Antimicrobial 3D printed implants for periprosthetic joint infections

Abstract

Periprosthetic joint infections (PJIs) remain a serious complication following hip and knee arthroplasty, affecting 1–5% of patients in developed countries and posing significant challenges to patients, clinicians, and healthcare systems. Conventional prophylactic strategies, such as antibiotic-loaded bone cement, suffer from limited post-implantation drug release and potential compromise of mechanical integrity. To overcome these limitations, we developed a personalized, 3D-printed implant designed to integrate with the acetabular component of joint prostheses. These implants deliver either monotherapy or a combination of amphotericin B (AmB) and vancomycin (VAN), targeting both fungal and bacterial pathogens. Fabricated via fused deposition modeling using a biocompatible polyvinyl alcohol–polyethylene glycol (PVA–PEG) matrix, the implants enable passive drug loading and rapid adhesion to prosthetic surfaces within 60 s, minimizing operative time. In vitro testing confirmed broad-spectrum antimicrobial activity against Candida spp. ( C. albicans , C. parapsilosis , C. glabrata , C. krusei ) and Staphylococcus spp. ( S. aureus , S. epidermidis ). VAN was released rapidly, while AmB exhibited sustained release for up to 10 h, with both maintaining saturation solubility for 48 h. Notably, AmB-loaded implants showed five-fold lower hemolytic toxicity compared to free drug. These results highlight the potential of 3D-printed, drug-eluting implants as a clinically viable solution for the prevention and early treatment of PJIs. Graphical abstract

Bibliographic Information