Orthopaedic applications of cold physical plasma

Abstract

Cold physical plasma (CPP) technology is of high promise for various medical applications. The interplay of specific components of physical plasma with living cells, tissues and organs on a structural and functional level is of paramount interest with the aim to induce therapeutic effects in a controlled and replicable fashion. In contrast to other medical disciplines such as dermatology and oromaxillofacial surgery, research reports on CPP application in orthopaedics are scarce. The present implementation of CPP in orthopaedics involves surface modifications of orthopaedic materials and biomaterials to optimize osseointegration. In addition, the influence of CPP on musculoskeletal cells and tissues is a focus of research, including possible adverse reactions and side effects. Its bactericidal aspects make CPP an attractive supplement to current treatment regimens in case of microbial inflammations such as periprosthetic joint infections. Attributed anticancerogenic and pro-apoptotic effects underline the clinical relevance of CPP as an additive in treating malignant bone lesions. The present review outlines ongoing research in orthopaedics involving CPP; it distinguishes considerations for safe application and the need for more evidence-based research to facilitate robust clinical implementation.

Case Report: Hip arthroplasty after fracture-related joint infection caused by extensively drug-resistant Klebsiella pneumoniae

“…Additionally, after repeated surgical interventions, CPP was used to support wound healing in this patient case. Recently, its feasibility in orthopaedic surgery has been reviewed and highlighted several promising applications ( 35 ). Particularly remarkable is CPPs effective action against biofilm and multidrug-resistent germs ( 36 , 37 ).…”

Comparing Redox and Intracellular Signalling Responses to Cold Plasma in Wound Healing and Cancer

“…First, plasma medicine has been limited to tumour cancers (currently excluding lymphomas and blood cancers), which are heterogeneous in classification, subtyping, and metastases [73,74]. Although CP has shown efficacy in osteosarcoma in vitro and in vivo, direct CP treatment is extremely invasive, and the use of less-invasive injectable PAL requires further research before clinical translation [75]. Fortuitously, CP treatment of blood from leukaemia patients has shown evidence that cancerous cells can be killed without adversely affecting haematological profiles [76].…”

Comparing Redox and Intracellular Signalling Responses to Cold Plasma in Wound Healing and Cancer

“…First, plasma medicine has been limited to tumour cancers (currently excluding lymphomas and blood cancers), which are heterogeneous in classification, subtyping, and metastases [88,89]. Although CP has shown efficacy in osteosarcoma in vitro and in vivo, direct CP treatment is extremely invasive, and the use of less-invasive injectable PAL requires further research before clinical translation [90]. Fortuitously, CP treatment of blood from leukaemia patients has shown evidence that cancerous cells can be killed without adversely affecting haematological profiles [91].…”