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  1. Article ; Online: Antibiotic-Loaded Ultrahigh Molecular Weight Polyethylenes.

    Lekkala, Sashank / Inverardi, Nicoletta / Yuh, Jean / Wannomae, Keith K / Tierney, Peyton / Sekar, Amita / Muratoglu, Orhun K / Oral, Ebru

    Macromolecular bioscience

    2024  Volume 24, Issue 4, Page(s) e2300389

    Abstract: The occurrence of periprosthetic joint infections (PJI) after total joint replacement constitutes a great burden for the patients and the healthcare system. Antibiotic-loaded polymethylmethacrylate (PMMA) bone cement is often used in temporary spacers ... ...

    Abstract The occurrence of periprosthetic joint infections (PJI) after total joint replacement constitutes a great burden for the patients and the healthcare system. Antibiotic-loaded polymethylmethacrylate (PMMA) bone cement is often used in temporary spacers during antibiotic treatment. PMMA is not a load-bearing solution and needs to be replaced by a functional implant. Elution from the ultrahigh molecular weight polyethylene (UHMWPE) bearing surface for drug delivery can combine functionality with the release of clinically relevant doses of antibiotics. In this study, the feasibility of incorporating a range of antibiotics into UHMWPE is investigated. Drug stability is assessed by thermo-gravimetric analysis and nuclear magnetic resonance spectroscopy. Drug-loaded UHMWPEs are prepared by compression molding, using eight antibiotics at different loading. The predicted intra-articular concentrations of drugs eluted from UHMWPE are above minimum inhibitory concentration for at least 3 weeks against Staphylococci, which are the major causative bacteria for PJI. The antibacterial efficacy is confirmed for samples covering 2% of a representative knee implant in vitro over 72 h, showing that a small fraction of the implant surface loaded with antibiotics may be sufficient against Staphylococci.
    MeSH term(s) Humans ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Polymethyl Methacrylate/chemistry ; Molecular Weight ; Prosthesis-Related Infections/etiology ; Prosthesis-Related Infections/microbiology ; Polyethylenes/pharmacology ; Bone Cements/pharmacology
    Chemical Substances Anti-Bacterial Agents ; ultra-high molecular weight polyethylene ; Polymethyl Methacrylate (9011-14-7) ; Polyethylenes ; Bone Cements
    Language English
    Publishing date 2024-01-07
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2039130-4
    ISSN 1616-5195 ; 1616-5187
    ISSN (online) 1616-5195
    ISSN 1616-5187
    DOI 10.1002/mabi.202300389
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The efficacy of vitamin E in preventing arthrofibrosis after joint replacement.

    Fan, Yingfang / Yuh, Jean / Lekkala, Sashank / Asik, Mehmet D / Thomson, Andrew / McCanne, Madeline / Randolph, Mark A / Chen, Antonia F / Oral, Ebru

    Animal models and experimental medicine

    2024  Volume 7, Issue 2, Page(s) 145–155

    Abstract: Background: Arthrofibrosis is a joint disorder characterized by excessive scar formation in the joint tissues. Vitamin E is an antioxidant with potential anti-fibroblastic effect. The aim of this study was to establish an arthrofibrosis rat model after ... ...

    Abstract Background: Arthrofibrosis is a joint disorder characterized by excessive scar formation in the joint tissues. Vitamin E is an antioxidant with potential anti-fibroblastic effect. The aim of this study was to establish an arthrofibrosis rat model after joint replacement and assess the effects of vitamin E supplementation on joint fibrosis.
    Methods: We simulated knee replacement in 16 male Sprague-Dawley rats. We immobilized the surgical leg with a suture in full flexion. The control groups were killed at 2 and 12 weeks (n = 5 per group), and the test group was supplemented daily with vitamin E (0.2 mg/mL) in their drinking water for 12 weeks (n = 6). We performed histological staining to investigate the presence and severity of arthrofibrosis. Immunofluorescent staining and α2-macroglobulin (α2M) enzyme-linked immunosorbent assay (ELISA) were used to assess local and systemic inflammation. Static weight bearing (total internal reflection) and range of motion (ROM) were collected for functional assessment.
    Results: The ROM and weight-bearing symmetry decreased after the procedure and recovered slowly with still significant deficit at the end of the study for both groups. Histological analysis confirmed fibrosis in both lateral and posterior periarticular tissue. Vitamin E supplementation showed a moderate anti-inflammatory effect on the local and systemic levels. The vitamin E group exhibited significant improvement in ROM and weight-bearing symmetry at day 84 compared to the control group.
    Conclusions: This model is viable for simulating arthrofibrosis after joint replacement. Vitamin E may benefit postsurgical arthrofibrosis, and further studies are needed for dosing requirements.
    MeSH term(s) Animals ; Vitamin E/pharmacology ; Vitamin E/administration & dosage ; Vitamin E/therapeutic use ; Male ; Rats, Sprague-Dawley ; Fibrosis ; Rats ; Range of Motion, Articular/drug effects ; Arthroplasty, Replacement, Knee ; Joint Diseases/prevention & control ; Joint Diseases/etiology ; Disease Models, Animal
    Chemical Substances Vitamin E (1406-18-4)
    Language English
    Publishing date 2024-03-25
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2576-2095
    ISSN (online) 2576-2095
    DOI 10.1002/ame2.12388
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: The efficacy of antibiotic-eluting material in a two-stage model of periprosthetic joint infection.

    Fan, Yingfang / McCanne, Madeline / Yuh, Jean / Lekkala, Sashank / Leape, Charlotte P / Hugard, Shannon / Thomson, Andrew / Collins, Jamie E / Muratoglu, Orhun K / Randolph, Mark / Oral, Ebru

    Journal of orthopaedic research : official publication of the Orthopaedic Research Society

    2023  Volume 42, Issue 2, Page(s) 460–473

    Abstract: Periprosthetic joint infections occur in about 2% of patients who undergo primary total joint arthroplasty, a procedure performed over 1 million times in the United States. The gold standard of treatment is a two-stage revision. This study aimed to ... ...

    Abstract Periprosthetic joint infections occur in about 2% of patients who undergo primary total joint arthroplasty, a procedure performed over 1 million times in the United States. The gold standard of treatment is a two-stage revision. This study aimed to establish a two-stage procedure in a preclinical small animal model (rat) to test and compare the efficacy of an antibiotic-eluting material in managing infection. Joint replacement was simulated by transchondylarly implanting a polyethylene (PE) plug into the distal femur and a titanium screw in the proximal tibia. Methicillin-sensitive Staphylococcus aureus (MSSA) 10
    MeSH term(s) Humans ; Rats ; Animals ; Anti-Bacterial Agents/therapeutic use ; Prosthesis-Related Infections/drug therapy ; Prosthesis-Related Infections/surgery ; Arthritis, Infectious/drug therapy ; Gentamicins/therapeutic use ; Reoperation ; Polyethylenes ; Retrospective Studies
    Chemical Substances Anti-Bacterial Agents ; Gentamicins ; Polyethylenes
    Language English
    Publishing date 2023-08-30
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 605542-4
    ISSN 1554-527X ; 0736-0266
    ISSN (online) 1554-527X
    ISSN 0736-0266
    DOI 10.1002/jor.25681
    Database MEDical Literature Analysis and Retrieval System OnLINE

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