article · Journal of Biomedical Materials Research Part B Applied Biomaterials
Joint replacement surgeries rely on bone cement, but post-operative infections and the growth of antibiotic resistance complicate patient recovery. To provide an alternative to traditional antibiotics, a generation 1 quaternary ammonium dendrimer was synthesised from tripropylene glycol diacrylate using octyl iodide to function as a contact-killing antimicrobial agent. This agent was incorporated into poly(methyl methacrylate) bone cement formulations at various concentrations. Evaluations showed that mechanical strength and compressive modulus decreased as dendrimer concentration rose, a trend observed in both dry conditions and when submerged in simulated body fluids. A 10 percent dendrimer concentration was identified as the optimal formulation. At this level, the cement retained adequate mechanical properties, successfully killed both Gram-positive and Gram-negative bacteria, and maintained its antimicrobial activity for at least 30 days.
Infections following arthroplasty or joint replacement procedures pose significant clinical challenges, particularly as bacteria become increasingly resistant to conventional antibiotics. By embedding contact-killing dendrimers into bone cement, surgical implants can resist bacterial colonisation directly. This provides a durable antimicrobial barrier that maintains its performance over several weeks without contributing to the broader risks associated with traditional antibiotic use.
This work is relevant to orthopaedic biomaterial manufacturers and surgical device developers seeking infection-resistant cements for joint replacements. The findings reflect applied, early-stage laboratory research, having demonstrated 30-day antimicrobial action and mechanical stability in simulated body fluids. Moving towards commercial use would require extensive preclinical biological safety assessments, regulatory validation, and in vivo testing.
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The use of novel antimicrobial molecules in bone cement can improve efficiency of recuperation after arthroplasty or joint replacement surgeries, avoiding the risks associated with antibiotic resistant antimicrobial agents. Nanomaterials particularly dendrimers are particularly useful for making broad spectrum killing agents owing to their large surface areas and functionalities. Therefore, we have synthesized generation 1 quaternary ammonium dendrimer of tripropylene glycol diacrylate (TPGDA) using octyl iodide (OI) [TPGDA G1.0 (=) quaternary octyl iodide (QOI)] and capitalized on their capabilities of contact killing based mechanism. We formulated different TPGDA G1.0 (=) QOI antimicrobial agent loaded liquid component composed of methyl methacrylate monomer and N,N-dimethyl-p-toluidine coinitiator. Different polymethyl methacrylate (PMMA) based experimental bone cement formulations were made and dendrimer concentration was optimized. Mechanical strength and compressive modulus of modified bone cement decreased on increasing concentrations and 10% was optimized for further analysis. The mechanical strength of bone cement yield the similar trend in wet conditions bone cement immersed in artificially created stimulated body fluids. Ten percent TPGDA G1.0 (=) QOI in bone cement was sufficient to kill gram positive and negative bacteria and its property is retained even after a period of 30 days. Thus novel dendritic structures show promise for clinical antimicrobial activity while retaining mechanical properties of bone cements. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 521-530, 2017.
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DOI: 10.1002/jbm.b.33553
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