{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:20:08Z","timestamp":1790702408339,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Biomed Mater Res"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Periprosthetic joint infection (PJI) is a devastating complication of total joint arthroplasty, often necessitating two\u2010stage revision surgery with antibiotic\u2010loaded bone cement (ALBC) spacers, which cannot maintain therapeutic local antibiotic concentrations over time. This study evaluated the long\u2010term stability, antimicrobial efficacy, and biocompatibility of an alternative material, submicron gentamicin sulfate\u2010loaded ultrahigh molecular weight polyethylene (SM\u2010GS\/UHMWPE), in\u00a0vitro and in\u00a0vivo by using a subcutaneous rat model. SM\u2010GS\/UHMWPE implants containing 6\u2009wt% and 10\u2009wt% gentamicin sulfate (GS) were fabricated and tested in\u00a0vitro and simultaneously in\u00a0vivo by subcutaneous implantation in rats for 4, 8, and 26\u2009weeks. Gentamicin stability was assessed using nuclear magnetic resonance (NMR) spectroscopy and liquid chromatography\u2010mass spectrometry (LC\u2013MS\/MS). Antimicrobial efficacy against\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    <\/jats:styled-content>\n                    was determined via bacterial culture assays. Mechanical integrity was evaluated using tensile testing in\u00a0vitro. Systemic toxicity was assessed through liver and kidney function markers, and histological analysis of kidney and skin tissues was performed. NMR and LC\u2013MS\/MS confirmed that gentamicin remained chemically stable over 26\u2009weeks in\u00a0vivo and in\u00a0vitro. Antimicrobial testing showed sustained bacterial inhibition, with implants containing 10% GS achieving a 3.5\u2010log reduction in bacterial counts for 6\u2009months. Mechanical testing demonstrated minimal changes in tensile properties over time. Serum biochemical markers remained within normal ranges, and histological evaluation showed no significant inflammation or tissue damage. Gentamicin elution profiles indicated sustained release, maintaining intraarticular levels above 100 times the minimum inhibitory concentration (MIC) of\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>S. aureus<\/jats:italic>\n                    <\/jats:styled-content>\n                    for 6\u2009months. SM\u2010GS\/UHMWPE implants demonstrated prolonged antibiotic release while maintaining mechanical integrity, antimicrobial efficacy, and biocompatibility. These findings support the potential use of SM\u2010GS\/UHMWPE as a next\u2010generation antibiotic\u2010eluting spacer for PJI treatment, offering an alternative to ALBC for sustained drug release and reduced systemic toxicity risks.\n                  <\/jats:p>","DOI":"10.1002\/jbm.b.35673","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T01:35:56Z","timestamp":1760405756000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Advancing Joint Infection Treatment: Long\u2010Term Animal Implantation of Submicron Gentamicin\u2010Loaded\n                    <scp>UHMWPE<\/scp>"],"prefix":"10.1002","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9154-2697","authenticated-orcid":false,"given":"Mehmet D.","family":"Asik","sequence":"first","affiliation":[{"name":"Harris Orthopaedics Laboratory Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School Department of Orthopaedic Surgery  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Zhao","sequence":"additional","affiliation":[{"name":"Harris Orthopaedics Laboratory Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingfang","family":"Fan","sequence":"additional","affiliation":[{"name":"Harris Orthopaedics Laboratory Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School Department of Orthopaedic Surgery  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheus","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Harris Orthopaedics Laboratory Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Yang","sequence":"additional","affiliation":[{"name":"Harris Orthopaedics Laboratory Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoletta","family":"Inverardi","sequence":"additional","affiliation":[{"name":"Harris Orthopaedics Laboratory Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School Department of Orthopaedic Surgery  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amita","family":"Sekar","sequence":"additional","affiliation":[{"name":"Harris Orthopaedics Laboratory Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School Department of Orthopaedic Surgery  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keita","family":"Fujino","sequence":"additional","affiliation":[{"name":"Harris Orthopaedics Laboratory Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fawaz Ben","family":"Malick","sequence":"additional","affiliation":[{"name":"Harris Orthopaedics Laboratory Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith K.","family":"Wannomae","sequence":"additional","affiliation":[{"name":"Harris Orthopaedics Laboratory Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5761-719X","authenticated-orcid":false,"given":"Ebru","family":"Oral","sequence":"additional","affiliation":[{"name":"Harris Orthopaedics Laboratory Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School Department of Orthopaedic Surgery  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orhun K.","family":"Muratoglu","sequence":"additional","affiliation":[{"name":"Harris Orthopaedics Laboratory Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School Department of Orthopaedic Surgery  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1039\/D4TB02672A"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.08.021"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1051\/sicotj\/2021054"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics12040752"},{"issue":"22","key":"e_1_2_8_6_1","first-page":"2049","article-title":"Vacuum\u2010Mixing Significantly Changes Antibiotic Elution Characteristics of Commercially Available Antibiotic\u2010Impregnated Bone Cements","volume":"93","author":"Meyer 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D.","year":"2025","journal-title":"Journal of Bone and Joint Surgery (American Volume)"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpharm.2006.07.039"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-024-04871-y"},{"issue":"4","key":"e_1_2_8_22_1","first-page":"277","article-title":"The Antibiotic Resistance Crisis: Part 1: Causes and Threats","volume":"40","author":"Ventola C. 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