Incorporation of chitosan in acrylic bone cement: Effect on antibiotic release, bacterial biofilm formation and mechanical properties

Bacterial infection remains a significant problem following total joint replacement. Efforts to prevent recurrent implant infection, including the use of antibiotic-loaded bone cement for implant fixation at the time of revision surgery, are not always successful. In this in vitro study, we investigated whether the addition of chitosan to gentamicin-loaded Palacos® R bone cement increased antibiotic release and prevented bacterial adherence and biofilm formation by Staphylococcus spp. clinical isolates. Furthermore, mechanical tests were performed as a function of time post-polymerisation in pseudo-physiological conditions. The addition of chitosan to gentamicin-loaded Palacos® R bone cement significantly decreased gentamicin release and did not increase the efficacy of the bone cement at preventing bacterial colonisation and biofilm formation. Moreover, the mechanical performance of cement containing chitosan was significantly reduced after 28 days of saline degradation with the compressive and bending strengths not in compliance with the minimum requirements as stipulated by the ISO standard for PMMA bone cement. Therefore, incorporating chitosan into gentamicin-loaded Palacos® R bone cement for use in revision surgery has no clinical antimicrobial benefit and the detrimental effect on mechanical properties could adversely affect the longevity of the prosthetic joint.

Low-pressure synthesis and characterisation of hydroxyapatite derived from mineralise red algae

There is a great need to design functional bioactive substitute materials capable of surviving harsh and diverse conditions within the human body. Calcium-phosphate ceramics, in particular hydroxyapatite are well established substitute materials for orthopaedic and dental applications. The aim of this study was to develop a bioceramic from alga origins suitable for bone tissue application. This was achieved by a novel synthesis technique using ambient pressure at a low temperature of 100 degrees C in a highly alkaline environment. The algae was characterised using SEM, BET, XRD and Raman Spectroscopy to determine its physiochemical properties at each stage. The results confirmed the successful conversion of mineralised red alga to hydroxyapatite, by way of this low-pressure hydrothermal process. Furthermore, the synthesised hydroxyapatite maintained the unique micro-porous structure of the original algae, which is considered beneficial in bone repair applications. (C) 2007 Elsevier B.V. All rights reserved.