A Novel Bone Void Filler for Use in Prosthetic Joint Infections

Abstract

Bone grafts and Bone Void Fillers (BVF) have multiple applications in total joint reconstruction surgeries. However, despite their widespread use, they are contraindicated in Prosthetic Joint Infections (PJI). A BVF device is needed that will provide sustained antimicrobial protection to prevent biofilm formation and, ultimately, will resorb and be replaced by host bone. Currently, BVF are only used in noninfected cases in which powder antibiotics are added in hopes of preventing future infections. These BVF do not provide a sustained antibiotic level and, therefore, are not recommended for infected cases. A novel BVF, EP Granules with Tobramycin, was designed to fulfill the need for successful bone growth when infection is present. To create this unique and original BVF, an osteoconductive biomaterial was combined with clinically used degradable polymers, resulting in a composite ceramic polymer. Initial in-vitro elution studies followed by successful and animal in-vivo testing have demonstrated its effectiveness.