Department of Orthopaedics and Traumatology, Medical Faculty, Osmangazi University, Meselik, 26480, Eskisehir, Turkey.
Clin Orthop Relat Res. 2013 Aug;471(8):2532-9. doi: 10.1007/s11999-013-2894-x.
Despite progress in surgical techniques, 1% to 2% of joint arthroplasties become complicated by infection. Coating implant surfaces with antimicrobial agents have been attempted to prevent initial bacterial adhesion to implants with varying success rates. We developed a silver ion-containing calcium phosphate-based ceramic nanopowder coating to provide antibacterial activity for orthopaedic implants.
QUESTIONS/PURPOSES: We asked whether titanium prostheses coated with this nanopowder would show resistance to bacterial colonization as compared with uncoated prostheses.
We inserted titanium implants (uncoated [n = 9], hydroxyapatite-coated [n = 9], silver-coated [n = 9]) simulating knee prostheses into 27 rabbits' knees. Before implantation, 5 × 10(2) colony-forming units of Staphylococcus aureus were inoculated into the femoral canal. Radiology, microbiology, and histology findings were quantified at Week 6 to define the infection, microbiologically by increased rate of implant colonization/positive cultures, histologically by leukocyte infiltration, necrosis, foreign-body granuloma, and devitalized bone, and radiographically by periosteal reaction, osteolysis, or sequestrum formation.
Swab samples taken from medullary canals and implants revealed a lower proportion of positive culture in silver-coated implants (one of nine) than in uncoated (eight of nine) or hydroxyapatite-coated (five of nine) implants. Silver-coated implants also had a lower rate of colonization. No cellular inflammation or foreign-body granuloma was observed around the silver-coated prostheses.
Silver ion-doped ceramic nanopowder coating of titanium implants led to an increase in resistance to bacterial colonization compared to uncoated implants.
Silver-coated orthopaedic implants may be useful for resistance to local infection but will require in vivo confirmation.
尽管手术技术取得了进步，但仍有 1%至 2%的关节置换术因感染而变得复杂。在植入物表面涂覆抗菌剂以防止初始细菌附着在植入物上的尝试已取得不同程度的成功。我们开发了一种含银离子的磷酸钙基陶瓷纳米粉末涂层，为骨科植入物提供抗菌活性。
问题/目的：我们想知道与未涂层的假体相比，这种纳米粉末涂层的钛假体是否具有抵抗细菌定植的能力。
我们将模拟膝关节假体的钛植入物（未涂层[9 个]、羟基磷灰石涂层[9 个]、银涂层[9 个]）插入 27 只兔子的膝关节中。在植入之前，将 5×10(2)个金黄色葡萄球菌的菌落形成单位接种到股骨髓腔内。在第 6 周时通过放射学、微生物学和组织学检查来量化感染情况，通过植入物定植/阳性培养物的增加速度、白细胞浸润、坏死、异物肉芽肿和失活骨的组织学来确定感染情况，并通过骨膜反应、骨质溶解或死骨形成的放射学来确定感染情况。
从髓腔和植入物中取出的拭子样本显示，银涂层植入物（9 个中有 1 个）的阳性培养比例低于未涂层植入物（9 个中有 8 个）或羟基磷灰石涂层植入物（9 个中有 5 个）。银涂层植入物的定植率也较低。在银涂层假体周围未观察到细胞炎症或异物肉芽肿。
与未涂层植入物相比，钛植入物的掺银陶瓷纳米粉末涂层导致其对细菌定植的抵抗力增加。
银涂层骨科植入物可能有助于抵抗局部感染，但需要体内确认。
