Kawanabe K, Okada Y, Matsusue Y, Iida H, Nakamura T
Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, Japan.
J Bone Joint Surg Br. 1998 May;80(3):527-30. doi: 10.1302/0301-620x.80b3.8576.
We have developed a new drug delivery system using porous apatite-wollastonite glass ceramic (A-W GC) to treat osteomyelitis. A-W GC (porosity, 70% and 20% to 30%), or porous hydroxyapatite (HA) blocks (porosity 35% to 48%) used as controls, were soaked in mixtures of two antibiotics, isepamicin sulphate (ISP) and cefmetazole (CMZ) under high vacuum. We evaluated the release concentrations of the antibiotics from the blocks. The bactericidal concentration of ISP from A-W GC was maintained for more than 42 days, but that from HA decreased to below the detection limit after 28 days. The concentrations of CMZ from both materials were lower than those of ISP. An in vivo study using rabbit femora showed that an osseous concentration of ISP was maintained at eight weeks after implantation. Osteoconduction of the A-W GC block was good. Four patients with infected hip arthroplasties and one with osteomyelitis of the tibia have been treated with the new delivery system with excellent results.
我们开发了一种使用多孔磷灰石-硅灰石玻璃陶瓷（A-W GC）的新型药物递送系统来治疗骨髓炎。将用作对照的A-W GC（孔隙率为70%以及20%至30%）或多孔羟基磷灰石（HA）块（孔隙率为35%至48%）在高真空下浸泡于两种抗生素硫酸异帕米星（ISP）和头孢美唑（CMZ）的混合物中。我们评估了抗生素从这些块中的释放浓度。来自A-W GC的ISP杀菌浓度维持超过42天，但来自HA的在28天后降至检测限以下。两种材料中CMZ的浓度均低于ISP。一项使用兔股骨的体内研究表明，植入后八周时ISP的骨内浓度得以维持。A-W GC块的骨传导性良好。四名感染性髋关节置换患者和一名胫骨骨髓炎患者已接受这种新型递送系统治疗，效果极佳。
