Periprosthetic Joint Infection

Implant‐associated osteomyelitis: Development, characterisation, and application of a porcine model

“…Biofilm in IAO -Both bone tissue exposed to surgery and the inserted bone implants are highly susceptible to infections [19,22]. If the infecting bacteria are not eliminated rapidly, they will adhere to the bone tissue and/or the surface of the implant (II, III, VI, VIII) [19,22].…”

“…Biofilm in IAO -Both bone tissue exposed to surgery and the inserted bone implants are highly susceptible to infections [19,22]. If the infecting bacteria are not eliminated rapidly, they will adhere to the bone tissue and/or the surface of the implant (II, III, VI, VIII) [19,22]. This process of bacterial attachment is mediated by physical factors, for example surface tension, hydrophobicity and electrostatic interactions or specific adhesion to plasma proteins such as fibronectin and fibrin [22][23][24].…”

“…Interestingly, the plasma protein coating plays a more important role in bacterial surface adhesion to implants than the implant material (e.g. steel or titanium) [22]. If the infecting bacteria are planktonic (single), then after adhering to the plasma protein-embedded bone tissue or implant, they will transform into a biofilm [6].…”

“…Biofilm bacteria are 1000-to 10,000-fold more tolerant of antibiotics than their planktonic counterparts [28]. A bone infection biofilm will also mature over time, increasing its antimicrobial tolerance [22]. Because of this biofilm maturation, the probability of successfully treating a bone infection decreases dramatically from 80-90% to 30-60% if treatment is initiated more than 3-4 weeks after infection [22].…”

“…A bone infection biofilm will also mature over time, increasing its antimicrobial tolerance [22]. Because of this biofilm maturation, the probability of successfully treating a bone infection decreases dramatically from 80-90% to 30-60% if treatment is initiated more than 3-4 weeks after infection [22]. Osteomyelitis research has shown that eradicating tissue-based biofilms is extremely difficult.…”