Department of Orthopedic Surgery, First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning, China.
J Mater Sci Mater Med. 2011 Nov;22(11):2525-35. doi: 10.1007/s10856-011-4427-z. Epub 2011 Aug 26.
Bone and intramedullary bacterial infections are one of the most serious complications of the surgical repair of fractures. To reduce the incidence of implant-related infections, several biomaterial surface treatments with integrated antibiotics, antiseptics, or metal ions have been developed for implants. In this study, we evaluated the antibacterial activity and biocompatibility of 317L stainless steel containing 4.5% copper alloy (317L-Cu) in vitro and in vivo using an animal model. Common pathogens of implant-related infections are Staphylococcus aureus and Escherichia coli, which were injected into implant materials to study their antimicrobial potential. We compared antimicrobial potential of 317L-Cu with 317L stainless steel (317L) and titanium (Ti-6Al-4V) alloys as controls. Compared with controls, 317L-Cu materials inhibited colonization by both bacteria in vitro and in vivo. Compared with 317L and Ti-6Al-4V controls, 317L-Cu showed no significant difference in colony formation of osteoblast-like cells on metal surfaces after 72 h of incubation in vitro. Metal screws containing these materials were also made for our vivo study in a rabbit model. Tissue-implants were analyzed for infection and inflammatory changes by hematoxylin-eosin staining of implants in bone. The screw tract inflammation and infection of 317L-Cu was minimal, although some inflammatory cells gathered at acutely infected sites. In addition, after materials had been implanted for 14 days in vivo, the expression of insulin-like growth factor-1 (IGF-1) in osteoblasts around 317L-Cu screws tracts had increased compared with 317L and Ti-6Al-4V controls. Overall, 317L-Cu demonstrated strong antimicrobial activity and biocompatibility in vitro and in vivo and may be used as a biomaterial to reduce implant-related infections.
骨和髓内细菌感染是骨折手术修复后最严重的并发症之一。为了降低植入物相关感染的发生率，已经开发出几种具有抗生素、防腐剂或金属离子整合功能的生物材料表面处理方法，用于植入物。在这项研究中，我们使用动物模型评估了含有 4.5%铜合金的 317L 不锈钢（317L-Cu）的体外和体内抗菌活性和生物相容性。植入物相关感染的常见病原体是金黄色葡萄球菌和大肠杆菌，我们将它们注入植入物材料中，以研究其抗菌潜力。我们将 317L-Cu 的抗菌潜力与 317L 不锈钢（317L）和钛（Ti-6Al-4V）合金作为对照进行比较。与对照组相比，317L-Cu 材料在体外和体内均能抑制两种细菌的定植。与 317L 和 Ti-6Al-4V 对照组相比，317L-Cu 材料在体外孵育 72 小时后，在金属表面上形成成骨样细胞的菌落无明显差异。我们还为兔模型的体内研究制造了含有这些材料的金属螺钉。通过对植入物在骨中的苏木精-伊红染色分析，研究了组织-植入物的感染和炎症变化。尽管在急性感染部位聚集了一些炎症细胞，但 317L-Cu 的螺钉轨迹炎症和感染最小。此外，在体内植入 14 天后，与 317L 和 Ti-6Al-4V 对照组相比，317L-Cu 周围成骨细胞中胰岛素样生长因子-1（IGF-1）的表达增加。总的来说，317L-Cu 在体外和体内均表现出较强的抗菌活性和生物相容性，可作为一种生物材料用于降低植入物相关感染。
