scholarly journals PMMA bone cement containing long releasing silica-based chlorhexidine nanocarriers

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257947
Author(s):  
Yazan Al Thaher ◽  
Hadil Faris Alotaibi ◽  
Lirong Yang ◽  
Polina Prokopovich
Keyword(s):  
Bone Cement ◽  
Mechanical Performance ◽  
Bacterial Species ◽  
Treatment Options ◽  
Commercial Formulation ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Joint Infections ◽  
Pmma Bone Cement ◽  
Prosthetic Joint Infections

Prosthetic joint infections (PJI) are still an extremely concerning eventuality after joint replacement surgery; growing antibiotic resistance is also limiting the prophylactic and treatment options. Chlorhexidine (a widely used topical non-antibiotic antimicrobial compound) coatings on silica nanoparticles capable of prolonged drug release have been successfully developed and characterised. Such nanocarriers were incorporated into commercial formulation PMMA bone cement (Cemex), without adversely affecting the mechanical performance. Moreover, the bone cement containing the developed nanocarriers showed superior antimicrobial activity against different bacterial species encountered in PJI, including clinical isolates already resistant to gentamicin. Cytocompatibility tests also showed non inferior performance of the bone cements containing chlorhexidine releasing silica nanocarriers to the equivalent commercial formulation.

Prosthetic Joint Infections

2016 ◽  
Author(s):  
David Mabey ◽  
Hasan E. Baydoun ◽  
Jamil D. Bayram
Keyword(s):  
Antimicrobial Prophylaxis ◽  
Joint Infection ◽  
Treatment Options ◽  
Joint Fluid ◽  
Care Providers ◽  
Joint Replacement Surgery ◽  
Fluid Analysis ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

Prosthetic joint infection (PJI), a complication of joint replacement surgery, presents with fever, joint pain, erythema, effusion, and joint loosening. Many advances have decreased the risk of infection, such as the use of perioperative antimicrobial prophylaxis and intraoperative laminar airflow. Joint fluid analysis should be pursued by the orthopedic surgeons; primary and acute care providers should consult the definitive care team and refer these patients for admission. Organisms causing prosthetic joint infections often grow in biofilms, which make them difficult to treat. Surgical treatment options include one or two-stage prosthesis exchange, debridement with retention of the prosthesis, resection arthroplasty, arthrodesis, or amputation. Antibiotic therapy should be guided by intraoperative cultures and selected in consultation with the infectious disease service.

scholarly journals The use of polymerase chain reaction in the diagnosis and management of prosthetic joint infections: a debatable issues at this time

2019 ◽  
Vol 5 (2) ◽  
pp. 362
Author(s):  
Temi Ogunleye ◽  
Marlina Ponce de Leon ◽  
Suresh J. Antony
Keyword(s):  
Polymerase Chain Reaction ◽  
High Sensitivity ◽  
Chain Reaction ◽  
Diagnosis And Management ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Polymerase Chain

<p class="abstract">Joint replacement surgery is increasing due to its success in decreasing pain and restoring function. Prosthetic joint infections (PJI) is one of the most detrimental complications of the surgery. These infections can either be acute or chronic and can be caused by a variety of organisms. Effective and efficient identification of the cause of infection is vital so that proper treatment can be provided. The use of polymerase chain reaction (PCR) is a possibility for diagnosis and management of PJI with a reduction in the use of incorrect antibiotics. This is due to its ability to quickly diagnosis viral, bacterial, rickettsia, mycobacterial, and protozoal infection in hours. It also has high sensitivity and specificity even with antimicrobial usage and biofilm production. However, more studies need to be done in order to be able to classify it as a possible gold standard.</p>

scholarly journals Predictors of Treatment Failure for Hip and Knee Prosthetic Joint Infections in the Setting of 1- and 2-Stage Exchange Arthroplasty: A Multicenter Retrospective Cohort

2019 ◽  
Vol 6 (11) ◽  
Author(s):  
Christopher E Kandel ◽  
Richard Jenkinson ◽  
Nick Daneman ◽  
David Backstein ◽  
Bettina E Hansen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Treatment Failure ◽  
Retrospective Cohort ◽  
Proportional Hazards Model ◽  
Bacterial Species ◽  
Cox Proportional Hazards Model ◽  
Joint Infections ◽  
Prosthesis Retention ◽  
Prosthetic Joint Infections ◽  
Prosthesis Removal

AbstractBackgroundProsthetic hip and knee joint infections (PJIs) are challenging to eradicate despite prosthesis removal and antibiotic therapy. There is a need to understand risk factors for PJI treatment failure in the setting of prosthesis removal.MethodsA retrospective cohort of individuals who underwent prosthesis removal for a PJI at 5 hospitals in Toronto, Canada, from 2010 to 2014 was created. Treatment failure was defined as recurrent PJI, amputation, death, or chronic antibiotic suppression. Potential risk factors for treatment failure were abstracted by chart review and assessed using a Cox proportional hazards model.ResultsA total of 533 individuals with prosthesis removal were followed for a median (interquartile range) of 814 (235–1530) days. A 1-stage exchange was performed in 19% (103/533), whereas a 2-stage procedure was completed in 88% (377/430). Treatment failure occurred in 24.8% (132/533) at 2 years; 53% (56/105) of recurrent PJIs were caused by a different bacterial species. At 4 years, treatment failure occurred in 36% of 1-stage and 32% of 2-stage procedures (P = .06). Characteristics associated with treatment failure included liver disease (adjusted hazard ratio [aHR], 3.12; 95% confidence interval [CI], 2.09–4.66), the presence of a sinus tract (aHR, 1.53; 95% CI, 1.12–2.10), preceding debridement with prosthesis retention (aHR, 1.68; 95% CI, 1.13–2.51), a 1-stage procedure (aHR, 1.72; 95% CI, 1.28–2.32), and infection due to Gram-negative bacilli (aHR, 1.35; 95% CI, 1.04–1.76).ConclusionsFailure of PJI therapy is common, and risk factors are not easily modified. Improvements in treatment paradigms are needed, along with efforts to reduce orthopedic surgical site infections.

Development of operator independent bone cement vacuum mixing system for joint replacement surgery

2006 ◽  
Vol 35 (8) ◽  
pp. 317-323 ◽  
Author(s):  
N. Dunne ◽  
Y. Xu ◽  
C. Daly ◽  
J. Makem ◽  
G. Walker ◽  
...  
Keyword(s):  
Bone Cement ◽  
Joint Replacement ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Vacuum Mixing

Addressing prosthetic joint infections via gentamicin-eluting UHMWPE spacer

2020 ◽  
Vol 102-B (6_Supple_A) ◽  
pp. 151-157
Author(s):  
Dmitry Gil ◽  
Ali E. Atici ◽  
Rachel L. Connolly ◽  
Shannon Hugard ◽  
Sergey Shuvaev ◽  
...  
Keyword(s):  
Bone Cement ◽  
The Novel ◽  
Wear Properties ◽  
Compression Moulding ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Drug Elution ◽  
Prosthetic Joint Infections ◽  
Tibial Insert

Aims We propose a state-of-the-art temporary spacer, consisting of a cobalt-chrome (CoCr) femoral component and a gentamicin-eluting ultra-high molecular weight polyethylene (UHMWPE) tibial insert, which can provide therapeutic delivery of gentamicin, while retaining excellent mechanical properties. The proposed implant is designed to replace conventional spacers made from bone cement. Methods Gentamicin-loaded UHMWPE was prepared using phase-separated compression moulding, and its drug elution kinetics, antibacterial, mechanical, and wear properties were compared with those of conventional gentamicin-loaded bone cement. Results Gentamicin-loaded UHMWPE tibial components not only eradicated planktonic Staphylococcus aureus, but also prevented colonization of both femoral and tibial components. The proposed spacer possesses far superior mechanical and wear properties when compared with conventional bone cement spacers. Conclusion The proposed gentamicin-eluting UHMWPE spacer can provide antibacterial efficacy comparable with currently used bone cement spacers, while overcoming their drawbacks. The novel spacer proposed here has the potential to drastically reduce complications associated with currently used bone cement spacers and substantially improve patients’ quality of life during the treatment. Cite this article: Bone Joint J 2020;102-B(6 Supple A):151–157.

scholarly journals Acute Septic Arthritis

2002 ◽  
Vol 15 (4) ◽  
pp. 527-544 ◽  
Author(s):  
Mark E. Shirtliff ◽  
Jon T. Mader
Keyword(s):  
Septic Arthritis ◽  
Antimicrobial Therapy ◽  
Bacterial Species ◽  
Good Prognosis ◽  
Medical Emergency ◽  
Laboratory Findings ◽  
Mortality And Morbidity ◽  
Joint Infections ◽  
Prosthetic Joint Infections ◽  
Focus Of Infection

SUMMARY Acute septic arthritis may develop as a result of hematogenous seeding, direct introduction, or extension from a contiguous focus of infection. The pathogenesis of acute septic arthritis is multifactorial and depends on the interaction of the host immune response and the adherence factors, toxins, and immunoavoidance strategies of the invading pathogen. Neisseria gonorrhoeae and Staphylococcus aureus are used in discussing the host-pathogen interaction in the pathogenesis of acute septic arthritis. While diagnosis rests on isolation of the bacterial species from synovial fluid samples, patient history, clinical presentation, laboratory findings, and imaging studies are also important. Acute nongonococcal septic arthritis is a medical emergency that can lead to significant morbidity and mortality. Therefore, prompt recognition, rapid and aggressive antimicrobial therapy, and surgical treatment are critical to ensuring a good prognosis. Even with prompt diagnosis and treatment, high mortality and morbidity rates still occur. In contrast, gonococcal arthritis is often successfully treated with antimicrobial therapy alone and demonstrates a very low rate of complications and an excellent prognosis for full return of normal joint function. In the case of prosthetic joint infections, the hardware must be eventually removed by a two-stage revision in order to cure the infection.

scholarly journals Advanced G-MPS-PMMA Bone Cements: Influence of Graphene Silanisation on Fatigue Performance, Thermal Properties and Biocompatibility

Nanomaterials ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 139
Author(s):  
Eva Paz ◽  
Yolanda Ballesteros ◽  
Juana Abenojar ◽  
Nicholas Dunne ◽  
Juan C. del Real
Keyword(s):  
Thermal Properties ◽  
Bone Cement ◽  
Bending Strength ◽  
Mechanical Performance ◽  
Fatigue Loading ◽  
Negative Influence ◽  
Fatigue Performance ◽  
Bone Cements ◽  
Bending Modulus ◽  
Pmma Bone Cement

The incorporation of well-dispersed graphene (G) powder to polymethyl methacrylate (PMMA) bone cement has been demonstrated as a promising solution to improving its mechanical performance. However, two crucial aspects limit the effectiveness of G as a reinforcing agent: (1) the poor dispersion and (2) the lack of strong interfacial bonds between G and the matrix of the bone cement. This work reports a successful functionalisation route to promote the homogenous dispersion of G via silanisation using 3-methacryloxypropyltrimethoxy silane (MPS). Furthermore, the effects of the silanisation on the mechanical, thermal and biocompatibility properties of bone cements are presented. In comparison with unsilanised G, the incorporation of silanised G (G_MPS1 and G_MPS2) increased the bending strength by 17%, bending modulus by 15% and deflection at failure by 17%. The most impressive results were obtained for the mechanical properties under fatigue loading, where the incorporation of G_MPS doubled the Fatigue Performance Index (I) value of unsilanised G-bone cement—meaning a 900% increase over the I value of the cement without G. Additionally, to ensure that the silanisation did not have a negative influence on other fundamental properties of bone cement, it was demonstrated that the thermal properties and biocompatibility were not negatively impacted—allowing its potential clinical progression.

scholarly journals Preparation and Characterization of Polymer Blend and Nano Composite Materials Based on PMMA Used for Bone Tissue Regeneration

2020 ◽  
Vol 38 (4A) ◽  
pp. 501-509
Author(s):  
Sally A. Alsaedi ◽  
Sihama I. Salih ◽  
Fadhil A. Hashim
Keyword(s):  
Tensile Strength ◽  
Bone Cement ◽  
Polymer Blend ◽  
Young Modulus ◽  
The Elderly ◽  
Bone Tissue Regeneration ◽  
Sem Images ◽  
Replacement Surgery ◽  
Pmma Bone Cement ◽  
Polymeric Blend

As the elderly population increases, the need for bone loss treatments is increasing.  Vital substances used in such treatments are required to continue for a longer period and work more effectively. The particularly important biological material is poly methyl methacrylate (PMMA) bone cement, which is widely used in damaged bone replacement surgery. So, this study focused on the role of added some nanoparticles consist of zirconia (ZrO2), and magnesia (MgO) on the binary polymeric blend (Acrylic bone cement: 15% PMMA) for a bone scaffold. Where, ZrO2 and MgO nanoparticle was added with selected weight percentages (0, 0.5, 1, 1.5 and 2 wt.%), which were added to the polymer blend matrix. Some mechanical properties were studied including the tensile strength and young modulus for all the prepared samples. The chemical bonding of nanoparticles and synthetic binary polymeric blend composites was evaluated by Fourier Transform Infrared (FTIR) spectroscopy. Tensile strength and young modulus of binary polymeric blend reinforced with 1.5 wt.% ZrO2, and 1 wt.% MgO, significantly increased. The surface morphology of the fracture surface of tensile specimens was examined by Scanning electron microscope (SEM). The SEM images confirmed that the homogenous distribution of nanoparticles (ZrO2, and MgO) within the polymeric blend matrix.

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