Authors: Weiping Ren David C Markel
Publish Date: 2011/05/17
Volume: 469, Issue: 8, Pages: 2399-2403
Abstract
Persistent inflammatory reaction to wear debris causes periprosthetic osteolysis and loosening Some authors have advocated pharmaceutical approaches to reduce the inflammatory reaction Erythromycin has antiinflammatory effects independent of its antimicrobial properties Although oral erythromycin reportedly inhibits periprosthetic tissue inflammation in patients with aseptic loosening longterm systematic erythromycin treatment is not recommended owing to its side effects Therefore it would be advantageous to restrict erythromycin delivery to the inflammatory periprosthetic tissue without causing side effectsWe propose restricting erythromycin delivery to the inflammatory periprosthetic site A previously described rat model of ultrahigh molecular weight polyethylene UHMWPE particleinduced periprosthetic tissue inflammation and osteolysis will be used to test the effect of local delivery of erythromycin via PeriApatiteTMcoated Ti implants The outcome measures will include bone ingrowth μCT implant stability pullout test and histologic analysis of periprosthetic tissuesPharmacologic intervention aimed at slowing preventing or reversing the aseptic loosening process would represent an advance in the management of joint replacement Erythromycin may be appropriate for prophylactically treating patients who have repeated revision surgery and/or show early signs of progressive osteolysis after arthroplasty
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