Abstract
Biomaterial-associated infection (BAI) is a kind of serious post-operative complication in orthopaedic surgery. Antibiotic-loaded bone cement shines a light on BAI prevention for convenient manipulation and complex filling. To this aim, we designed an antibacterial bone cement based on Nano-hydroxyapatite/Polyurethane (PUHA) loading with antibiotic Enoxacin (EN). The distinct shear-thinning behavior of the prepolymers was observed, indicating a good injectability. The PUHA bone cement possessed a suitable curing speed, and the addition of EN might slightly expedite the curing process and enhance the mechanical properties. The EN release profile indicated that the EN-loaded bone cement could reach the minimum inhibitory concentration in 2 h, and sustainedly released EN for almost 8 days, exhibiting an antibacterial delivery potential. Antibacterial test further confirmed the antibacterial ability of EN-loaded bone cement is in a dose-dependent manner. However, the osteogenic performance of drug-loaded bone cement with high dosage is not as good as antibacterial activity. When the EN concentration of antibacterial cement was lower than 32 μg⋅mL−1, the proliferation and osteogenic differentiation of rat mesenchymal stem cells could be significantly promoted. Overall, this study verified the potential of the EN-loaded PUHA bone cement in anti-infection and osteogenesis for bone repairing.
Highlights
Biomaterial-associated infection (BAI) is extremely difficult to prevent and cure due to the fracture fixation meets with osteoporosis treatment [1, 2]
It was reported that the BAI rate was between 2.6 and 45% if tibial plateau fractures managed with Open Reduction and Internal Fixation (ORIF) in bone fracture fixation clinically [3, 4]
A new type of treatment strategy that antibiotic-loaded bone cement was covered on intramedullary nail achieved significant effect for deep infection after ORIF of ankle fractures [5]
Summary
BAI is extremely difficult to prevent and cure due to the fracture fixation meets with osteoporosis treatment [1, 2]. A new type of treatment strategy that antibiotic-loaded bone cement was covered on intramedullary nail achieved significant effect for deep infection after ORIF of ankle fractures [5]. The mainly bone cement were Polymethyl Methacrylate (PMMA) and Calcium Phosphate Cement (CPC) in clinic. Both these bone cements had their shortcomings during clinical use. PMMA has undergone an exothermic polymerization reaction that can cause terrible local thermal necrosis during the curing process [8].
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