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WO2008035535A1 - Capsule including antibacterial agent and artificial joint having the capsule attached thereto - Google Patents

Capsule including antibacterial agent and artificial joint having the capsule attached thereto Download PDF

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Publication number
WO2008035535A1
WO2008035535A1 PCT/JP2007/066352 JP2007066352W WO2008035535A1 WO 2008035535 A1 WO2008035535 A1 WO 2008035535A1 JP 2007066352 W JP2007066352 W JP 2007066352W WO 2008035535 A1 WO2008035535 A1 WO 2008035535A1
Authority
WO
WIPO (PCT)
Prior art keywords
capsule
drugs
antibacterial
drug
porous
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP2007/066352
Other languages
English (en)
French (fr)
Inventor
Takao Hotokebuchi
Iwao Noda
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Saga University NUC
Kyocera Medical Corp
Original Assignee
Saga University NUC
Kyocera Medical Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Saga University NUC, Kyocera Medical Corp filed Critical Saga University NUC
Publication of WO2008035535A1 publication Critical patent/WO2008035535A1/ja
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30721Accessories
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/41641,3-Diazoles
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    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/425Thiazoles
    • A61K31/429Thiazoles condensed with heterocyclic ring systems
    • A61K31/43Compounds containing 4-thia-1-azabicyclo [3.2.0] heptane ring systems, i.e. compounds containing a ring system of the formula, e.g. penicillins, penems
    • AHUMAN NECESSITIES
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    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/4965Non-condensed pyrazines
    • A61K31/497Non-condensed pyrazines containing further heterocyclic rings
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    • A61K31/70Carbohydrates; Sugars; Derivatives thereof
    • A61K31/7028Compounds having saccharide radicals attached to non-saccharide compounds by glycosidic linkages
    • A61K31/7034Compounds having saccharide radicals attached to non-saccharide compounds by glycosidic linkages attached to a carbocyclic compound, e.g. phloridzin
    • A61K31/7036Compounds having saccharide radicals attached to non-saccharide compounds by glycosidic linkages attached to a carbocyclic compound, e.g. phloridzin having at least one amino group directly attached to the carbocyclic ring, e.g. streptomycin, gentamycin, amikacin, validamycin, fortimicins
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    • A61K31/7042Compounds having saccharide radicals and heterocyclic rings
    • A61K31/7048Compounds having saccharide radicals and heterocyclic rings having oxygen as a ring hetero atom, e.g. leucoglucosan, hesperidin, erythromycin, nystatin, digitoxin or digoxin
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    • A61K31/7042Compounds having saccharide radicals and heterocyclic rings
    • A61K31/7052Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides
    • A61K31/7056Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing five-membered rings with nitrogen as a ring hetero atom
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    • A61K9/0012Galenical forms characterised by the site of application
    • A61K9/0019Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
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    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/50Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • A61L27/54Biologically active materials, e.g. therapeutic substances
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    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/50Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • A61L27/56Porous materials, e.g. foams or sponges
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    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
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    • A61P31/04Antibacterial agents
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    • A61P31/04Antibacterial agents
    • A61P31/06Antibacterial agents for tuberculosis
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    • A61P31/10Antimycotics
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    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/3094Designing or manufacturing processes
    • AHUMAN NECESSITIES
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    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • A61F2/36Femoral heads ; Femoral endoprostheses
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/32Joints for the hip
    • A61F2/36Femoral heads ; Femoral endoprostheses
    • A61F2/3662Femoral shafts
    • A61F2/367Proximal or metaphyseal parts of shafts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
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    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30108Shapes
    • A61F2002/30199Three-dimensional shapes
    • A61F2002/30224Three-dimensional shapes cylindrical
    • A61F2002/30233Stepped cylinders, i.e. having discrete diameter changes
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
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    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30317The prosthesis having different structural features at different locations within the same prosthesis
    • A61F2002/30322The prosthesis having different structural features at different locations within the same prosthesis differing in surface structures
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    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
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    • A61F2002/30667Features concerning an interaction with the environment or a particular use of the prosthesis
    • A61F2002/30677Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61L2300/60Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a special physical form
    • A61L2300/62Encapsulated active agents, e.g. emulsified droplets

Definitions

  • the present invention relates to a capsule attached to an artificial joint and containing an antibacterial drug, and an artificial joint to which the capsule is attached.
  • Patent Document 1 discloses a method in which hydroxyapatite is deposited on an implant surface and dried to form a hydroxyapatite layer having a large specific surface area, and the hydroxyapatite layer is impregnated with an antibiotic or the like ( Patent Document 1). Since the hydroxyapatite layer deposited on the implant surface contains antibiotics, infection with artificial joint replacement can be suppressed with the antibiotics after the implant is attached to the human body Patent Document 1: Special Table 2005— No. 506879
  • an object of the present invention is to provide an antibacterial agent that can be slowly and slowly released at a desired rate and retain a large amount of drug.
  • the object is to provide a medicine-containing capsule and an artificial joint to which the medicine-containing capsule is attached.
  • the inventors of the present invention made porous capsules containing antibacterial drugs, and contained antibacterial drugs such as antibiotics in the porous capsules.
  • antibacterial drugs such as antibiotics
  • the porous layer By coating the porous layer on the implant and impregnating the porous layer with the antibacterial drug, more drug can be retained, and by controlling the pore diameter and porosity of the porous wall, The present inventors have found that the drug can be released slowly at a desired rate and have completed the present invention.
  • the present invention has been made on the basis of force and knowledge, and the gist of the present invention is a capsule filled with an antibacterial drug, and the capsule is composed of a porous member.
  • An antibacterial drug-containing capsule that is attached to at least a part of an artificial joint and gradually releases the filled antibacterial drug into a joint capsule or bone via the porous member.
  • the member is in an antibacterial drug-containing capsule, wherein the member has an average porosity of 10% to 80%.
  • the average porosity is less than 10%, the pores are in a dispersed state, cannot be in communication with each other, and the antibacterial drug cannot be released from the capsule! /, .
  • the average porosity exceeds 80%, the mechanical strength of the capsule is decreased, which is not preferable. Yes.
  • the average porosity of the porous member of the capsule is 10% to 80%, sustained release in the medium to long term is possible.
  • the porous wall portion of the capsule is preferably made of porous ceramics, porous metal, or porous resin.
  • the antibacterial drug filled in the capsule is a beta-ratata antibacterial agent such as penicillin, an amino darcoside antibacterial agent such as gentamicin, ciprofloxacin fluo Roquinolone antibiotics, macrolide antibiotics such as erythromycin, darcopeptide antibiotics such as ticobranine, lincomycin antibiotics such as clindamycin, tetracycline antibiotics such as tetracycline, ST combination, metronidazole, and ketolide
  • a beta-ratata antibacterial agent such as penicillin, an amino darcoside antibacterial agent such as gentamicin, ciprofloxacin fluo Roquinolone antibiotics, macrolide antibiotics such as erythromycin, darcopeptide antibiotics such as ticobranine, lincomycin antibiotics such as clindamycin, tetracycline antibiotics such as tetracycline, ST combination, metronidazole, and ketolide
  • antibacterial agents include animal drugs such as chitin and chitosan, microbial drugs such as polylysine, enzyme drugs such as lysozyme, plant drugs such as hinokitiol, and metal ions such as silver, copper, and zinc.
  • animal drugs such as chitin and chitosan
  • microbial drugs such as polylysine
  • enzyme drugs such as lysozyme
  • plant drugs such as hinokitiol
  • metal ions such as silver, copper, and zinc.
  • the antibacterial agent is preferably mixed with a gelling agent such as gelatin, agar, carrageenan or pectin.
  • a gelling agent such as gelatin, agar, carrageenan or pectin.
  • the present invention provides an artificial joint to which any one of the antibacterial drug-containing capsules is attached, and the antibacterial agent filled in the capsule when the artificial joint is inserted into a bone.
  • the artificial joint is characterized in that the drug is gradually released into the joint capsule or bone.
  • the capsule is most effective when placed in a joint capsule having a high possibility of infection, and is effective for the growth of bacteria in the joint capsule. Can be suppressed or sterilized.
  • controlled release of the drug can be achieved by controlling the porosity and pore diameter as described above, and controlling the pore diameter, the number of pores and the pore distribution. Since the capsule has a hollow portion inside and has a sufficiently large space, a sufficient amount of drug can be held.
  • inorganic antibacterial agents that could not be effectively retained by the prior art can be retained in an amount sufficient for the prevention and treatment of infection by using the present invention.
  • FIG. 1 is a schematic diagram showing an example of an antibacterial drug-containing capsule according to an embodiment of the present invention.
  • FIG. 2 is a schematic view showing an example of a sustained release capsule attached to a stem.
  • FIG. 3 is a schematic view showing a production process by a green tape laser sintering method.
  • an antibacterial drug-containing capsule according to the present invention and an artificial joint to which the capsule is attached will be described in detail with reference to the drawings.
  • the antibacterial drug-containing capsule according to the present embodiment and the artificial joint to which the capsule is attached are merely examples, and the present invention is not limited to these embodiments.
  • common parts are denoted by the same reference numerals, and redundant description is omitted.
  • the number of arrangement of each component, the arrangement position, and the like can be appropriately set depending on the purpose, application, desired performance, etc. of the capsule containing the antibacterial drug.
  • FIG. 1 is a schematic view showing an example of an antibacterial drug-containing capsule according to an embodiment of the present invention.
  • the antibacterial drug-containing capsule 1 includes a hollow part 2 filled with an antibacterial drug, and a porous wall part 3 covering the hollow part 2.
  • the antibacterial drug-containing capsule 1 is attached to the upper end of the stem 4 and is inserted into the medullary cavity (not shown) of the femur to regenerate the joint capsule. 1 is located in the joint capsule.
  • Stem 4 If it is attached to the lower end of the stem, the stem 4 can be positioned in the medullary cavity of the femur, for example.
  • the capsule containing the antibacterial drug according to the present invention is used, it is antibacterial Since the capsule containing the drug is placed in the joint capsule or in the medullary cavity and bacteria in the joint capsule and in the medullary cavity are sterilized, there is no need for reoperation.
  • a porous hydroxyapatite layer is formed on the implant surface, and more antibacterial drugs can be retained than the conventional type in which antibiotics are impregnated in the hydroxyapatite. It is possible to sterilize bacteria and the like effectively. Insufficient sterilization in infection treatment will not only cause the infection to recur, but also lead to the development of resistant bacteria. Therefore, placing a sufficient amount of antibacterial agent at the site of infection is an important factor in preventing infection and treating infection.
  • the antibacterial drug-containing capsule 1 includes a porous portion at least in part.
  • the porous part is preferably a porous ceramic, a porous metal, or a porous resin.
  • porous ceramics include oxide ceramics such as aluminum oxide (alumina) and zirconium oxide (zircoua), calcium phosphates such as hydroxyapatite (HA), tricalcium phosphate (TCP), and tetracalcium phosphate (TeCP).
  • the sintered body is preferably made of a ceramic ceramic or phosphoric glass ceramic. Further, the porous ceramic may be a sintered body made of these composites.
  • the porous metal is preferably titanium, titanium alloy, zirconium, tantalum, cobalt chromium alloy, or stainless steel, and the porous resin is polyethylene, polyurethane, acrylic resin, or epoxy resin. It is preferable.
  • the shape of the capsule may be any shape.
  • the capsule When the capsule is screwed to the stem using a hand or a wrench, it is preferably a polygonal columnar shape. Further, when the capsule is fitted using a hammer or the like, any shape may be used.
  • the thickness of the capsule wall is preferably 0.5 mm to 2 mm. More preferably, it is Omm. If the thickness is reduced, the sustained release time can be shortened, but the structural strength is lowered. Further, if the thickness is increased, the structural strength is improved, but the sustained release time becomes longer. Therefore, the thickness is preferably 0.5 mm to 1 Omm.
  • the pore size of the pores provided in the capsule is preferably 0.1 ⁇ m to 300 ⁇ m! / ⁇ .
  • the porosity is preferably 10 to 80%.
  • the controlled release period of the antibacterial drug is 1 to 90 days.
  • the capsule is effective not only for short-term infection prevention after artificial joint surgery but also for medium- to long-term infection prevention. Even after all the antibacterial drugs have disappeared, the antibacterial effects can be regained by supplementing the antibacterial drugs or replacing them with new ones.
  • the capsule When the capsule is applied to an artificial hip joint, the capsule may be attached to an artificial hip joint femoral component (stem) or an artificial hip joint acetabular component (cup). It can also be attached to the screw head of the screw, in which case it can be placed on any native bone. In cases where it is difficult to attach to an artificial joint or to a natural bone, it can be fixed to cartilage with a thread or wire.
  • a method for producing the porous ceramic after mixing a ceramic powder with a pore material such as carbon powder and naphthalene powder of a predetermined particle size, after molding by a method such as squeeze molding, extrusion molding, press molding, rubber press molding, Effective methods include firing and grinding, or cutting and firing after forming. Adjust the amount of pore agent added so that the pores communicate with each other. Further, a method using a foaming agent such as hydrogen peroxide or a method of adjusting the sintering temperature to make it porous can be used. In addition, a thin layer of powder material strength is formed, and the layer is irradiated with laser light and instantaneously sintered to form a hardened layer. Fine powders of ceramics, metal, etc.
  • the method for producing an antibacterial drug-containing capsule according to the present invention will be described taking as an example the case of a hydoxy xylate.
  • polyethyleneimine or the like is added as a crosslinkable resin to hydroxyapatite powder, and mixed and crushed using ultrapure water as a dispersion medium to prepare a slurry.
  • a foaming agent at least one selected from polyoxyethylene lauryl ether, lauryl betaine, lauryl sulfate triethanolamine, etc. is added to the slurry and stirred to foam.
  • a crosslinking agent (sorbitol polyglycidyl ether, etc.) is added, the foam slurry is put in a mold, the foam structure is fixed and dried, and then sintered at a temperature of about 1100 ° C to about 1300 ° C. A hydroxyapatite porous sintered body is obtained. This calcination is carried out for 0.5 to 3 hours.
  • a green tape is produced.
  • a slurry 5 is prepared by mixing ceramics and / or metal fine particles, a binder, and a solvent that constitute the capsule.
  • the power that can use any material as ceramics and metal
  • quaternary calcium phosphate (Te CP), calcium phosphate glass ceramic, titanium, titanium alloy, zirconium, tantalum, cobalt chromium alloy, stainless steel, or the like can be used.
  • Te CP quaternary calcium phosphate
  • Ca CP calcium phosphate glass ceramic
  • titanium, titanium alloy, zirconium, tantalum, cobalt chromium alloy, stainless steel, or the like can be used.
  • acrylic resin or styrene resin as the binder and water, ethyl alcohol, butyl alcohol, isopropyl alcohol, or toluene as the solvent.
  • the slurry 5 mixed as described above is formed into a sheet having a constant thickness in the same manner as the doctor blade method. Then by drying this sheet The solvent in the slurry is volatilized and solidified. Thereafter, the sheet is cut into a certain size.
  • one sheet of the sheet cut into a certain size is stacked, and laser light 7 is applied to the sheet 6 according to the 3D CAD data of the capsule. Irradiate to solidify the metal or ceramic in the irradiated part.
  • the second sheet 6 is laminated, and the laser beam 7 is irradiated in the same manner as described above to solidify the metal or ceramic in the irradiated portion.
  • the portion 8 solidified by sintering is taken out from the laminated green tape and processed into a predetermined shape, whereby an antibacterial drug-containing capsule can be produced.
  • the pore diameter and porosity of the produced capsule can be adjusted by adjusting the concentration of the metal or ceramic contained in the green tape, thereby filling the inside. Since the release rate of an antibacterial drug can be adjusted, it is preferably used. In addition, this manufacturing method is preferable because any material can be used and a complicated shape can be manufactured.
  • the antibacterial drug capsule is made of a porous metal body, it can be made using a sintered body of metal powder or metal particles as described above, but the metallic mesh is fixed by sintering. It is easy to make it.
  • the hole diameter, the number of holes, and the hole distribution can be arbitrarily controlled.
  • holes having a diameter of 76 ⁇ m were processed at a pitch interval of 100 ⁇ m using a laser beam on a titanium plate having a thickness of 0.2 mm.
  • sustained release of the drug is preferably carried out by adjusting the porosity and the pore diameter.
  • the size of the antibacterial drug-containing capsule can be increased as long as it does not cause a problem in the function of the artificial joint. If the size is large, a large amount of drug can be held in the force vessel.
  • the capsule is generally composed of two parts, a main body and a lid. This is to store the antibacterial drug in the hollow portion inside the capsule. In the case of a drug with low viscosity and easy impregnation, it can be stored even if the capsule is integrally molded.
  • any of an antibacterial agent, a natural antibacterial agent, an inorganic antibacterial agent, and an organic antibacterial agent may be used. You can use any mixture of two or more of these.
  • antibacterial agent examples include beta-latatam antibacterial agents such as penicillin, amaminodarcoside antibacterial agents such as gentamicin, ciprofloxacin fluoroquinolone antibacterial agents, macrolide antibacterial agents such as erythromycin, Examples include darcopeptide antibiotics such as ticobranine, lincomycin antibiotics such as clindamycin, tetracycline antibiotics such as tetracycline, ST combinations, metronidazole, and ketolide antibiotics.
  • natural antibacterial agents include animal drugs such as chitin and chitosan, microbial drugs such as polylysine, enzyme drugs such as lysozyme, and plant drugs such as hinokitiol.
  • examples of the inorganic antibacterial agent include those in which metal ions such as silver, copper and zinc are supported on a silicate such as zeolite and a phosphate such as zirconium phosphate.
  • organic antibacterial agents include alcoholic agents such as ethyl alcohol, alcoholic agents such as benzenecarboxylic acid, esteric agents such as methylparaben, nitrile agents such as TPN, and Sampras.
  • Halogen drugs pyridin quinoline drugs such as oxine, isothiazolone drugs such as caisson, imidazole thiazole drugs such as TBZ, anilide drugs such as halcarban, biguanide drugs such as clodin hexidine dalconate
  • Examples include thiocarbamate agents such as carbam, surfactant agents such as benzalkonium chloride, and oxine copper.
  • These antibacterial drugs are preferably mixed with a gelling agent. It is possible to adjust the sustained release period of the antibacterial drug by mixing it with the gelling agent and filling it in the capsule according to the present invention. Especially in the case of liquid drugs, mixing with a genolic agent is possible. It is effective.
  • the sustained release period is adjusted by adjusting the content of the gelling agent in the gel. In other words, gels using a large amount of gelling agent do not contain much hard water, so that drug elution is suppressed. On the other hand, when a small amount of gelling agent is used, the gel contains a lot of soft water, so it does not significantly suppress the elution of the drug. By using the gelling agent in this way, it is possible to increase the force 1.5 times to 20 times when the sustained release period of the antibacterial drug is not used.
  • the gelling agent gelatin, agar, carrageenan or pectin is preferably used.
  • a slurry was prepared by mixing hydroxyapatite as a ceramic, a water-soluble acrylic resin as a binder, and pure water as a solvent. Subsequently, the slurry was formed into a 0.2 mm sheet in the same manner as the doctor blade method. Thereafter, the sheet was dried to evaporate and solidify the solvent in the slurry, and then the sheet was cut into a plurality of pieces.
  • the antibacterial drug-containing capsule is composed of two members, a container-like part and a lid part that fits snugly.
  • Penicillin powder (which is gelled with agar) is put into the capsule as an antibacterial agent, and then the container part and the lid part are fitted together, and the stem behind the tapered part of the artificial hip joint stem Screwed into the driving hole.
  • press molding was performed using a mold.
  • the molded body was sintered at 1150 ° C and ground into a capsule shape to produce the container and lid.
  • Gentamicin powder was placed in the container.
  • the porosity of this cabcel material was 40% and the pore diameter was 80-200 m.
  • Capsule containers and lids were made by pouring titanium beads with a diameter of 200 m into capsule-shaped tungsten molds and heat-treating them in a vacuum oven at 1300 ° C for 2 hours.
  • the capsule material had a porosity of 30% and a pore diameter of 20-40 m. This cuff.
  • the cell contained ceramic powder loaded with silver ions, a typical inorganic antibacterial agent, and showed good elution of silver ions in bovine serum.
  • the antibacterial drug-containing capsule is a container that contains an antibacterial drug and can be gradually released.
  • the capsule is attached to a part of an artificial joint, and after the artificial joint is mounted, It is used to suppress and sterilize bacterial growth in the joint capsule and around the stem by slowly releasing the antibacterial agent into the cavity.

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Description

明 现 曞
抗菌性薬剀含有カプセル及びそれが取着されおなる人工関節
技術分野
[0001] 本発明は、人工関節に取着され抗菌性薬剀を含有するカプセル、及びこれが装着 された人工関節に関する。
背景技術
[0002] 人工関節は疟病や怪我などで関節機胜が倱われた堎合にその再建を目的ずしお 広く甚いられおいる。人工関節は有甚な医療甚具であるが、いく぀かの課題を有しお おり、その内最も重節なものが感染の問題である。
[0003] 䟋えば、倧腿骚の髄腔に人工股関節が揷入された堎合にその滅菌が完党でない ず、人工股関節郚分、特に関節包内及び髄腔内においお现菌等が増殖しおしたい 最悪の堎合倧がかりな人工股関節の抜去、再眮換手術を行わなければならず、患者 にず぀お倧きな負担ずなっお!/、る。
[0004] このような術埌の感染症を防止するため様々な方法が採られおいる。特蚱文献 1で は、むンプラント衚面にハむドロキシアパタむトを沈着させそれを也燥させお、比衚面 積が倧きなハむドロキシアパタむト局を圢成し、圓該ハむドロキシアパタむト局に抗生 物質などを含浞させる方法が開瀺されおいる特蚱文献 1)。むンプラント衚面に沈着 したハむドロキシアパタむト局が抗生物質を含有するため、このむンプラントを人䜓に 装着埌、圓該抗生物質により、人工関節眮換術による感染症を抑制するこずができる 特蚱文献 1 :特衚 2005— 506879号公報
発明の開瀺
発明が解決しょうずする課題
[0005] しかしながら、䞊蚘方法により䜜補したむンプラントでは、ハむドロキシアパタむト局皮 膜の気孔埄、気孔率を傟斜的に蚭定するこずは困難であり、そのため圓該皮膜の気 孔埄、気孔率が均䞀ずなるため、薬剀は䞀定速床で急速に溶出しおしたい、所望の 速床で薬剀を埐攟するこずができなレ、。 [0006] たた、ハむドロキシアパタむト等からなるコヌティング局には厚みの制玄があるため、 倚量の薬剀を含浞した状態で保持するこずは困難である。
[0007] さらに、䞊蚘方法により䜜補したむンプラントでは、氎などに溶解性のある倩然系、 有機系抗菌剀をコヌティング局に保持させ䜿甚するこずができる力 これらの抗菌性 胜は䜎ぐ抗生物質同様に耐性菌が発生し易い。䞀方、最も抗菌性胜が高く耐性菌 も発生させない無機系抗菌剀のような非溶解性の抗菌剀にずっおは䞍利ずなる。なぜ ならば、懞濁液に非溶解性の抗菌剀を混合しこれをコヌティング局の衚局に含浞さ せる力 これではアパタむト局の衚面に埃のように乗っおいるだけであり保持性を有さ ず、実甚性があるずは蚀い難いからである。
[0008] したがっお、本発明は叙䞊の課題に鑑みおなされたものであり、その目的ずするずこ ろは、所望の速床で緩やかに埐攟され、倚量の薬剀を保持するこずができる抗菌性 薬剀含有カプセル及びそれが装着されおなる人工関節を提䟛するこずにある。
課題を解決するための手段
[0009] 本発明者らは、鋭意研究を重ねた結果、抗菌性薬剀を含有させるものを倚孔性の カプセル状ずし、該倚孔性のカプセル内に抗生物質等の抗菌性薬剀を含有させるず 、倚孔質局をむンプラント䞊に被芆し圓該倚孔質局内に抗菌性薬剀を含浞させた堎 合より倚くの薬剀を保持でき、さらに倚孔質壁郚の気孔埄、気孔率を制埡するこずに よっお、所望の速床で薬剀を埐攟するこずができるこずを芋出し、本発明を完成する に至った。
[0010] 本発明は、力、かる知芋に基づいお成されたものであり、その芁旚ずするずころは、抗 菌性薬剀が充填されるカプセルであっお、該カプセルは倚孔質郚材から構成され、 人工関節の少なくずも䞀郚に取着され、䞊蚘充填された抗菌性薬剀を䞊蚘倚孔質郚 材を介しお関節包内又は骚内に埐攟する抗菌性薬剀含有カプセルであっお、䞊蚘 倚孔質郚材が、 10%〜80%の平均気孔率を有するこずを特城ずする抗菌性薬剀含 有カプセルにある。
[0011] ここで、平均気孔率が 10%未満である堎合、気孔が分散状態ずなり、盞互に連通し た状態ずするこずができず抗菌性薬剀をカプセルから攟出するこずができな!/、。たた 平均気孔率が 80%を超えるず圓該カプセルの機械的匷床が䜎䞋するため奜たしくな い。圓該カプセルの倚孔質郚材の平均気孔率を 10%〜80%ずするこずにより、䞭長 期の埐攟が可胜ずなる。
[0012] たた、䞊蚘カプセルの倚孔質壁郚は、倚孔質セラミックス、倚孔質金属又は倚孔質 暹脂からなるこずが奜たしい。
[0013] 本発明に係る抗菌性薬剀含有カプセルにおいお、䞊蚘カプセル内に充填される抗 菌性薬剀は、ペニシリンなどのベヌタラタタム系抗菌薬、ゲンタマむシンなどのアミノ ダルコシド系抗菌薬、シプロフロキサシンフルォロキノロン系抗菌薬、゚リスロマむシン などのマクロラむド系抗菌薬、ティコブラニンなどのダルコペプチド系抗菌薬、クリンダ マむシンなどのリンコマむシン系抗菌薬、テトラサむクリン等のテトラサむクリン系抗菌薬 、 ST合剀、メトロニダゟヌル、及びケトラむド系抗菌薬からなる矀から遞択される少な くずも 1぀であるこずが奜たしレ、。
[0014] さらに、抗菌性薬剀は、キチン'キトサンなどの動物系薬剀、ポリリゞンなどの埮生物 系薬剀、リゟチヌムなどの酵玠系薬剀、ヒノキチオヌルなどの怍物系薬剀、銀、銅、 亜鉛などの金属むオンをれオラむトなどの珪酞塩や燐酞ゞルコニりムなどの燐酞塩に 担持させた無機系薬剀、゚チルアルコヌルなどのアルコヌル系薬剀、ベンれンカル ボン酞などのアルコヌル系薬剀、メチルパラベンなどの゚ステル系薬剀、 TPNなどの 二トリル系薬剀、サンプラスなどのハロゲン系薬剀、ォキシンなどのピリゞン'キノリン 系薬剀、ケヌ゜ンなどのむ゜チアゟロン系薬剀、 TBZなどのむミダゟヌル'チアゟヌル 系薬剀、ハルカルバンなどのァニリド系薬剀、ダルコン酞クロ口ぞキシゞンなどのビグ アナむド系薬剀、カヌバムなどのチォカヌバメヌト系薬剀、塩化ベンザルコニゥムな どの界面掻性剀系薬剀、ォキシン銅などの有機系金属系薬剀から遞択される少なく ずも 1぀であるこずが奜たしい。
[0015] たた、䞊蚘抗菌性薬剀は、れラチン、寒倩、カラギヌナン若しくはぺクチンなどのゲ ル化剀に混合されおなるこずが奜たしい。抗菌性薬剀をこのようなゲル化剀に混合す るこずにより、抗菌性薬剀の埐攟期間を調敎するこずができる。
[0016] たた、本発明は、䞊蚘いずれかの抗菌性薬剀含有カプセルが取着されおなる人工 関節であっお、該人工関節を骚内に挿入した際、䞊蚘カプセル内に充填された抗菌 性薬剀が関節包内又は骚内に埐攟されるこずを特城ずする人工関節にある。 発明の効果
[0017] 本発明に係る抗菌性薬剀含有カプセルによれば、圓該カプセルは感染の可胜性 の高い関節包内に配眮された堎合に最も有効であり、関節包内の现菌の増殖を効 果的に抑制するたたは殺菌するこずができる。たた、䞊述の劂ぐ気孔率や気孔埄を 制埡したり、孔埄、孔数、孔分垃を制埡するこずにより、薬剀の埐攟を行うこずができる 。圓該カプセルは内郚に䞭空郚を有し十分倧きなスペヌスを有するため十分な量の 薬剀を保持させるこずができる。
[0018] さらに、埓来技術では有効に保持できなかった無機系抗菌剀も、本発明を䜿甚す れば、感染の予防や治療に十分な量を保持させるこずができる。
図面の簡単な説明
[0019] [図 1]図 1は、本発明の実斜の圢態に係る抗菌性薬剀含有カプセルの䞀䟋を瀺す抂 略図である。
[図 2]図 2は、ステムに取り付けられた埐攟性カプセルの䞀䟋を瀺す抂略図である。
[図 3]図 3は、グリヌンテヌプレヌザヌ焌結法による補造工皋を瀺した抂略図である。 発明を実斜するための最良の圢態
[0020] 以䞋、本発明に係る抗菌性薬剀含有カプセル及びこれが装着された人工関節の 奜たしい実斜の圢態を、図面を参照しながら詳现に説明する。しかし、本実斜の圢態 に係る抗菌性薬剀含有カプセル及びそれが取着された人工関節は、䟋瀺するもの であっお、本発明はこれらの実斜の圢態に限定されるものではない。なお、各図にお いお、共通する郚分に぀いおは同䞀の笊号を付し重耇した説明を省略する。各構成 芁玠の配眮個数、配眮䜍眮等は限定的でなぐ抗菌性薬剀含有カプセルの䜿甚目 的、甚途、所望の性胜等により適宜蚭定するこずができる。
[0021] (抗菌性薬剀含有カプセル
図 1は、本発明の実斜の圢態に係る抗菌性薬剀含有カプセルの䞀䟋を瀺す抂略 図である。抗菌性薬剀含有カプセル 1は、抗菌性薬剀が充填される䞭空郚 2ず、該䞭 空郚 2を芆う倚孔質の壁郚 3ず、を備える。抗菌性薬剀含有カプセル 1は、図 2に瀺す ように、ステム 4の䞊端に取り付けられ、か぀ステム 4が倧腿骚の髄腔䞍図瀺に揷 入され関節包が再生されるず、圓該カプセル 1は関節包内に䜍眮する。たた、ステム 4 の䞋端に取り付ければ、圓該ステム 4を䟋えば倧腿骚の髄腔内に䜍眮させるこずがで きる。関節包内又は髄腔内に现菌等が䟵入しお繁殖する (感染が発生するず、再手 術を行うこずが必芁になる力 本発明に係る抗菌性薬剀含有カプセルを甚いれば、 抗菌性薬剀を含有するカプセルが関節包内又は髄腔内に配眮され関節包内及び 髄腔内の现菌等が殺菌されるため再手術を行う必芁がない。
[0022] たた本発明では、むンプラント衚面に倚孔質性のハむドロキシアパタむト局を圢成し 、圓該ハむドロキシアパタむト内に抗生物質等が含浞された埓来型のものより、倚くの 抗菌性薬剀を保持するこずができ、现菌などを有効に殺菌するこずが可胜である。感 染治療においお十分な殺菌ができないず、感染が再発するのみならず、耐性菌を発 生させるこずに繋がる。よっお十分な量の抗菌性薬剀を感染郚䜍に配眮するこずは感 染予防、感染治療を行う䞊で重芁なファクタヌである。
[0023] 本発明に係る抗菌性薬剀含有カプセル 1は、少なくずもその䞀郚に倚孔質郚を備 える。圓該倚孔質郚は、倚孔質セラミック、倚孔質金属若しくは倚孔質暹脂であるこず が奜たしい。䞊蚘倚孔質セラミックスずしおは、酞化アルミニりムアルミナ、酞化ゞル コニゥムゞルコナアなどの酞化物系セラミックス、ハむドロキシアパタむトHA)、第 䞉燐酞カルシりムTCP)、第四燐酞カルシりムTeCP)などのリン酞カルシりム系セ ラミックス、若しくはリン酞系ガラスセラミックスからなる焌結䜓であるこずが奜たしい。た た、倚孔質セラミックスは、これらの耇合物からなる焌結䜓であっおもよい。これらは、 圓該カプセル 1を人䜓内に配眮したずしおも、生䜓に察しお無毒無害でし力、も倧きな 機械的匷床を有しおいるからである。たた、倚孔質金属は、チタン、チタン系合金、ゞ ルコニゥム、タンタル、コバルト クロム系合金、若しくはステンレス鋌であるこずが奜た しぐ倚孔質暹脂は、ポリ゚チレン、ポリりレタン、アクリル暹脂、若しくぱポキシ暹脂 であるこずが奜たしい。
[0024] たた、䞊蚘カプセルの圢状は劂䜕なる圢状であっおもよい。し力、し、圓該カプセル は手若しくはレンチ等を甚いおステムに螺着される堎合は倚角圢の柱状であるこずが 奜たしい。たた、圓該カプセルがハンマヌ等を甚いお嵌着される堎合は、圢状は劂䜕 なるものであっおも良い。
[0025] 䞊蚘カプセルの壁郚の厚さは、 0. lmm〜2mmであるこずが奜たしぐ 0. 5mm〜l . Ommであるこずがさらに奜たしい。圓該厚さを薄くすれば埐攟時間を短くするこずが できるが構造的匷床が萜ちる。たた、圓該厚さを厚くすれば構造的匷床は向䞊する が埐攟時間が長くなる。そのため、圓該厚さを 0. 5mm〜 1. Ommずするこずが奜たし い。
[0026] カプセルに蚭けられた気孔の気孔埄は 0· 1 ÎŒ m〜300 ÎŒ mであるこずが奜たし!/ボ。
さらに、気孔率は 10〜80%であるこずが奜たしい。カプセルの気孔埄及び気孔率を 調敎するこずにより、カプセルの䞭に充填された抗菌性薬剀の埐攟期間を調敎するこ ず力 Sできる。䞊蚘のような範囲ずするこずにより、抗菌性薬剀の埐攟期間を 1日〜90日 ずするこず力 Sでさる。
[0027] 圓該カプセルは、人工関節手術埌短期の感染防止のみならず、䞭長期の感染防 止にも有効である。たた、抗菌性薬剀が党お消倱した埌でも、抗菌性薬剀を補充する 若しくは新たなものず亀換するこずにより抗菌効果を再床取り戻すこずができる。
[0028] 圓該カプセルを人工股関節に適甚する堎合、圓該カプセルを人工股関節倧腿骚 偎郚品ステムに装着しおもよいし、人工股関節臌蓋偎郚品カップに装着しおもよ い。たた、スクリュヌのネゞの頭郚に装着するこずもでき、この堎合任意の生来骚に蚭 眮するこずもできる。たた、人工関節に装着したり、生来骚に固定するこずが困難な症 䟋では軟骚組織に糞やワむダヌで固定するこずも可胜である。
[0029] (抗菌性薬剀含有カプセルの補造方法
䞊蚘倚孔質セラミックスの補造方法ずしおは、セラミックス粉末に所定粒床のカヌボ ン粉末、ナフタレン粉末などのポア材を混合埌、铞蟌み成圢、抌し出し成圢、プレス 成圢、ラバヌプレス成圢などの方法で成圢埌、焌成、研削加工する方法、もしくは成 圢埌に切削加工しお焌成する方法などが有効である。ポア剀の添加量はポア同士が 十分連通するよう調敎する。たた過酞化氎玠などの発泡剀を䜿甚する方法や焌結枩 床を調敎しお倚孔質ずする方法も䜿甚できる。さらに粉末玠材力 なる薄い局を圢成 し、圓該局にレヌザヌ光を照射しこれを瞬間焌結し硬化局を圢成する工皋を連続し お行うこずにより立䜓物を造圢する粉末焌結法、バむンダヌ䞭にセラミックス、金属等 の埮粉末を混合し也燥させお予め薄いシヌトを圢成しこれらのシヌト毎に䞊蚘同様 レヌザヌ照射し焌結䜓を圢成し、この工皋を連続しお行うこずにより立䜓物を造圢す るグリヌンテヌプレヌザヌ焌結法、緻密なセラミックス䜓を補䜜埌にレヌザヌ光線で 埮现な穎加工を行うレヌザヌ加工法を甚いるこずもできる。これらの補造方法によれ ば、盎接倚孔質のカプセルを䜜補するこずができ、たた倚皮倚様な材料を甚いるこず ができ、さらに環境負荷を䜎枛するこずができるため望たしい。なお、これらの手法の 倚くは倚孔質金属、倚孔質プラスチックの補造にも応甚するこずが可胜である。
[0030] 本発明に係る抗菌性薬剀含有カプセルの補造方法に぀!/、お、ハむド口キシァバタ むトの堎合を䟋に説明する。䟋えば、ハむドロキシアパタむト粉末に架橋重合性暹脂ず しおポリ゚チレンむミン等を添加し、分散媒ずしお超玔氎を甚いお混合 '解砕し、スラリ 䞀を調補する。次いで、該スラリヌに起泡剀ポリオキシ゚チレンラりリル゚ヌテル、ラ ゥリルべタむン、ラりリル硫酞トリ゚タノヌルァミン等から遞ばれた少なくずも䞀皮)を添 加しお攪拌し、起泡する。
[0031] 曎に架橋剀゜ルビトヌルポリグリシゞル゚ヌテル等を加え泡沫状スラリヌを成圢 型に入れお泡構造を固定しお也燥し、次いで 1100°C〜 1300°C皋床の枩床で焌結 しおハむドロキシアパタむト倚孔質焌結䜓を埗る。この焌成は 0. 5時間〜 3時間行わ れる。
[0032] 続いお、図 3 (A)及びB)に基づいお、グリヌンテヌプレヌザヌ焌結法を甚いお力 プセルを䜜補する堎合に関しお詳现に説明する。
[0033] たず、図 3 (A)に瀺すように、グリヌンテヌプを䜜補する。カプセルを構成するこずに なるセラミックス及び/又は金属埮粒子、バむンダヌ䞊びに溶剀を混合しスラリヌ 5を 調補する。ここで、セラミックス、金属ずしお、劂䜕なる材料を甚いるこずができる力 人 䜓に圱響を及がさなレ、酞化アルミニりムアルミナ、酞化ゞノレコニゥムゞノレコナア、 ハむドロキシアパタむトHA)、第䞉燐酞カルシりム (TCP)、第四燐酞カルシりムTe CP)、リン酞カルシりム系ガラスセラミックス、若しくはチタン、チタン系合金、ゞルコ二 ゥム、タンタル、コバルト クロム系合金、若しくはステンレス鋌等を甚いるこずができる 。たた、バむンダヌずしお、アクリル系暹脂若しくはスチレン系暹脂を、溶剀ずしお、氎、 ゚チルアルコヌル、ブチルアルコヌル、む゜プロピルアルコヌル、若しくは、トル゚ン を甚いるこず力 Sできる。続いお、䞊蚘のように混合したスラリヌ 5をドクタヌブレヌド法ず 同様にしお䞀定厚のシヌト状に圢成する。その埌、このシヌトを也燥させるこずにより スラリヌ䞭の溶剀を揮発させ固化させる。その埌、シヌトを䞀定の倧きさに切断する。
[0034] 続いお、図 3 (B)に瀺すように、圓該シヌトを䞀定の倧きさに切断したものを䞀枚積 局し、圓該カプセルの 3次元 CADデヌタに埓っお、シヌト 6にレヌザヌ光 7を照射し 、照射郚分においお金属若しくはセラミックスを固化させる。続いお、 2枚目のシヌト 6 を積局し、䞊蚘同様レヌザヌ光 7を照射させ、照射郚分においお金属若しくはセラミ ックスを固化させる。この工皋を耇数回繰り返し、積局されたグリヌンテヌプから焌結 により固化した郚分 8を取り出し、所定の圢状に加工するこずにより、抗菌性薬剀含有 カプセルを䜜補するこずができる。
[0035] 圓該䜜補方法は、グリヌンテヌプに含たれる金属若しくはセラミックスの濃床を調敎 するこずにより、䜜補されたカプセルの気孔埄、気孔率を調敎するこずができ、そのこ ずにより䞭に充填された抗菌性薬剀の攟出速床等を調補するこずができるため、奜適 に甚いられる。たた、圓該補造方法では、いかなる材料をも甚いるこずができ、しかも 耇雑な圢状のものを䜜補するこずができるため奜たしい。
[0036] たた、圓該抗菌性薬剀カプセルを倚孔質金属䜓で䜜補する堎合、前述の劂く金属 粉末や金属小粒䜓の焌結䜓を甚いお䜜補するこずもできるが、金属性メッシュを焌結 固着しお䜜補するこずあでさる。
[0037] たた、緻密なセラミック䜓、金属䜓で党䜓を圢成した埌、レヌザヌ光線などを利甚し お埮现な孔加工を行う堎合には、他の方法にはないメリットがある。それは、孔埄、孔 数、孔分垃を任意に制埡するこずができる点である。具䜓的な䟋ずしおは厚さ 0. 2m mのチタン板にレヌザヌ光線を利甚しお、孔埄 76 ÎŒ mの孔を、ピッチ間隔 100 ÎŒ m で加工した。
[0038] 薬剀の埐攟は、倚孔質セラミック䜓、倚孔質金属䜓の堎合では、その気孔率、気孔 埄を調敎するこずにより行うこずが奜たしい。
[0039] たた、レヌザヌ光線などによる穎孔加工の堎合では、その穎埄、数量、穎分垃密床 で調敎を行うこずが奜たしレ、。
[0040] 圓該抗菌性薬剀含有カプセルの倧きさは、人工関節の機胜に䞍具合を生じさせな い範囲であれば、いくらでも倧きくするこず力 Sできる。圓該倧きさが倧きければ、その力 プセル内に倚量の薬剀を保持させるこずができる。 [0041] 圓該カプセルは、通垞本䜓ず蓋の 2぀のパヌツから構成されるこずが奜たしい。これ は、圓該カプセル内郚の䞭空郚に抗菌性薬剀を貯留させるためである。粘性が䜎く 含浞が容易な薬剀の堎合は、カプセルが䞀䜓成圢されたものでも貯留は可胜である
[0042] (抗菌性薬剀
本発明に係るカプセル䞭に充填される抗菌性薬剀ずしお、抗菌薬、倩然系抗菌剀 、無機系抗菌性薬剀、又は有機系抗菌性薬剀、いずれを甚いおもよい。いずれか二 皮以䞊のものを混合しおこれを甚いおもょレ、。
[0043] 抗菌薬の具䜓䟋ずしおは、ペニシリンなどのベヌタラタタム系抗菌薬、ゲンタマむシ ンなどのァミノダルコシド系抗菌薬、シプロフロキサシンフルォロキノロン系抗菌薬、ェ リスロマむシンなどのマクロラむド系抗菌薬、ティコブラニンなどのダルコペプチド系抗 菌薬、クリンダマむシンなどのリンコマむシン系抗菌薬、テトラサむクリン等のテトラサむ クリン系抗菌薬、 ST合剀、メトロニダゟヌル、及びケトラむド系抗菌薬が挙げられる。
[0044] たた、倩然系抗菌剀の具䜓䟋ずしおは、キチン'キトサンなどの動物系薬剀、ポリリゞ ンなどの埮生物系薬剀、リゟチヌムなどの酵玠系薬剀、ヒノキチオヌルなどの怍物系 薬剀等が挙げられる。
[0045] さらに、無機系抗菌剀ずしお、銀、銅、亜鉛などの金属むオンをれオラむトなどの珪 酞塩や燐酞ゞルコニりムなどの燐酞塩に担持させたもの等が挙げられる。
[0046] 有機系抗菌剀の具䜓䟋ずしおは、゚チルアルコヌルなどのアルコヌル系薬剀、ベ ンれンカルボン酞などのアルコヌル系薬剀、メチルパラベンなどの゚ステル系薬剀、 TPNなどの二トリル系薬剀、サンプラスなどのハロゲン系薬剀、ォキシンなどのピリゞ ン'キノリン系薬剀、ケヌ゜ンなどのむ゜チアゟロン系薬剀、 TBZなどのむミダゟヌル' チアゟヌル系薬剀、ハルカルバンなどのァニリド系薬剀、ダルコン酞クロ口ぞキシゞン などのビグアナむド系薬剀、カヌバムなどのチォカヌバメヌト系薬剀、塩化べンザル コニゥムなどの界面掻性剀系薬剀、ォキシン銅などが挙げられる。
[0047] これらの抗菌性薬剀は、ゲル化剀に混合されおなるこずが奜たしレ、。ゲル化剀ず混 合しこれを本発明に係るカプセル䞭に充填するこずにより、抗菌性薬剀の埐攟期間を 調敎するこず力 Sできる力、らである。特に液䜓の薬剀の堎合はゲノレ化剀ずの混合が有 効である。埐攟期間の調敎は、ゲル䞭のゲル化剀の含有量を調敎するこずによっお 行う。即ち倚量のゲル化剀を䜿甚したゲルは硬ぐ氎分を䜙り含たないため、薬剀の 溶出が抑制される。䞀方、少量のゲル化剀を䜿甚した堎合には、ゲルは軟らかぐ氎 分を倚く含有するため、薬剀の溶出をあたり抑制しない。このようにゲル化剀を䜿甚 するこずによっお、抗菌性薬剀の埐攟期間を䜿甚しない堎合の 1. 5倍〜 20倍に䌞ば すこず力 Sできる。ゲル化剀ずしおは、れラチン、寒倩、カラギヌナン若しくはぺクチンを 䜿甚するこずが奜たしい。
実斜䟋
[0048] (実斜䟋 1)
以䞋に本発明に係る抗菌性薬剀含有カプセルの実斜䟋を比范䟋ずずもに説明する 力 本発明で察象ずしおいるカプセルは、以䞋の実斜䟋に限定されないこずは蚀うた でもない。
[0049] セラミックスずしおハむドロキシアパタむト、バむンダヌずしお氎溶性アクリル系暹脂、 溶剀ずしお玔氎を甚いこれらを混合しスラリヌを調補した。続いお、圓該スラリヌをドク タヌブレヌド法ず同様にしお 0. 2mmのシヌト状に圢成した。その埌、このシヌトを也 燥させるこずによりスラリヌ䞭の溶剀を揮発させ固化させ、その埌シヌトを耇数に切断 した。
[0050] 切断されたシヌトを䞀枚積局し、カプセルの 3次元 CADデヌタに埓っお、シヌトに レヌザヌ光を照射し、照射郚分においおハむドロキシアパタむトを焌結させた。続い お、 2枚目のシヌトを積局し、䞊蚘同様レヌザヌ光を照射させ、照射郚分においおハ むドロキシアパタむトを焌結させた。この工皋を耇数回繰り返し、積局されたグリヌンテ ヌプから、焌結により固化した郚分を取り出し、カプセル圢状に加工するこずにより、 抗菌性薬剀含有カプセルを䜜補した。
[0051] 圓該抗菌性薬剀含有カプセルは、容噚状の郚分ずそれにぎったりず嵌合される蓋 郚ずの 2぀の郚材より構成されおいる。圓該カプセルの䞭には抗菌性薬剀ずしおぺニ シリン粉末 (これは寒倩でゲル化されおいるを入れた埌、容噚郚ず蓋郚ずを嵌合させ 、人工股関節ステムのテヌパヌ郚埌方のステム打ち蟌み穎に螺着させた。
[0052] (実斜䟋 2) ノ、むドロキシアパタむト粉末にポア剀ずしおナフタレン粉末を添加し、よく混合した埌
、金型を䜿甚しおプレス成圢した。成圢䜓を 1150°Cで焌結し、カプセル圢状に研削 加工しお、容噚郚ず蓋郚を補䜜した。容噚郚にゲンタマむシン粉末を入れた。本カブ セル材質の気孔率は 40%、気孔埄 80— 200 mであった。
[0053] (実斜䟋 3)
盎埄 200 mのチタンビヌズをカプセル圢状のタングステン補金型に流し蟌み、真 空炉䞭で、 1300°C、 2時間熱凊理するこずによっお、カプセルの容噚郚ず蓋郚を補 䜜した。本カプセル材質の気孔率は 30%、気孔埄は 20— 40 mであった。本カフ。 セル䞭には代衚的な無機系抗菌剀である銀むオンを担持したセラミック粉末を入れ た所、牛血枅䞭で良奜な銀むオンの溶出を瀺した。
産業䞊の利甚可胜性
[0054] 本件に係る抗菌性薬剀含有カプセルは、抗菌性薬剀を含有し埐々に攟出可胜な 容噚であっお、特に人工関節の䞀郚に取り付けられ、人工関節の装着埌、関節包内 又は髄腔内に抗菌性薬剀を埐攟するこずにより、関節包内及びステム呚囲で、现菌 の増殖抑制、殺菌を行うために甚いられる。

Claims

請求の範囲
[1] 抗菌性薬剀が充填されるカプセルであっお、該カプセルは倚孔質郚材から構成さ れ、人工関節の少なくずも䞀郚に取着され、䞊蚘充填された抗菌性薬剀を䞊蚘倚孔 質郚材を介しお関節包内又は骚内に埐攟する抗菌性薬剀含有カプセルであっお、 䞊蚘倚孔質郚材が、 10%〜80%の平均気孔率を有するこずを特城ずする抗菌性 薬剀含有カプセル。
[2] 䞊蚘倚孔質壁郚が、倚孔質セラミックス、倚孔質金属又は倚孔質暹脂からなるこず を特城ずする請求項 1蚘茉の抗菌性薬剀含有カプセル。
[3] 䞊蚘抗菌性薬剀が、ペニシリンなどのベヌタラタタム系抗菌薬、ゲンタマむシンなど のァミノダルコシド系抗菌薬、シプロフロキサシンフルォロキノロン系抗菌薬、゚リス口 マむシンなどのマクロラむド系抗菌薬、ティコブラニンなどのダルコペプチド系抗菌薬 、クリンダマむシンなどのリンコマむシン系抗菌薬、テトラサむクリン等のテトラサむクリン 系抗菌薬、 ST合剀、メトロニダゟヌル、及びケトラむド系抗菌薬からなる矀から遞択さ れる少なくずも 1぀であるこずを特城ずする請求項 1又は 2に蚘茉の抗菌性薬剀含有力 プセル。
[4] 䞊蚘抗菌性薬剀が、キチン'キトサンなどの動物系薬剀、ポリリゞンなどの埮生物系 薬剀、リゟチヌムなどの酵玠系薬剀、ヒノキチオヌルなどの怍物系薬剀、銀、銅、亜 鉛などの金属むオンをれオラむトなどの珪酞塩や燐酞ゞルコニりムなどの燐酞塩に担 持させた無機系薬剀、゚チルアルコヌルなどのアルコヌル系薬剀、ベンれンカルボ ン酞などのアルコヌル系薬剀、メチルパラベンなどの゚ステル系薬剀、 TPNなどの二 トリル系薬剀、サンプラスなどのハロゲン系薬剀、ォキシンなどのピリゞン'キノリン系 薬剀、ケヌ゜ンなどのむ゜チアゟロン系薬剀、 TBZなどのむミダゟヌル'チアゟヌル系 薬剀、ハルカルバンなどのァニリド系薬剀、ダルコン酞クロ口ぞキシゞンなどのビグァ ナむド系薬剀、カヌバムなどのチォカヌバメヌト系薬剀、塩化ベンザルコニゥムなど の界面掻性剀系薬剀、ォキシン銅などの有機系金属系薬剀から遞択される少なくず も 1぀であるこずを特城ずする請求項 1又は 2に蚘茉の抗菌性薬剀含有カプセル。
[5] 䞊蚘抗菌性薬剀が、れラチン、寒倩、カラギヌナン若しくはぺクチンなどのゲル化 剀に混合されおなるこずを特城ずする請求項 3又は 4蚘茉の抗菌性薬剀含有カプセ ル。
請求項 1〜5のいずれかの抗菌性薬剀含有カプセルが取着されおなる人工関節で あっお、該人工関節を骚内に挿入した際、䞊蚘カプセル内に充填された抗菌性薬剀 が関節包内又は骚内に埐攟されるこずを特城ずする人工関節。
PCT/JP2007/066352 2006-09-19 2007-08-23 Capsule including antibacterial agent and artificial joint having the capsule attached thereto Ceased WO2008035535A1 (en)

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