Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, People's Republic of China.
Institute of Metal Research, Chinese Academy of Sciences, Shenyang 10000, People's Republic of China.
J Biomed Mater Res B Appl Biomater. 2020 Feb;108(2):484-495. doi: 10.1002/jbm.b.34405. Epub 2019 May 9.
Implant-related infection (IRI) is a devastating complication in orthopedic procedures. Traditional materials used in orthopedics are susceptible to bacterial infection. In this study, we developed a copper-bearing 316L stainless steel (316L-Cu SS) for the prevention of IRI. This 316L-Cu SS allowed stable and continuous release of copper ions with a rate of 5.079 ng/cm /day. Compared with 316L stainless steel (316L SS), 316L-Cu SS exhibited a broad-spectrum antibacterial effect against Staphylococcus aureus, Escherichia coli, and Staphylococcus epidermidis with the bacterial reduction percentages of 95.2, 94.8, and 94.1%, respectively. The antibiofilm activity was confirmed by crystal violet assay, scanning electron microscopy, and confocal laser scanning microscopy. The in vivo antibacterial performance was tested on a rat model. When nails were treated with a low concentration of bacteria, 316L SS group exhibit a bone infection with a radiographic score of 8.9 ± 1.1 and a histological score of 10.4 ± 1.0, which were higher than 316L-Cu SS group (1.2 ± 0.2 and 0.9 ± 0.2), indicating IRI was reduced by 316L-Cu SS. When nails were treated with a high concentration of bacteria, IRI was also alleviated by 316L-Cu SS. Together, these results demonstrated that 316L-Cu SS is a promising material for preventing IRI.
植入物相关感染（IRI）是骨科手术中一种破坏性的并发症。传统的骨科材料容易受到细菌感染。在这项研究中，我们开发了一种含铜的 316L 不锈钢（316L-Cu SS），用于预防 IRI。这种 316L-Cu SS 允许铜离子以 5.079ng/cm /天的速度稳定和持续释放。与 316L 不锈钢（316L SS）相比，316L-Cu SS 对金黄色葡萄球菌、大肠杆菌和表皮葡萄球菌表现出广谱抗菌作用，细菌减少率分别为 95.2%、94.8%和 94.1%。结晶紫测定、扫描电子显微镜和共聚焦激光扫描显微镜证实了其抗生物膜活性。在大鼠模型上测试了其体内抗菌性能。当钉子被低浓度细菌处理时，316L SS 组的 X 光评分为 8.9±1.1，组织学评分 10.4±1.0，高于 316L-Cu SS 组（1.2±0.2 和 0.9±0.2），表明 316L-Cu SS 减轻了 IRI。当钉子被高浓度细菌处理时，316L-Cu SS 也减轻了 IRI。总之，这些结果表明 316L-Cu SS 是一种有前途的预防 IRI 的材料。
