Efficacy of an antibiotic loaded ceramic-based bone graft substitute for the treatment of infected non-unions

The treatment of non-unions is often complicated by segmental bone defects and bacterial colonization. Because of the limited availability of autologous bone grafts, tissue engineering focuses on antibiotic-loaded bone graft substitutes. HACaS+G is a resorbable calcium sulphate-hydroxyapatite loaded...

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Hauptverfasser: Freischmidt, Holger (VerfasserIn) , Armbruster, Jonas (VerfasserIn) , Rothhaas, Catharina (VerfasserIn) , Titze, Nadine (VerfasserIn) , Gühring, Thorsten (VerfasserIn) , Nurjadi, Dennis (VerfasserIn) , Kretzer, Jan Philippe (VerfasserIn) , Schmidmaier, Gerhard (VerfasserIn) , Grützner, Paul Alfred (VerfasserIn) , Helbig, Lars (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 8 October 2022
In: Biomedicines
Year: 2022, Jahrgang: 10, Heft: 10, Pages: 1-17
ISSN:2227-9059
DOI:10.3390/biomedicines10102513
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/biomedicines10102513
Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/2227-9059/10/10/2513
Volltext
Verfasserangaben:Holger Freischmidt, Jonas Armbruster, Catharina Rothhaas, Nadine Titze, Thorsten Guehring, Dennis Nurjadi, Jan Philippe Kretzer, Gerhard Schmidmaier, Paul Alfred Grützner and Lars Helbig

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520 |a The treatment of non-unions is often complicated by segmental bone defects and bacterial colonization. Because of the limited availability of autologous bone grafts, tissue engineering focuses on antibiotic-loaded bone graft substitutes. HACaS+G is a resorbable calcium sulphate-hydroxyapatite loaded with gentamicin. The osteoinductive, osteoconductive, and anti-infective effect of HACaS+G has already been demonstrated in clinical studies on patients with chronic osteomyelitis. However, especially for the treatment of infected non-unions with segmental bone defects by HACaS+G, reliable clinical testing is difficult and sufficient experimental data are lacking. We used an already established sequential animal model in infected and non-infected rat femora to investigate the osteoinductive, osteoconductive, and anti-infective efficacy of HACaS+G for the treatment of infected non-unions. In biomechanical testing, bone consolidation could not be observed under infected and non-infected conditions. Only a prophylactic effect against infections, but no eradication, could be verified in the microbiological analysis. Using µ-CT scans and histology, osteoinduction was detected in both the infected and non-infected bone, whereas osteoconduction occurred only in the non-infected setting. Our data showed that HACaS+G is osteoinductive, but does not have added benefits in infected non-unions in terms of osteoconduction and mechanical bone stability, especially in those with segmental bone defects. 
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