Allograft Bone as Antibiotic Carrier

Journal of Bone and Joint Infection
Heinz Winkler, Peter Haiden

Abstract

The treatment of chronic bone and joint infections is characterized by obstinate persistency of the causing microorganisms and resulting long term disability to patients, associated with remarkable costs for the health care system. Difficulties derive from biofilm formed on dead bone and eventual implants, with resistance against immunological defences and antimicrobial substances. Biofilm embedded bacteria require up to 1000 times the antibiotic concentration of planktonic bacteria for elimination. Systemic antibiotic treatment alone cannot provide the concentrations required and surgical intervention is always prerequisite for potentially providing a cure. A second issue is that osseous defects are almost always present after surgical debridement, and it is difficult to address their reconstruction. One option is to use bone grafts, either from the patient´s own body or from foreign donors (allografts). Grafts are usually unvascularized and are prone to colonization with bacteria. Loading of allografts with antibiotics may not only protect grafts from bacterial adhesion but, using appropriate processing methods, may also provide high local antibiotic concentrations that may eliminate remaining sessile pathogens. For efficient...Continue Reading

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Citations

Nov 9, 2019·Journal of Bone and Joint Infection·Arne PeetersLieven Thorrez
May 23, 2017·Journal of Bone and Joint Infection·Antonia F Chen, Heinz Winkler
Aug 12, 2020·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Dimitrios SotiriouGösta Ullmark
Aug 12, 2018·Pharmaceutics·Riccardo FerraciniGiuseppe Perale
Aug 30, 2019·Journal of Orthopaedic Trauma·Willem-Jan MetsemakersUNKNOWN Fracture-Related Infection (FRI) consensus group
Dec 10, 2019·Orthopaedics & Traumatology, Surgery & Research : OTSR·Jean-Yves Jenny
Feb 8, 2021·Injury·Meir T MarmorTheodore Miclau
Feb 14, 2021·Materials Science & Engineering. C, Materials for Biological Applications·Xinggui TianJinshan Guo
Jul 23, 2021·Journal of Biomedical Materials Research. Part B, Applied Biomaterials·Markus RuppMaximilian Kerschbaum

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Methods Mentioned

BETA
amputation
PCR
lavage

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