Comparison of various surgical methods in the treatment of implant-related infection

Şener, Muhittin; Kazımoğlu, Cemal; Karapınar, Hasan; Günal, İzge; Afşar, İlhan; Şener, Aslı Gamze

doi:10.1007/s00264-009-0750-0

Cited by 23 publications

(19 citation statements)

References 19 publications

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“…This complication harms patients and strains healthcare systems around the world [7,17]. In addition, current treatment for periprosthetic infection such as implant extraction, meticulous débridement, antibioticloaded cement, and high-dose systemic antibiotic administration adds certain morbidity and can often result in side effects without assuring cure [37].…”

Section: Introductionmentioning

confidence: 99%

Antibacterial and Biocompatible Titanium-Copper Oxide Coating May Be a Potential Strategy to Reduce Periprosthetic Infection: An In Vitro Study

Norambuena

Patel

Karau

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background Periprosthetic infections are devastating for patients and more efficacious preventive strategies are needed. Surface-modified implants using antibacterial coatings represent an option to cope with this problem; however, manufacturing limitations and cytotoxicity have curbed clinical translation. Among metals with antibacterial properties, copper has shown superior in vitro antibacterial performance while maintaining an acceptable cytotoxicity profile. A thin film containing copper could prevent early biofilm formation to limit periprosthetic infections. This pilot study presents the in vitro antibacterial effect, cytotoxicity, and copper ion elution pattern of a thin film of titanium-copper oxide (TiCuO). Questions/purposes (1) Do titanium alloy (Ti6Al4V) discs coated with a thin film of TiCuO reduce Staphylococcus epidermidis biofilm and planktonic cell density compared with uncoated discs? (2) Do Ti6Al4V discs coated with a thin film of TiCuO affect normal human osteoblast viability compared with untreated cells? (3) Is copper ion concentration generated by coated discs lower than previously published copper ion concentrations that cause 50% toxicity in similar human cell lines in vitro (TC50)? Methods Ninety Ti6Al4V discs (12.5 mm diameter; 1.25 mm thick) were used in this study. Seventy-two Ti6Al4V discs were coated with a thin film of either titanium oxide (TiO) or TiCuO containing 20%, 40%, or 80% copper using high-power impulse magnetron sputtering (HiPIMS). Eighteen Ti6Al4V discs remained uncoated for control purposes. We tested antibacterial properties of S epidermidis grown on The institution of one or more of the authors (GAN, RP, MK, CCW, PJJ, KEB, ADH, RJS) has received funding in excess of USD 100,000 from Codelco (Codelco Lab, Santiago, Chile; FP00076314-01-S01) and in excess of USD 10,000 from the Mayo Clinic. With the exception of one of the authors (RJS), the investigators have not personally received any money related to this study. One of the authors certifies that he (RJS), or a member of his immediate family, has received or may receive payments or benefits, during the study period, in an amount of USD 10,000 to USD 100,000 from Biomet Inc (Warsaw, IN, USA Clinical Orthopaedics and Related Research ®A Publication of The Association of Bone and Joint Surgeons® discs in wells containing growth medium. After 24 hours, planktonic bacteria as well as biofilms removed by sonication were quantitatively cultured. Annexin/Pi staining was used to quantify in vitro normal human osteoblast cell viability at 24 hours and Day 7, respectively. Copper elution was measured at Days 1, 2, 3, 7, 14, and 28 using an inductively coupled plasma mass spectrometer to analyze aliquots of culture medium. Copper ion concentration achieved at 24 hours was compared with previously published TC50 for gingival fibroblast, a phenotypically similar cell line with available data regarding copper ion exposure. Results Discs coated with TiCuO 80% copper showed greater biofilm and planktonic cell density re...

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Section: Introductionmentioning

confidence: 99%

Antibacterial and Biocompatible Titanium-Copper Oxide Coating May Be a Potential Strategy to Reduce Periprosthetic Infection: An In Vitro Study

Norambuena

Patel

Karau

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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“…Infections in the setting of orthopaedic implants is a particularly serious problem (Sener et al, 2010;Diefenbeck et al, 2006). In orthopaedic trauma, infection of osteosynthetic devices results in considerable morbidity due to prolonged hospitalisation, poor functional status and sepsis.…”

Section: Use Of Antibiotic Loaded Bone Cement For Treatment Of Infectmentioning

confidence: 99%

“…However, they noted that three animals in the bone cement group revealed extensive infection, which was not seen in the debridement only group. Therefore, although antibiotic-loaded bone cement showed superiority over other treatment modalities, they concluded that it should be employed only after unsuccessful trials of débridement because of the risk of extensive infection (Sener et al, 2010). If the infection cannot be eradicated by débridement and the initial rapid phase of antibiotic elution, then the cement beads may provide a suitable environment for the spread of infection and development of resistance to antibiotics (Sener et al, 2010).…”

Section: Use Of Antibiotic Loaded Bone Cement For Treatment Of Infectmentioning

confidence: 99%

“…Sener et al studied the effectiveness of antibiotic loaded bone cement in the trreatment of implant-related infection in 32 Wistar albino rats in whom deep infection was established after intra-medullary stabilisation of fresh fractures (Sener et al, 2010). They studied the efficacy of three treatment modalities in this randomised study and the 4 treatment groups included: no treatment, surgical débridement, antibiotic-loaded bone cement and antibiotic-loaded autogenous bone.…”

Section: Use Of Antibiotic Loaded Bone Cement For Treatment Of Infectmentioning

confidence: 99%

“…This means a second surgical intervention solely dedicated for its removal, especially if further procedures are not required for a given case (Hanssen, 2005). The advise to remove antibiotic bone cement beads is based on the possibility that the cement beads would act as a foreign substance suitable for bacterial colonisation after the antibiotic has been depleted (Sener et al, 2010). In practise, after 4 to 6 weeks, beads become surrounded by dense scar tissue and the ability to identify and remove them can become extremely difficult (Hanssen, 2005).…”

Section: Drawbacks and Adverse Effectsmentioning

confidence: 99%

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Antibiotic Loaded Acrylic Bone Cement in Orthopaedic Trauma

Samuel¹

2012

Osteomyelitis

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Testing of a bioactive, moldable bone graft substitute in an infected, critically sized segmental defect model

et al. 2017

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Large infected bone defects, often resulting from high energy traumas, are difficult to treat due to their variability in complexity and location. Standard treatment for infected bone defects begins with a protocol that includes a series of debridements in conjunction with an extended course of systemic antibiotics. Only after the infection has been eliminated will repair of the defect commence, typically with implantation of autologous bone. To address some of the shortcomings of the standard treatment methods, such as serial procedures, limited grafting material, and the need for a second surgical site for autologous bone, a sequential, dual drug-releasing, moldable, calcium sulfate-based bone graft substitute was developed previously. In the present studies, the effectiveness of the material for treating both the infection with vancomycin and bone defect with simvastatin was evaluated in vivo using a critically sized, infected segmental defect model in rat femurs. Although the infection was not fully eliminated, the local release of vancomycin increased survivorship of infected animals by 464% compared to nontreated controls. Infected animals receiving antimicrobial treatment showed comparable amounts of new bone formation within the defect site when compared to noninfected controls. Incorporating agents capable of disrupting established biofilms into bone graft substitutes may enhance effectiveness in treating a biofilm infection within a bone defect. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1878-1886, 2018.

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Comparison of various surgical methods in the treatment of implant-related infection

Cited by 23 publications

References 19 publications

Antibacterial and Biocompatible Titanium-Copper Oxide Coating May Be a Potential Strategy to Reduce Periprosthetic Infection: An In Vitro Study

Antibacterial and Biocompatible Titanium-Copper Oxide Coating May Be a Potential Strategy to Reduce Periprosthetic Infection: An In Vitro Study

Antibiotic Loaded Acrylic Bone Cement in Orthopaedic Trauma

Testing of a bioactive, moldable bone graft substitute in an infected, critically sized segmental defect model

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