Main Article Content
dose of antibiotic administered systemically is high, therapeutically effective drug concentrations are not always achieved at the site of infection. This problem can be overcome by the use of local antibiotics from a biodegradable implant for chronic osteomyelitis that can deliver the drug at least for 6 weeks.The implant delivers high antibiotic concentration at tissue levels, obliterates dead space, aids bone repair and does not need to be removed. The aim of this study was to develop and evaluate a calcium sulfate and polycaprolactone (PCL)-based composite biodegradable implantable delivery system of cefuroxime for
the localized treatment of osteomyelitis that can deliver the drug for at least 6 weeks.The PCL and calcium sulfate composite system has not been studied yet. Interaction studies were carried out to check any incompatibility between the ingredients. Implants were prepared by a modified fabrication technique to avoid solvent use. The prepared implants were evaluated for various in vitro parameters like dimensions, hardness, tensile strength, drug release profile, sterility test and morphological changes in pellet before and after drug release. The pellets were also tested for microbiological efficacy and compared with a plain drug solution in different concentrations. Developed pellets are regular in shape and size with good tensile strength. The release profile displayed drug levels above the minimum inhibitory concentration continuously for up to 2 months.
A wide zone of inhibition by the pellet against Staphylococcus aureus as compared with the drug solution proves its efficacy in the treatment of osteomyelitis. Results show that the developed calcium sulfate and PCL-based composite biodegradable implantable delivery system of cefuroxime is a good alternate system and can deliver the drug for more than 6 weeks,
maintaining an adequate inhibitory concentration at the site.
This is an Open Access article distributed under the terms of the Attribution-Noncommercial 4.0 International License [CC BY-NC 4.0], which requires that reusers give credit to the creator. It allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, for noncommercial purposes only.
Tortoara GJ, Derrickson B. Ch 6. The Skeletal System: Bone Tissue.
In Principles of Anatomy and Physiology. 11th ed. Wiley International;
Gitelis S, Brebach GT. The treatment of chronic osteomyelitis with
a biodegradable antibiotic impregnated implant. J Orthop Surg (Hong
Hanssen AD. Local antibiotic delivery vehicle in the treatment
of musculoskeletal infection. Session IV. Clin Orthop Relat Res
Gao C, Gao J, You X, Huo S, Li X, Zhang Y, et al. Fabrication of calcium
sulfate/PLLA composite for bone Repair. J Biomed Mater Res A
Walsh D, Furuzono T, Tanaka J. Preparation of porous composite
implant materials by in situ polymerization of porous apatite containing
Îµ-caprolactone or methyl methacrylate. Biomaterial 2001;21:1205-12.
Sato S, Koshino T, Saito T. Osteogenic response of rabbit tibia
to hydroxyapatite particle: Plaster of Paris mixture. Biomaterial
Georgiade NG, Hanker J, Levin S, Ruff G. The use of particular
hydroxyapatite and Plaster of Paris in aesthetic and reconstructive
surgery. Aesthetic Plast Surg 1993;17:5-92.
Khairoun I, Boltong MG, Driessens FC, Planell JA. Effect of calcium
carbonate on the compliance of apatitic calcium phosphate bone
cement. Biomaterial 1997;18:1535-9.
Higashi S, Yamamuro T, Nakamura T, Ikada Y, Hyon SH, Jamshidi K.
Polymer-hydroxyapatite composites for biodegradable bone fillers.
Chen G, Ushida T, Tateishi T. Poly (DL-lactic-co-glycolic acid) sponge
hybridized with collagen microspongea and deposited apatite
particulates. J Biomed Mater Res 2001;57:8-14.
Bakos D, SoldÃ¡n M, HernÃ¡ndez-Fuentes I. Hydroxyapatite- ollagen- yaluronic ch acid composite. Biomaterial 1999;20:191-5.
Tamura H, Tokma S. Carboxymethyl-chitin and hydroxyapatite
composite for bone repairing. Polymer Preprints 2000;41:1032â€“3.
Coetzee AS. Regeneration of bone in the presence of calcium sulfate.
Arch Otolaryngol 1980;106:405-9.
Laurencin CT, Ambrosio AM, Borden MD, Cooper JA Jr. Tissue
engineering: Orthopaedic applications. Annu Rev Biomed Eng
Orsini G, Ricci J, Scarano A, Pecora G, Petrone G, Piattelli A. Bone- defect healing with calcium-sulfate particles and cement: An experimental
study in rabbit. J Biomed Mater Res B Appl Biomater 2004;68:199-208.
Ziran BH, Smith WR, Morgan SJ. Use of calcium-based demineralized
bone matrix/allograft for nonunions and posttraumatic reconstruction
of the appendicular skeleton: Preliminary results and complications.
J Trauma 2007;63:1324-8.
Harris RJ. Clinical evaluation of a composite bone graft with a calcium
sulfate barrier. J Periodontol 2004;75:685-92.
La Gatta A, De Rosa A, Laurienzo P, Malinconico M, De Rosa M,
Schiraldi C. A Novel Injectable Poly(epsilon-caprolactone)/Calcium
Sulfate System for Bone Regeneration: Synthesis and Characterization.
Macromol Biosci 2005;5:1108-17.
Gao C, Huo S, Li X, You X, Zhang Y, Gao J. Characteristics of calcium
sulfate/gelatin composite biomaterials for bone repair. J Biomater Sci
Polym Ed 2007;18:799-824.
A. grawal CM, Ray RB. Biodegradable polymeric scaffolds for
musculoskeletal tissue engineering. J Biomed Mater Res 2001;55:141- 0.
Mano JF, Sousa RA, Boesel LF, Neves NM, Reis RL. Bioinert, biodegradable
and injectable polymeric matrix composites for hard tissue replacement:
State of the art and recent developments. Composites Science and
Technology 2004; 64: 789-817.
Overbeck JP, Winckler ST, Meffert R, TÃ¶rmÃ¤lÃ¤ P, Spiegel HU, Brug E.
Penetration of ciprofloxacin into bone: A new bioabsorbable implant.
J Invest 1995;8:155-62.
Ramchandani M, Robinson D. In vitro in vivo release of ciprofloxacin
from PLGA 50:50 implants. J Control Rel 1998;54:167-75.
DÃ©sÃ©vaux C, Lenaerts V, Girard C, Dubreuil P. Characterization of
crosslinked high amylase starch matrix implants: In vivo release of
ciprofloxacin. J Control Rel 2002;82:95-103.
DÃ©sÃ©vaux C, Dubreuil P, Lenaerts V. Characterization of crosslinked
high amylase starch matrix implants: In vitro release of ciprofloxacin.
J Control Rel 2002;82:83â€“93.
El-Kamel AH, Baddour MM. Gatifloxacin Biodegradable Implant for
Treatment of Experimental Osteomyelitis: In vitro and in vivo Evaluation.
Drug Deliv 2007;14:349-56.
Shinto Y, Uchida A, Korkusuz F, Araki N, Ono K. Calcium hydroxyapatite
ceramic used as a delivery system for antibiotics. J Bone Joint Surg Br
BÃ¡lint L, Kocsis B, SzÃ¡ntÃ³ Z, SzabÃ³ G. In vitro measurement of the time
related efficacy of gentamicin sulfate release from bone cements.