Data from: A resorbable antibiotic-eluting polymer composite bone void filler for perioperative infection prevention in a rabbit radial defect model

Nearly 1.3 million total joint replacement procedures are performed in the
United States annually, with numbers projected to rise exponentially in
the coming decades. Although finite infection rates for these procedures
remain consistently low, device-related infections represent a significant
cause of implant failure, requiring secondary or revision procedures.
Revision procedures manifest several-fold higher infection recurrence
rates. Importantly, many revision surgeries, infected or not, require bone
void fillers to support the host bone and provide a sufficient tissue bed
for new hardware placement. Antibiotic-eluting bone void fillers (ABVF),
providing both osteoconductive and antimicrobial properties, represent one
approach for reducing rates of orthopedic device-related infections. Using
a solvent-free, molten-cast process, a polymer-controlled
antibiotic-eluting calcium carbonate hydroxyapatite (HAP) ceramic
composite BVF (ABVF) was fabricated, characterized, and evaluated in vivo
using a bacterial challenge in a rabbit radial defect window model. ABVF
loaded with tobramycin eliminated the infectious burden in rabbits
challenged with a clinically relevant strain of Staphylococcus aureus
(inoculum as high as 107 CFU). Histological, microbiological, and
radiographic methods were used to detail the effects of ABVF on microbial
challenge to host bone after 8 weeks in vivo. In contrast to the HAP/BVF
controls, which provided no antibiotic protection and required euthanasia
3 weeks post-operatively, tobramycin-releasing ABVF animals showed no
signs of infection (clinical, microbiological, or radiographic) when
euthanized at the 8-week study endpoint. ABVF sites did exhibit fibrous
encapsulation around the implant at 8 weeks. Local antibiotic release from
ABVF to orthopedic sites requiring bone void fillers eliminated the
periprosthetic bacterial challenge in this 8-week in vivo study,
confirming previous in vitro results.