Cleveland Clinic Adult Reconstruction Research (CCARR), Department of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Ave. A40, Cleveland, OH, 44113, USA.
Department of Chemistry, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH, 44106, USA.
Eur J Orthop Surg Traumatol. 2024 Dec;34(8):3989-3994. doi: 10.1007/s00590-024-04093-4. Epub 2024 Sep 11.
Periprosthetic joint infection is a complication of total joint arthroplasty with treatment costs over $1.6 billion dollars per year in the US with high failure rates. Therefore, generation of coatings that can prevent infection is paramount. Diamond-like carbon (DLC) is an ideal coating for implants as they are wear-resistant, corrosion-resistant, inert, and have a low friction coefficient. The purpose of this study was to test the efficacy of DLC surface treatment in prevention of biofilm on titanium discs infected with Staphylococcus aureus in vitro.
Titanium alloy discs (n = 4 non-coated and n = 4 DLC-coated) were infected with 5 × 10 colony-forming units (CFU) of S. aureus for 2 weeks then analysed via crystal violet and scanning electron microscopy (SEM).
Crystal violet analysis yielded differences in the appearance of biofilm on implant surface where DLC-coated had a clumpier appearance but no difference in biofilm quantification. Interestingly, this clumpy appearance did lead to differences in SEM biofilm coverage where significantly less biofilm coverage was found on DLC-coated discs (81.78% vs. 54.17%, p < 0.003).
DLC-coated titanium alloy implants may have preventative properties in S. aureus infection. Observing differences in biofilm coverage does warrant additional testing including CFU titration and biofilm kinetics with eventual use in an animal model of periprosthetic joint infection.
假体周围关节感染是全关节置换术的一种并发症，在美国每年的治疗费用超过 16 亿美元，且失败率很高。因此，开发能够预防感染的涂层至关重要。类金刚石碳（DLC）是一种理想的植入物涂层，因为它们具有耐磨、耐腐蚀、惰性和低摩擦系数的特点。本研究旨在测试 DLC 表面处理在预防金黄色葡萄球菌体外感染钛盘生物膜方面的功效。
将钛合金盘（非涂层 n=4，DLC 涂层 n=4）用 5×10 菌落形成单位（CFU）的金黄色葡萄球菌感染 2 周，然后通过结晶紫和扫描电子显微镜（SEM）进行分析。
结晶紫分析显示，DLC 涂层钛合金植入物表面生物膜的外观存在差异，DLC 涂层的生物膜外观更结块，但生物膜定量无差异。有趣的是，这种结块外观确实导致了 SEM 生物膜覆盖的差异，DLC 涂层盘上的生物膜覆盖明显减少（81.78%比 54.17%，p<0.003）。
DLC 涂层钛合金植入物可能具有预防金黄色葡萄球菌感染的特性。观察到生物膜覆盖的差异确实需要进一步的测试，包括 CFU 滴定和生物膜动力学，最终在假体周围关节感染的动物模型中使用。
