Abstract
Chitosan hydrogels stand out for being an adhesive matrix, which presents biocompatibility, antibacterial and osteogenic properties, biodegradability, non-toxicity, capable of retaining, releasing, and distributing therapeutic agents (drugs) at the application site. Therefore, new strategies in the field of orthopedics have focused, above all, on limiting the initial preoperative and postoperative microbial adhesion to implant surfaces, modifying these surfaces, protecting them from eventual adhesions or releasing the antimicrobial agent. The production of chitosan-based hydrogels has been achieved through physical and chemical cross-linking routes. In this context, this research aimed to develop an antibacterial hydrogel based on chitosan and vancomycin for application in total knee arthroplasty and to prevent bacterial infections. For that, three crosslinking procedures of chitosan with genipin were investigated to obtain the hydrogels and drug delivery. For this purpose, initially, the raw materials chitosan, genipin and vancomycin were characterized by infrared spectroscopy (FTIR), scanning electron microscopy (SEM), X-ray diffraction (XRD), pHmetry (pH) and microbiological tests. From the chemical crosslinking procedures evaluated, the drug release was investigated, and the hydrogels were characterized by FTIR, pH, viscosity, microbiology, and cytotoxicity. A new H5Q1GV hydrogel was obtained with good antibacterial activity, potentiated by the acidity of its pH 5.7, which showed good drug release in the first 4 hours after implantation, homogeneous, with ideal viscosity and adhesion for application through syringes in prosthesis surgery. knee and with excellent biocompatibility.
Highlights
Osteoarthritis (OA) is the most common progressive musculoskeletal condition that can affect joints, and especially the hips and knees as the predominant weight-bearing joints (Hunter & Bierma-Zeinstra, 2019)
This work aimed to develop a chitosan hydrogel chemically cross-linked with genipin and carrying the drug vancomycin and further characterized by structural, rheological, microbiological, biocompatibility and drug release analysis were performed to assess the real antibacterial benefit and of antibiotic release to be used in knee arthroplasty surgeries and to avoid bacterial infections
According to the researchers: Saita et al (2012), Huang et al (2017), Bakshi et al (2018) and (Fan et al, 2018), the crystallinity observed in chitosan is explained by the fact that its molecular structure presents certain regularity and the presence of -NH2 and OH groups that provide strong intermolecular and intramolecular hydrogen bonds, which ends up causing more stability and ordering in the structure polymer chain, and as a result the presence of crystalline regions in the molecular structure of chitosan
Summary
Osteoarthritis (OA) is the most common progressive musculoskeletal condition that can affect joints, and especially the hips and knees as the predominant weight-bearing joints (Hunter & Bierma-Zeinstra, 2019). Due to the higher prevalence of asymptomatic OA, it affects 250 million people worldwide. Recent Medicare data reported an increase in total knee arthroplasty volume from 9,650 in 1991 to 19,871 in 2010, while overall in the US it is projected that up to 270,000 total knee arthroplasty procedures will be performed in 45 years. Survival of primary total knee arthroplasties is well reported, with long-term survival greater than 95%. While failure rates and mechanisms for TKA revision are less well reported, over the long term, ranging from 71% to 96%. Given the increasing TKA revision rate, the economic burden associated with revision procedures is important to understand the reasons and risk factors for failure to focus efforts on improving revision durability (Geary et al, 2020)
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