Single-Dose, Preoperative Vitamin-D Supplementation Decreases Infection in a Mouse Model of Periprosthetic Joint Infection

Hegde, Vishal; Dworsky, Erik M.; Stavrakis, Alexandra I.; Loftin, Amanda H.; Zoller, Stephen D.; Park, Howard Y.; Richman, Sherif; Johansen, Daniel; Hu, Yan; Taylor, Julie; Hamad, Christopher D.; Chun, Rene F.; Xi, Weixian; Adams, John S.; Bernthal, Nicholas M.

doi:10.2106/jbjs.16.01598

Cited by 55 publications

(41 citation statements)

References 40 publications

(54 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[1][2][3][4][5] Management of an implant-associated infection often necessitates multiple debridement surgeries, implant replacement or removal, and long-term antibiotic treatment. [6][7][8][9] These problems are aggravated in patients with bone healing disorders associated with rheumatoid arthritis, osteoporosis, diabetes, or aging due to the difficulty of clearing an infection from poorly vascularized bone tissues and other necrotic tissues. 3,5,10,11 Implant-associated infections are caused by bacterial adhesion to an implant surface and subsequent formation of biofilms around implanted devices.…”

Section: Introductionmentioning

confidence: 99%

<p>Nanosilver/poly (DL-lactic-co-glycolic acid) on titanium implant surfaces for the enhancement of antibacterial properties and osteoinductivity</p>

Zeng

Xiong

Zhuo

et al. 2019

IJN

View full text Add to dashboard Cite

Background: Despite titanium (Ti) implants have been commonly used in the medical device field due to their superior biocompatibility, implant-associated bacterial infection remains a major clinical complication. Nanosilver, an effective antibacterial agent against a wide spectrum of bacterial strains, with a low-resistance potential, has attracted much interest too. Incorporation of nanosilver on Ti implants may be a promising approach to prevent biofilm formation. Purpose: The objective of the study was to investigate the antibacterial effects and osteoinductive properties of nanosilver/poly (dl-lactic-co-glycolic acid)-coated titanium (NSPTi). Methods: Gram-positive methicillin-resistant Staphylococcus aureus (MRSA) and the Gramnegative opportunistic pathogen Pseudomonas aeruginosa (PAO-1) were used to evaluate the antibacterial activity of NSPTi implants through the analysis of bacterial colonization in vitro and in vivo. Furthermore, we examined the osteoinductive potential of NSPTi implants by investigating the proliferation and differentiation of MC3T3-E1 preosteoblast cells. In vivo, the osteoinductive properties of NSPTi implants were assessed by radiographic evaluation, H&E staining, and Masson's trichrome staining. Results: In vitro, bacterial adhesion to the 2% NSPTi was significantly inhibited and ,1% of adhered bacteria survived after 24 hours. In vitro, the average colony-forming units (CFU)/g ratios in the 2% NSPTi with 10 3 CFU MRSA and PAO-1 were 1.50±0.68 and 1.75±0.6, respectively. In the uncoated Ti groups, the ratios were 1.03±0.82×10 3 and 0.94±0.49×10 3 , respectively. These results demonstrated that NSPTi implants had prominent antibacterial properties. Proliferation of MC3T3-E1 cells on the 2% NSPTi sample was 1.51, 1.78, and 2.22 times that on the uncoated Ti control after 3, 5, and 7 days' incubation, respectively. Furthermore, NSPTi implants promoted the maturation and differentiation of MC3T3-E1 cells. In vivo, NSPTi accelerated the formation of new bone while suppressing bacterial survival. Conclusion: NSPTi implants have simultaneous antibacterial and osteoinductive activities and therefore have the potential in clinical applications.

show abstract

Section: Introductionmentioning

confidence: 99%

<p>Nanosilver/poly (DL-lactic-co-glycolic acid) on titanium implant surfaces for the enhancement of antibacterial properties and osteoinductivity</p>

Zeng

Xiong

Zhuo

et al. 2019

IJN

View full text Add to dashboard Cite

show abstract

“…Although Hegde et al were able to show in vivo by means of a PPI mouse model that vitamin D3 deficiency leads to increased bacterial load as well as neutrophil infiltration and that this effect can be reversed by preoperative supplementation, valid clinical data are missing. 24 …”

Section: Discussionmentioning

confidence: 99%

The significance of the vitamin D metabolism in the development of periprosthetic infections after THA and TKA: a prospective matched-pair analysis of 240 patients

Zajonz

Prager

Edel

et al. 2018

CIA

View full text Add to dashboard Cite

BackgroundThe importance of the vitamin D homeostasis in infections is already known. However, its significance in periprosthetic infections (PPIs) after total hip arthroplasty and total knee arthroplasty is largely unexplored. The aim of the study is to precisely analyze the vitamin D balance in patients with PPIs after total hip arthroplasty and total knee arthroplasty. Here, cases with primary endoprosthesis implants and aseptic loosening are used as comparison groups.Materials and methodsIn this prospective matched-pair analysis, patients with PPI at the hip and knee joints were included in the study group (SG). The control groups (CGs) consisted of patients with primary implants (CG I) and who underwent replacement surgery due to aseptic loosening (CG II). In addition to 25 OH vitamin D3 and calcium, bone mineral and protein parameters were determined. An osteoporosis-specific questionnaire was collected.ResultsThere are no significant differences in the 25 OH-vitamin D levels between the SG (17.9±8.9) and both CGs (CG I: 16.8±6.90; CG II: 19.7±7.90). However, compared with the SG, significantly higher levels of calcium (Ca) and bone-specific alkaline phosphatase were found in both CGs in comparison with the SG. Significantly lower values concerning the protein balance in PPI were conspicuous. Acute PPI showed a significant reduction in 25 OH vitamin D3 compared with chronic infections (8.3±5.98 vs 21.6±8.40, P=0.002). Calcium and protein balance were also significantly reduced in acute PPIs.ConclusionAcute PPIs of the hip and knee joints show a significantly reduced calcium and 25 OH vitamin D3 levels as well as lowered proteins (albumin and total protein) compared with chronic infections as well as primary endoprostheses and aseptic replacement operations. Substitution of vitamin D3 and calcium with simultaneous adaptation of the protein balance is recommended in all PPIs, especially in the acute PPI.

show abstract

“…Infection prevention was also achieved by administering active and passive immunization against Staphylococcus aureus in a rat model 18 . Preoperative supplementation with 25-hydroxyvitamin D3 in mice with 25hydroxyvitamin D deficiency reduced infection risk by lowering bacterial and neutrophil burden 19 .…”

Section: Preventionmentioning

confidence: 99%

What’s New in Musculoskeletal Infection: Update on Biofilms

Nana

Nelson

McLaren

et al. 2016

The Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

show abstract

Single-Dose, Preoperative Vitamin-D Supplementation Decreases Infection in a Mouse Model of Periprosthetic Joint Infection

Cited by 55 publications

References 40 publications

<p>Nanosilver/poly (DL-lactic-co-glycolic acid) on titanium implant surfaces for the enhancement of antibacterial properties and osteoinductivity</p>

<p>Nanosilver/poly (DL-lactic-co-glycolic acid) on titanium implant surfaces for the enhancement of antibacterial properties and osteoinductivity</p>

The significance of the vitamin D metabolism in the development of periprosthetic infections after THA and TKA: a prospective matched-pair analysis of 240 patients

What’s New in Musculoskeletal Infection: Update on Biofilms

Contact Info

Product

Resources

About