DUAL USE OF BONE SCAFFOLD FOR ANTIBIOTICS DELIVERY DELAYS THE ONSET OF OSTEOMYELITIS

Osteomyelitis (OM) poses significant treatment challenges, making dual platform implants a promising technology. This study introduces a dual platform device designed to promote bone healing and deliver antibiotics to prevent OM, addressing the limitations of current osteogenic implants that lack antimicrobial properties. 23 goats were allocated into four treatment groups: 1) SA: scaffolds loaded with Vancomycin (n=5); 2) SB: scaffolds with bacteria (UAMS-1) (n=6); 3) SBA: scaffolds with Vancomycin and bacteria (n=6); 4) NS: native scaffolds (n=6). A segmental defect was created on the right tibia of each goat, followed by scaffold implantation according to the treatment group. Goats were monitored for 90 days. Biweekly radiographs, post-euthanasia CT imaging, and bacteriology on scaffold and soft tissue were performed. Radiographs and CT were scored by a blinded radiologist for OM and Healing. 16 goats reached the study endpoint. All SB group goats were removed early due to OM complications. Radiograph OM scores differed significantly across groups, with SA and NS showing similar outcomes, while SB and SBA differed from other groups. Healing scores did not differ significantly between SA, SBA, and NS (p = 0.3675). CT comparison findings aligned with radiograph OM scores but differed significantly between methods (p = 0.0238) indicating that these methods assess disease severity differently. Both radiographs and CT provided consistent healing assessments with no significant difference between methods (p = 0.3332). These results indicate that Vancomycin-loaded scaffolds offer a distinct advantage in contaminated surgeries, underscoring the importance of antibiotic integration in treating osteomyelitis.