Transcutaneous electromagnetic induction heating of an intramedullary nickel–titanium shape memory implant

Müller, Christian; El-Kashef, Tarek; Pfeifer, Ronny; Decker, Sebastian; Neunaber, Claudia; Meier, Karen; Fehr, Michael; Wesling, Volker; Gösling, Thomas; Hurschler, Christof; Krettek, Christian

doi:10.1007/s00264-014-2460-5

Cited by 14 publications

(17 citation statements)

References 26 publications

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“…Although this may seem high, such a thermal dose is not uncommon in orthopedic surgery with cementing, drilling and using diathermia [11][12][13]. There are also animal experiments that confirm the lack of significant necrosis after induction heating up to 60-65 C. M€ uller et al heated a nickel-titanium shape memory rod in the femur of rats at 40-60 C using induction heating and observed no necrosis in the surrounding bone and tissue [29]. They also heated an osteosynthesis plate in a rabbit model with induction heating and noted that all osteotomies underneath the plate healed [30].…”

Section: Discussionmentioning

confidence: 99%

Synergy between induction heating, antibiotics, and N-acetylcysteine eradicates Staphylococcus aureus from biofilm

Pijls

Sanders

Kuijper

et al. 2020

International Journal of Hyperthermia

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Background: Non-contact induction heating (NCIH) is a noninvasive treatment modality that can be used to cause thermal damage to bacterial biofilms on a metal implant surface in the context of a prosthetic joint infection. The purpose of this study was (1) to determine the effectiveness of NCIH on killing Staphylococcus aureus from biofilm and (2) to determine the possible synergistic effect of NCIH and cocktails of antibiotics and N-acetylcysteine (NAC). Methods: Staphylococcus aureus biofilms were grown on titanium alloy (Ti6Al4V) coupons. These coupons were heated to 50 C, 60 C, 70 C, 80 C, and 90 C for 3.5 min and subsequently exposed to cocktails of vancomycin, rifampicin and NAC at clinically relevant concentrations over 24 h. Results: In the control group without induction heating, 2.2 Ã 10 7 colony forming units (CFU)/cm 2 were observed. At 50 C, 60 C, 70 C, 80 C, and 90 C, a reduction of 0.3-log, 3.9-log, 4.2-log, 4.3-log, and 6.6-log CFU/cm 2 were observed, respectively. There was synergy between antibiotics and induction heating that resulted in less than 100 CFU/cm 2 remaining after 3.5 min at 60 C, and exposure to vancomycin and rifampicin. Total eradication was observed at 80 C. Total eradication was also observed at 60 C and a cocktail of antibiotics with NAC. Conclusion: Induction heating of titanium alloy coupons is effective for the reduction of bacterial load in vitro in S. aureus biofilms. Induction heating and cocktails of antibiotics and NAC have a synergistic effect that results in the total eradication of the biofilm at 60 C and higher for clinically relevant concentrations of vancomycin, rifampicin and NAC. ARTICLE HISTORY

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Section: Discussionmentioning

confidence: 99%

Synergy between induction heating, antibiotics, and N-acetylcysteine eradicates Staphylococcus aureus from biofilm

Pijls

Sanders

Kuijper

et al. 2020

International Journal of Hyperthermia

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“…2,3 There are also animal experiments that confirm the lack of necrosis after induction heating up to 60°C. 12,26 Muller et al 12 have heated a nickel-titanium shape memory rod in the femur of rats at 40°C to 60°C using induction heating and demonstrated no necrosis of the surrounding bone and tissue. The same research group have heated an osteosynthesis plate in a rabbit model with induction heating and found that all osteotomies have healed.…”

Section: Discussionmentioning

confidence: 99%

“…9,11 In the field of fracture healing with shape memory devices, Müller et al 12 have also shown the feasibility and safety of contact-free electromagnetic induction heating of Nickel Titanium alloy (NiTi) implants in a rat model. There are, however, no reports of non-contact heating of orthopaedic implants by induction heating to prevent and treat infections of orthopaedic implants.…”

Section: Introductionmentioning

confidence: 99%

Non-contact electromagnetic induction heating for eradicating bacteria and yeasts on biomaterials and possible relevance to orthopaedic implant infections

Pijls

Sanders

Kuijper

et al. 2017

Bone & Joint Research

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ObjectivesInfection of implants is a major problem in elective and trauma surgery. Heating is an effective way to reduce the bacterial load in food preparation, and studies on hyperthermia treatment for cancer have shown that it is possible to heat metal objects with pulsed electromagnetic fields selectively (PEMF), also known as induction heating. We therefore set out to answer the following research question: is non-contact induction heating of metallic implants effective in reducing bacterial load in vitro?MethodsTitanium alloy cylinders (Ti6Al4V) were exposed to PEMF from an induction heater with maximum 2000 watts at 27 kHz after being contaminated with five different types of micro-organisms: Staphylococcus epidermidis; Staphylococcus aureus; Pseudomonas aeruginosa; spore-forming Bacillus cereus; and yeast Candida albicans. The cylinders were exposed to incremental target temperatures (35°C, 45°C, 50°C, 55°C, 60°C, 65°C, 70°C) for up to 3.5 minutes.ResultsThere was an average linear heating rate of 0.39°C per second up to the target temperature, and thereafter the target temperature was maintained until the end of the experiment. At 60°C and higher (duration 3.5 minutes), there was a 6-log reduction or higher for every micro-organism tested. At 60°C, we found that the shortest duration of effective induction heating was 1.5 minutes. This resulted in a 5-log reduction or higher for every micro-organism tested.ConclusionNon-contact induction heating of a titanium disk is effective in reducing bacterial load in vitro. These promising results can be further explored as a new treatment modality for infections of metal orthopaedic implants.Cite this article: B. G. Pijls, I. M. J. G. Sanders, E. J. Kuijper, R. G. H. H. Nelissen. Non-contact electromagnetic induction heating for eradicating bacteria and yeasts on biomaterials and possible relevance to orthopaedic implant infections: In vitro findings. Bone Joint Res 2017;6:323–330. DOI: 10.1302/2046-3758.65.BJR-2016-0308.R1.

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“…The induction heating process was performed using a water-cooled generator-oscillator combination as described before (HFG 10, Eldec Schwenk Induction, Dornstetten, Germany) [ 30 , 31 ]. The induction coil was made of three copper windings with an inner diameter of 150 mm leaving enough room to place a rabbit's hind leg inside the coil.…”

Section: Methodsmentioning

confidence: 99%

“…We have implemented electromagnetic field induction for this purpose. In previous studies, we demonstrated that electromagnetic induction heating can be used to achieve controlled transcutaneous warming of NiTi-SMA specimens located between the quadriceps muscle and the femur or intramedullary in rat models from 40 to 60°C [ 30 , 31 ]. This is a viable temperature range of austenite finish temperatures (temperatures at which the intended SME is deployed) for our application.…”

Section: Introductionmentioning

confidence: 99%

A Novel Shape Memory Plate Osteosynthesis for Noninvasive Modulation of Fixation Stiffness in a Rabbit Tibia Osteotomy Model

Müller

Pfeifer

Meier

et al. 2015

BioMed Research International

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Nickel-titanium shape memory alloy (NiTi-SMA) implants might allow modulating fracture healing, changing their stiffness through alteration of both elastic modulus and cross-sectional shape by employing the shape memory effect (SME). Hypotheses: a novel NiTi-SMA plate stabilizes tibia osteotomies in rabbits. After noninvasive electromagnetic induction heating the alloy exhibits the SME and the plate changes towards higher stiffness (inverse dynamization) resulting in increased fixation stiffness and equal or better bony healing. In 14 rabbits, 1.0 mm tibia osteotomies were fixed with our experimental plate. Animals were randomised for control or induction heating at three weeks postoperatively. Repetitive X-ray imaging and in vivo measurements of bending stiffness were performed. After sacrifice at 8 weeks, macroscopic evaluation, µCT, and post mortem bending tests of the tibiae were carried out. One death and one early implant dislocation occurred. Following electromagnetic induction heating, radiographic and macroscopic changes of the implant proved successful SME activation. All osteotomies healed. In the treatment group, bending stiffness increased over time. Differences between groups were not significant. In conclusion, we demonstrated successful healing of rabbit tibia osteotomies using our novel NiTi-SMA plate. We demonstrated shape-changing SME in-vivo through transcutaneous electromagnetic induction heating. Thus, future orthopaedic implants could be modified without additional surgery.

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Transcutaneous electromagnetic induction heating of an intramedullary nickel–titanium shape memory implant

Cited by 14 publications

References 26 publications

Synergy between induction heating, antibiotics, and N-acetylcysteine eradicates Staphylococcus aureus from biofilm

Synergy between induction heating, antibiotics, and N-acetylcysteine eradicates Staphylococcus aureus from biofilm

Non-contact electromagnetic induction heating for eradicating bacteria and yeasts on biomaterials and possible relevance to orthopaedic implant infections

A Novel Shape Memory Plate Osteosynthesis for Noninvasive Modulation of Fixation Stiffness in a Rabbit Tibia Osteotomy Model

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