Effect of Lattice Structures on the Antibiotic Release from Bone Cement: In Vitro Study
- Authors: Shafigulin R.A.1,2,3, Galyautdinova A.E.1, Kharin N.V.1, Bespalov I.A.1, Valeeva I.K.2, Boichuk S.V.1,2, Akhtyamov I.F.1,2,3, Sachenkov O.A.1
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Affiliations:
- Kazan Federal (Volga Region) State University
- Kazan State Medical University
- Republican Clinical Hospital
- Issue: Vol 31, No 2 (2025)
- Pages: 120-131
- Section: Theoretical and experimental studies
- URL: https://journal-vniispk.ru/2311-2905/article/view/314142
- DOI: https://doi.org/10.17816/2311-2905-17670
- ID: 314142
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Abstract
Background. Local therapy aimed to suppress infection of the osteoarticular apparatus is based on the use of coated spacers. As a rule, the coating surfaces are composed of bone cement supplemented with bioactive substances, e.g., antibiotics. However, current approaches aimed to stimulate the release of antibiotics from bone cement are not always effective and may even decrease their properties and biological activities.
The aim of the study — to examine the effect of the lattice structures of base implants on the dynamics and amount of antibiotics released from bone cement in vitro.
Methods. A novel type of implants with a lattice structure and traditional reinforced spacer filled with bone cement and antibiotic were used in present study. The release of vancomycin and cefazolin was measured spectrophotometrically for up to 30 days. Calibration curves were made according to the regression lines based on the values of the stock solutions with the well-known concentrations of the antibiotics.
Results. For all tested samples, the elution profile of antibiotics was determined and illustrated the significant release of the drugs during the initial time-period followed by the decrease (day 7) and reaching a uniform elution plateau (day 15). In all samples, the amount of released antibiotic did not exceed 1% of total amount of the drug present in the implant. Notably, the higher release of the antibiotics was found for the samples with lattice structure when compared with control group, despite the relatively higher initial amount of bone cement and antibiotics in control samples. A difference in the amount of antibiotics was also detected between the tested samples of two types of lattice structures.
Conclusion. The lattice structure of the implants increases the amount of antibiotic release from the bone cement and also facilitates the antibiotic dynamics release when compared to the traditional bone cement used as the reinforced spacers.
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##article.viewOnOriginalSite##About the authors
Rashid A. Shafigulin
Kazan Federal (Volga Region) State University; Kazan State Medical University; Republican Clinical Hospital
Author for correspondence.
Email: rashid221@yandex.ru
ORCID iD: 0009-0008-6146-4470
SPIN-code: 1458-1630
Cand. Sci. (Med.)
Russian Federation, Kazan; Kazan; KazanAlina E. Galyautdinova
Kazan Federal (Volga Region) State University
Email: wiiskas15@gmail.com
ORCID iD: 0009-0003-0885-5994
SPIN-code: 7346-1225
Russian Federation, Kazan
Nikita V. Kharin
Kazan Federal (Volga Region) State University
Email: nik1314@mail.ru
ORCID iD: 0000-0003-4850-143X
SPIN-code: 3574-8161
Russian Federation, Kazan
Igor A. Bespalov
Kazan Federal (Volga Region) State University
Email: bespalovigora@gmail.com
ORCID iD: 0009-0008-8062-8733
SPIN-code: 6866-7850
Russian Federation, Kazan
Ildaria K. Valeeva
Kazan State Medical University
Email: valeeva.ildaria@yandex.ru
ORCID iD: 0000-0003-3707-6511
SPIN-code: 9818-5421
Dr. Sci. (Biol.)
Russian Federation, KazanSergei V. Boichuk
Kazan Federal (Volga Region) State University; Kazan State Medical University
Email: boichuksergei@mail.ru
ORCID iD: 0000-0003-2415-1084
SPIN-code: 8058-6246
Dr. Sci. (Med.), Professor
Russian Federation, Kazan; KazanIldar F. Akhtyamov
Kazan Federal (Volga Region) State University; Kazan State Medical University; Republican Clinical Hospital
Email: yalta60@mail.ru
ORCID iD: 0000-0002-4910-8835
SPIN-code: 6579-8640
Dr. Sci. (Med.), Professor
Russian Federation, Kazan; Kazan; KazanOskar A. Sachenkov
Kazan Federal (Volga Region) State University
Email: 4works@bk.ru
ORCID iD: 0000-0002-8554-2938
SPIN-code: 2926-2436
Cand. Sci. (Phys.-Math.), Associate Professor
Russian Federation, KazanReferences
- Божкова С.А., Новокшонова А.А., Конев В.А. Современные возможности локальной антибиотикотерапии перипротезной инфекции и остеомиелита (обзор литературы). Травматология и ортопедия России. 2015;3(77):92-107. doi: 10.21823/2311-2905-2015-0-3-92-107. Bozhkova S.A., Novokshonova A.A., Konev V.A. Modern possibilities of local antibiotic therapy for periprosthetic infection and osteomyelitis (literature review). Traumatology and Orthopedics of Russia. 2015;3(77):92-107. (In Russian). doi: 10.21823/2311-2905-2015-0-3-92-107.
- von Hertzberg-Boelch S.P., Luedemann M., Rudert M., Steinert A.F. PMMA Bone Cement: Antibiotic Elution and Mechanical Properties in the Context of Clinical Use. Biomedicines. 2022;10(8):1830. doi: 10.3390/biomedicines10081830.
- Wall V., Nguyen T.H., Nguyen N., Tran P.A. Controlling Antibiotic Release from Poly-methylmethacrylate Bone Cement. Biomedicines. 2021;9(1):26. doi: 10.3390/biomedicines9010026.
- Шафигулин Р.А., Ахтямов И.Ф., Емелин А.Л., Беспалов И.А., Акифьев К.Н. Элюция антибиотиков из костного цемента: проблемы и пути их решения. Гений ортопедии. 2025;31(1):119-128. doi: 10.18019/1028-4427-2025-31-1-119-128. Shafigulin R.A., Akhtyamov I.F., Emelin A.L., Bespalov I.A., Akifyev K.N. Elution of antibiotics from bone cement: problems and ways to solution. Genij Ortopedii. 2025;31(1):119-128. (In Russian). doi: 10.18019/1028-4427-2025-31-1-119-128.
- Obaton A.F., Fain J., Meinel D., Tsamos A., Léonard F., Lécuelle B. et al. In Vivo Bone Progression in and around Lattice Implants Additively Maufactured with a New Titanium Alloy. Appl Sci. 2023;13(12):7282. doi: 10.3390/app13127282.
- Килина П.Н., Сиротенко Л.Д., Козлов М.С., Дроздов А.А. Теплофизические аспекты обеспечения качества высокопористых имплантатов с ячеистой структурой, полученных методом селективного лазерного сплавления. Российский журнал биомеханики. 2023;27(4):200-211. doi: 10.15593/RZhBiomeh/2023.4.16. Kilina P.N., Sirotenko L.D., Kozlov M.S., Drozdov A.A. Quality assurance thermophysical aspects of highly porous implants with cellular structure obtained by selective laser melting. Russian Journal of Biomechanics. 2023;27(4):200-211. (In Russian). doi: 10.15593/RZhBiomeh/2023.4.16.
- Borovkov A.I., Maslov L.B., Zhmaylo M.A., Tarasenko F.D., Nezhinskaya L.S. Elastic properties of additively produced metamaterials based on lattice structures. Mater Phys Mech. 2023;51(7):42-62.
- Федорова Н.В., Косинов А.М. Определение механических параметров и проницаемости пористых костных имплантатов из титанового сплава в условиях их взаимодействия с биологическими жидкостями. Российский журнал биомеханики. 2023;28(1):54-66. doi: 10.15593/RZhBiomeh/2024.1.04. Fedorova N.V., Kosinov A.M. Determination mechanical properties and permeability of porous titanium alloy bone implants, including under conditions of their interaction with biological fluids. Russian Journal of Biomechanics. 2024;28(1):45-56. (In Russian). doi: 10.15593/rjbiomech/2024.1.04.
- Abdudeen A., Abu Qudeiri J.E., Kareem A., Valappil A.K. Latest developments and insights of orthopedic implants in biomaterials using additive manufacturing technologies. J Manuf Mater Process. 2022;6(6):162. doi: 10.3390/jmmp6060162.
- Frazar E.M., Shah R.A., Dziubla T.D., Hilt J.Z. Multifunctional Temperature-Responsive Polymers as Advanced Biomaterials and Beyond. J Appl Polym Sci. 2020;137:48770. doi: 10.1002/app.48770.
- Sufiiarov V.Sh., Borisov E.V., Sokolova V.V., Chukovenkova M.O., Soklakov A.V., Mikhaluk D.S. et al. Structural analysis of an endoprosthesis designed with graded density lattice structures. Int J Numer Method Biomed Eng. 2021;37(2):e3420. doi: 10.1002/cnm.3420.
- Müller P., Gembarski P.C., Lachmayer R. Design Automation of a Patient-Specific Endoprosthesis with Multi-Objective Optimized Lattice Structures. In: Innovative Product Development by Additive Manufacturing 2021. 2023;113-128. doi: 10.1007/978-3-031-05918-6_8.
- Акифьев К.Н., Харин Н.В., Стаценко Е.О., Саченков О.А., Большаков П.В. Пилотное исследование потери устойчивости на сжатие решетчатого эндопротеза с помощью рентгеновской томографии. Российский журнал биомеханики. 2023;27(4):40-49. doi: 10.15593/RZhBiomeh/2023.4.03. Akifyev K.N., Kharin N.V., Statsenko E.O., Sachenkov O.A., Bolshakov P.V. Pilot study of lattice endoprosthesis buckling by compression in-situ using X-ray tomography. Russian Journal of Biomechanics. 2023;27(4):40-49. (In Russian). doi: 10.15593/RZhBiomeh/2023.4.03.
- Герасимов О.В., Рахматулин Р.Р., Балтина Т.В., Саченков О.А. Определение механических свойств костной ткани численно-цифровым методом на основе данных компьютерной томографии. Российский журнал биомеханики. 2023;27(3):53-66. doi: 10.15593/RZhBiomech/2023.3.04. Gerasimov O.V., Rakhmatulin R.R., Baltina T.V., Sachenkov O.A. Determination of the bone tissue mechanical properties by a numerical-digital method using CT data. Russian Journal of Biomechanics. 2023;27(3):53-66. (In Russian). doi: 10.15593/RZhBiomech/2023.3.04.
- Abdullah N.N.A.A., Abdullah A.H., Ramlee M.H. Current trend of lattice structures designed and analysis for porous hip implants: A short review. Mater Today Proc. 2023;110:96-100. doi: 10.1016/j.matpr.2023.09.199.
- Bolshakov P., Kharin N., Kashapov R., Sachenkov O. Structural Design Method for Constructions: Simulation, Manufacturing and Experiment. Materials (Basel). 2021;14(20):6064. doi: 10.3390/ma14206064.
- Kladovasilakis N., Tsongas K., Tzetzis D. Finite Element Analysis of Orthopedic Hip Implant with Functionally Graded Bioinspired Lattice Structures. Biomimetics (Basel). 2020;5(3):44. doi: 10.3390/biomimetics5030044.
- Luo S., Jiang T., Long L., Yang Y., Yang X., Luo L. et al. A dual PMMA/calcium sulfate carrier of vancomycin is more effective than PMMA-vancomycin at inhibiting Staphylococcus aureus growth in vitro. FEBS Open Bio. 2020;10(4):552-560. doi: 10.1002/2211-5463.12809.
- Mensah L.M., Love B.J. A meta-analysis of bone cement mediated antibiotic release: Overkill, but a viable approach to eradicate osteomyelitis and other infections tied to open procedures. Mater Sci Eng C Mater Biol Appl. 2021;123:111999. doi: 10.1016/j.msec.2021.111999.
- Paz E., Sanz-Ruiz P., Abenojar J., Vaquero-Martín J., Forriol F., Del Real J.C. Evaluation of Elution and Mechanical Properties of High-Dose Antibiotic-Loaded Bone Cement: Comparative «In Vitro» Study of the Influence of Vancomycin and Cefazolin. J Arthroplasty. 2015;30(8):1423-1429. doi: 10.1016/j.arth.2015.02.040.
- Меликова Р.Э., Цискарашвили А.В., Артюхов А.А., Сокорова Н.В. In vitro исследование динамики элюции антибактериальных препаратов, импрегнированных в матрицы на основе полимерного гидрогеля. Гений ортопедии. 2023;29(1):64-70. doi: 10.18019/1028-4427-2023-29-1-64-70. Melikova R.E., Tsiskarashvili A.V., Artyukhov A.A., Sokorova N.V. In vitro study of the dynamics in elution of antibacterial drugs impregnated into matrices based on polymer hydrogel. Genij Ortopedii. 2023;29(1):64-70. (In Russian). doi: 10.18019/1028-4427-2023-29-1-64-70.
- Miller R., Leon C., McLemore R. Mixing method affects elution and strength of high-dose ALBC: A pilot study. Clin Orthop Relat Res. 2012;470:2677-2683. doi: 10.1007/s11999-012-2351-2.
- Samelis P.V., Papagrigorakis E., Sameli E., Mavrogenis A., Savvidou O., Koulouvaris P. Current Concepts on the Application, Pharmacokinetics and Complications of Antibiotic-Loaded Cement Spacers in the Treatment of Prosthetic Joint Infections. Cureus. 2022;14:e20968. doi: 10.7759/cureus.20968.
- Wu K., Chen Y.C., Hsu Y.M., Chang C.H. Enhancing Drug Release from Antibiotic-loaded Bone Cement Using Porogens. J Am Acad Orthop Surg. 2016;24:188-195. doi: 10.5435/JAAOS-D-15-00469.
- Shi M., Kretlow J.D., Spicer P.P., Tabata Y., Demian N., Wong M.E. et al. Antibiotic-releasing porous polymethylmethacrylate/gelatin/antibiotic constructs for craniofacial tissue engineering. J Control Release. 2011;152:196-205. doi: 10.1016/j.jconrel.2011.01.029.
- Spicer P.P., Shah S.R., Henslee A.M., Watson B.M., Kinard L.A., Kretlow J.D. et al. Evaluation of antibiotic releasing porous polymethylmethacrylate space maintainers in an infected composite tissue defect model. Acta Biomater. 2013;9:8832-8839. doi: 10.1016/j.actbio.2013.07.018.
- Куропаткин Г.В., Ахтямов И.Ф. Костный цемент в травматологии и ортопедии. Казань: ТаГраф; 2014. c. 128-131. Kuropatkin G.V., Akhtyamov I.F. Bone cement in surgery. Kazan: TaGraf; 2014. p. 128-131. (In Russian).
- Duey R.E., Chong A.C., McQueen D.A., Womack J.L., Song Z., Steinberger T.A. et al. Mechanical properties and elution characteristics of polymethylmethacrylate bone cement impregnated with antibiotics for various surface area and volume constructs. Iowa Orthop J. 2012;32:104-115.
- Bistolfi A., Massazza G., Verné E., Massè A., Deledda D., Ferraris S. et al. Antibiotic-loaded cement in orthopedic surgery: a review. ISRN Orthop. 2011;2011:290851. doi: 10.5402/2011/290851.
- Samelis P.V., Papagrigorakis E., Sameli E., Mavrogenis A., Savvidou O., Koulouvaris P. Current Concepts on the Application, Pharmacokinetics and Complications of Antibiotic-Loaded Cement Spacers in the Treatment of Prosthetic Joint Infections. Cureus. 2022;14(1):e20968. doi: 10.7759/cureus.20968.
- Perry N.P.J., Tucker N.J., Hadeed M.M., Heare A., Stacey S.C., Hammerberg E.M. et al. The Antibiotic Cement Bead Rouleaux: A Technical Trick to Maximize the Surface Area to Volume Ratio of Cement Beads to Improve the Elution of Antibiotics. J Orthop Trauma. 2022;36(9):369-373. doi: 10.1097/BOT.0000000000002335.
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