applications considering its comparable handling and mechanical strength to poly (methyl methacrylate) cements.
一种自设定、可注射的磷酸二钙无水骨移植替代物，具有机械强度高和极好的内聚性。我们评估了载红霉素的聚磷酸二钙无水水泥的性能。其特性包括药物释放、对金黄色葡萄球菌的生长抑制作用以及与成骨细胞 MC3T3 细胞的生物相容性。还评估了红霉素负载对水泥可注射性、凝固时间和机械强度的影响。观察到红霉素的持续、低突释释放。从载红霉素水泥中收集的洗脱液在长达 28 天的时间内显示出相当大的抑菌区。红霉素载水泥片与琼脂平板直接接触在长达 22 天的时间内显示出类似大小的抑菌区。降解陶瓷残余物也具有很强的抑菌区。虽然载红霉素水泥具有可注射性，但与对照（无药物水泥，12.2±2.6min）相比，凝固时间明显延迟（49.2±6.8min）。与对照（59.41±6.48MPa）相比，载红霉素水泥的抗压强度略有增加（60.83±6.28MPa）。尽管在水泥洗脱液存在的情况下观察到细胞生长减少，但载红霉素水泥具有生物相容性。我们提出，载红霉素水泥的杀菌功效是由释放的红霉素和降解陶瓷接触表面暴露的红霉素的联合作用引起的。我们的数据可能阐明了用于治疗骨科感染的聚磷酸二钙无水骨移植替代物的未来应用以及考虑到其与聚甲基丙烯酸甲酯水泥相当的处理和机械强度，使用其他抗生素和应用的机会。
