Immobilized antibiotics to prevent orthopaedic implant infections

Hickok, Noreen J.; Shapiro, Irving M.

doi:10.1016/j.addr.2012.03.015

Cited by 258 publications

(201 citation statements)

References 172 publications

(188 reference statements)

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“…51 This problem cannot be circumvented neither by a releasing strategy because the antibacterial agent will run out eventually nor by a long-term administration of prophylactic antibiotics due to the risk of resistance development. 24 Thus, Ag NPs were immobilized onto the SLA surface using the Ag-PIII technique.…”

Section: Discussionmentioning

confidence: 99%

Hierarchical micro/nanostructured titanium with balanced actions to bacterial and mammalian cells for dental implants

Zhu

Cao

Qiao

et al. 2015

IJN

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A versatile strategy to endow dental implants with long-term antibacterial ability without compromising the cytocompatibility is highly desirable to combat implant-related infection. Silver nanoparticles (Ag NPs) have been utilized as a highly effective and broad-spectrum antibacterial agent for surface modification of biomedical devices. However, the high mobility and subsequent hazardous effects of the particles on mammalian cells may limit its practical applications. Thus, Ag NPs were immobilized on the surface of sand-blasted, large grit, and acid-etched (SLA) titanium by manipulating the atomic-scale heating effect of silver plasma immersion ion implantation. The silver plasma immersion ion implantation-treated SLA surface gave rise to both good antibacterial activity and excellent compatibility with mammalian cells. The antibacterial activity rendered by the immobilized Ag NPs was assessed using Fusobacterium nucleatum and Staphylococcus aureus , commonly suspected pathogens for peri-implant disease. The immobilized Ag NPs offered a good defense against multiple cycles of bacteria attack in both F. nucleatum and S. aureus , and the mechanism was independent of silver release. F. nucleatum showed a higher susceptibility to Ag NPs than S. aureus , which might be explained by the presence of different wall structures. Moreover, the immobilized Ag NPs had no apparent toxic influence on the viability, proliferation, and differentiation of rat bone marrow mesenchymal stem cells. These results demonstrated that good bactericidal activity could be obtained with very small quantities of immobilized Ag NPs, which were not detrimental to the mammalian cells involved in the osseointegration process, and promising for titanium-based dental implants with commercial SLA surfaces.

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Section: Discussionmentioning

confidence: 99%

Hierarchical micro/nanostructured titanium with balanced actions to bacterial and mammalian cells for dental implants

Zhu

Cao

Qiao

et al. 2015

IJN

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“…Despite the introduction of standardised strategies, such as laminar flow clean air operating rooms and pre-operative antibiotics, periprosthetic infection still occurs in approximately 1-2% of patients following a total joint arthroplasty procedure [1] and [2]. When periprosthetic infections do occur they can lead to a need for rescue or revision surgery, and ultimately device failure.…”

mentioning

confidence: 99%

Adding functionality with additive manufacturing: Fabrication of titanium-based antibiotic eluting implants

Cox

Jamshidi

Eisenstein

et al. 2016

Materials Science and Engineering: C

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Additive manufacturing technologies have been utilised in healthcare to create patient-specific implants. This study demonstrates the potential to add new implant functionality by further exploiting the design flexibility of these technologies. Selective laser melting was used to manufacture titanium-based (Ti-6Al-4V) implants containing a reservoir. Pore channels, connecting the implant surface to the reservoir, were incorporated to facilitate antibiotic delivery. An injectable brushite, calciumphosphate cement, was formulated as a carrier vehicle for gentamicin. Incorporation of the antibiotic significantly (p=0.01) improved the compressive strength (5.8± 0.7 MPa) of the cement compared to non-antibiotic samples. The controlled release of gentamicin sulphate from the calcium phosphate cement injected into the implant reservoir was demonstrated in short term elution studies using ultraviolet visible spectroscopy. Orientation of the implant pore channels were shown, using micro-computed tomography, to impact design reproducibility and the back-pressure generated during cement injection which ultimately altered porosity. The amount of antibiotic released from all implant designs over a 6 hour period (b28% of the total amount) were found to exceed the minimum inhibitory concentrations of Staphylococcus aureus (16 μg/mL) and Staphylococcus epidermidis (1 μg/mL); two bacterial species commonly associated with periprosthetic infections. Antibacterial efficacy was confirmed against both bacterial cultures using an agar diffusion assay. Interestingly, pore channel orientation was shown to influence the directionality of inhibition zones. Promisingly, this work demonstrates the potential to additively manufacture a titanium-based antibiotic eluting implant, which is an attractive alternative to current treatment strategies of periprosthetic infections.

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“…Infection can result in traumatic and costly revision surgery [1][2][3], and the prevention of such infection, without impeding the function of the implant, is of high importance. Antimicrobial Ti and Ti alloy implant surfaces have been achieved with binding of antibiotics [4], antimicrobial peptides [3] or nanoparticles that have bactericidal effects [1], to the surface of the implant. A more favourable method of preventing Ti implant infection that could help combat the use of antimicrobials and thus the risk of driving development of antimicrobial resistance, is to use surface topography that actively discourages bacterial adhesion or has inherent antimicrobial properties, without the addition of antibiotics or other chemicals.…”

Section: Introductionmentioning

confidence: 99%

Bactericidal nanospike surfaces via thermal oxidation of Ti alloy substrates

Sjöström

Nobbs

2016

Materials Letters

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Highlights Thermal oxidation was used to grow bioinspired nanospikes on Ti alloy. Nanospike dimension and arrangement could be controlled. The method worked on arbitrary shaped Ti alloy surfaces. A 40 % reduction of E. Coli viability was achieved on Ti alloy nanospike surfaces. AbstractWith the aim to fabricate bio-inspired antibacterial nanotopography surfaces, nanospikes with varying dimensions were grown on Ti alloy surfaces using a thermal oxidation method. By controlling the acetone vapour concentration inside the tube furnace, the resulting oxide surface changed from nanocolumn shapes to nanospikes with approximately 20 nm diameters. The nanospikee growth was demonstrated to work on 3D Ti alloy bead surfaces, which means translation of the method to implant surfaces would be possible. Microbiology studies using Escherichia coli. showed that the nanospikes on the Ti alloy surfaces has potential to reduce bacterial viability. More dead bacteria were present on the nanospike surfaces compared to a smooth control and a 40 % reduction of viability was noted in bacterial suspensions incubated with a nanospike surface. It was shown that by annealing the Ti alloy surfaces prior to thermal oxidation, it is possible to grow vertically aligned nanospikes. This could be highly valuable when designing implant surfaces with antimicrobial properties.

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Immobilized antibiotics to prevent orthopaedic implant infections

Cited by 258 publications

References 172 publications

Hierarchical micro/nanostructured titanium with balanced actions to bacterial and mammalian cells for dental implants

Hierarchical micro/nanostructured titanium with balanced actions to bacterial and mammalian cells for dental implants

Adding functionality with additive manufacturing: Fabrication of titanium-based antibiotic eluting implants

Bactericidal nanospike surfaces via thermal oxidation of Ti alloy substrates

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