Optimizing vancomycin release from novel carbon fiber-reinforced polymer implants with small holes: periprosthetic joint infection treatment

• Published in: Journal of artificial organs 2024-09, Vol.27 (3), p.269-276
• Main Authors: Kamihata, Satoshi, Ando, Wataru, Nakahara, Ichiro, Enami, Hideaki, Takashima, Kazuma, Uemura, Keisuke, Hamada, Hidetoshi, Sugano, Nobuhiko
• Format: Article
• Language: English
• Subjects: Animals; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - pharmacokinetics; Biomedical Engineering and Bioengineering; Biomedical materials; Carbon; Carbon Fiber; Carbon fiber reinforced plastics; Carbon fiber reinforcement; Cardiac Surgery; Diffusion; Distilled water; Dynamics; Fiber reinforced polymers; Hole size; In vitro methods and tests; In vivo methods and tests; Joint diseases; Medicine; Medicine & Public Health; Mixing ratio; Nephrology; Original Article; Orthopaedic implants; Parameters; Polymers; Prostheses; Prosthesis-Related Infections - drug therapy; Rabbits; Surgical implants; Total hip arthroplasty; Transplants & implants; Vancomycin; Vancomycin - administration & dosage; Vancomycin - pharmacokinetics
• ISSN: 1434-7229; 1619-0904; 1619-0904
• DOI: 10.1007/s10047-023-01407-x

Periprosthetic joint infection (PJI) is a catastrophic complication after total hip arthroplasty. A new drug-loaded carbon fiber-reinforced polymer (CFRP) prosthesis with a sustained drug-release mechanism is being developed for one-stage surgery. We aimed to examine the diffusion dynamics of vancomycin from vancomycin paste-loaded CFRP implants. The differences in the in vitro diffusion dynamics of vancomycin paste were investigated using the elution test by varying parameters. These included the mixing ratio of vancomycin and distilled water (1:0.8, 1:1.2, and 1:1.4) for vancomycin paste, and hole diameter (1 mm and 2 mm) on the container. The in vivo diffusion dynamics were investigated using a rabbit model with vancomycin-loaded CFRP implants placed subcutaneously. The in vitro experiments showed that the diffusion effect of vancomycin was highest in the parameters of vancomycin paste with distilled water mixed in a ratio of 1:1.4, and with a 2 mm hole diameter. The in vivo experiments revealed diffusion dynamics similar to those observed in the in vitro study. The drug diffusion effect tended to be high for vancomycin paste with a large water ratio, and a large diameter of holes. These results indicate that the drug diffusion dynamics from a CFRP implant with holes can be adjusted by varying the water ratio of the vancomycin paste, and the hole size on the CFRP implant.