Complex fractures are difficult to manage because of the increased risk of
secondary infection. Traditional treatments include debridment and local administration of
antibiotics. Local
antibiotic therapy is a safe technique resulting in high local concentration of
antibiotics with minimal systemic levels. Local
antibiotics effectively control infection in animal models. The length of implantation and the need for removal of the delivery vehicle places the patient at risk for additional
surgical procedure as well as delays the fixation procedure. Development of a bioresorbable carrier that can deposit therapeutic concentrations of
antibiotics locally without side-effects will provide positive outcomes for the patient.
Tricalcium phosphate lysine (TCPL) ceramic capsules containing
tobramycin were implanted at the site of a femoral
osteotomy delivered therapeutic concentrations of the
drug locally and reduced the incidence of
infection compared to TCPL
capsule which were uncharged by 50%. In addition, the ceramic material was osteoconductive and animals in TCPL + TOB and TCPL carrier alone showed evidence of osteoblast
alkaline phosphatase activity for a period of 15 weeks. Neither the carrier nor the carrier containing
antibiotics displayed untoward effects on
body weight, vital organs and reproductive organs over a 15 week period. The results from this study demonstrated that TCPL can be used as an effective osteoconductive material capable of delivering therapeutic concentrations of
antibiotics over 15 week period.