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Localized erythromycin may reduce aseptic loosening
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Erythromycin administered directly at the site of bone breakdown — rather than taken orally — can help prevent and treat bone wear without resulting in long-term whole-body side effects, according to a study published in the August issue of Clinical Orthopaedics and Related Research.
“Long-term systemic use of erythromycin raises concerns about various side effects, including bacterial resistance, liver damage and gastrointestinal discomfort,” study author Weiping Ren, MD, PhD, stated in a release. “We hypothesized that it may be advantageous to restrict erythromycin delivery to the inflammatory tissue around the implant to avoid these side effects.”
To test the idea, the researchers implanted metal pins coated with erythromycin in the inflamed tissue surrounding a prosthetic joint in a rat model. Bone growth and implant stability were measured, and microscopic images of the periprosthetic tissue were analyzed. It was found that in very low doses — about a quarter of the dose used for killing bacteria — erythromycin can effectively reduce aseptic loosening and inflammation.
“At the same time, we confirmed that oral erythromycin can be effectively delivered into the periproshetic tissues, supporting our hypothesis that oral erythromycin can be used as one of the nonsurgical treatment methods to extend implant longevity.”
According to the study authors, localized erythromycin treatment could safely treat aseptic loosening and reduce the likelihood that affected patients will require revision surgery.
“Medical insurance costs will be greatly reduced, because revision surgery is much more expensive than primary surgery,” Ren stated in the release.
Reference:
- Ren W, Markel DC. Emerging ideas: Can erythromycin reduce the risk of aseptic loosening? Clin Orthop Relat Res. 2011. doi: 10.1007/s11999-011-1918-7.
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