• Christian Fölsch, Maike Federmann, Klaus D Kuehn, Clemens Kittinger, Stefan Kogler, Gernot Zarfel, Martina Kerwat, Steve Braun, Susanne Fuchs-Winkelmann, Jürgen R J Paletta, and Philip P Roessler.
• Department of Orthopaedics and Rheumatology, University Hospital Marburg, Marburg, Germany.
• Int Orthop. 2015 May 1; 39 (5): 981-8.

PurposeImplant-associated osteomyelitis still represents a demanding challenge due to unfavourable biological conditions, bacterial properties and incremental resistance to antibiotic treatment. Therefore different bactericide or bacteriostatic implant coatings have been developed recently to control local intramedullary infections. Controlled local release of gentamicin base from a highly lipophilic gentamicin palmitate compound achieves extended intramedullary retention times and thus may improve its bactericide effect.MethodsForty male Sprague-Dawley rats were divided into two groups receiving an intramedullary femoral injection of 10(2) colony-forming units (CFU) of a common methicillin susceptible Staphylococcus aureus strain (MSSA Rosenbach) and either an uncoated femur nail (Group I) or a nail coated with gentamicin palmitate (Group II). Animals were observed for 28 and 42 days. Serum haptoglobin and relative weight gain were assessed as well as rollover cultures of explanted femur nails and histological scores of periprosthetic infection in dissected femurs.ResultsImplants coated with gentamicin palmitate significantly reduced periprosthetic bacterial growth as well as signs of systemic inflammation compared with uncoated implants.ConclusionsGentamicin palmitate appears to be a viable coating for the prevention of implant-associated infections. These findings will have to be confirmed in larger animal models as well as in clinical trials.

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