Department of Orthopaedic Surgery, University of New Mexico School of Medicine, Albuquerque, NM, USA.
Waldemar Link GmbH, Germany.
Surg Technol Int. 2021 Nov 23;39:413-417. doi: 10.52198/21.STI.39.OS1500.
Prosthetic joint infection (PJI) is one of the most devastating complications that can occur following total hip and total knee arthroplasty. Despite the remarkable advances that have been made in surgical techniques and implant technology, the incidence of PJI has remained largely unchanged over the past two decades. One approach that has been described in the literature to minimize the risk of PJI has been the use of silver-coated prostheses. Silver has been reported to have antimicrobial properties when added to a variety of orthopaedic materials including bone cement, hydroxyapatite coatings and wound dressings. Silver is also being increasingly used as a surface coating for endoprostheses used for reconstruction around the hip and the knee with the specific aim of reducing the incidence of prosthetic joint infection. Despite the increasing adoption of this technology, the use of silver coatings remains controversial. The optimal method for preparation and the thickness of the coating, as well as the mechanism(s) of action in reducing the incidence of PJI, are unclear. The issue of silver toxicity is also an important consideration. This paper provides an overview of the use of silver coatings in reconstructive orthopaedics, as well as the types available and techniques used to coat endoprostheses. We also review the basic science as well as the clinical applications of silver coatings in the prevention of PJIs.
人工关节感染（PJI）是全髋关节和全膝关节置换术后最严重的并发症之一。尽管在手术技术和植入物技术方面取得了显著进展，但在过去的二十年中，PJI 的发病率基本保持不变。文献中描述的一种降低 PJI 风险的方法是使用银涂层假体。当将银添加到各种骨科材料中时，包括骨水泥、羟基磷灰石涂层和伤口敷料，已报道银具有抗菌特性。银也越来越多地用作髋关节和膝关节周围重建用内假体的表面涂层，其特定目的是降低人工关节感染的发生率。尽管越来越多地采用这项技术，但银涂层的使用仍然存在争议。用于降低 PJI 发生率的最佳涂层制备方法和厚度、作用机制尚不清楚。银毒性问题也是一个重要的考虑因素。本文概述了银涂层在重建骨科中的应用，以及可用的类型和用于涂层内假体的技术。我们还回顾了银涂层在预防 PJI 中的基础科学和临床应用。
