3D PRINTING TECHNOLOGY FOR ANTIBIOTIC-LOADED SCAFFOLDS IN THE TREATMENT OF POST-SURGICAL BONE REGENERATION: PRESENT STATUS, CHALLENGES, AND PROSPECTS

Abstract

Post-surgical bone infection is one of the most challenging complications in orthopaedic surgery due to the hypo vascularization of the affected tissue, bacterial biofilm formation, and inadequate antibiotic penetration to the infection site.[1,2] Currently available antibiotic-loaded systems, including polymethyl methacrylate (PMMA) bone cement, have a number of disadvantages, such as the need for surgical removal and low adaptability to heat-sensitive antibiotics.[3,4] Three-dimensional (3D) printing is a promising technology that allows the fabrication of patient-specific biodegradable scaffolds.[5–7] Such scaffolds can be loaded with antibiotics and possess both osteogenic and antibiotic elution properties.[5–7] The present review highlights recent advances in the development of antibiotic-loaded 3D-printed scaffolds for the treatment of post-surgical infections[8,9], including the description of various scaffolding technologies, materials suitable for 3D printing, methods for antibiotic incorporation, and the mechanism of their antibacterial and osteogenic activity.[5,6] Additionally, the preclinical and clinical evaluation of antibiotic-loaded 3D-printed scaffolds, as well as the regulatory, safety, and translational aspects of their application in orthopaedics and future perspectives, including the use of stimuli-responsive scaffolds and artificial intelligence, are discussed.[10–12] Overall, antibiotic-loaded 3D-printed scaffolds represent a new generation of scaffolds with good prospects for future clinical applications in orthopaedics.[12,13]