Periferakis Argyrios, Periferakis Aristodemos-Theodoros, Troumpata Lamprini, Dragosloveanu Serban, Timofticiuc Iosif-Aliodor, Georgatos-Garcia Spyrangelos, Scheau Andreea-Elena, Periferakis Konstantinos, Caruntu Ana, Badarau Ioana Anca, Scheau Cristian, Caruntu Constantin
Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Akadimia of Ancient Greek and Traditional Chinese Medicine, 16675 Athens, Greece.
Biomimetics (Basel). 2024 Mar 1;9(3):154. doi: 10.3390/biomimetics9030154.
The incidence of microbial infections in orthopedic prosthetic surgeries is a perennial problem that increases morbidity and mortality, representing one of the major complications of such medical interventions. The emergence of novel technologies, especially 3D printing, represents a promising avenue of development for reducing the risk of such eventualities. There are already a host of biomaterials, suitable for 3D printing, that are being tested for antimicrobial properties when they are coated with bioactive compounds, such as antibiotics, or combined with hydrogels with antimicrobial and antioxidant properties, such as chitosan and metal nanoparticles, among others. The materials discussed in the context of this paper comprise beta-tricalcium phosphate (β-TCP), biphasic calcium phosphate (BCP), hydroxyapatite, lithium disilicate glass, polyetheretherketone (PEEK), poly(propylene fumarate) (PPF), poly(trimethylene carbonate) (PTMC), and zirconia. While the recent research results are promising, further development is required to address the increasing antibiotic resistance exhibited by several common pathogens, the potential for fungal infections, and the potential toxicity of some metal nanoparticles. Other solutions, like the incorporation of phytochemicals, should also be explored. Incorporating artificial intelligence (AI) in the development of certain orthopedic implants and the potential use of AI against bacterial infections might represent viable solutions to these problems. Finally, there are some legal considerations associated with the use of biomaterials and the widespread use of 3D printing, which must be taken into account.
骨科假体手术中微生物感染的发生率是一个长期存在的问题,它会增加发病率和死亡率,是此类医疗干预的主要并发症之一。新技术的出现,尤其是3D打印技术,为降低此类意外情况的风险提供了一条有前景的发展途径。目前已有许多适用于3D打印的生物材料,它们在涂覆生物活性化合物(如抗生素)或与具有抗菌和抗氧化性能的水凝胶(如壳聚糖和金属纳米颗粒等)结合时,正在接受抗菌性能测试。本文讨论的材料包括β-磷酸三钙(β-TCP)、双相磷酸钙(BCP)、羟基磷灰石、二硅酸锂玻璃、聚醚醚酮(PEEK)、聚富马酸丙二醇酯(PPF)、聚碳酸三亚甲基酯(PTMC)和氧化锆。虽然最近的研究结果很有前景,但仍需要进一步发展,以应对几种常见病原体日益增长的抗生素耐药性、真菌感染的可能性以及一些金属纳米颗粒的潜在毒性。其他解决方案,如加入植物化学物质,也应加以探索。在某些骨科植入物的开发中纳入人工智能(AI)以及将AI用于对抗细菌感染可能是解决这些问题的可行方案。最后,在生物材料的使用和3D打印的广泛应用方面存在一些法律考量,必须予以重视。