Unraveling the potential of bioadhesive antimicrobial microparticles for the treatment of prosthetic joint infections

Periprosthetic joint infections (PJIs) are serious complications following hip or knee arthroplasty, and current preventive and therapeutic strategies remain suboptimal due to inadequate antimicrobial efficacy. This study explores a novel approach for preventing and treating bacterial and fungal PJIs using smart bioadhesive microparticles obtained by spray drying and loaded with vancomycin (a broad-spectrum antibacterial) and amphotericin B (AmB, an antifungal). Dry microparticles were redispersed into a hyaluronic gel before adhesion to the prosthesis. The microparticles exhibited a sustained drug release profile, characterized by an initial burst release (40 %–80 % for AmB and vancomycin respectively) within the first 10 h, followed by prolonged release over seven days. The formulation demonstrated high efficacy against multiple pathogens, including Staphylococcus spp. (S. epidermidis and S. aureus) and Candida spp. (C. albicans, C. parapsilopsis, C. glabrata, and C. krusei). Additionally, the microparticles showed low hemolytic toxicity and provided a protective effect on mammalian cell lines (Saos-2, BJ, hFOB). These findings highlight a promising strategy for PJI prophylaxis and treatment, with potential for seamless integration into clinical practice.