Effect of surface roughness and sterilization on bacterial adherence to ultra-high molecular weight polyethylene

Abstract

Sterilization with ethylene oxide (EO) and gas plasma (GP) are well-known methods applied to ultra-high molecular weight polyethylene (UHMWPE) surfaces in the belief that they prevent major material changes caused by gamma irradiation. However, the influence of these surface sterilization methods on bacterial adherence to UHMWPE is unknown. UHMWPE samples with various degrees of roughness (0.3, 0.8 and 2.0 μm) were sterilized with either GP or EO. The variations in hydrophobicity, surface free energy and surface functional groups were investigated before and after sterilization. Sterilized samples were incubated with either Staphylococcus aureus or Staphylococcus epidermidis in order to study bacterial adherence to these materials. Fewer bacteria adhered to UHMWPE after sterilization with EO than after sterilization with GP, especially to the smoothest surfaces. No changes in chemical composition of the UHMWPE surface due to sterilization were observed using X-ray photoemission spectroscopy analysis. The decreased bacterial adherence to UHMWPE found at the smoothest surfaces after sterilization with EO was not directly related to changes in chemical composition. Increased bacterial adherence to rougher surfaces was associated with increased polar surface energy of EO-sterilized surfaces.

Antibiotic-Loaded Cement in Orthopedic Surgery: A Review

“…Also, bacterial strains resistant to gentamicin were found in the 88% of the cases of infection in arthroplasty where cement was loaded with antibiotic, compared to the 16% found after those where the common cement was used [28, 29]. Another important factor for bacteria adhesion is the roughness of the surface: in general the higher the roughness, the higher the adhesion and the PMMA is characterized by a rough surface [11]. …”

“…With the spread of the prosthetic joint replacement in the seventies, the problem increased [1, 8–10]. Actually, the mainstay of treatment of an infected joint prosthesis is based on the removing of the implant and on the accurate toiletries around the surrounding necrotic soft and bone tissue, either in on- or two- stage technique [11–13]. …”

Interplay between surface properties of standard, vitamin E blended and oxidised ultra high molecular weight polyethylene used in total joint replacement and adhesion of Staphylococcus aureus and Escherichia coli

“…The physical properties of the biomaterial surface, such as roughness, hydrophobicity, surface energy, electrostatic charge, and coating can strongly influence the feasibility and kinetics of microbial adhesion. 3,6,7 Ultra High Molecular Weight Polyethylene (UHMWPE) has a long successful clinical record as bearing material in TJR and remains the most commonly used material in modern joint replacement prostheses. 7 However, it has been demonstrated that oxidation has been the main cause of many dramatic implant failures in the last two decades.…”

CHAPTER 13. Bacterial Adhesion and Interaction with Biomaterial Surfaces

“…It has been reported that increases in surface roughness promotes the bacterial adhesion. 102,103 The reason for this phenomenon may include that a rough surface has a greater surface area and provides more favorable site for colonization. However, the effect of surface roughness on adhesion is apparently related to the degree of roughness and topographic features of surface.…”