Ex vivo study of use of physiotherapy ultrasound in polymethylmethacrylate beads doped with methylene blue as an antibiotic carrier in small animals orthopedic surgery

Luigi Milanez Ávila Dias Maciel; Sheila Canevese Rahal; Alessandra Melchert; Tulio Genari Filho; Carlos Dias Maciel; Ivan Felismino Charas dos Santos

doi:10.1590/1809-6891v22e-68013

Authors

Luigi Milanez Ávila Dias Maciel Universidade Estadual Paulista (UNESP), Botucatu, São Paulo, Brasil https://orcid.org/0000-0002-5815-7399
Sheila Canevese Rahal Universidade Estadual Paulista (UNESP), Botucatu, São Paulo, Brasil https://orcid.org/0000-0002-9211-4093
Alessandra Melchert Universidade Estadual Paulista (UNESP), Botucatu, São Paulo, Brasil https://orcid.org/0000-0002-8680-2121
Tulio Genari Filho Universidade Estadual Paulista (UNESP), Botucatu, São Paulo, Brasil https://orcid.org/0000-0001-8123-7912
Carlos Dias Maciel Universidade de São Paulo (USP), São Carlos, São Paulo, Brasil https://orcid.org/0000-0003-0137-6678
Ivan Felismino Charas dos Santos Universidade Estadual Paulista (UNESP), Botucatu, São Paulo, Brasil https://orcid.org/0000-0002-1175-4532

DOI:

https://doi.org/10.1590/1809-6891v22e-68013

Abstract

Polymethylmethacrylate bone cement is a standard material used as antibiotic carrier in the orthopedic surgery. The ultrasonic energy method is capable of triggering biological effects based on both thermal and non-thermal mechanisms. The aim of the current study is to analyze methylene blue dispersion in polymethylmethacrylate beads, in association with the acoustic field generated by non-thermal ultrasound. Forty-nine specimens were used, and each specimen comprised one polymethylmethacrylate bead (0.6-mm diameter) doped with methylene blue and deposited in gelatin sample. Forty test specimens were divided into four groups comprising 10 samples, each, based on different ultrasound intensities (Group 1: 1.0 W/cm²; Group 2: 1.5 W/cm²) and polymethylmethacrylate bead depths (A - 2 cm; B - 3 cm) in gelatin sample. The control group comprised other nine specimens and statistically differed from the other groups. All groups irradiated with ultrasound have shown statistically significant differences in methylene blue dispersion, except for Groups 2A and 2B. Methylene blue dispersion in gelatin among groups was 1A> 1B; 2A> 1A; 2B> 1A; 2A> 1B; and 2B> 1B. Low-intensity ultrasound enabled the highest methylene blue dispersion when polymethylmethacrylate bead was positioned superficial; bead depth associated with high-intensity ultrasound did not influence methylene blue dispersion.
Keywords: phonophoresis; non-thermal ultrasound; osteomyelitis; treatment.

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References

Gogia JS, Meehan JP, Di Cesare PE, Jamali AA. Local antibiotic therapy in osteomyelitis. Seminars in Plastic Surgery. 2009. 23(2): 100–107. Disponível em:http://dx.doi.org/10.1055/s-0029-1214162.

Gomes D, Pereira M, Bettencourt AF. Osteomyelitis: an overview of antimicrobial therapy. Brazilian Journal of Pharmacology Science. 2013. 49(1): 13-27. Disponível em:http://dx.doi.org/10.1590/S1984-82502013000100003.

Mihok P, Murray J, Williams R. Novel antibiotic delivery and novel antimicrobials in prosthetic joint infection. Journal of Traumatology and Orthopedics. 2016. 4(1): 52-54. Disponível em:http://dx.doi.org/10.82502013000100003.

Dorati R, Detrizio A, Modena T, Conti B, Benazzo F, Gastaldi G, GENTA I. Biodegradable scaffolds for bone regeneration combined with drug-delivery systems in osteomyelitis therapy. Pharmacology (Basel). 2017. 10(4): 1-21. Disponível em:http://dx.doi.org/10.3390/ph10040096.

Ford CA, Cassat JE. Advances in the local and targeted delivery of anti-infective agents for management of osteomyelitis. Expert Review of Anti-infective Therapy. 2017. 15(9): 851-860. Disponível em:http://dx.doi.org/10.1080/14787210.2017.1372192.

Mclaren AC. Alternative materials to acrylic bone cement for delivery of depot antibiotics in orthopaedic infections. Clinical Orthopaedics and Related Research. 2004. 427: 101-106. Disponível em:http://dx.doi.org/10.1097/01.blo.0000143554.56897.26.

Cui Q, Mihalko WM, Shields JS, Ries M, Saleh KJ. Antibiotic-impregnated cement spacers for the treatment of infection associated with total hip or knee arthroplasty. Journal of Bone Joint Surgery American. 2007. 89: 871-882. Disponível em:http://dx.doi.org/10.2106/JBJS.E.01070.

Magnan B, Bondi M, Maluta T, Samaila E, Schirru L, Dall’Oca C. Acrylic bone cement: current concept review. Musculoskeletal Surgery. 2013. 97: 93–100. Disponível em:http://dx.doi.org/10.1007/s12306-013-0293-9.

Mohanty SP, Kumar MN, Murthy NS. Use of antibiotic-loaded polymethyl methacrylate beads in the management of musculoskeletal sepsis — a retrospective study. Journal of Orthopedic Surgery. 2003. 11(1): 73-79. Disponível em:http://dx.doi.org/10.1177/230949900301100115.

Baker KG, Robertson VJ, Duck FA. A review of therapeutic ultrasound: biophysical effects. Physics Therapy. 2001. 81(7): 1351-1358. Disponível em:http://dx.doi.org/10.1093/ptj/81.7.1351.

Miller DL, Smith NB, Bailey MR, Czarnota GJ, Hynynen K, Makin IR. Overview of therapeutic ultrasound applications and safety considerations. Journal of Ultrasound Medical. 2012. 31(4): 623–634. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810427/.

Ter Haar G. Therapeutic ultrasound. European Journal of Ultrasound. 1999. 9:3–9. Disponível em: http://dx.doi.org 10.1016/s0929-8266(99)00013-0.

Goldstein A. The effect of acoustic velocity on phantom measurements. Ultrasound Medical Biology. 2000. 26(7): 1133-1143. Disponível em: http://dx.doi.org/10.1016/s0301-5629(00)00248-9.

Beard M. Guided wave inspection of embedded cylindrical structures. 2002. Engineering. 11 (2): 233-236.

Cárnio PB. Variação dos parâmetros físicos do campo ultra-sônico em fonoforese com diclofenaco gel. 2006. 76p. Dissertação (Mestrado em Bioengenharia) – Escola de Engenharia de São Carlos, Faculdade de Medicina de Ribeirão Preto, Instituto de Química de São Carlos, Universidade de São Paulo. Disponível em:http://dx.doi.org/10.11606/D.82.2006.tde-30072007-160907.

Escobar-Chávez JJ, Bonilla-Martínez D, Villegas-González MA, Rodríguez-Cruz IM, Domínguez-Delgado CL. The use of sonophoresis in the administration of drugs throughout the skin. Journal of Pharmacology Science. 2009. 12(1): 88-115. Disponível em: http://dx.doi.org/10.18433/J3C30D.

Azi ML, Kfuri Junior M, Martinez R, Paccola CAJ. Bone cement and gentamicin in the treatment of bone infection: background and in vitro study. Acta Orthopedics. 2010. 18(1): 31-34. Disponível em:http://dx.doi.org/10.1590/S1413-78522010000100006.

Goldstein A. The effect of acoustic velocity on phantom measurements. Ultrasound in Medicine and Biology. 2000. 26(7): 1133–1143. Disponível em:http://dx.doi.org/10.1016/s0301-5629(00)00248-9.

Culjat MO, Goldenberg D, Tewari P, Singh RS. A review of tissue substitutes for ultrasound imaging. Ultrasound Medice and Biology. 2010. 36(6): 861-873. Disponível em:http://dx.doi.org/10.1016/j.ultrasmedbio.2010.02.012.

Low L, Reed A. Eletroterapia explicada: princípios e prática. 2001. 3 ed. São Paulo, Manole, 131p.

Balmaseda Junior MT, Fatehi MT, Koozekanani SH, Lee AL. Ultrasound therapy: a comparative study of different coupling media. 1986. Archive of Physic and Medice Rehabilitation. 67: e14750. Disponível em:http://dx.doi.org/10.1016/0003-9993(86)90052-3.

Benson HAE, McElnay JC. Topical non-steroidal anti-inflammatory products as ultrasound couplants: their potential in phonophoresis. 1994. Physiotherapy. 80(2): 74-76. Disponível em:http://dx.doi.org/ 10.1016/S0031-9406(10)61010-3.