A review on the structure of hydroxyapatite loaded by systemic antibiotics as an antibiotic delivery system for covering orthopedic schanzes

Document Type : Research Paper


1 Department of Orthopedics, Ghaem Hospital, Mashhad University of Medical Science, P. O. Box 91388-13944, Mashhad, Iran

2 Associate Professor of Orthopedics, Hand Surgeon, PhD of Artificial Limbs


Occurrence of infection is one of the complications of orthopedic surgery, which has bad consequences for the patient and the health care system. Loosing of bone tissue occurs due to the formation of a biological layer on the implant fixator, and it leads to the breaking of the infected implant and subsequently to local inflammation and bone destruction. In this review article, the effect of hydroxyapatite-loaded with antibiotics, due to its effective biological activity and appropriate chemical structure in orthopedic treatments is investigated. Vancomycin, gentamicin and tobramabicin are common antibiotics in orthopedic surgeries. The use of these mentioned antibiotics by injection cannot effectively reduce or treat the infection on the surface of the implant. In this regard, the use of antibiotic coatings on the implant surface can be a more effective method in controlling infection after orthopedic surgeries. Studies show that the implants coated with hydroxyapatite-loaded with antibiotics are a suitable choice for useful applications such as reducing recovery time, reducing pain and simultaneous growth of new bone on the implant. Researchers showed that the antibacterial activity and clinical applications of implants coated with hydroxyapatite along with antibiotics are very effective in orthopedic surgeries. All the examined antibiotics showed favorable results in the treatment of infection, and Vancomycin, due to its longer release time and the lowest level of toxicity compared to other antibiotics, can be used as a medicine. With more successful clinical results, it can be used in hydroxyapatite loading in order to cover the orthopedic schanzes


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