Department of Mechanical and Construction Engineering, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK.
Institute of Mechanical, Process, and Energy Engineering (IMPEE), School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, EH14 4AS, UK.
Acta Biomater. 2023 Sep 1;167:54-68. doi: 10.1016/j.actbio.2023.06.037. Epub 2023 Jun 29.
Diamond-like carbon (DLC) coatings doped with bioactive elements of silver (Ag) and copper (Cu) have been receiving increasing attention in the last decade, particularly in the last 5 years, due to their potential to offer a combination of enhanced antimicrobial and mechanical performance. These multi-functional bioactive DLC coatings offer great potential to impart the next generation of load-bearing medical implants with improved wear resistance and strong potency against microbial infections. This review begins with an overview of the status and issues with current total joint implant materials and the state-of-the art in DLC coatings and their application to medical implants. A detailed discussion of recent advances in wear resistant bioactive DLC coatings is then presented with a focus on doping the DLC matrix with controlled quantities of Ag and Cu elements. It is shown that both Ag and Cu doping can impart strong antimicrobial potency against a range of Gram-positive and Gram-negative bacteria, but this is always accompanied so far by a reduction in mechanical performance of the DLC coating matrix. The article concludes with discussion of potential synthesis methods to accurately control bioactive element doping without jeopardising mechanical properties and gives an outlook to the potential long-term impact of developing a superior multifunctional bioactive DLC coating on implant device performance and patient health and wellbeing. STATEMENT OF SIGNIFICANCE: Multi-functional diamond-like carbon (DLC) coatings doped with bioactive elements of silver (Ag) and copper (Cu) offer great potential to impart the next generation of load-bearing medical implants with improved wear resistance and strong potency against microbial infections. This article provides a critical review of the state-of-the-art in Ag and Cu doped DLC coatings, beginning with an overview of the current applications of DLC coatings in implant technology followed by a detailed discussion of Ag/Cu doped DLC coatings with particular focus on the relationship between their mechanical and antimicrobial performance. Finally, it ends with a discussion on the potential long-term impact of developing a truly multifunctional ultra-hard wearing bioactive DLC coating to extend the lifetime of total joint implants.
类金刚石碳（DLC）涂层掺杂有银（Ag）和铜（Cu）等生物活性元素，在过去十年中受到越来越多的关注，尤其是在过去五年中，因为它们有可能提供增强的抗菌和机械性能的组合。这些多功能生物活性 DLC 涂层为下一代具有改进的耐磨性和对微生物感染的强大抵抗力的承重医疗植入物提供了巨大的潜力。
本综述首先概述了当前全关节植入物材料的现状和问题，以及 DLC 涂层及其在医疗植入物中的应用的最新技术。然后详细讨论了耐磨生物活性 DLC 涂层的最新进展，重点是在 DLC 基质中掺杂受控量的 Ag 和 Cu 元素。结果表明，Ag 和 Cu 掺杂都可以赋予对一系列革兰氏阳性和革兰氏阴性细菌的强大抗菌效力，但迄今为止，这总是伴随着 DLC 涂层基质机械性能的降低。文章最后讨论了潜在的合成方法，以在不损害机械性能的情况下准确控制生物活性元素掺杂，并展望了开发具有优越多功能生物活性 DLC 涂层对植入物设备性能和患者健康和福祉的潜在长期影响。
掺杂有生物活性元素银（Ag）和铜（Cu）的多功能类金刚石碳（DLC）涂层为改善耐磨性和对微生物感染的强大抵抗力赋予下一代承重医疗植入物提供了巨大的潜力。本文对 Ag 和 Cu 掺杂 DLC 涂层的最新技术进行了批判性综述，首先概述了 DLC 涂层在植入技术中的当前应用，然后详细讨论了 Ag/Cu 掺杂 DLC 涂层，特别关注它们的机械和抗菌性能之间的关系。最后，讨论了开发真正多功能超耐磨生物活性 DLC 涂层以延长全关节植入物寿命的潜在长期影响。
