Prophylaxis of infection and effects on osseointegration using a tobramycin-periapatite coating on titanium implants-An experimental study in the rabbit

• Published in: Journal of orthopaedic research 2009-06, Vol.27 (6), p.710-716
• Main Authors: Moojen, Dirk Jan F., Vogely, H. Charles, Fleer, André, Nikkels, Peter G.J., Higham, Paul A., Verbout, Abraham J., Castelein, René M., Dhert, Wouter J.A.
• Format: Article
• Language: English
• Subjects: Animals; Anti-Bacterial Agents - pharmacology; Apatites; Bone Nails - microbiology; Coated Materials, Biocompatible; Female; osseointegration; Osseointegration - drug effects; prophylaxis of infection; Prosthesis-Related Infections - pathology; Prosthesis-Related Infections - prevention & control; Rabbits; Staphylococcal Infections - pathology; Staphylococcal Infections - prevention & control; Staphylococcus aureus - drug effects; Titanium; titanium implants; Tobramycin - pharmacology; tobramycin-periapatite coating
• ISSN: 0736-0266; 1554-527X
• DOI: 10.1002/jor.20808

No options are available for local antibiotic delivery from uncemented implants. By loading a porous titanium implant with a biomimetic HA‐coating (PeriApatite, PA) with antibiotics, we could obtain adequate local antibiotic concentrations and reduce infection susceptibility. This study investigated the efficacy of a tobramycin‐loaded PA‐coated titanium foam implant in preventing infection, as well as the effects on osseointegration. In 72 New Zealand White rabbits, an uncoated (Ti), PA‐coated (PA), or Tobramycin‐PA‐coated (PA‐tobra) titanium foam rod was implanted intramedullary in the left tibiae after contamination of the implant bed with none (control), 103, 104 or 105 CFU Staphylococcus aureus. PA‐tobra implants were loaded with 2.4 mg tobramycin. After 28 days analysis was done by bacteriology, histopathology and histomorphometry. Six percent of the contaminated PA‐tobra rabbits were infected, whereas this was 53 and 67% for PA and Ti, respectively (p