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Efficacy of periprosthetic erythromycin delivery for wear debris-induced inflammation and osteolysis

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Abstract

Objectives

We have reported that oral erythromycin (EM) inhibits periprosthetic tissue inflammation in a group of patients with aseptic loosening. The purpose of this study was to assess the efficacy of local, periprosthetic EM delivery in a rat model.

Methods

Uncoated Ti pins were press-fit into the right tibia of fourteen Sprague–Dawley rats following an intramedullar injection of UHMWPE (ultra high molecular weight polyethylene) particles. Revision surgeries were performed 2 months after the primary surgery. EM was applied to the Peri-Apatite™ (PA) layer of the titanium (Ti) pins. The previously implanted Ti pins were withdrawn and replaced with Ti pins coated either with (n = 7) or without (n = 7) EM. The rats were killed 1 month after “revision surgery”. The EM efficacy was evaluated by (MicroCT) μCT and histology.

Results

μCT analysis showed that bone volume percentage (BV/TV) was significantly higher in the EM-treated group compared to the untreated group (p < 0.05). Histological analysis showed that EM treatment inhibits UHMWPE particle-induced periprosthetic tissue inflammation compared to the untreated group.

Conclusion

This study demonstrated that periprosthetic EM delivery reduced periprosthetic inflammation and improved the quality of surrounding bone.

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Abbreviations

EM:

Erythromycin

PA:

Peri-Apatite™

Ti:

Titanium

S. aureus :

Staphylococcus aureus

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Acknowledgments

This work was supported by an institutional research grant from Stryker Orthopedics (Mahwah, NJ).

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Detroit Medical Center and Providence Hospital Orthopaedic Residency, Detroit, MI, USA

    Weiping Ren & David C. Markel

  2. Stryker Orthopaedics, Mahwah, NJ, USA

    Renwen Zhang & Monica Hawkins

  3. Department of Biomedical Engineering, Wayne State University College of Engineering and School of Medicine, 818 W. Hancock Bioengineering Center, Detroit, MI, 48201, USA

    Weiping Ren & Tong Shi

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  1. Weiping Ren
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  2. Renwen Zhang
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  3. Monica Hawkins
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  4. Tong Shi
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  5. David C. Markel
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Correspondence to Weiping Ren.

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Responsible Editor: Michael Parnham.

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Ren, W., Zhang, R., Hawkins, M. et al. Efficacy of periprosthetic erythromycin delivery for wear debris-induced inflammation and osteolysis. Inflamm. Res. 59, 1091–1097 (2010). https://doi.org/10.1007/s00011-010-0229-x

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  • DOI: https://doi.org/10.1007/s00011-010-0229-x

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