Antibiotic TMA (Therapeutic Methacrylic) Comonomers: Synergizing Mechanical Integrity with Infection Control in Bone Cement

Abstract

AbstractBone infections are common complications of joint replacement surgeries. Standard antibiotic therapies often fail due to compromised blood supply and bacterial growth on prosthetics. Currently, localized antibiotic delivery is accomplished by antibiotic‐loaded bone cements (ALBCs). However, ALBCs lack the required mechanical strength. To address these limitations, therapeutic gentamicin methacrylic comonomers (gMAs) are developed. These comonomers use a methacrylic carbonyl bond for hydrolytically controlled drug release, and actively contribute to poly (methyl methacrylate) cement curing, enhancing strength. Structure‐property relationships evaluate mechanical properties of fresh and aged cements, release behavior, and antibacterial performance with respect to type of tether bond, and gMA loading percentage (3–10%). gMA‐loaded cements match clinical strength, even at 10% loading, with threefold higher drug release than ALBCs. In vitro studies show effective biofilm inhibition when challenged with E. coli and B. subtilis for 7 days. Initial in vivo testing of gMA‐loaded cement against methicillin resistant S. aureus reveals a notable decrease in bacterial count on both implant surface and in femur homogenate, surpassing the impact observed with systemic antibiotic treatment in mice. This innovative approach shows promise to transform the treatment of implant‐associated infections by providing bone cements that are both mechanically robust and able to treat infections.