Biodegradable Sleeves for Metal Implants to Prevent Implant-Associated Infection: An Experimental In Vivo Study in Sheep

Authors

  • Stephanie C. von Plocki Dr med vet,

    1. Musculoskeletal Research Unit (MSRU), Equine Department, Vetsuisse Faculty ZH, University of Zurich, Zürich, Switzerland
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  • David Armbruster MSE,

    1. Synthes USA, Biomaterials R&D, West Chester, PA
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  • Karina Klein Dr med vet,

    1. Musculoskeletal Research Unit (MSRU), Equine Department, Vetsuisse Faculty ZH, University of Zurich, Zürich, Switzerland
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  • Käthi Kämpf,

    1. Musculoskeletal Research Unit (MSRU), Equine Department, Vetsuisse Faculty ZH, University of Zurich, Zürich, Switzerland
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  • Katalin Zlinszky,

    1. Musculoskeletal Research Unit (MSRU), Equine Department, Vetsuisse Faculty ZH, University of Zurich, Zürich, Switzerland
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  • Monika Hilbe Dr med vet, Diplomate ECVP,

    1. Musculoskeletal Research Unit (MSRU), Equine Department, Vetsuisse Faculty ZH, University of Zurich, Zürich, Switzerland
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  • Peter Kronen Dr med vet, Diplomate ECVAA,

    1. Musculoskeletal Research Unit (MSRU), Equine Department, Vetsuisse Faculty ZH, University of Zurich, Zürich, Switzerland
    2. Competence Center for Applied Biotechnology and Molecular Medicine (CABMM), Vetsuisse Faculty ZH, University of Zurich, Zurich, Switzerland
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  • Elliott Gruskin,

    1. Competence Center for Applied Biotechnology and Molecular Medicine (CABMM), Vetsuisse Faculty ZH, University of Zurich, Zurich, Switzerland
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  • Brigitte von Rechenberg Prof. Dr med vet, Diplomate ECVS

    Corresponding author
    1. Competence Center for Applied Biotechnology and Molecular Medicine (CABMM), Vetsuisse Faculty ZH, University of Zurich, Zurich, Switzerland
    • Musculoskeletal Research Unit (MSRU), Equine Department, Vetsuisse Faculty ZH, University of Zurich, Zürich, Switzerland
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Corresponding Author

Brigitte von Rechenberg, Prof. Dr med vet, Diploma ECVS, MSRU, CABMM, Equine Department, Vetsuisse Faculty ZH, Winterthurerstr 260, 8057 Zürich, Switzerland.

E-mail: bvonrechenberg@vetclinics.uzh.ch

Abstract

Objective

To evaluate biocompatibility of biodegradable sleeves containing antimicrobial agents, designed for local drug delivery to prevent implant-related infection.

Study Design

Synthetic polyester sleeves (a copolymer of glycolide, caprolactone, trimethylene carbonate, lactide) were cast as thin films. The antimicrobial agents incorporated in the sleeves included gentamicin sulfate, triclosan, or a combination of these drugs.

Animals

Adult sheep (n = 15).

Methods

Two limited contact dynamic compression plates (LC-DCP) with or without sleeves were implanted on tibiae (bilateral) of 15 sheep. Sleeves were placed over the plates before implantation. Beneath half of the plates, 5-mm drill hole defects were made in the near cortex. Samples were harvested 4 weeks later for histology and microradiography.

Results

Macroscopically, no irritation of bone or adjacent tissue was seen. Small remnants of sleeves were visible on histology, and positively correlated with the presence of macrophages and foreign body cells. Thick sections showed no difference between the test samples and controls in terms of fibrous capsule formation, periosteal remodeling, and defect remodeling. Inflammatory cells, macrophages, and foreign body cells were more prominent in sections with sleeves, but were not statistically significantly different from controls. Cell numbers were within normal physiologic limits normally seen as cellular response to foreign bodies consisting of polymers.

Conclusion

The normal healing response indicated that the biodegradable sleeves demonstrate tissue biocompatibility.

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