Biodegradable Antimicrobial Agent/Analgesic/Bone Morphogenetic Protein-Loaded Nanofibrous Fixators for Bone Fracture Repair

<div data-language="eng" data-ev-field="abstract">Background Post-operative infection and pain management are two critical aspects that are of great concern to orthopedic surgeons. Although there are several protocols available to deal with these issues, they are fraught with complications such as cartilage damage, cardiovascular and neurological intoxication, and systemic adverse responses. Therefore, it is necessary to develop safe and effective perioperative protocols. In the present study, antimicrobial agents/analgesics/growth factor-embedded biodegradable hybrid fixators (polycaprolactone fixator + poly[lactide-co-glycolide] sheath-core structured nanofibers) for bone fracture repair were designed. These fixators were fabricated using solution-extrusion three-dimensional printing and electrospinning. The in vitro and in vivo release of the incorporated vancomycin, ceftazidime, lidocaine, and bone morphogenetic protein-2 (BMP-2) was evaluated. The in vivo efficacy of the biomolecule-loaded nanofibrous fixators was investigated in rabbit rib-fracture models. Results The nanofibrous fixators were shown to release vancomycin, ceftazidime, and lidocaine in a sustained manner in both in vitro and in vivo conditions and protected BMP-2 from burst release. The implantation of these hybrid fixators around the fractured rib significantly improved animal activities and bone union indicating that the inclusion of analgesic in the fixator effectively reduced the post-surgical pain and thereby helped in recovery. Conclusions The novel biomolecule-loaded nanofibrous hybrid fixators resulted in excellent therapeutic outcomes. They may be effective in the repair of rib fractures in clinical settings and may help deal with surgical complications such as infection, non-union, and intolerable post-operative pain.<br/></div> &copy; 2021, CC BY.