3D-Printed Vancomycin- and Gentamicin-Loaded Bone Grafts for Osteomyelitis Treatment: Drug Release and Antibacterial Efficacy.

In this study, the potential of 3D printing technology for patient-adaptable osteomyelitis treatment was determined as well as the effects of antibiotic-loaded grafts on physicochemical properties, thermal stability, antimicrobial efficacy, and cell viability were evaluated. Polycaprolactone (PCL) and nanohydroxyapatite (HA) were used as the backbone of 3D grafts using different models, including Grid, Tri-Hexagon, Zigzag, and Gyroid. Later, gentamicin (10% and 15%), vancomycin (10% and 15%), and their combinations (5%-5% and 7.5%-7.5%) were added to the selected model graft. X-ray diffraction, thermal characterization, Fourier transform infrared spectroscopy (FTIR), and Raman spectroscopy analyses were conducted to characterize the obtained filament before 3D printing. The interaction of drugs and HA within the composite filaments was confirmed by FTIR and Raman spectroscopy. Thermal studies showed that the optimal temperature range for 3D printing did not disturb the structural integrity of the grafts. Cell viability and cytotoxicity assays also confirmed sustained cell viability, as well as those mentioned drug-loaded filaments' tests showed antibacterial effects against osteomyelitis-causing pathogens (Staphylococcus aureus, Escherichia coli). This study demonstrated the potential of combining 3D printing technology with localized drug delivery systems to enhance osteomyelitis treatment by providing patient-adaptable scaffold architectures that maximize drug efficacy and minimize systemic side effects, representing a promising strategy that warrants further preclinical validation before clinical translation.