Recent Advances in the Evaluation of Antimicrobial Materials for Resolution of Orthopedic Implant-Associated Infections In Vivo

Abstract

While orthopedic implant-associated infections are rare, revision surgeries resulting from infections incur considerable healthcare costs and represent a substantial research area clinically, in academia, and in industry. In recent years, there have been numerous advances in the development of antimicrobial strategies for the prevention and treatment of orthopedic implant-associated infections which offer promise to improve the limitations of existing delivery systems through local and controlled release of antimicrobial agents. Prior to translation to in vivo orthopedic implant-associated infection models, the properties (e.g., degradation, antimicrobial activity, biocompatibility) of the antimicrobial materials can be evaluated in subcutaneous implant in vivo models. The antimicrobial materials are then incorporated into in vivo implant models to evaluate the efficacy of using the material to prevent or treat implant-associated infections. Recent technological advances such as 3D-printing, bacterial genomic sequencing, and real-time in vivo imaging of infection and inflammation have contributed to the development of preclinical implant-associated infection models that more effectively recapitulate the clinical presentation of infections and improve the evaluation of antimicrobial materials. This Review highlights the advantages and limitations of antimicrobial materials used in conjunction with orthopedic implants for the prevention and treatment of orthopedic implant-associated infections and discusses how these materials are evaluated in preclinical in vivo models. This analysis serves as a resource for biomaterial researchers in the selection of an appropriate orthopedic implant-associated infection preclinical model to evaluate novel antimicrobial materials.

Microporous surface containing flower-like molybdenum disulfide submicro-spheres of sulfonated polyimide with antibacterial effect and promoting bone regeneration and osteointegration

“…When implanted in vivo , bacteria may attach and colonize on the implant surface, leading to biofilm formation, which protects bacteria from antibiotics and the host immune system, and consequently causes implant-associated infection. 38 Implant infection can lead to additional treatments or implant removal. Therefore, efforts are required to produce implants with antibacterial functions that reduce infection in orthopedics.…”

Mg-, Zn-, and Fe-Based Alloys With Antibacterial Properties as Orthopedic Implant Materials

“…Strategies for IAI mainly start from three aspects: 1) preventing the initial adhesion of bacteria, 2) destroying the biofilm that is just starting to form, and 3) destroying the mature biofilm. Many research studies have been devoted to improvements in antibiotic therapy, such as bone cement ( Ismat et al, 2021 ), biopolymers ( Kasza et al, 2021 ), ceramic materials ( Cyphert et al, 2021 ), hydrogels ( Garg et al, 2021 ), and nanomaterials ( Keskin et al, 2021 ; Nag et al, 2021 ). They are designed as local drug delivery vehicles or coatings.…”

Antimicrobial Nanomaterials Based on Halloysite Clay Mineral: Research Advances and Outlook

“…The rising age and longevity of the population have led to the implementation of primary arthroplasties worldwide. A consequence of this treatment is often represented by the occurrence of some infections, depending upon the type of bacteria involved and whether the infection is acute or chronic [ 65 ].…”