An Additive to PMMA Bone Cement Enables Postimplantation Drug Refilling, Broadens Range of Compatible Antibiotics, and Prolongs Antimicrobial Therapy

Advanced Healthcare Materials
Erika L CyphertHorst A von Recum

Abstract

Poly(methyl methacrylate) (PMMA) bone cement is used in several biomedical applications including as antibiotic-filled beads, temporary skeletal spacers, and cement for orthopedic implant fixation. To mitigate infection following surgery, antibiotics are often mixed into bone cement to achieve local delivery. However, since implanted cement is often structural, incorporated antibiotics must not compromise mechanical properties; this limits the selection of compatible antibiotics. Furthermore, antibiotics cannot be added to resolve future infections once cement is implanted. Finally, delivery from cement is suboptimal as incorporated antibiotics exhibit early burst release with most of  the drug remaining permanently trapped. This prolonged subtherapeutic dosage drives pathogen antibiotic resistance. To overcome these limitations of antibiotic-laden bone cement, insoluble cyclodextrin (CD) microparticles are incorporated into PMMA to provide more sustained delivery of a broader range of drugs, without impacting mechanics. PMMA formulations with and without CD microparticles are synthesized and filled with one of three antibiotics and evaluated using zone of inhibition, drug release, and compression studies. Additionally, the abi...Continue Reading

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Citations

Feb 17, 2019·Journal of Biomedical Materials Research. Part a·Rebecca M HaleyHorst A von Recum
Apr 23, 2019·Artificial Cells, Nanomedicine, and Biotechnology·Firdos Alam KhanAbdelhamid Elaissari
Mar 23, 2019·Experimental Biology and Medicine·Rebecca M HaleyHorst A von Recum
Dec 20, 2018·Macromolecular Bioscience·Dajan JuricHorst A von Recum
Apr 28, 2019·International Journal of Molecular Sciences·Jiaying LiBin Li
Mar 21, 2020·Pharmaceutics·Nathan A RohnerHorst A von Recum
May 23, 2020·International Journal of Molecular Sciences·Rebecca M HaleyEvon S Ereifej
Feb 6, 2021·Journal of Orthopaedic Surgery and Research·Hui SunXiangbei Qi
Apr 23, 2021·Macromolecular Bioscience·Chao-Yi LuHorst A von Recum
Jan 19, 2021·ACS Biomaterials Science & Engineering·Stephanie L McNamaraDavid J Mooney

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