Antibacterial iodine-supported titanium implants

Preparation and antibiotic drug release of mineralized collagen coatings on titanium

In this study, a mineralized collagen coating was electrolytically deposited onto titanium. The results showed that the mineralized collagen coatings with dense or porous morphology could be obtained. The mineral phase was mainly hydroxyapatite. In vitro evaluation showed the mineralized collagen coatings were stable in Kokubo's simulated body fluid, and displayed a good cytocompatibility in the cell multiplication test. The mineralized collagen coatings loaded with vancomycin hydrochloride showed an inhibitory effect on the growth of S. aureus. The present mineralized collagen coating demonstrates good suitability for surface modification of orthopedic metal implants.

Innovative antimicrobial coating of titanium implants with iodine

BACKGROUND

Postoperative infection associated with implants remains a serious complication in orthopedic surgery. Several biomaterial surface treatments have been proposed as a means of reducing the incidence of implant-associated infections. In this study, a clinical trial was performed using an iodine-supported titanium that suppresses the microbial activities.

METHODS

A total of 222 patients with postoperative infection or compromised status were treated using iodine-supported titanium implants. The mean age of the patients was 49.4 years (range 5-85 years). One hundred twenty-seven patients were male and 95 were female. In 158 patients, iodine-supported implants were used to prevent infection, such as compromised hosts and conditions, and in 64 patients to treat active infection. White blood cell (WBCs) and C-reactive protein (CRP) levels were measured pre- and postoperatively in all patients. To confirm whether iodine from the implant affected physiological functions, thyroid hormone levels in the blood were examined. Both examinations were conducted sequentially for a year. Radiological evaluations were performed regularly after the operation. The chronological changes of the iodine amount were evaluated using half pins removed after completion of external fixation.

RESULTS

The mean follow-up period was 18.4 months (range 3-44 months). Acute infection developed in three tumor cases among the 158 patients on preventive therapy. All three recovered without removal of the implants. Infection was cured in all 64 patients with infection. Median WBC levels were in the normal range, and median CRP levels returned to <0.5 within 4 weeks after surgery. Abnormalities of thyroid gland function were not detected. None of the patients experienced loosening of the implants. There were two patients with mechanical implant failure, which was treated by re-implantation. Excellent bone ingrowth and ongrowth were found around all hip and tumor prostheses. One year later, the amount of iodine on external fixation pins remained about 20-30%.

CONCLUSIONS

Iodine-supported titanium implants can be very effective for preventing and treating infections after orthopedic surgery. Cytotoxicity and adverse effects were not detected.