Three-dimensional printing of antibiotics-loaded poly-ε-caprolactone/poly(lactic-co-glycolic acid) scaffolds for treatment of chronic osteomyelitis

Osteomyelitis, an infection and inflammation of bone marrow, often progresses to chronic stage because of delay in diagnosis and treatment. Once it becomes chronic, intravenous antibiotics therapy is no longer effective as swollen surrounding tissue interrupts blood flow into the infected tissue. In severe cases, debridement of the necrotic tissue becomes necessary to prevent further infection. In this study, for the first time, we produced three-dimensional (3D) printed antibiotics-loaded biodegradable poly-e-caprolactone/poly(lactic-co-glycolic acid) scaffold for treatment of chronic osteomyelitis. Subsequent bone regeneration in debrided site was also observed with the customized scaffolds fabricated using 3D printing. Tobramycin, one of the most widely used antibiotics in orthopedic surgery, was chosen due to its thermostable nature compliant to the heat-based fabrication conditions. In in vitro tests, antibacterial and anti-inflammatory effects and release profile of tobramycin from the scaffold were evaluated to verify the potential of our scaffold as a drug delivery system. In addition, in vivo efficacy of the developed drug loaded scaffolds for treatment of chronic osteomyelitis was also examined in a rat model.