Drug-loaded biomaterials for orthopedic applications: A review

Drug-eluting implants are one of the leading implant technologies to facilitate the healing capacity of bones by eliminating implant-associated infections. Treatment of the infections like osteomyelitis, prevention of pathogen growth in the bone, and elimination of residual cancer cells, have become the predominant need of the orthopedic industry. Moreover, the mechanical compatibility of the implants to retain their strength under the corrosive environment of the body is one of the vital critical components needed to balance with biological properties. The drawbacks of permanent implants have already shifted the attention towards biodegradable materials due to various advantages, i.e., 1) eliminate the need for a second surgery and 2) Degradation rate, which will slowly transfer the load to the healing bone and reduces the problem of stress-shielding. However, implant-related infections are still a matter of concern despite these properties. The review focuses on highlighting various drug-loaded implant technologies investigated previously. The effects of different drugs to overcome the repercussions of bacterial colonies formed due to adherence of different bacteria over the surface of the bone are also highlighted. Gentamicin, vancomycin, and tobramycin are the frequently used antibiotics for such functions to act as an anti-inflammatory and antimicrobial agent and are evaluated through this study. Different in-vitro and in-vivo studies were performed to analyze the cytocompatibility, hemolytic behavior, release rate of drugs, and anti-bacterial properties of the implant materials against different pathogens such as S. Aureus, E.Coli, S. Epidermidisare covered under this review.