Department of Process, Energy and Transport Engineering, Munster Technological University, Cork, Ireland.
School of Pharmacy, University College Cork, Cork, Ireland.
Drug Deliv Transl Res. 2021 Apr;11(2):702-716. doi: 10.1007/s13346-021-00946-1. Epub 2021 Mar 13.
Poor integration of orthopaedic devices with the host tissue owing to aseptic loosening and device-associated infections are two of the leading causes of implant failure, which represents a significant problem for both patients and the healthcare system. Novel strategies have focused on silver to combat antimicrobial infections as an alternative to drug therapeutics. In this study, we investigated the impact of increasing the % substitution (12% wt) of silver and strontium in hydroxyapatite (HA) coatings to enhance antimicrobial properties and stimulate osteoblasts, respectively. Additionally, we prepared a binary substituted coating containing both silver and strontium (AgSrA) at 12% wt as a comparison. All coatings were deposited using a novel blasting process, CoBlast, onto biomedical grade titanium (V). Surface physicochemical properties, cytocompatibility and antimicrobial functionality were determined. The anticolonising properties of the coatings were screened using Staphylococcus aureus ATCC 1448, and thereafter, the AgA coating was evaluated using clinically relevant strains. Strontium-doped surfaces demonstrated enhanced osteoblast viability; however, a lower inhibition of biofilm formation was observed compared with the other surfaces. A co-substituted AgSrA surface did not show enhanced osteoblast or anticolonising properties compared with the SrA and AgA surfaces, respectively. Due to its superior anticolonising performance in preliminary studies, AgA was chosen for further studies. The AgA coated surfaces demonstrated good antibacterial activity (eluted and immobilised ion) against methicillin-resistant S. aureus followed by methicillin-sensitive Staphylococcus aureus clinical isolates; however, the AgA surface displayed poor impact against Staphylococcus epidermidis. In conclusion, herein, we demonstrate that HA can be substituted with a range of ions to augment the properties of HA coatings on orthopaedic devices, which offer promising potential to combat orthopaedic device-associated infections and enhance device performance.
由于无菌性松动和器械相关感染，骨科器械与宿主组织的整合不良是导致植入物失败的两个主要原因，这对患者和医疗保健系统来说都是一个重大问题。新策略侧重于使用银来对抗抗菌感染，作为药物治疗的替代方法。在这项研究中，我们研究了增加羟基磷灰石（HA）涂层中银和锶的取代率（12wt%）对增强抗菌性能和刺激成骨细胞的影响。此外，我们还制备了一种含有银和锶的二元取代涂层（AgSrA）作为比较，含量为 12wt%。所有涂层均使用新型喷砂工艺 CoBlast 沉积在医用级钛（V）上。测定了表面物理化学性质、细胞相容性和抗菌功能。使用金黄色葡萄球菌 ATCC 1448 筛选了涂层的抗定植特性，然后使用临床相关菌株评估了 AgA 涂层。锶掺杂表面显示出增强的成骨细胞活力；然而，与其他表面相比，观察到生物膜形成的抑制作用较低。与 SrA 和 AgA 表面相比，共取代的 AgSrA 表面没有显示出增强的成骨细胞或抗定植特性。由于其在初步研究中具有卓越的抗定植性能，因此选择 AgA 进行进一步研究。AgA 涂层表面对耐甲氧西林金黄色葡萄球菌和耐甲氧西林敏感的金黄色葡萄球菌临床分离株表现出良好的抗菌活性（洗脱和固定离子）；然而，AgA 表面对表皮葡萄球菌的影响较差。总之，本文证明 HA 可以被多种离子取代，以增强骨科器械上 HA 涂层的性能，这为对抗骨科器械相关感染和提高器械性能提供了有前途的潜力。
