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Clin Orthop Relat Res. 2013 Aug;471(8):2532-9. doi: 10.1007/s11999-013-2894-x.

A silver ion-doped calcium phosphate-based ceramic nanopowder-coated prosthesis increased infection resistance.

Author information

1
Department of Orthopaedics and Traumatology, Medical Faculty, Osmangazi University, Meselik, 26480, Eskisehir, Turkey. nkose@ogu.edu.tr

Abstract

BACKGROUND:

Despite progress in surgical techniques, 1% to 2% of joint arthroplasties become complicated by infection. Coating implant surfaces with antimicrobial agents have been attempted to prevent initial bacterial adhesion to implants with varying success rates. We developed a silver ion-containing calcium phosphate-based ceramic nanopowder coating to provide antibacterial activity for orthopaedic implants.

QUESTIONS/PURPOSES:

We asked whether titanium prostheses coated with this nanopowder would show resistance to bacterial colonization as compared with uncoated prostheses.

METHODS:

We inserted titanium implants (uncoated [n = 9], hydroxyapatite-coated [n = 9], silver-coated [n = 9]) simulating knee prostheses into 27 rabbits' knees. Before implantation, 5 × 10(2) colony-forming units of Staphylococcus aureus were inoculated into the femoral canal. Radiology, microbiology, and histology findings were quantified at Week 6 to define the infection, microbiologically by increased rate of implant colonization/positive cultures, histologically by leukocyte infiltration, necrosis, foreign-body granuloma, and devitalized bone, and radiographically by periosteal reaction, osteolysis, or sequestrum formation.

RESULTS:

Swab samples taken from medullary canals and implants revealed a lower proportion of positive culture in silver-coated implants (one of nine) than in uncoated (eight of nine) or hydroxyapatite-coated (five of nine) implants. Silver-coated implants also had a lower rate of colonization. No cellular inflammation or foreign-body granuloma was observed around the silver-coated prostheses.

CONCLUSIONS:

Silver ion-doped ceramic nanopowder coating of titanium implants led to an increase in resistance to bacterial colonization compared to uncoated implants.

CLINICAL RELEVANCE:

Silver-coated orthopaedic implants may be useful for resistance to local infection but will require in vivo confirmation.

PMID:
23463287
PMCID:
PMC3705076
DOI:
10.1007/s11999-013-2894-x
[Indexed for MEDLINE]
Free PMC Article

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