1
|
Hanslik-Schnabel B, Flöry D, Borchert GH, Schanda JE. Clinical and Radiologic Outcome of First Metatarsophalangeal Joint Arthrodesis Using a Human Allogeneic Cortical Bone Screw. FOOT & ANKLE ORTHOPAEDICS 2022; 7:24730114221112944. [PMID: 35924004 PMCID: PMC9340918 DOI: 10.1177/24730114221112944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Different fixation techniques are established for first metatarsophalangeal joint (MTPJ) arthrodesis, including compression screws, plates, Kirschner wires, metal- and bioabsorbable screws as well as staples. The purpose of this study was to investigate and present first clinical and radiologic results using a novel human, allogeneic cortical bone screw for arthrodesis of the first MTPJ. Methods: Arthrodesis of the first MTPJ was performed in 31 patients with hallux rigidus. Percentage union and time to union were the first outcomes; visual analog scale for pain, hallux valgus angle (HVA), intermetatarsal angle, and American Orthopaedic Foot & Ankle Society (AOFAS) hallux score were secondary outcomes. Results: Median time to union was 89 days, and union was observed in all patients. There were 4 complications (2 osteolysis margin, 1 cystic brightening, and 1 severe swelling at the first follow-up) all of that resolved at last follow-up. Pain significantly decreased from visual analog scale 8.0 to 0.2 points ( P < .0001). The HVA decreased from 30.4 to 10.2 degrees in the patient group with deformities. The total AOFAS score increased significantly from 48 to 87 ( P < .0001). Conclusion: Primary and revision arthrodesis of hallux rigidus with the human, allogeneic cortical bone screw reveals satisfying results similar to clinical and radiologic outcomes of other surgical techniques. Within 1 year, the human, allogeneic cortical bone screw is fully remodeled to host bone. Level of Evidence: Level IV, retrospective case series without control group.
Collapse
Affiliation(s)
- Beatrice Hanslik-Schnabel
- Sickness Welfare Institution for the Employees of the City of Vienna, Sanatorium Hera, Vienna, Austria
| | - Daniel Flöry
- Department for Radiology, Diakonissenhospital Linz, Linz, Austria
| | | | - Jakob E. Schanda
- AUVA Trauma Center Vienna-Meidling, Vienna, Austria
- Ludwig Boltzmann Institut for Traumatology - The Research Center in Cooperation with AUVA, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| |
Collapse
|
2
|
Enhancement of Bacterial Anti−Adhesion Properties on Robust PDMS Micro−Structure Using a Simple Flame Treatment Method. NANOMATERIALS 2022; 12:nano12030557. [PMID: 35159902 PMCID: PMC8839957 DOI: 10.3390/nano12030557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 01/30/2022] [Accepted: 02/02/2022] [Indexed: 02/01/2023]
Abstract
Biofilm-associated infections caused by an accumulation of micro-organisms and pathogens significantly impact the environment, health risks, and the global economy. Currently, a non-biocide-releasing superhydrophobic surface is a potential solution for antibacterial purposes. This research demonstrated a well-designed robust polydimethylsiloxane (PDMS) micro-structure and a flame treatment process with improved hydrophobicity and bacterial anti-adhesion properties. After the flame treatment at 700 ± 20 °C for 15 s, unique flower-petal re-entrant nano-structures were formed on pillars (PIL-F, width: 1.87 ± 0.30 μm, height: 7.76 ± 0.13 μm, aspect ratio (A.R.): 4.14) and circular rings with eight stripe supporters (C-RESS-F, width: 0.50 ± 0.04 μm, height: 3.55 ± 0.11 μm, A.R.: 7.10) PDMS micro-patterns. The water contact angle (WCA) and ethylene glycol contact angle (EGCA) of flame-treated flat-PDMS (FLT-F), PIL–F, and C–RESS-F patterns were (133.9 ± 3.8°, 128.6 ± 5.3°), (156.1 ± 1.5°, 151.5 ± 2.1°), and (146.3 ± 3.5°, 150.7 ± 1.8°), respectively. The Escherichia coli adhesion on the C-RESS-F micro-pattern with hydrophobicity and superoleophobicity was 42.6%, 31.8%, and 2.9% less than FLT-F, PIL-F, and Teflon surfaces. Therefore, the flame-treated C-RESS-F pattern is one of the promising bacterial anti-adhesion micro-structures in practical utilization for various applications.
Collapse
|
3
|
Jennison T, Arveladze S, Moriarty F. The influence of pin material and coatings on the incidence of pin site infection after external fixation. JOURNAL OF LIMB LENGTHENING & RECONSTRUCTION 2022. [DOI: 10.4103/jllr.jllr_35_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
4
|
Jastifer JR, Gustafson PA, Silva LF, Noffsinger S, Coughlin MJ. Nitinol, Stainless Steel, and Titanium Kirschner Wire Durability. Foot Ankle Spec 2021; 14:317-323. [PMID: 32336159 DOI: 10.1177/1938640020914677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Kirschner wires (K wires) are a common fixation device in foot and ankle surgery, particularly in lesser-toe fixation. Fatigue failure is a known complication of this fixation. The material properties of the K wire are a factor in the strength and durability of the wire. The purpose of this study is to compare the durability of K wires made of stainless steel, titanium, and Nitinol. Ten samples each of stainless steel, titanium. and Nitinol underwent cyclic durability testing using a rotating beam approach, and S-N curves (applied stress vs the number of cycles to failure) were generated. The results demonstrate that, generally, Nitinol K wires have a shorter life for the same applied stress than the stainless steel or titanium wires. Titanium had a longer life at low stresses compared with stainless steel, and stainless steel had a longer life at higher stresses. This study provides comparative durability data for K wires made of different metals, which have not been previously reported. Although there was a statistically significant difference in durability for wires used in K wire fixation, all 3 metal types are reasonable choices for temporary K wire fixation.Levels of Evidence: Level 5: Mechanical study.
Collapse
Affiliation(s)
- James R Jastifer
- Borgess Orthopedics, Kalamazoo, Michigan (JRJ, SN).,Mechanical and Aerospace Engineering, Western Michigan University, Kalamazoo, Michigan (PAG, LFS).,Saint Alphonsus Coughlin Foot and Ankle Clinic, Boise, Idaho (MJC)
| | - Peter A Gustafson
- Borgess Orthopedics, Kalamazoo, Michigan (JRJ, SN).,Mechanical and Aerospace Engineering, Western Michigan University, Kalamazoo, Michigan (PAG, LFS).,Saint Alphonsus Coughlin Foot and Ankle Clinic, Boise, Idaho (MJC)
| | - Luis F Silva
- Borgess Orthopedics, Kalamazoo, Michigan (JRJ, SN).,Mechanical and Aerospace Engineering, Western Michigan University, Kalamazoo, Michigan (PAG, LFS).,Saint Alphonsus Coughlin Foot and Ankle Clinic, Boise, Idaho (MJC)
| | - Sarah Noffsinger
- Borgess Orthopedics, Kalamazoo, Michigan (JRJ, SN).,Mechanical and Aerospace Engineering, Western Michigan University, Kalamazoo, Michigan (PAG, LFS).,Saint Alphonsus Coughlin Foot and Ankle Clinic, Boise, Idaho (MJC)
| | - Michael J Coughlin
- Borgess Orthopedics, Kalamazoo, Michigan (JRJ, SN).,Mechanical and Aerospace Engineering, Western Michigan University, Kalamazoo, Michigan (PAG, LFS).,Saint Alphonsus Coughlin Foot and Ankle Clinic, Boise, Idaho (MJC)
| |
Collapse
|
5
|
Pranno N, Cristalli MP, Mengoni F, Sauzullo I, Annibali S, Polimeni A, La Monaca G. Comparison of the effects of air-powder abrasion, chemical decontamination, or their combination in open-flap surface decontamination of implants failed for peri-implantitis: an ex vivo study. Clin Oral Investig 2021; 25:2667-2676. [PMID: 32975703 PMCID: PMC8060238 DOI: 10.1007/s00784-020-03578-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/07/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To compare, using an ex vivo model, the biofilm removal of three surface decontamination methods following surgical exposure of implants failed for severe peri-implantitis. MATERIALS AND METHODS The study design was a single-blind, randomized, controlled, ex vivo investigation with intra-subject control. Study participants were 20 consecutive patients with at least 4 hopeless implants, in function for >12 months and with progressive bone loss exceeding 50%, which had to be explanted. Implants of each patient were randomly assigned to the untreated control group or one of the three decontamination procedures: mechanical debridement with air-powder abrasion, chemical decontamination with hydrogen peroxide and chlorhexidine gluconate, or combined mechanical-chemical decontamination. Following surgical exposure, implants selected as control were retrieved, and afterwards, test implants were decontaminated according to allocation and carefully explanted with a removal kit. Microbiological analysis was expressed in colony-forming-units (CFU/ml). RESULTS A statistically significant difference (p < 0.001) in the concentrations of CFU/ml was found between implants treated with mechanical debridement (531.58 ± 372.07) or combined mechanical-chemical decontamination (954.05 ± 2219.31) and implants untreated (37,800.00 ± 46,837.05) or treated with chemical decontamination alone (29,650.00 ± 42,596.20). No statistically significant difference (p = 1.000) was found between mechanical debridement used alone or supplemented with chemical decontamination. Microbiological analyses identified 21 microbial species, without significant differences between control and treatment groups. CONCLUSIONS Bacterial biofilm removal from infected implant surfaces was significantly superior for mechanical debridement than chemical decontamination. CLINICAL RELEVANCE The present is the only ex vivo study based on decontamination methods for removing actual and mature biofilm from infected implant surfaces in patients with peri-implantitis.
Collapse
Affiliation(s)
- Nicola Pranno
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Paola Cristalli
- Department of Biotechnologies and Medical Surgical Sciences, Sapienza University of Rome, 6. Caserta St., 00161, Rome, Italy.
| | - Fabio Mengoni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Ilaria Sauzullo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Susanna Annibali
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Gerardo La Monaca
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
6
|
Zhou L, Pan M, Zhang Z, Diao Z, Peng X. Enhancing Osseointegration of TC4 Alloy by Surficial Activation Through Biomineralization Method. Front Bioeng Biotechnol 2021; 9:639835. [PMID: 33708765 PMCID: PMC7940542 DOI: 10.3389/fbioe.2021.639835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/02/2021] [Indexed: 11/25/2022] Open
Abstract
Titanium (Ti) alloys have been applied to biomedical implants for a long time. Although Ti alloys are biocompatible, efforts have been continuously made to improve their bone conductivity and osteogenesis for enhancing their performance. Silk fibroin (SF) is a natural biomaterial with excellent biomedical and mechanical properties, and hydroxyapatite (HAP) nanocomposites derived from SF are promising for producing “artificial bone” owing to their biomedical applicability and strong mechanical functions. Therefore, we built an SF coating on the surface of Ti–6Al–4V alloy, and then the incubated SF-coated Ti alloy were immersed in simulated body fluid to induce mineral deposition of HAP on the alloys. The results from Scanning Electron Microscopy (SEM), X-ray Diffraction (XRD) analysis, and Attenuated Total Reflection–Fourier Transform Infrared Spectroscopy (ATR–FTIR) confirmed the deposition of a mineral layer on the SF film surface. The proliferation, adhesion, and differentiation of MG-63 were tested, along with the BMP-2, COX-2, and OPG expression and protein content in the MG-63. Both Ti + SF and Ti + SF + HAP groups exhibited significantly better performance than a control Ti group with regard to the cell adhesion, cell proliferation, and protein expression. Furthermore, the hybrid layer comprising HAP and SF delivered more significant improvement of the osseointegration than the SF alone. It is hoped that the proposed methods can be used for constructing modified surfaces on Ti alloys, as they endowed the implants with good osteogenic potential.
Collapse
Affiliation(s)
- Liang Zhou
- Department of Materials and Engineering, School of Forestry and Landscape Architecture, Anhui Agriculture University, Hefei, China
| | - Meng Pan
- Department of Materials and Engineering, School of Forestry and Landscape Architecture, Anhui Agriculture University, Hefei, China
| | - Zhenghua Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Zijie Diao
- Department of Materials and Engineering, School of Forestry and Landscape Architecture, Anhui Agriculture University, Hefei, China
| | - Xiaochun Peng
- Department of Orthopaedics, The Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
7
|
Tanner MC, Fischer C, Schmidmaier G, Haubruck P. Evidence-based uncertainty: do implant-related properties of titanium reduce the susceptibility to perioperative infections in clinical fracture management? A systematic review. Infection 2021; 49:813-821. [PMID: 33586124 PMCID: PMC8476472 DOI: 10.1007/s15010-021-01583-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 02/02/2021] [Indexed: 11/28/2022]
Abstract
Background Implant-associated infections (IAI) remain a challenging complication in osteosynthesis. There is no consensus or clear evidence whether titanium offers a relevant clinical benefit over stainless steel. Purpose In this systematic review, we sought to determine whether the implant properties of titanium reduce the susceptibility to IAI compared to stainless steel in fracture management. Methods A systematic literature search in German and English was performed using specific search terms and limits. Studies published between 1995 and 1st June 2020 in the Cochrane library, MEDLINE and Web of Science databases were included. Only clinical studies comparing titanium and stainless steel implants regarding the susceptibility to infections were selected for detailed review. Results Five studies out of 384 papers were identified and reviewed. From the studies meeting inclusion criteria one study was a systematic review, two studies were randomized controlled studies (RCT) and two studies were of retrospective comparative nature of level IV evidence. Conclusion Our results show that currently, no proven advantage for titanium implants in respect to IAI can be seen in contemporary literature. Implants preserving periosteal blood-flow and minimising soft-tissue trauma show statistically significant benefits in reducing the incidence of IAI. Clinical studies providing reliable evidence regarding the influence of titanium implants on IAI and investigating the susceptibility of titanium to infection are necessary
Collapse
Affiliation(s)
- Michael C Tanner
- HTRG-Heidelberg Trauma Research Group, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Trauma and Reconstructive Surgery, Heidelberg University Hospital, 69118, Heidelberg, Germany.
| | - Christian Fischer
- HTRG-Heidelberg Trauma Research Group, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Trauma and Reconstructive Surgery, Heidelberg University Hospital, 69118, Heidelberg, Germany
| | - Gerhard Schmidmaier
- HTRG-Heidelberg Trauma Research Group, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Trauma and Reconstructive Surgery, Heidelberg University Hospital, 69118, Heidelberg, Germany
| | - Patrick Haubruck
- HTRG-Heidelberg Trauma Research Group, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Trauma and Reconstructive Surgery, Heidelberg University Hospital, 69118, Heidelberg, Germany
| |
Collapse
|
8
|
Zhang X, Yang C, Xi T, Zhao J, Yang K. Surface Roughness of Cu-Bearing Stainless Steel Affects Its Contact-Killing Efficiency by Mediating the Interfacial Interaction with Bacteria. ACS APPLIED MATERIALS & INTERFACES 2021; 13:2303-2315. [PMID: 33395246 DOI: 10.1021/acsami.0c19655] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Numerous studies have found that the surface topography affects the material antibacterial properties by reducing the attachment of bacteria on the surfaces without influencing the viability of the adhered cells. For Cu-bearing alloys with excellent contact-killing properties, bacterial adhesion on the surface is also accompanied by short-range interactions which regulate the toxic effects of the material surface against bacterial cells. Thus, the surface topography of Cu-bearing alloys, as an important factor dominating the exposure level of bacteria on the surfaces, should affect the subsequent contact-killing efficiency. In this work, our major focus was on the regulation mechanism of the surface features on the material-bacterial interactions. We correlated the surface properties including different surface roughnesses of Cu-bearing stainless steel (SS) with the bacterial damage pattern and attempted to clarify the role of surface roughness in mediating the contact-killing behavior of Cu-bearing SS. The results of both atomic force microscopy and scanning electron microscopy investigations showed that E. coli cells experienced the most rapid physical and mechanical damages after incubating with the diamond-polished Cu-bearing SS surface. The bacterial cells noticeably stiffened and the adhesion force significantly increased, as evidenced by force-distance curve measurements. Because of the enhanced hydrophobicity and higher surface potential of the diamond-polished surface, which strengthened the Lewis acid-base attractive forces and weakened the electrostatic barrier between the bacteria and the surface, a higher exposure surface for bacteria was generated. Furthermore, the contact-induced charge transfer, manifested by Cu ion burst release, and reactive oxygen species overexpression contribute to an efficient contact-killing process.
Collapse
Affiliation(s)
- Xinrui Zhang
- School of Materials Science and Engineering, University of Science and Technology of China, Shenyang 110016, China
- Shi-changxu Innovation Center for Advanced Materials, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| | - Chunguang Yang
- Shi-changxu Innovation Center for Advanced Materials, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| | - Tong Xi
- Shi-changxu Innovation Center for Advanced Materials, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| | - Jinlong Zhao
- Shi-changxu Innovation Center for Advanced Materials, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| | - Ke Yang
- Shi-changxu Innovation Center for Advanced Materials, Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| |
Collapse
|
9
|
Krätzig T, Mende KC, Mohme M, von Kroge S, Stangenberg M, Dreimann M, Westphal M, Weisselberg S, Eicker SO. Bacterial adhesion characteristics on implant materials for intervertebral cages: titanium or PEEK for spinal infections? EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:1774-1782. [PMID: 33423133 DOI: 10.1007/s00586-020-06705-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 12/13/2020] [Accepted: 12/16/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE Surgical intervention with intercorporal stabilisation in spinal infections is increasingly needed. Our aim was to compare titanium and polyetheretherketon (PEEK) cages according to their adhesion characteristics of different bacteria species in vitro. METHODS Plates made from PEEK, polished titanium (Ti), two-surface-titanium (TiMe) (n = 2-3) and original PEEK and porous trabecular structured titanium (TiLi) interbody cages (n = 4) were inoculated in different bacterial solutions, S.aureus (MSSA, MRSA), S.epidermidis and E.coli. Growth characteristics were analysed. Biofilms and bacteria were visualised using confocal- and electron microscopy. RESULTS Quantitative adherence of MSSA, MRSA, S.epidermidis and E.coli to Ti, TiMe and PEEK plates were different, with polished titanium being mainly advantageous over PEEK and TiMe with significantly less counts of colony forming units (CFU) for MRSA after 56 h compared to TiMe and at 72 h compared to PEEK (p = 0.04 and p = 0.005). For MSSA, more adherent bacteria were detected on PEEK than on TiMe at 32 h (p = 0.02). For PEEK and TiLi cages, significant differences were found after 8 and 72 h for S.epidermidis (p = 0.02 and p = 0.008) and after 72 h for MSSA (p = 0.002) with higher bacterial counts on PEEK, whereas E.coli showed more CFU on TiLi than PEEK (p = 0.05). Electron microscopy demonstrated enhanced adhesion in transition areas. CONCLUSION For S.epidermidis, MSSA and MRSA PEEK cages showed a higher adherence in terms of CFU count, whereas for E.coli PEEK seemed to be advantageous. Electron microscopic visualisation shows that bacteria did not adhere at the titanium mesh structure, but at the border zones of polished material to rougher parts.
Collapse
Affiliation(s)
- Theresa Krätzig
- Department of Neurosurgery, University Medical Centre Hamburg-Eppendorf, Martinistr, 52, 20246, Hamburg, Germany.
| | - Klaus Christian Mende
- Department of Neurosurgery, University Medical Centre Hamburg-Eppendorf, Martinistr, 52, 20246, Hamburg, Germany
| | - Malte Mohme
- Department of Neurosurgery, University Medical Centre Hamburg-Eppendorf, Martinistr, 52, 20246, Hamburg, Germany
| | - Simon von Kroge
- Department of Osteology and Biomechanics, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Stangenberg
- Division of Spine Surgery, Department of Trauma and Orthopaedic Surgery, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Marc Dreimann
- Division of Spine Surgery, Department of Trauma and Orthopaedic Surgery, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Manfred Westphal
- Department of Neurosurgery, University Medical Centre Hamburg-Eppendorf, Martinistr, 52, 20246, Hamburg, Germany
| | - Samira Weisselberg
- Institute of Medical Microbiology, Virology and Hygiene, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Sven Oliver Eicker
- Department of Neurosurgery, University Medical Centre Hamburg-Eppendorf, Martinistr, 52, 20246, Hamburg, Germany
| |
Collapse
|
10
|
Abd-Ul-Salam H. Peri-implantitis. INNOVATIVE PERSPECTIVES IN ORAL AND MAXILLOFACIAL SURGERY 2021:47-59. [DOI: 10.1007/978-3-030-75750-2_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
|
11
|
Abstract
Antibiotic resistance is a global human health threat, causing routine treatments of bacterial infections to become increasingly difficult. The problem is exacerbated by biofilm formation by bacterial pathogens on the surfaces of indwelling medical and dental devices that facilitate high levels of tolerance to antibiotics. The development of new antibacterial nanostructured surfaces shows excellent prospects for application in medicine as next-generation biomaterials. The physico-mechanical interactions between these nanostructured surfaces and bacteria lead to bacterial killing or prevention of bacterial attachment and subsequent biofilm formation, and thus are promising in circumventing bacterial infections. This Review explores the impact of surface roughness on the nanoscale in preventing bacterial colonization of synthetic materials and categorizes the different mechanisms by which various surface nanopatterns exert the necessary physico-mechanical forces on the bacterial cell membrane that will ultimately result in cell death.
Collapse
|
12
|
Strategies for improving antimicrobial properties of stainless steel. MATERIALS 2020; 13:ma13132944. [PMID: 32630130 PMCID: PMC7372344 DOI: 10.3390/ma13132944] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/27/2020] [Accepted: 06/28/2020] [Indexed: 12/27/2022]
Abstract
In this review, strategies for improving the antimicrobial properties of stainless steel (SS) are presented. The main focus given is to present current strategies for surface modification of SS, which alter surface characteristics in terms of surface chemistry, topography and wettability/surface charge, without influencing the bulk attributes of the material. As SS exhibits excellent mechanical properties and satisfactory biocompatibility, it is one of the most frequently used materials in medical applications. It is widely used as a material for fabricating orthopedic prosthesis, cardiovascular stents/valves and recently also for three dimensional (3D) printing of custom made implants. Despite its good mechanical properties, SS lacks desired biofunctionality, which makes it prone to bacterial adhesion and biofilm formation. Due to increased resistance of bacteria to antibiotics, it is imperative to achieve antibacterial properties of implants. Thus, many different approaches were proposed and are discussed herein. Emphasis is given on novel approaches based on treatment with highly reactive plasma, which may alter SS topography, chemistry and wettability under appropriate treatment conditions. This review aims to present and critically discuss different approaches and propose novel possibilities for surface modification of SS by using highly reactive gaseous plasma in order to obtain a desired biological response.
Collapse
|
13
|
Bandara CD, Ballerin G, Leppänen M, Tesfamichael T, Ostrikov KK, Whitchurch CB. Resolving Bio-Nano Interactions of E. coli Bacteria-Dragonfly Wing Interface with Helium Ion and 3D-Structured Illumination Microscopy to Understand Bacterial Death on Nanotopography. ACS Biomater Sci Eng 2020; 6:3925-3932. [PMID: 33463326 DOI: 10.1021/acsbiomaterials.9b01973] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Obtaining a comprehensive understanding of the bactericidal mechanisms of natural nanotextured surfaces is crucial for the development of fabricated nanotextured surfaces with efficient bactericidal activity. However, the scale, nature, and speed of bacteria-nanotextured surface interactions make the characterization of the interaction a challenging task. There are currently several different opinions regarding the possible mechanisms by which bacterial membrane damage occurs upon interacting with nanotextured surfaces. Advanced imaging methods could clarify this by enabling visualization of the interaction. Charged particle microscopes can achieve the required nanoscale resolution but are limited to dry samples. In contrast, light-based methods enable the characterization of living (hydrated) samples but are limited by the resolution achievable. Here we utilized both helium ion microscopy (HIM) and 3D structured illumination microscopy (3D-SIM) techniques to understand the interaction of Gram-negative bacterial membranes with nanopillars such as those found on dragonfly wings. Helium ion microscopy enables cutting and imaging at nanoscale resolution, while 3D-SIM is a super-resolution optical microscopy technique that allows visualization of live, unfixed bacteria at ∼100 nm resolution. Upon bacteria-nanopillar interaction, the energy stored due to the bending of natural nanopillars was estimated and compared with fabricated vertically aligned carbon nanotubes. With the same deflection, shorter dragonfly wing nanopillars store slightly higher energy compared to carbon nanotubes. This indicates that fabricated surfaces may achieve similar bactericidal efficiency as dragonfly wings. This study reports in situ characterization of bacteria-nanopillar interactions in real-time close to its natural state. These microscopic approaches will help further understanding of bacterial membrane interactions with nanotextured surfaces and the bactericidal mechanisms of nanotopographies so that more efficient bactericidal nanotextured surfaces can be designed and fabricated, and their bacteria-nanotopography interactions can be assessed in situ.
Collapse
Affiliation(s)
- Chaturanga D Bandara
- The ithree Institute, University of Technology Sydney, Ultimo, NSW 2007, Australia.,School of Chemistry, Physics and Mechanical Engineering, Science and Engineering Faculty, Queensland University of Technology (QUT), Brisbane, Queensland 4001, Australia
| | - Giulia Ballerin
- The ithree Institute, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Miika Leppänen
- Nanoscience Center, Department of Physics, Department of Biological and Environmental Science, University of Jyvaskyla, FI-40014 Jyvaskyla, Finland
| | - Tuquabo Tesfamichael
- School of Chemistry, Physics and Mechanical Engineering, Science and Engineering Faculty, Queensland University of Technology (QUT), Brisbane, Queensland 4001, Australia
| | - Kostya Ken Ostrikov
- School of Chemistry, Physics and Mechanical Engineering, Science and Engineering Faculty, Queensland University of Technology (QUT), Brisbane, Queensland 4001, Australia
| | - Cynthia B Whitchurch
- The ithree Institute, University of Technology Sydney, Ultimo, NSW 2007, Australia
| |
Collapse
|
14
|
Electrochemical Polishing of Austenitic Stainless Steels. MATERIALS 2020; 13:ma13112557. [PMID: 32512733 PMCID: PMC7321480 DOI: 10.3390/ma13112557] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/28/2020] [Accepted: 05/28/2020] [Indexed: 11/17/2022]
Abstract
Improvement of the corrosion resistance capability, surface roughness, shining of stainless-steel surface elements after electrochemical polishing (EP) is one of the most important process characteristics. In this paper, the mechanism, obtained parameters, and results were studied on electropolishing of stainless-steel samples based on the review of the literature. The effects of the EP process parameters, especially current density, temperature, time, and the baths used were presented and compared among different studies. The samples made of stainless steel presented in the articles were analysed in terms of, among other things, surface roughness, resistance to corrosion, microhardness, and chemical composition. All results showed that the EP process greatly improved the analysed properties of the stainless-steel surface elements.
Collapse
|
15
|
Application Solid Laser-Sintered or Machined Ti6Al4V Alloy in Manufacturing of Dental Implants and Dental Prosthetic Restorations According to Dentistry 4.0 Concept. Processes (Basel) 2020. [DOI: 10.3390/pr8060664] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This paper presents a comparison of the impact of milling technology in the computer numerically controlled (CNC) machining centre and selective laser sintering (SLS) and on the structure and properties of solid Ti6Al4V alloy. It has been shown that even small changes in technological conditions in the SLS manufacturing variant significantly affect changes from two to nearly two and a half times in tensile and bending strengths. Both the tensile and bending strength obtained in the most favourable manufacturing variant by the SLS method is over 25% higher than in the case of cast materials subsequently processed by milling. Plug-and-play SLS conditions provide about 60% of the possibilities. Structural, tribological and electrochemical tests were carried out. In vitro biological tests using osteoblasts confirm the good tendency for the proliferation of live cells on the substrate manufactured under the most favourable SLS conditions. The use of SLS additive technology for the manufacturing of dental implants and abutments made of Ti6Al4V alloy in combination with the digitisation of dental diagnostics and computer-aided design and manufacture of computer-aided design/manufacturing (CAD/CAM) following the idea of Dentistry 4.0 is the best choice of technology for manufacturing of prosthetic and implant devices used in dentistry.
Collapse
|
16
|
Tsikopoulos K, Drago L, Koutras G, Givissis P, Vagdatli E, Soukiouroglou P, Papaioannidou P. Radial Extracorporeal Shock Wave Therapy Against Cutibacterium acnes Implant-Associated Infections: An in Vitro Trial. Microorganisms 2020; 8:E743. [PMID: 32429267 PMCID: PMC7285346 DOI: 10.3390/microorganisms8050743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/29/2020] [Accepted: 05/11/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Antibiotic management of low-virulent implant-associated infections induced by Cutibacterium acnes may be compromised by multi-drug resistance development, side effects, and increased cost. Therefore, we sought to assess the effects of shock wave therapy against the above pathogen using an in vitro model of infection. METHODS We used a total of 120 roughened titanium alloy disks, simulating orthopedic biomaterials, to assess the results of radial extracorporeal shock wave therapy (rESWT) against C. acnes (ATCC 11827) biofilms relative to untreated control. In particular, we considered 1.6 to 2.5 Bar with a frequency ranging from 8-11 Hz and 95 to 143 impulses per disk to investigate the antibacterial effect of rESWT against C. acnes planktonic (free-floating) and biofilm forms. RESULTS Planktonic bacteria load diminished by 54% compared to untreated control after a 1.8-bar setting with a frequency of 8 Hz and 95 impulses was applied (median absorbance (MA) for intervention vs. control groups was 0.9245 (IQR= 0.888 to 0.104) vs. 0.7705 (IQR = 0.712 to 0.864), respectively, p = 0.001). Likewise, a statistically significant reduction in the amount of biofilm relative to untreated control was documented when the above setting was considered (MA for treatment vs biofilm control groups was 0.244 (IQR= 0.215-0.282) and 0.298 (IQR = 0.247-0.307), respectively, p = 0.033). CONCLUSION A 50% biofilm eradication was documented following application of low-pressure and low-frequency radial shock waves, so rESWT could be investigated as an adjuvant treatment to antibiotics, but it cannot be recommended as a standalone treatment against device-associated infections induced by C. ances.
Collapse
Affiliation(s)
- Konstantinos Tsikopoulos
- 1st Department of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Lorenzo Drago
- Laboratory of Clinical Microbiology, Department of Biochemical Sciences for Health, University of Milan, 20133 Milan, Italy;
| | - Georgios Koutras
- Department of Physical Therapy, Technological Education Institute of Thessaloniki, 57400 Sindos, Greece;
| | - Panagiotis Givissis
- 1st Orthopaedic Department of Aristotle University, G. Papanikolaou General Hospital, Exohi, 57010 Thessaloniki, Greece;
| | - Eleni Vagdatli
- Laboratory of Microbiology, Hippokration Hospital, 54642 Thessaloniki, Greece; (E.V.); (P.S.)
| | - Prodromos Soukiouroglou
- Laboratory of Microbiology, Hippokration Hospital, 54642 Thessaloniki, Greece; (E.V.); (P.S.)
| | - Paraskevi Papaioannidou
- 1st Department of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| |
Collapse
|
17
|
Karbysheva S, Di Luca M, Butini ME, Winkler T, Schütz M, Trampuz A. Comparison of sonication with chemical biofilm dislodgement methods using chelating and reducing agents: Implications for the microbiological diagnosis of implant associated infection. PLoS One 2020; 15:e0231389. [PMID: 32267888 PMCID: PMC7141651 DOI: 10.1371/journal.pone.0231389] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 03/23/2020] [Indexed: 01/23/2023] Open
Abstract
The diagnosis of implant-associated infections is hampered due to microbial adherence and biofilm formation on the implant surface. Sonication of explanted devices was shown to improve the microbiological diagnosis by physical removal of biofilms. Recently, chemical agents have been investigated for biofilm dislodgement such as the chelating agent ethylenediaminetetraacetic acid (EDTA) and the reducing agent dithiothreitol (DTT). We compared the activity of chemical methods for biofilm dislodgement to sonication in an established in vitro model of artificial biofilm. Biofilm-producing laboratory strains of Staphylococcus epidermidis (ATCC 35984), S. aureus (ATCC 43300), E. coli (ATCC 25922) and Pseudomonas aeruginosa (ATCC 53278) were used. After 3 days of biofilm formation, porous glass beads were exposed to control (0.9% NaCl), sonication or chemical agents. Quantitative and qualitative biofilm analyses were performed by colony counting, isothermal microcalorimetry and scanning electron microscopy. Recovered colony counts after treatment with EDTA and DTT were similar to those after exposure to 0.9% NaCl for biofilms of S. epidermidis (6.3 and 6.1 vs. 6.0 log10 CFU/mL, S. aureus (6.4 and 6.3 vs. 6.3 log10 CFU/mL), E. coli (5.2 and 5.1 vs. 5.1 log10 CFU/mL and P. aeruginosa (5.1 and 5.2 vs. 5.0 log10 CFU/mL, respectively). In contrast, with sonication higher CFU counts were detected with all tested microorganisms (7.5, 7.3, 6.2 and 6.5 log10 CFU/mL, respectively) (p <0.05). Concordant results were observed with isothermal microcalorimetry and scanning electron microscopy. In conclusion, sonication is superior to both tested chemical methods (EDTA and DTT) for dislodgement of S. epidermidis, S. aureus, E. coli and P. aeruginosa biofilms. Future studies may evaluate potential additive effect of chemical dislodgement to sonication.
Collapse
Affiliation(s)
- Svetlana Karbysheva
- Center for Musculoskeletal Surgery, Charité –Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Berlin-Brandenburg Centre for Regenerative Therapies (BCRT), Berlin, Germany
| | - Mariagrazia Di Luca
- Center for Musculoskeletal Surgery, Charité –Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Berlin-Brandenburg Centre for Regenerative Therapies (BCRT), Berlin, Germany
| | - Maria Eugenia Butini
- Center for Musculoskeletal Surgery, Charité –Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Berlin-Brandenburg Centre for Regenerative Therapies (BCRT), Berlin, Germany
| | - Tobias Winkler
- Center for Musculoskeletal Surgery, Charité –Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Berlin-Brandenburg Centre for Regenerative Therapies (BCRT), Berlin, Germany
| | - Michael Schütz
- Department of Orthopaedics and Trauma, Jamieson Trauma Institute, Queensland University of Technology, Brisbane, Australia
| | - Andrej Trampuz
- Center for Musculoskeletal Surgery, Charité –Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Berlin-Brandenburg Centre for Regenerative Therapies (BCRT), Berlin, Germany
- * E-mail:
| |
Collapse
|
18
|
Increased Staphylococcus aureus Biofilm Formation on Biodegradable Poly(3-Hydroxybutyrate)-Implants Compared with Conventional Orthopedic Implants: An In Vitro Analysis. J Orthop Trauma 2020; 34:210-215. [PMID: 32195889 DOI: 10.1097/bot.0000000000001674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To compare the biofilm formation on a biodegradable material, poly(3-hydroxybutyrate) (PHB), with that on conventional titanium (Ti) and steel (St) implant material. METHODS Pins made of the different materials were incubated in Müller-Hinton broth inoculated with 2 × 10 colony-forming units (CFU)·mL of Staphylococcus aureus for 2 and 7 days and then sonicated for the disruption of the biofilms. CFU were counted to quantify the number of bacteria in the biofilm, and the cell proliferation assay 2,3-Bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H- tetrazolium-5-carboxanilid salt was used to evaluate their metabolic activity. Scanning electron microscopy visualized the structure of the biofilm. RESULTS We found a significantly higher metabolic activity and CFU count in the biofilm of PHB pins compared with St and Ti pins (analysis of variance, P < 0.0001). Scanning electron microscopy revealed structured biofilms on PHB pins already after 2 days of incubation, which was not observed on the other tested implants. CONCLUSION PHB implants seem to provide an environment that advantages the formation of biofilms of S. aureus, a common pathogen in implant-related infections. The amount of biofilm is higher on PHB implant compared with conventionally used orthopedic titanium and steel implants. To overcome the potential risk of surgical site infections linked to the clinical use of PHB implants, possible modifications of the material, increasing its antibacterial properties, need to be further investigated.
Collapse
|
19
|
Abstract
There is a significant burden of disease associated with infected fractures, and their management is challenging. Prevention of infection after musculoskeletal trauma is essential because treatment of an established infection continues to be a major obstacle. Despite the need for evidence-based decision making, there is a lack of consensus around strategies for prevention and surgical management of the infected fracture. The current evidence for the prevention of the infected fracture is reviewed here with a focus on evidence for antibiotic therapy and debridement, the induced membrane technique, management of soft-tissue defects, patient optimization, and adjuncts to prevent infection.
Collapse
|
20
|
Rochford ETJ, Sabaté Brescó M, Poulsson AHC, Kluge K, Zeiter S, Ziegler M, O'Mahony L, Richards RG, Moriarty TF. Infection burden and immunological responses are equivalent for polymeric and metallic implant materials in vitro and in a murine model of fracture-related infection. J Biomed Mater Res B Appl Biomater 2018; 107:1095-1106. [PMID: 30332531 DOI: 10.1002/jbm.b.34202] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/30/2018] [Accepted: 02/18/2018] [Indexed: 12/31/2022]
Abstract
The development of an infection is a major complication for some patients with implanted biomaterials. Whether the material or surface composition of the used biomaterial influences infection has not been directly compared for key biomaterials currently in use in human patients. We conducted a thorough in vitro and in vivo investigation using titanium (Ti) and polyether-ether-ketone (PEEK) as both commercially available and as modified equivalents (surface polished Ti, and oxygen plasma treated PEEK). Complement activation and cytokine secretion of cell of the immune system was assessed in vitro for all materials in the absence and presence of bacterial stimulants. In a follow-up in vivo study, we monitored bacterial infection associated with clinically available and standard Ti and PEEK inoculated with Staphylococcus aureus. Complement activation was affected by material choice in the absence of bacterial stimulation, although the material based differences were largely lost upon bacterial stimulation. In the in vivo study, the bacterial burden, histological response and cytokine secretion suggests that there is no significant difference between both PEEK and Ti. In conclusion, the underlying material has a certain impact in the absence of bacterial stimulation, however, in the presence of bacterial stimulation, bacteria seem to dictate the responses in a manner that overshadows the influence of material surface properties. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1095-1106, 2019.
Collapse
Affiliation(s)
| | | | | | | | | | - Mario Ziegler
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Liam O'Mahony
- Departments of Medicine and Microbiology, APC Microbiome Ireland, National University of Ireland, Cork, Ireland
| | | | | |
Collapse
|
21
|
Wahl P, Sprecher CM, Brüning C, Meier C, Milz S, Gautier E, Fintan Moriarty T. Successful bony integration of a porous tantalum implant despite longlasting and ongoing infection: Histologic workup of an explanted shoulder prosthesis. J Biomed Mater Res B Appl Biomater 2018; 106:2924-2931. [PMID: 30199602 DOI: 10.1002/jbm.b.34174] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 01/25/2018] [Accepted: 05/13/2018] [Indexed: 01/30/2023]
Abstract
Infection associated with an implant is a complication feared in surgery, as it leads to loosening and dysfunction. This report documents an unexpected good bony integration of a porous tantalum shoulder prosthesis despite infection. A shoulder prosthesis with a porous tantalum glenoidal base plate was retrieved after 3 years of ongoing infection with Staphylococcus spp. Methyl-methacrylate embedded sections of the retrieved glenoidal component were analyzed by optical and scanning electron beam microscopy (SEM). Bone ongrowth and ingrowth were quantified. Bone had formed at the implant surface and within the open cell structure of the porous tantalum. The bone implant contact index was 32%. The bone ingrowth or relative bone area within the open structure was 8.2%, respectively 11.9% in the outer 50% of the thickness. Due to the section thickness, bone ongrowth could best be documented in SEM. Despite long-lasting and ongoing infection, the glenoidal base plate of the prosthesis showed good bony integration upon removal. The bone ingrowth into the porous tantalum was comparable to the values previously reported for the undersurface of retrieved proximal humerus resurfacing implants. Good integration of the implant however did not solve the problem of infection, and related morbidity. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2924-2931, 2018.
Collapse
Affiliation(s)
- Peter Wahl
- Division of Orthopaedic and Trauma Surgery, Cantonal Hospital, Winterthur, Switzerland.,Department of Septic Surgery, BG Trauma Centre, Frankfurt, Germany
| | | | | | - Christoph Meier
- Division of Orthopaedic and Trauma Surgery, Cantonal Hospital, Winterthur, Switzerland
| | - Stefan Milz
- Institute of Anatomy, Ludwig-Maximilians-University, Munich, Germany
| | - Emanuel Gautier
- Department of Orthopaedic Surgery, HFR Fribourg-Cantonal Hospital, Fribourg, Switzerland
| | | |
Collapse
|
22
|
Pan C, Zhou Z, Yu X. Coatings as the useful drug delivery system for the prevention of implant-related infections. J Orthop Surg Res 2018; 13:220. [PMID: 30176886 PMCID: PMC6122451 DOI: 10.1186/s13018-018-0930-y] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 08/22/2018] [Indexed: 12/13/2022] Open
Abstract
Implant-related infections (IRIs) which led to a large amount of medical expenditure were caused by bacteria and fungi that involve the implants in the operation or in ward. Traditional treatments of IRIs were comprised of repeated radical debridement, replacement of internal fixators, and intravenous antibiotics. It needed a long time and numbers of surgeries to cure, which meant a catastrophe to patients. So how to prevent it was more important than to cure it. As an excellent local release system, coating is a good idea by its local drug infusion and barrier effect on resisting biofilms which were the main cause of IRIs. So in this review, materials used for coatings and evidences of prevention were elaborated.
Collapse
Affiliation(s)
- Chenhao Pan
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233 China
| | - Zubin Zhou
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233 China
| | - Xiaowei Yu
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233 China
- Department of Orthopaedic Surgery, Shanghai Sixth People’s Hospital East Campus, Shanghai University of Medicine and Health Sciences, Shanghai, 201306 China
| |
Collapse
|
23
|
Wu S, Altenried S, Zogg A, Zuber F, Maniura-Weber K, Ren Q. Role of the Surface Nanoscale Roughness of Stainless Steel on Bacterial Adhesion and Microcolony Formation. ACS OMEGA 2018; 3:6456-6464. [PMID: 30023948 PMCID: PMC6045408 DOI: 10.1021/acsomega.8b00769] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 05/28/2018] [Indexed: 05/25/2023]
Abstract
Hospital-acquired infections can cause serious complications and are a severe problem because of the increased emergence of antibiotic-resistant bacteria. Biophysical modification of the material surfaces to prevent or reduce bacteria adhesion is an attractive alternative to antibiotic treatment. Since stainless steel is a widely used material for implants and in hospital settings, in this work, we used stainless steel to investigate the effect of the material surface topographies on bacterial adhesion and early biofilm formation. Stainless steel samples with different surface roughnesses Rq in a range of 217.9-56.6 nm (Ra in a range of 172.5-45.2 nm) were fabricated via electropolishing and compared for adhesion of bacterial pathogens Pseudomonas aeruginosa and Staphylococcus aureus. It was found that the number of viable cells on the untreated rough surface was at least 10-fold lower than those on the electropolished surfaces after 4 h of incubation time for P. aeruginosa and 15-fold lower for S. aureus. Fluorescence images and scanning electron microscopy images revealed that the bacterial cells tend to adhere individually as single cells on untreated rough surfaces. In contrast, clusters of the bacterial cells (microcolonies) were observed on electropolished smooth surfaces. Our study demonstrates that nanoscale surface roughness can play an important role in restraining bacterial adhesion and formation of microcolonies.
Collapse
Affiliation(s)
- Songmei Wu
- School
of Science, Beijing Jiaotong University, No. 3 Shangyuancun, Haidian District, Beijing 100044, P. R. China
| | - Stefanie Altenried
- Laboratory
for Biointerfaces, Empa, Swiss Federal Laboratories
for Materials Science and Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland
| | - Andi Zogg
- HESS
Medizintechnik AG, Grabenstrasse
14, 8865 Bilten, Switzerland
| | - Flavia Zuber
- Laboratory
for Biointerfaces, Empa, Swiss Federal Laboratories
for Materials Science and Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland
| | - Katharina Maniura-Weber
- Laboratory
for Biointerfaces, Empa, Swiss Federal Laboratories
for Materials Science and Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland
| | - Qun Ren
- Laboratory
for Biointerfaces, Empa, Swiss Federal Laboratories
for Materials Science and Technology, Lerchenfeldstrasse 5, 9014 St. Gallen, Switzerland
| |
Collapse
|
24
|
Influence of Material and Microtopography on the Development of Local Infection in vivo: Experimental Investigation in Rabbits. Int J Artif Organs 2018; 32:663-70. [DOI: 10.1177/039139880903200916] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Polishing the surface of internal fracture fixation (IFF) implant materials can ease implant removal and reduce irritation to gliding tissues by reducing soft tissue adhesion and bony overgrowth. Thus, polishing the surface of these implants is expected to have significant clinical benefit in certain situations. The aim of the present study was to determine if polishing the surface of an IFF device influences susceptibility to infection. The local infection rate associated with 4-hole 2.0 mm Synthes® locking compression plates (LCPs) composed of clinically available commercially pure titanium (cpTi) and titanium aluminium niobium (TAN) in their standard microrough form was compared with that of their test polished equivalents and also to clinically available electropolished stainless steel (EPSS). The LCPs were fixed in locking mode onto the tibia of mature, female New Zealand White rabbits and a clinical strain of Staphylococcus aureus was added to the implantation site. Twenty eight days after surgery the rabbits were euthanized and assessed for infection. The rank order based on descending ID50 was; polished TAN, standard TAN, standard cpTi, EPSS and finally polished cpTi, however, the ID50 values did not differ greatly between the groups with the same material. Using the LCP model in locking mode, polishing the surface of both cpTi and TAN was not found to influence the susceptibility to infection in our animal model.
Collapse
|
25
|
Complications during removal of stainless steel versus titanium nails used for intramedullary nailing of diaphyseal fractures of the tibia. Ann Med Surg (Lond) 2018; 26:38-42. [PMID: 29348913 PMCID: PMC5767899 DOI: 10.1016/j.amsu.2017.12.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 12/08/2017] [Accepted: 12/29/2017] [Indexed: 11/23/2022] Open
Abstract
Objectives Intramedullary nailing is the treatment of choice for fractures of the tibial shaft, which might necessitate the nail removal due to complications in the long-term. Although considered as a low-risk procedure, intramedullary nail removal is also associated with certain complications. Here, we compared the most commonly used stainless steel and titanium nails with respect to the complications during removal and clinical outcome for intramedullary nailing of diaphyseal fractures of the tibia. Patients and methods Sixty-two patients (26 females, 36 males) were included in this retrospective study. Of the removed nails, 24 were of stainless steel and 38 of titanium. Preoperative and intraoperative parameters, such as implant discomfort, anterior knee pain, operating time and amount of bleeding, and postoperative outcomes were evaluated for each patient. Results Titanium nail group had more, but not statistically significant, intraoperative complications than stainless steel group during the removal of nails (p = .4498). Operating time and amount of intraoperative bleeding were significantly higher in titanium group than stainless steel group (p = .0306 and p < .001, respectively). Preoperative SF-36 physical component and KSS scores were significantly lower in patients who had removal of titanium nails than those of stainless steel nails, whereas there was no difference in terms of postoperative SF-36 and KSS scores. Conclusion In conclusion, although greater bone contact with titanium increases implant stability, nail removal is more difficult, resulting in more longer surgical operation and more intraoperative bleeding. Therefore, we do not recommend titanium nail removal in asymptomatic patients.
Collapse
|
26
|
Langsteiner A, Loncaric I, Henkel-Odwody AM, Tichy A, Licka TF. Initial adhesion of methicillin-sensitive and methicillin-resistant Staphylococcus aureus strains to untreated and electropolished surgical steel drill bits. Res Vet Sci 2017; 114:474-481. [PMID: 28946121 DOI: 10.1016/j.rvsc.2017.09.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 05/22/2017] [Accepted: 09/14/2017] [Indexed: 11/26/2022]
Abstract
Electropolishing of stainless steel has been thoroughly investigated as a prophylactic measure to prevent bacterial colonization of orthopaedic implants and infection. Initial bacterial adhesion onto surgical drill bits as a possible factor for orthopaedic surgical site infections has not yet been documented. The present study investigated the influence of electropolishing on initial staphylococcal adhesion onto AISI 440A stainless steel drill bits. Specifically, one methicillin-susceptible standard laboratory Staphylococcus aureus type strain (DSM 20231T), one methicillin-resistant S. aureus reference strain (DSM 46320) and one methicillin-resistant clinical isolate from an infected orthopaedic implant were used. After standard sterilization, drill bits were immersed in the respective bacterial suspension; bacteria adherent to surface were harvested by vortexing the drill bits in phosphate-buffered saline and viable counts of bacteria transferred from the suspension were made (transferred to log10 for further analysis). Electropolishing significantly reduced adhesion of the clinical S. aureus strain and the S. aureus DSM 20231T. However, electropolishing significantly increased adhesion of the S. aureus DSM 46320. These results show that electropolishing significantly influences initial adhesion of S. aureus strains to surgical drill bits and that the nature of this influence depends on the S. aureus strain examined. For a general recommendation of electropolishing drill bits and guidelines for their handling during surgery, further studies with more strains isolated from infected wounds are suggested.
Collapse
Affiliation(s)
- Annemarie Langsteiner
- Department for Companion Animals and Horses, Equine University Clinic, University of Veterinary Medicine, Veterinärplatz 1, 1210 Vienna, Austria
| | - Igor Loncaric
- Department for Pathobiology, Institute of Microbiology, University of Veterinary Medicine, Veterinärplatz 1, 1210 Vienna, Austria.
| | - Anna-Maria Henkel-Odwody
- Department for Companion Animals and Horses, Equine University Clinic, University of Veterinary Medicine, Veterinärplatz 1, 1210 Vienna, Austria
| | - Alexander Tichy
- Department of Biomedical Sciences, Bioinformatics and Biostatistics Platform, University of Veterinary Medicine, Veterinärplatz 1, 1210 Vienna, Austria.
| | - Theresia F Licka
- Department for Companion Animals and Horses, Equine University Clinic, University of Veterinary Medicine, Veterinärplatz 1, 1210 Vienna, Austria; Department of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, EH25 9RG Edinburgh, United Kingdom.
| |
Collapse
|
27
|
Gasik M. Understanding biomaterial-tissue interface quality: combined in vitro evaluation. SCIENCE AND TECHNOLOGY OF ADVANCED MATERIALS 2017; 18:550-562. [PMID: 28970865 PMCID: PMC5613488 DOI: 10.1080/14686996.2017.1348872] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 06/26/2017] [Accepted: 06/27/2017] [Indexed: 06/07/2023]
Abstract
One of the greatest challenges in the development of new medical products and devices remains in providing maximal patient safety, efficacy and suitability for the purpose. A 'good quality' of the tissue-implant interface is one of the most critical factors for the success of the implant integration. In this paper this challenge is being discussed from the point of view of basic stimuli combination to experimental testing. The focus is in particular on bacterial effects on tissue-implant interaction (for different materials). The demonstration of the experimental evaluation of the tissue-implant interface is for dental abutment with mucosal contact. This shows that testing of the interface quality could be the most relevant in controlled conditions, which mimic as possible the clinical applications, but consider variables being under the control of the evaluator.
Collapse
Affiliation(s)
- Michael Gasik
- School of Chemical Engineering, Aalto University Foundation, Finland
| |
Collapse
|
28
|
Haubruck P, Schmidmaier G. [Susceptibility to infections and behavior of stainless steel : Comparison with titanium implants in traumatology]. Unfallchirurg 2017; 120:110-115. [PMID: 28070629 DOI: 10.1007/s00113-016-0300-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Despite modern treatment options, implant-associated infections (IAI) remain a severe and challenging complication in the treatment of trauma patients. Almost 30 years after the introduction of implants made of titanium alloy into the treatment of trauma patients, there is still no uniform consensus regarding the clinical benefit of titanium alloy in the context of patients with IAI. OBJECTIVE We sought to determine if implants made of titanium alloy have been proven to be less susceptible regarding IAI in contrast to implants made of stainless steel. MATERIAL AND METHODS A review of the current literature on IAI in association with the utilized implant material was conducted. Relevant articles from the years 1995 to 2016 were searched in the PubMed database. A total of 183 articles were identified and all abstracts were reviewed for relevance. A total of 14 articles met the inclusion criteria and were stratified according to the level of evidence and furthermore evaluated regarding the influence of the implant material on IAI. RESULTS AND DISCUSSION Considerable debate remains concerning the influence of the implant material on the susceptibility to IAI; however, the available literature shows that despite slight tendencies, there is no proof of titanium alloy being favorable in the susceptibility to IAI. Furthermore, the literature shows that the design of plates for osteosynthesis might influence IAI. In particular, plates that cause less soft tissue damage and preserve perfusion of the periosteum proved to be beneficial regarding IAI.
Collapse
Affiliation(s)
- Patrick Haubruck
- Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Deutschland
| | - Gerhard Schmidmaier
- Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Deutschland.
| |
Collapse
|
29
|
Gambardella A, Bianchi M, Kaciulis S, Mezzi A, Brucale M, Cavallini M, Herrmannsdoerfer T, Chanda G, Uhlarz M, Cellini A, Pedna M, Sambri V, Marcacci M, Russo A. Magnetic hydroxyapatite coatings as a new tool in medicine: A scanning probe investigation. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 62:444-9. [DOI: 10.1016/j.msec.2016.01.071] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 12/21/2015] [Accepted: 01/27/2016] [Indexed: 11/25/2022]
|
30
|
Influence of implant properties and local delivery systems on the outcome in operative fracture care. Injury 2016; 47:595-604. [PMID: 26847958 DOI: 10.1016/j.injury.2016.01.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 01/15/2016] [Indexed: 02/02/2023]
Abstract
Fracture fixation devices are implanted into a growing number of patients each year. This may be attributed to an increase in the popularity of operative fracture care and the development of ever more sophisticated implants, which may be used in even the most difficult clinical cases. Furthermore, as the general population ages, fragility fractures become more frequent. With the increase in number of surgical interventions, the absolute number of complications of these surgical treatments will inevitably rise. Implant-related infection and compromised fracture healing remain the most challenging and prevalent complications in operative fracture care. Any strategy that can help to reduce these complications will not only lead to a faster and more complete resumption of activities, but will also help to reduce the socio-economic impact. In this review we describe the influence of implant design and material choice on complication rates in trauma patients. Furthermore, we discuss the importance of local delivery systems, such as implant coatings and bone cement, and how these systems may have an impact on the prevalence, prevention and treatment outcome of these complications.
Collapse
|
31
|
Titanium and steel fracture fixation plates with different surface topographies: Influence on infection rate in a rabbit fracture model. Injury 2016; 47:633-9. [PMID: 26830128 DOI: 10.1016/j.injury.2016.01.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 12/15/2015] [Accepted: 01/11/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Implant-related infection is a challenging complication in musculoskeletal trauma surgery. In the present study, we examined the role of implant material and surface topography as influencing factors on the development of infection in an experimental model of plating osteosynthesis in the rabbit. METHODS The implants included in this experimental study were composed of: standard Electropolished Stainless Steel (EPSS), standard titanium (Ti-S), roughened stainless steel (RSS) and surface polished titanium (Ti-P). Construct stability and load-to-failure of Ti-P implants was compared to that of Ti-S implants in a rabbit cadaveric model. In an in vivo study, a rabbit humeral fracture model was used. Each rabbit received one of three Staphylococcus aureus inocula, aimed at determining the infection rate at a low, medium and high dose of bacteria. Outcome measures were quantification of bacteria on the implant and in the surrounding tissues, and determination of the infectious dose 50 (ID50). RESULTS No significant differences were observed between Ti-S and Ti-P regarding stiffness or failure load in the cadaver study. Of the 72 rabbits eventually included in the in vivo study, 50 developed an infection. The ID50 was found to be: EPSS 3.89×10(3) colony forming units (CFU); RSS 8.23×10(3) CFU; Ti-S 5.66×10(3) CFU; Ti-P 3.41×10(3) CFU. Significantly lower bacterial counts were found on the Ti-S implants samples compared with RSS implants (p<0.001) at the high inoculum. Similarly, lower bacterial counts were found in the bone samples of animals in the Ti-S group in comparison with both RSS and EPSS groups, again at the high inoculation dose (p<0.005). CONCLUSION No significant differences were seen in susceptibility to infection when comparing titanium and steel implants with conventional or modified topographies. Ti-P implants, which have previously been shown in preclinical studies to reduce complications associated with tissue adherence, do not affect infection rate in this preclinical fracture model. Therefore, Ti-P implants are not expected to affect the infection rate, or influence implant stability in the clinical situation.
Collapse
|
32
|
Widodo A, Spratt D, Sousa V, Petrie A, Donos N. An in vitro study on disinfection of titanium surfaces. Clin Oral Implants Res 2016; 27:1227-1232. [PMID: 26863898 DOI: 10.1111/clr.12733] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2015] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The aim of this in vitro study was to evaluate the efficacy of different methods used for the decontamination of titanium surfaces previously infected with a Staphylococcus aureus biofilm. MATERIALS AND METHODS S. aureus biofilms were grown on three different titanium surfaces (n = 114); polished, sandblasted large-grit acid-etched (SLA) and SLActive. The experimental groups were divided into six different disinfection modalities as follows: (i) rinsing with phosphate-buffered saline, (ii) rinsing with chlorhexidine digluconate 0.2% (CHX), (iii) application of photodynamic therapy (PDT), (iv) use of cotton pellet, (v) use of titanium brush (TiB) and (vi) the use of TiB and PDT. The decontamination effect of each modality was evaluated by microbial culture analysis and by scanning electron microscopy imaging. Two-way analysis of variance (ANOVA) and Bonferroni's post hoc comparisons were used to compare mean differences between colony-forming units per millilitre (CFU/ml) values, surfaces and treatments (P < 0.025). RESULTS This study demonstrated that the combination protocol (TiB and PDT) was the most effective in reducing S. aureus (P < 0.025) on polished (2.0 × 103 CFU/Disc) and SLA surface (6.9 × 103 CFU/Disc). On the SLActive surface, the combination treatment was not significantly different to the TiB group (1.0 × 105 CFU/Disc) or the PDT group (2.0 × 105 CFU/Disc). CONCLUSION The combined technique of TiB and PDT was shown to be an efficient method in reducing the number of S. aureus in both polished and rough titanium surfaces. These findings prompt further investigations in titanium decontamination techniques with a combination of TiB and PDT within a natural microcosm bacterial environment.
Collapse
Affiliation(s)
- Arifo Widodo
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK
| | - David Spratt
- Department of Microbial Diseases, UCL Eastman Dental Institute, London, UK
| | - Vanessa Sousa
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK.,Department of Microbial Diseases, UCL Eastman Dental Institute, London, UK
| | - Aviva Petrie
- Biostatistics Unit, UCL Eastman Dental Institute, London, UK.,Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine & Dentistry, QMUL, London, UK
| | - Nikolaos Donos
- Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK.
| |
Collapse
|
33
|
Kyomoto M, Shobuike T, Moro T, Yamane S, Takatori Y, Tanaka S, Miyamoto H, Ishihara K. Prevention of bacterial adhesion and biofilm formation on a vitamin E-blended, cross-linked polyethylene surface with a poly(2-methacryloyloxyethyl phosphorylcholine) layer. Acta Biomater 2015; 24:24-34. [PMID: 26050636 DOI: 10.1016/j.actbio.2015.05.034] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 04/30/2015] [Accepted: 05/21/2015] [Indexed: 12/25/2022]
Abstract
In the construction of artificial hip joint replacements, the surface and substrate of a cross-linked polyethylene (CLPE) liner are designed to achieve high wear resistance and prevent infection by bacteria. In this study, we fabricated a highly hydrophilic and antibiofouling poly(2-methacryloyloxyethyl phosphorylcholine [MPC]) (PMPC)-graft layer on the vitamin E-blended CLPE (HD-CLPE(VE)) surface. The 100-nm-thick, smooth, and electrically neutral PMPC layer was successfully fabricated on the HD-CLPE(VE) surface using photoinduced graft polymerization. The PMPC-grafted HD-CLPE(VE) was found to prevent bacterial adherence and biofilm formation on the surface because of the formation of a highly hydrophilic polyzwitterionic layer on the surface of HD-CLPE(VE), which can serve as an extremely efficient antibiofouling layer. The number of bacterial adhered on the PMPC-grafted HD-CLPE(VE) surface was reduced by 100-fold or more by PMPC grafting, regardless of the biofilm-production characteristics of the strains. In contrast, vitamin E blending did not affect bacterial adhesion. Moreover, the number of planktonic bacteria did not differ significantly, regardless of PMPC grafting and vitamin E blending. In conclusion, the PMPC-grafted HD-CLPE(VE) provided bacteriostatic effects associated with smooth, highly hydrophilic surfaces with a neutral electrostatic charge owing to the zwitterionic structure of the MPC unit. Thus, this modification may prove useful for the production of artificial hip joint replacement materials. STATEMENT OF SIGNIFICANCE Our preliminary in vitro findings suggest that improved bacteriostatic performance of the HD-CLPE(VE) surface in orthopedic implants is possible via PMPC grafting. The results also indicate that surface modifications affect the anti-infection properties of the orthopedic implants and demonstrate that the application of a PMPC-grafted HD-CLPE(VE) surface may be a promising approach to extend the longevity and clinical outcomes of total hip arthroplasty. Further research is needed to evaluate the resistance to infection of PMPC-grafted HD-CLPE(VE) in terms of the varieties of biofilm formation tests including fluid flow conditions and animal experiments, which may offer useful clues to the possible performance of these materials in vivo.
Collapse
|
34
|
Cruz HV, Henriques M, Teughels W, Celis JP, Rocha LA. Combined Influence of Fluoride and Biofilms on the Biotribocorrosion Behavior of Titanium Used for Dental Applications. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/s40735-015-0021-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
35
|
Furustrand Tafin U, Betrisey B, Bohner M, Ilchmann T, Trampuz A, Clauss M. Staphylococcal biofilm formation on the surface of three different calcium phosphate bone grafts: a qualitative and quantitative in vivo analysis. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2015; 26:130. [PMID: 25693675 PMCID: PMC4333228 DOI: 10.1007/s10856-015-5467-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 01/09/2015] [Indexed: 06/04/2023]
Abstract
Differences in physico-chemical characteristics of bone grafts to fill bone defects have been demonstrated to influence in vitro bacterial biofilm formation. Aim of the study was to investigate in vivo staphylococcal biofilm formation on different calcium phosphate bone substitutes. A foreign-body guinea-pig infection model was used. Teflon cages prefilled with β-tricalcium phosphate, calcium-deficient hydroxyapatite, or dicalcium phosphate (DCP) scaffold were implanted subcutaneously. Scaffolds were infected with 2 × 10(3) colony-forming unit of Staphylococcus aureus (two strains) or S. epidermidis and explanted after 3, 24 or 72 h of biofilm formation. Quantitative and qualitative biofilm analysis was performed by sonication followed by viable counts, and microcalorimetry, respectively. Independently of the material, S. aureus formed increasing amounts of biofilm on the surface of all scaffolds over time as determined by both methods. For S. epidermidis, the biofilm amount decreased over time, and no biofilm was detected by microcalorimetry on the DCP scaffolds after 72 h of infection. However, when using a higher S. epidermidis inoculum, increasing amounts of biofilm were formed on all scaffolds as determined by microcalorimetry. No significant variation in staphylococcal in vivo biofilm formation was observed between the different materials tested. This study highlights the importance of in vivo studies, in addition to in vitro studies, when investigating biofilm formation of bone grafts.
Collapse
Affiliation(s)
- Ulrika Furustrand Tafin
- Infectious Diseases Service, Department of Internal Medicine, University Hospital Lausanne (CHUV), Lausanne, Switzerland
- Unit of Septic Surgery, Department of Surgery and Anaesthesiology, University Hospital Lausanne (CHUV), Lausanne, Switzerland
| | - Bertrand Betrisey
- Infectious Diseases Service, Department of Internal Medicine, University Hospital Lausanne (CHUV), Lausanne, Switzerland
| | | | - Thomas Ilchmann
- Department for Orthopaedics and Trauma Surgery, Clinic for Orthopaedics and Trauma Surgery, Kantonsspital Baselland Liestal, Rheinstreet 26, 4410 Liestal, Switzerland
| | - Andrej Trampuz
- Infectious Diseases Service, Department of Internal Medicine, University Hospital Lausanne (CHUV), Lausanne, Switzerland
- Department of Traumatology and Reconstructive Surgery including Department of Orthopaedic Surgery, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Martin Clauss
- Infectious Diseases Service, Department of Internal Medicine, University Hospital Lausanne (CHUV), Lausanne, Switzerland
- Unit of Septic Surgery, Department of Surgery and Anaesthesiology, University Hospital Lausanne (CHUV), Lausanne, Switzerland
- RMS Foundation, Bettlach, Switzerland
- Department for Orthopaedics and Trauma Surgery, Clinic for Orthopaedics and Trauma Surgery, Kantonsspital Baselland Liestal, Rheinstreet 26, 4410 Liestal, Switzerland
| |
Collapse
|
36
|
Uskoković V. Nanostructured platforms for the sustained and local delivery of antibiotics in the treatment of osteomyelitis. Crit Rev Ther Drug Carrier Syst 2015; 32:1-59. [PMID: 25746204 PMCID: PMC4406243 DOI: 10.1615/critrevtherdrugcarriersyst.2014010920] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This article provides a critical view of the current state of the development of nanoparticulate and other solid-state carriers for the local delivery of antibiotics in the treatment of osteomyelitis. Mentioned are the downsides of traditional means for treating bone infection, which involve systemic administration of antibiotics and surgical debridement, along with the rather imperfect local delivery options currently available in the clinic. Envisaged are more sophisticated carriers for the local and sustained delivery of antimicrobials, including bioresorbable polymeric, collagenous, liquid crystalline, and bioglass- and nanotube-based carriers, as well as those composed of calcium phosphate, the mineral component of bone and teeth. A special emphasis is placed on composite multifunctional antibiotic carriers of a nanoparticulate nature and on their ability to induce osteogenesis of hard tissues demineralized due to disease. An ideal carrier of this type would prevent the long-term, repetitive, and systemic administration of antibiotics and either minimize or completely eliminate the need for surgical debridement of necrotic tissue. Potential problems faced by even hypothetically "perfect" antibiotic delivery vehicles are mentioned too, including (i) intracellular bacterial colonies involved in recurrent, chronic osteomyelitis; (ii) the need for mechanical and release properties to be adjusted to the area of surgical placement; (iii) different environments in which in vitro and in vivo testings are carried out; (iv) unpredictable synergies between drug delivery system components; and (v) experimental sensitivity issues entailing the increasing subtlety of the design of nanoplatforms for the controlled delivery of therapeutics.
Collapse
Affiliation(s)
- Vuk Uskoković
- Advanced Materials and Nanobiotechnology Laboratory, Richard and Loan Hill Department of Bioengineering, College of Medicine, University of Illinois at Chicago, 851 South Morgan St, #205 Chicago, Illinois, 60607-7052
| |
Collapse
|
37
|
Jahed Z, Lin P, Seo BB, Verma MS, Gu FX, Tsui TY, Mofrad MRK. Responses of Staphylococcus aureus bacterial cells to nanocrystalline nickel nanostructures. Biomaterials 2014; 35:4249-54. [PMID: 24576805 DOI: 10.1016/j.biomaterials.2014.01.080] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 01/31/2014] [Indexed: 12/19/2022]
Abstract
A broad range of human diseases are associated with bacterial infections, often initiated by specific adhesion of a bacterium to the target environment. Despite the significant role of bacterial adhesion in human infectious diseases, details and mechanisms of bacterial adhesion have remained elusive. Herein, we study the physical interactions between Staphylococcus aureus, a type of micro-organism relevant to infections associated with medical implants, and nanocrystalline (nc) nickel nanostructures with various columnar features, including solid core, hollow, x-shaped and c-shaped pillars. Scanning electron microscopy results show the tendency of these bacterial cells to attach to the nickel nanostructures. Moreover, unique single bacterium attachment characteristics were observed on nickel nanostructures with dimensions comparable to the size of a single bacterium.
Collapse
Affiliation(s)
- Zeinab Jahed
- Molecular Cell Biomechanics Laboratory, Departments of Bioengineering and Mechanical Engineering, University of California Berkeley, 208A Stanley Hall, Berkeley, CA 94720-1762, USA; Physical Biosciences Division, Lawrence Berkeley National Lab, Berkeley, CA 94720, USA
| | - Peter Lin
- Department of Chemical Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Brandon B Seo
- Department of Mechanical Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Mohit S Verma
- Department of Chemical Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Frank X Gu
- Department of Chemical Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Ting Y Tsui
- Department of Chemical Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada; Department of Mechanical Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Mohammad R K Mofrad
- Molecular Cell Biomechanics Laboratory, Departments of Bioengineering and Mechanical Engineering, University of California Berkeley, 208A Stanley Hall, Berkeley, CA 94720-1762, USA; Physical Biosciences Division, Lawrence Berkeley National Lab, Berkeley, CA 94720, USA.
| |
Collapse
|
38
|
Pascoe B, Dams L, Wilkinson TS, Harris LG, Bodger O, Mack D, Davies AP. Dormant cells of Staphylococcus aureus are resuscitated by spent culture supernatant. PLoS One 2014; 9:e85998. [PMID: 24523858 PMCID: PMC3921112 DOI: 10.1371/journal.pone.0085998] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 12/03/2013] [Indexed: 11/18/2022] Open
Abstract
We describe the first in vitro model of dormancy in Staphylococcus aureus, showing that cells are generated which can be resuscitated by addition of spent medium supernatant taken from cultures of the same organism. Over 30 days, culturable counts in dormant cultures of S. aureus SH1000 fell from 10(6)-10(7) cfu/ml to <10 cfu/ml as measured by the Most Probable Number method in liquid culture, while total counts as determined by microscopy, and supported by data from RT-qPCR, remained around 10(6)-10(7) cells/ml. Supplementing cultures with 25-50% spent medium resulted in a >600-fold increase in bacterial growth. Resuscitation was a specific effect, greatly reduced by boiling or addition of trypsin to the spent supernatant. Supernatant also effected a reduction in lag phase of dormant cultures. SEM demonstrated the presence of small coccoid cells in dormant cultures. The results are similar to those seen with resuscitation promoting factors (Rpfs) in actinobacteria. This is the first time resuscitation has been demonstrated in Staphylococcus aureus, which is an important human pathogen. A better understanding of control and reactivation of dormant cells could lead to major improvements in managing staphylococcal infections; resuscitation could be an important step in restoring susceptibility to antibiotic treatment.
Collapse
Affiliation(s)
- Ben Pascoe
- Institute of Life Science, Swansea University College of Medicine, Swansea, United Kingdom
| | - Lucy Dams
- Institute of Life Science, Swansea University College of Medicine, Swansea, United Kingdom
| | - Tom S. Wilkinson
- Institute of Life Science, Swansea University College of Medicine, Swansea, United Kingdom
| | - Llinos G. Harris
- Institute of Life Science, Swansea University College of Medicine, Swansea, United Kingdom
| | - Owen Bodger
- Institute of Life Science, Swansea University College of Medicine, Swansea, United Kingdom
| | - Dietrich Mack
- Institute of Life Science, Swansea University College of Medicine, Swansea, United Kingdom
- Public Health Wales Microbiology Swansea, Swansea, United Kingdom
- Bioscientia Labor Ingelheim, Institut für Medizinische Diagnostik GmbH, Mainz, Germany
| | - Angharad P. Davies
- Institute of Life Science, Swansea University College of Medicine, Swansea, United Kingdom
- Public Health Wales Microbiology Swansea, Swansea, United Kingdom
- * E-mail:
| |
Collapse
|
39
|
Hayes JS, Richards RG. Surfaces to control tissue adhesion for osteosynthesis with metal implants:in vitroandin vivostudies to bring solutions to the patient. Expert Rev Med Devices 2014; 7:131-42. [DOI: 10.1586/erd.09.55] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
40
|
Rochford E, Poulsson A, Salavarrieta Varela J, Lezuo P, Richards R, Moriarty T. Bacterial adhesion to orthopaedic implant materials and a novel oxygen plasma modified PEEK surface. Colloids Surf B Biointerfaces 2014; 113:213-22. [DOI: 10.1016/j.colsurfb.2013.09.012] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 08/23/2013] [Accepted: 09/05/2013] [Indexed: 10/26/2022]
|
41
|
Dallavecchia DL, da Silva Filho RG, Aguiar VM. Sterilization of Chrysomya putoria (Insecta: Diptera: Calliphoridae) eggs for use in biotherapy. JOURNAL OF INSECT SCIENCE (ONLINE) 2014; 14:160. [PMID: 25399429 PMCID: PMC5633979 DOI: 10.1093/jisesa/ieu022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 07/23/2013] [Indexed: 06/04/2023]
Abstract
Large-scale, quality-controlled laboratory production of fly larvae is needed for biotherapy. The objective of this study was to assess the action of glutaraldehyde on the sterilization of Chrysomya putoria eggs by applying pharmaceutical sterility tests. Egg masses with 0.600 g were divided into three parts of 0.200 g, the eggs were separated using sterile distilled water, and the suspensions obtained were mixed with activated 2% glutaraldehyde solution. After 15-min contact, the suspensions were filtered through Whatman filter paper, and the glutaraldehyde residue obtained in the filtrate was neutralized by rinsing with Tryptone Soy Broth. The treated eggs were placed aseptically on Petri dishes containing gauze moistened with sterile saline solution. About 10% of the sterilized mass was transferred to test tubes containing Tryptone Soy Broth and Fluid Thioglycollate Broth. The tubes were incubated, respectively, at 22.5 and 35.0°C for 14 d to verify egg mass sterility. The plates containing the rest of the eggs (90%) were sealed with plastic film and kept in a climatized chamber at 30°C/d, 28°C per night, 60 ± 10% relative humidity, and under a 12-h light period to assess insect viability and survival. Each experiment was carried out in triplicate using a biological class II safety cabinet. No change in color or turgidity was observed with the agent tested, proving the sterility of the product and that there was no trace of contamination. Forty larvae (in three replications) in the periods of 12, 24, and 48 h after sterilization, when transferred to diet, produced larvae, pupae, and total viability similar to the control (larvae without sterilization). However, for the 72-h treatment, larvae and total viability were significantly lower than for the other treatments. There was no significant difference for the pupal stage. The product tested was shown to be efficacious for use as a sterilizer of C. putoria eggs for all the parameters assessed.
Collapse
Affiliation(s)
- Daniele Lourinho Dallavecchia
- Laboratory of Diptera Studies of the Microbiology Laboratory, Department of Microbiology and Parasitology, Biomedical Institute, Federal University of the State of Rio de Janeiro, Post-graduate Program in Biological Sciences: Neotropical Biodiversity, Rio de Janeiro, Brazil
| | - Renato Geraldo da Silva Filho
- Laboratory of Diptera Studies of the Microbiology Laboratory, Department of Microbiology and Parasitology, Biomedical Institute, Federal University of the State of Rio de Janeiro, Post-graduate Program in Biological Sciences: Neotropical Biodiversity, Rio de Janeiro, Brazil
| | - Valéria Magalhães Aguiar
- Laboratory of Diptera Studies of the Microbiology Laboratory, Department of Microbiology and Parasitology, Biomedical Institute, Federal University of the State of Rio de Janeiro, Post-graduate Program in Biological Sciences: Neotropical Biodiversity, Rio de Janeiro, Brazil
| |
Collapse
|
42
|
Material and biofilm load of K wires in toe surgery: titanium versus stainless steel. Clin Orthop Relat Res 2013; 471:2312-7. [PMID: 23504538 PMCID: PMC3676592 DOI: 10.1007/s11999-013-2919-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 03/06/2013] [Indexed: 01/31/2023]
Abstract
BACKGROUND Recurrence rates for toe deformity correction are high and primarily are attributable to scar contractures. These contractures may result from subclinical infection. QUESTIONS/PURPOSES We hypothesized that (1) recurrence of toe deformities and residual pain are related to low-grade infections from biofilm formation on percutaneous K wires, (2) biofilm formation is lower on titanium (Ti) K wires compared with stainless steel (SS) K wires, and (3) clinical outcome is superior with the use of Ti K wires compared with SS K wires. METHODS In this prospective nonrandomized, comparative study, we investigated 135 lesser toe deformities (61 patients; 49 women; mean ± SD age, 60 ± 15 years) temporarily fixed with K wires between August 2010 and March 2011 (81 SS, 54 Ti). K wires were removed after 6 weeks. The presence of biofilm-related infections was analyzed by sonication. RESULTS High bacterial loads (> 500 colony-forming units [CFU]/mL) were detected on all six toes requiring revision before 6 months. Increased bacterial load was associated with pain and swelling but not recurrence of the deformity. More SS K wires had greater than 100 CFU/mL bacteria than Ti K wires. For K wires with a bacterial count greater than 100 CFU/mL, toes with Ti K wires had a lower recurrence rate, less pain, and less swelling than toes with SS K wires. CONCLUSIONS Ti K wires showed superior clinical outcomes to SS K wires. This appears to be attributable to reduced infection rates. Although additional study is needed, we currently recommend the use of Ti K wires for the transfixation of toe deformities. LEVEL OF EVIDENCE Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Collapse
|
43
|
Myllymaa K, Levon J, Tiainen VM, Myllymaa S, Soininen A, Korhonen H, Kaivosoja E, Lappalainen R, Konttinen YT. Formation and retention of staphylococcal biofilms on DLC and its hybrids compared to metals used as biomaterials. Colloids Surf B Biointerfaces 2013; 101:290-7. [DOI: 10.1016/j.colsurfb.2012.07.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Revised: 06/20/2012] [Accepted: 07/09/2012] [Indexed: 12/01/2022]
|
44
|
Rochford E, Richards R, Moriarty T. Influence of material on the development of device-associated infections. Clin Microbiol Infect 2012; 18:1162-7. [DOI: 10.1111/j.1469-0691.2012.04002.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
45
|
Crawford RJ, Webb HK, Truong VK, Hasan J, Ivanova EP. Surface topographical factors influencing bacterial attachment. Adv Colloid Interface Sci 2012; 179-182:142-9. [PMID: 22841530 DOI: 10.1016/j.cis.2012.06.015] [Citation(s) in RCA: 195] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 06/13/2012] [Accepted: 06/28/2012] [Indexed: 12/17/2022]
Abstract
Substratum surface roughness is known to be one of the key factors in determining the extent of bacterial colonization. Understanding the way by which the substratum topography, especially at the nanoscale, mediates bacterial attachment remains ambiguous at best, despite the volume of work available on the topic. This is because the vast majority of bacterial attachment studies do not perform comprehensive topographical characterization analyses, and typically consider roughness parameters that describe only one aspect of the surface topography. The most commonly reported surface roughness parameters are average and root mean square (RMS) roughness (R(a) and R(q) respectively), which are both measures of the typical height variation of the surface. They offer no insights into the spatial distribution or shape of the surface features. Here, a brief overview of the current state of research on topography-mediated bacterial adhesion is presented, as well as an outline of the suite of roughness characterization parameters that are available for the comprehensive description of the surface architecture of a substratum. Finally, a set of topographical parameters is proposed as a new standard for surface roughness characterization in bacterial adhesion studies to improve the likelihood of identifying direct relationships between substratum topography and the extent of bacterial adhesion.
Collapse
Affiliation(s)
- Russell J Crawford
- Faculty of Life and Social Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia.
| | | | | | | | | |
Collapse
|
46
|
Walkowiak-Przybyło M, Klimek L, Okrój W, Jakubowski W, Chwiłka M, Czajka A, Walkowiak B. Adhesion, activation, and aggregation of blood platelets and biofilm formation on the surfaces of titanium alloys Ti6Al4V and Ti6Al7Nb. J Biomed Mater Res A 2012; 100:768-75. [PMID: 22238248 DOI: 10.1002/jbm.a.34006] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Revised: 10/11/2011] [Accepted: 10/17/2011] [Indexed: 11/08/2022]
Abstract
Titanium alloys are still on the top list of fundamental materials intended for dental, orthopedics, neurological, and cardiovascular implantations. Recently, a special attention has been paid to vanadium-free titanium alloy, Ti6Al7Nb, that seems to represent higher biocompatibility than traditional Ti6Al4V alloy. Surprisingly, these data are not thoroughly elaborated in the literature; particularly there is a lack of comparative experiments conducted simultaneously and at the same conditions. Our study fills these shortcomings in the field of blood contact and microbiological colonization. To observe platelets adhesion and biofilm formation on the surfaces of compared titanium alloys, fluorescence microscope Olympus GX71 and scanning electron microscope HITACHI S-3000N were used. Additionally, flow cytometry analysis of platelets aggregation and activation in the whole blood after contact with sample surface, as an essential tool for biomaterial thrombocompatibility assessment, was proposed. As a result of our study it was demonstrated that polished surfaces of Ti6Al7Nb and Ti6Al4V alloys after contact with whole citrated blood and E. coli bacterial cells exhibit a considerable difference. Overall, it was established that Ti6Al4V has distinct tendency to higher thrombogenicity, more excessive bacterial biofilm formation and notable cytotoxic properties in comparison to Ti6Al7Nb. However, we suggest these studies should be extended for other types of cells and biological objects.
Collapse
Affiliation(s)
- M Walkowiak-Przybyło
- Department of Materials' Research, Technical University of Lodz, Stefanowskiego 1/15, 90-924 Lodz, Poland.
| | | | | | | | | | | | | |
Collapse
|
47
|
Fröjd V, Chávez de Paz L, Andersson M, Wennerberg A, Davies J, Svensäter G. In situ analysis of multispecies biofilm formation on customized titanium surfaces. Mol Oral Microbiol 2011; 26:241-52. [DOI: 10.1111/j.2041-1014.2011.00610.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
48
|
Persson GR, Roos-Jansåker AM, Lindahl C, Renvert S. Microbiologic results after non-surgical erbium-doped:yttrium, aluminum, and garnet laser or air-abrasive treatment of peri-implantitis: a randomized clinical trial. J Periodontol 2011; 82:1267-78. [PMID: 21417591 DOI: 10.1902/jop.2011.100660] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The purpose of this study is to assess clinical and microbiologic effects of the non-surgical treatment of peri-implantitis lesions using either an erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser or an air-abrasive subgingival polishing method. METHODS In a 6-month clinical trial, 42 patients with peri-implantitis were treated at one time with an Er:YAG laser or an air-abrasive device. Routine clinical methods were used to monitor clinical conditions. Baseline and 6-month intraoral radiographs were assessed with a software program. The checkerboard DNA-DNA hybridization method was used to assess 74 bacterial species from the site with the deepest probing depth (PD) at the implant. Non-parametric tests were applied to microbiology data. RESULTS PD reductions (mean ± SD) were 0.9 ± 0.8 mm and 0.8 ± 0.5 mm in the laser and air-abrasive groups, respectively (not significant). No baseline differences in bacterial counts between groups were found. In the air-abrasive group, Pseudomonas aeruginosa, Staphylococcus aureus, and Staphylococcus anaerobius were found at lower counts at 1 month after therapy (P <0.001) and with lower counts in the laser group for Fusobacterium nucleatum naviforme (P = 0.002), and Fusobacterium nucleatum nucleatum (P = 0.002). Both treatments failed to reduce bacterial counts at 6 months. Porphyromonas gingivalis counts were higher in cases with progressive peri-implantitis (P <0.001). CONCLUSIONS At 1 month, P. aeruginosa, S. aureus, and S. anaerobius were reduced in the air-abrasive group, and Fusobacterium spp. were reduced in the laser group. Six-month data demonstrated that both methods failed to reduce bacterial counts. Clinical improvements were limited.
Collapse
Affiliation(s)
- G Rutger Persson
- Department of Oral Sciences, School of Health and Society, Kristianstad University, Kristianstad, Sweden
| | | | | | | |
Collapse
|
49
|
Bruellhoff K, Fiedler J, Möller M, Groll J, Brenner RE. Surface coating strategies to prevent biofilm formation on implant surfaces. Int J Artif Organs 2011; 33:646-53. [PMID: 20890881 DOI: 10.1177/039139881003300910] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2010] [Indexed: 02/02/2023]
Abstract
Implant surfaces should ideally be designed to promote the attachment of target tissue cells; at the same time, they should prevent bacterial adhesion, achievable through modification strategies comprising three lines of defense. As the first criterion, selective adhesion can be realized by means of non-adhesive coatings that can be functionalized with small peptides, thereby supporting osteogenic cell attachment for implants in bone contact but not bacterial adhesion. The second line of defense, defined by bacterial survival, quorum sensing and biofilm formation, can be addressed by various antimicrobial substances that can be leaching or non-leaching. The possibility of a third line of defense, the disruption of an established biofilm, is just emerging. Since microorganisms are quite ''ingenious'' at finding ways to overcome a certain line of defense, the most promising solution might be a combination of all these antibacterial strategies. Coating systems that allow such different approaches to be combined are scarce. However, ultrathin multifunctional NCO-sP(EO-stat-PO)-based layers may represent a promising platform for such an integrated approach.
Collapse
Affiliation(s)
- Kristina Bruellhoff
- DWI e.V. and Institute of Technical and Macromolecular Chemistry, RWTH Aachen University, Aachen, Germany
| | | | | | | | | |
Collapse
|
50
|
Moriarty TF, Campoccia D, Nees SK, Boure LP, Richards RG. In vivo evaluation of the effect of intramedullary nail microtopography on the development of local infection in rabbits. Int J Artif Organs 2011; 33:667-75. [PMID: 20890880 DOI: 10.1177/039139881003300913] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2010] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIM Fractures of the tibia and femoral diaphysis are commonly repaired by intramedullary (IM) nails, which are currently composed of either electropolished stainless steel (EPSS) or standard, non-polished titanium-aluminum-niobium (TAN). Once the fracture has fully healed, removal of IM nails is common, but the strong adhesion of bone to standard TAN complicates removal. Polishing the surface of TAN IM nails has been shown to reduce bony adhesion and ease implant removal without compromising fixation. Polished TAN nails are, therefore, expected to have significant clinical benefit in situations where the device is to be removed. The aim of the present study was to determine the effect of polishing TAN IM nails on susceptibility to infection in an animal model. MATERIALS AND METHODS Solid IM nails (Synthes, Betlach, Switzerland) composed of standard TAN were compared with polished equivalents and also to clinically available EPSS nails. The surface chemical and topographical properties of the materials were assessed by X-ray photon spectroscopy (XPS), white light profilometry, and scanning electron microscopy (SEM). An in vivo infection study was performed using a clinical isolate of Staphylococcus aureus that was characterized with respect to various virulence factors. RESULTS Polishing TAN IM nails caused no significant change to the chemistry of the nails, but the topography of the polished TAN nails was significantly smoother than standard TAN nails. In the infection study, the rank order based on descending infectious dose 50 (ID(50)) was: standard TAN, polished TAN, and finally EPSS. The ID(50) values did not differ greatly between any of the groups. CONCLUSIONS Polishing the surface TAN IM nails was not found to influence the susceptibility to infection in our animal model.
Collapse
|