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Kaspiris A, Vasiliadis E, Pantazaka E, Lianou I, Melissaridou D, Savvidis M, Panagopoulos F, Tsalimas G, Vavourakis M, Kolovos I, Savvidou OD, Pneumaticos SG. Current Progress and Future Perspectives in Contact and Releasing-Type Antimicrobial Coatings of Orthopaedic Implants: A Systematic Review Analysis Emanated from In Vitro and In Vivo Models. Infect Dis Rep 2024; 16:298-316. [PMID: 38667751 PMCID: PMC11050497 DOI: 10.3390/idr16020025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/05/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Despite the expanding use of orthopedic devices and the application of strict pre- and postoperative protocols, the elimination of postoperative implant-related infections remains a challenge. Objectives: To identify and assess the in vitro and in vivo properties of antimicrobial-, silver- and iodine-based implants, as well as to present novel approaches to surface modifications of orthopedic implants. Methods: A systematic computer-based review on the development of these implants, on PubMed and Web of Science databases, was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Overall, 31 in vitro and 40 in vivo entries were evaluated. Regarding the in vitro studies, antimicrobial-based coatings were assessed in 12 entries, silver-based coatings in 10, iodine-based in 1, and novel-applied coating technologies in 8 entries. Regarding the in vivo studies, antimicrobial coatings were evaluated in 23 entries, silver-coated implants in 12, and iodine-coated in 1 entry, respectively. The application of novel coatings was studied in the rest of the cases (4). Antimicrobial efficacy was examined using different bacterial strains, and osseointegration ability and biocompatibility were examined in eukaryotic cells and different animal models, including rats, rabbits, and sheep. Conclusions: Assessment of both in vivo and in vitro studies revealed a wide antimicrobial spectrum of the coated implants, related to reduced bacterial growth, inhibition of biofilm formation, and unaffected or enhanced osseointegration, emphasizing the importance of the application of surface modification techniques as an alternative for the treatment of orthopedic implant infections in the clinical settings.
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Affiliation(s)
- Angelos Kaspiris
- Third Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “KAT” General Hospital, Nikis 2, 14561 Athens, Greece; (E.V.); (G.T.); (M.V.); (I.K.); (S.G.P.)
| | - Elias Vasiliadis
- Third Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “KAT” General Hospital, Nikis 2, 14561 Athens, Greece; (E.V.); (G.T.); (M.V.); (I.K.); (S.G.P.)
| | - Evangelia Pantazaka
- Synthetic Organic Chemistry Laboratory, Department of Chemistry, University of Patras, 26504 Patras, Greece;
| | - Ioanna Lianou
- Department of Orthopedic Surgery, “Rion” University Hospital and Medical School, School of Health Sciences, University of Patras, 26504 Patras, Greece; (I.L.); (F.P.)
| | - Dimitra Melissaridou
- First Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, Rimini 1, 12462 Athens, Greece; (D.M.); (O.D.S.)
| | - Matthaios Savvidis
- Second Orthopedic Department, 424 General Military Hospital, 56429 Thessaloniki, Greece;
| | - Fotios Panagopoulos
- Department of Orthopedic Surgery, “Rion” University Hospital and Medical School, School of Health Sciences, University of Patras, 26504 Patras, Greece; (I.L.); (F.P.)
| | - Georgios Tsalimas
- Third Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “KAT” General Hospital, Nikis 2, 14561 Athens, Greece; (E.V.); (G.T.); (M.V.); (I.K.); (S.G.P.)
| | - Michail Vavourakis
- Third Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “KAT” General Hospital, Nikis 2, 14561 Athens, Greece; (E.V.); (G.T.); (M.V.); (I.K.); (S.G.P.)
| | - Ioannis Kolovos
- Third Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “KAT” General Hospital, Nikis 2, 14561 Athens, Greece; (E.V.); (G.T.); (M.V.); (I.K.); (S.G.P.)
| | - Olga D. Savvidou
- First Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, Rimini 1, 12462 Athens, Greece; (D.M.); (O.D.S.)
| | - Spiros G. Pneumaticos
- Third Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “KAT” General Hospital, Nikis 2, 14561 Athens, Greece; (E.V.); (G.T.); (M.V.); (I.K.); (S.G.P.)
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Dorozhkin SV. There Are over 60 Ways to Produce Biocompatible Calcium Orthophosphate (CaPO4) Deposits on Various Substrates. JOURNAL OF COMPOSITES SCIENCE 2023; 7:273. [DOI: 10.3390/jcs7070273] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
A The present overview describes various production techniques for biocompatible calcium orthophosphate (abbreviated as CaPO4) deposits (coatings, films and layers) on the surfaces of various types of substrates to impart the biocompatible properties for artificial bone grafts. Since, after being implanted, the grafts always interact with the surrounding biological tissues at the interfaces, their surface properties are considered critical to clinical success. Due to the limited number of materials that can be tolerated in vivo, a new specialty of surface engineering has been developed to desirably modify any unacceptable material surface characteristics while maintaining the useful bulk performance. In 1975, the development of this approach led to the emergence of a special class of artificial bone grafts, in which various mechanically stable (and thus suitable for load-bearing applications) implantable biomaterials and artificial devices were coated with CaPO4. Since then, more than 7500 papers have been published on this subject and more than 500 new publications are added annually. In this review, a comprehensive analysis of the available literature has been performed with the main goal of finding as many deposition techniques as possible and more than 60 methods (double that if all known modifications are counted) for producing CaPO4 deposits on various substrates have been systematically described. Thus, besides the introduction, general knowledge and terminology, this review consists of two unequal parts. The first (bigger) part is a comprehensive summary of the known CaPO4 deposition techniques both currently used and discontinued/underdeveloped ones with brief descriptions of their major physical and chemical principles coupled with the key process parameters (when possible) to inform readers of their existence and remind them of the unused ones. The second (smaller) part includes fleeting essays on the most important properties and current biomedical applications of the CaPO4 deposits with an indication of possible future developments.
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Affiliation(s)
- Sergey V. Dorozhkin
- Faculty of Physics, M.V. Lomonosov Moscow State University, Leninskie Gory 1-2, Moscow 119991, Russia
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Yang X, Wang Q, Zhang Y, He H, Xiong S, Chen P, Li C, Wang L, Lu G, Xu Y. A dual-functional PEEK implant coating for anti-bacterial and accelerated osseointegration. Colloids Surf B Biointerfaces 2023; 224:113196. [PMID: 36764204 DOI: 10.1016/j.colsurfb.2023.113196] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/05/2023]
Abstract
Polyetheretherketone (PEEK) has been widely applied in biomedical engineering. However, the unsatisfactory bioactivity essentially limits the clinical application of PEEK. In this study, a simply immersing method was proposed to fabricate a dual-functional PEEK with antibacterial properties and enhanced bone integration. Firstly, the surface of PEEK was modified with a polydopamine (PDA) coating by incubating at dopamine solution. Afterward, the PEEK-PDA was modified with manganese (Mn) and silver (Ag) ions by the soaking method to fabricate the PEEK-PDA-Mn/Ag. The physicochemical capabilities of PEEK-PDA-Mn/Ag were further explored in the ions release, wettability, morphology, and element distributions. PEEK-PDA-Mn/Ag obviously accelerated the adhesion and distribution of MC3T3-E1 cells, indicating favorable biosafety in vitro. Meanwhile, the osteogenic properties of PEEK-PDA-Mn and PEEK-PDA-Mn/Ag were proved by the increased expression of osteogenic genes, alkaline phosphatase (ALP), and mineralization in vitro. Additionally, the wide antibacterial capabilities of PEEK-PDA-Mn/Ag were proved in both Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) in vitro. Furthermore, the PEEK-PDA-Mn/Ag was antibacterial with capability in enhancing osseointegration in vivo. Overall, the simply immersing method can modify the surface of PEEK, giving the bioactivity, biocompatibility, and antibacterial ability to the composited PEEK, which could be applied as an orthopedic implant in clinical.
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Affiliation(s)
- Xin Yang
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, Jiangsu 215006, China; Department of Orthopedics, The First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Anhui, China
| | - Qiang Wang
- Department of Orthopedics, The First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Anhui, China
| | - Yinchang Zhang
- Department of Orthopedics, The First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Anhui, China
| | - Huazheng He
- Department of Orthopedics, The First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Anhui, China
| | - Shouliang Xiong
- Department of Orthopedics, The First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Anhui, China
| | - Pingbo Chen
- Department of Orthopedics, The First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Anhui, China
| | - Congming Li
- Department of Orthopedics, The First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Anhui, China
| | - Lei Wang
- Department of Orthopedics, The First Affiliated Hospital of Wannan Medical College, Wuhu 241001, Anhui, China.
| | - Guohai Lu
- Department of orthopedics, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215500, Jiangsu, China.
| | - Yaozeng Xu
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, Jiangsu 215006, China.
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An ionic silver coating prevents implant-associated infection by anaerobic bacteria in vitro and in vivo in mice. Sci Rep 2022; 12:18387. [PMID: 36319854 PMCID: PMC9626628 DOI: 10.1038/s41598-022-23322-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 10/29/2022] [Indexed: 11/07/2022] Open
Abstract
Currently, implants are utilized clinically for bone transplant procedures. However, if infectious osteomyelitis occurs at implant sites, removal of bacteria can be challenging. Moreover, altered blood flow at peri-implant infectious sites can create an anaerobic environment, making it more difficult to treat infection with antibiotics. Thus, it would be beneficial if implants could be modified to exhibit antibacterial activity, even in anaerobic conditions. Here, we show antibacterial activity of silver ions coated on titanium rods, even against the anaerobic bacteria Porphyromonas gingivalis (P. gingivalis), both in vitro and in vivo. Specifically, we implanted silver-coated or control uncoated titanium rods along with P. gingivalis in mouse femoral bone BM cavities and observed significantly inhibited P. gingivalis infection with silver-coated compared with non-coated rods, based on in vivo bio-imaging. Osteonecrosis by infectious osteomyelitis and elevation of the inflammatory factors C-reactive protein and IL-6 promoted by P. gingivalis s were also significantly reduced in the presence of silver-coated rods. Overall, our study indicates that silver ion coating of an implant represents a therapeutic option to prevent associated infection, even in anaerobic conditions or against anaerobic bacteria.
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Recent Advances in Antimicrobial Coatings and Material Modification Strategies for Preventing Urinary Catheter-Associated Complications. Biomedicines 2022; 10:biomedicines10102580. [PMID: 36289841 PMCID: PMC9599887 DOI: 10.3390/biomedicines10102580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/28/2022] [Accepted: 10/06/2022] [Indexed: 11/28/2022] Open
Abstract
In recent years, we have witnessed prominent improvements in urinary catheter coatings to tackle the commonly occurring catheter-associated urinary tract infection (CAUTI) in catheterized patients. CAUTIs are claimed to be one of the most frequent nosocomial infections that can lead to various complications, from catheter encrustation to severe septicaemia and pyelonephritis. Besides general prevention hygienic strategies, antimicrobial-coated urinary catheters show great potential in the prevention of urinary catheter-associated complications. The aim of this review is to present and evaluate recent updates on the development of antimicrobial urinary catheters in the context of the aetiology of urinary malfunction. Subsequently, we shed some light on future perspectives of utilizing 3D printing and the surrounding regulatory directions.
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6
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Wu Z, Chan B, Low J, Chu JJH, Hey HWD, Tay A. Microbial resistance to nanotechnologies: An important but understudied consideration using antimicrobial nanotechnologies in orthopaedic implants. Bioact Mater 2022; 16:249-270. [PMID: 35415290 PMCID: PMC8965851 DOI: 10.1016/j.bioactmat.2022.02.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 12/11/2022] Open
Abstract
Microbial resistance to current antibiotics therapies is a major cause of implant failure and adverse clinical outcomes in orthopaedic surgery. Recent developments in advanced antimicrobial nanotechnologies provide numerous opportunities to effective remove resistant bacteria and prevent resistance from occurring through unique mechanisms. With tunable physicochemical properties, nanomaterials can be designed to be bactericidal, antifouling, immunomodulating, and capable of delivering antibacterial compounds to the infection region with spatiotemporal accuracy. Despite its substantial advancement, an important, but under-explored area, is potential microbial resistance to nanomaterials and how this can impact the clinical use of antimicrobial nanotechnologies. This review aims to provide a better understanding of nanomaterial-associated microbial resistance to accelerate bench-to-bedside translations of emerging nanotechnologies for effective control of implant associated infections.
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Affiliation(s)
- Zhuoran Wu
- Institute of Health Innovation & Technology, National University of Singapore, 117599, Singapore
| | - Brian Chan
- Department of Biomedical Engineering, National University of Singapore, 117583, Singapore
| | - Jessalyn Low
- Department of Biomedical Engineering, National University of Singapore, 117583, Singapore
| | - Justin Jang Hann Chu
- Biosafety Level 3 Core Facility, Yong Loo Lin School of Medicine, National University of Singapore, 117599, Singapore.,Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, 117545, Singapore.,Infectious Disease Programme, Yong Loo Lin School of Medicine, National University of Singapore, 117547, Singapore.,Institute of Molecular and Cell Biology, 35 Agency for Science, Technology and Research, 138673, Singapore
| | - Hwee Weng Dennis Hey
- National University Health System, National University of Singapore, 119228, Singapore
| | - Andy Tay
- Institute of Health Innovation & Technology, National University of Singapore, 117599, Singapore.,Department of Biomedical Engineering, National University of Singapore, 117583, Singapore.,Tissue Engineering Programme, National University of Singapore, 117510, Singapore
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7
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Development of Silver-Containing Hydroxyapatite-Coated Antimicrobial Implants for Orthopaedic and Spinal Surgery. Medicina (B Aires) 2022; 58:medicina58040519. [PMID: 35454358 PMCID: PMC9029955 DOI: 10.3390/medicina58040519] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/30/2022] [Accepted: 03/30/2022] [Indexed: 11/30/2022] Open
Abstract
The prevention of surgical site infections is directly related to the minimization of surgical invasiveness, and is in line with the concept of minimally invasive spine therapy (MIST). In recent years, the incidence of postoperative infections has been increasing due to the increased use of spinal implant surgery in patients at high risk of infection, including the elderly and easily infected hosts, the limitations of poor bone marrow transfer of antibiotics, and the potential for contamination of surgical gloves and instruments. Thus, the development of antimicrobial implants in orthopedic and spinal surgery is becoming more and more popular, and implants with proven antimicrobial, safety, and osteoconductive properties (i.e., silver, iodine, antibiotics) in vitro, in vivo, and in clinical trials have become available for clinical use. We have developed silver-containing hydroxyapatite (Ag-HA)-coated implants to prevent post-operative infection, and increase bone fusion capacity, and have successfully commercialized antibacterial implants for hip prostheses and spinal interbody cages. This narrative review overviews the present status of available surface coating technologies and materials; describes how the antimicrobial, safety, and biocompatibility (osteoconductivity) of Ag-HA-coated implants have been demonstrated for commercialization; and reviews the clinical use of antimicrobial implants in orthopedic and spinal surgery, including Ag-HA-coated implants that we have developed.
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8
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Cyphert EL, Zhang N, Learn GD, Hernandez CJ, von Recum HA. Recent Advances in the Evaluation of Antimicrobial Materials for Resolution of Orthopedic Implant-Associated Infections In Vivo. ACS Infect Dis 2021; 7:3125-3160. [PMID: 34761915 DOI: 10.1021/acsinfecdis.1c00465] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
While orthopedic implant-associated infections are rare, revision surgeries resulting from infections incur considerable healthcare costs and represent a substantial research area clinically, in academia, and in industry. In recent years, there have been numerous advances in the development of antimicrobial strategies for the prevention and treatment of orthopedic implant-associated infections which offer promise to improve the limitations of existing delivery systems through local and controlled release of antimicrobial agents. Prior to translation to in vivo orthopedic implant-associated infection models, the properties (e.g., degradation, antimicrobial activity, biocompatibility) of the antimicrobial materials can be evaluated in subcutaneous implant in vivo models. The antimicrobial materials are then incorporated into in vivo implant models to evaluate the efficacy of using the material to prevent or treat implant-associated infections. Recent technological advances such as 3D-printing, bacterial genomic sequencing, and real-time in vivo imaging of infection and inflammation have contributed to the development of preclinical implant-associated infection models that more effectively recapitulate the clinical presentation of infections and improve the evaluation of antimicrobial materials. This Review highlights the advantages and limitations of antimicrobial materials used in conjunction with orthopedic implants for the prevention and treatment of orthopedic implant-associated infections and discusses how these materials are evaluated in preclinical in vivo models. This analysis serves as a resource for biomaterial researchers in the selection of an appropriate orthopedic implant-associated infection preclinical model to evaluate novel antimicrobial materials.
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Affiliation(s)
- Erika L. Cyphert
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, United States
| | - Ningjing Zhang
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, United States
| | - Greg D. Learn
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, United States
| | - Christopher J. Hernandez
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, New York 14853, United States
- Hospital for Special Surgery, New York, New York 10021, United States
| | - Horst A. von Recum
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, United States
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Xu W, Chen Y, Zhang B, Xu W, Niu J, Liu Y. Supramolecular Assembly of β-Cyclodextrin-Modified Polymer by Electrospinning with Sustained Antibacterial Activity. Biomacromolecules 2021; 22:4434-4445. [PMID: 34495641 DOI: 10.1021/acs.biomac.1c01007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Supramolecular assembly loading drug as biomedical materials is a research hotspot. Herein, we reported a supramolecular electrospun assembly constructed via the hydrophobic and hydrogen bonding interaction. The obtained results showed that the assembly by supramolecular electrospinning not only increased the interactions of multiple antibacterial active species including antibiotics, cationic polymers, and silver to form a flexible membrane with good mechanical strength but also indicated the dual effects of rapid doxycycline and polyethyleneimine release as well as a sustained Ag release. Interestingly, the assembly showed not only good degradability but also a high bacteriostatic efficacy toward Escherichia coli (E. coli) up to 99.9%. More importantly, the in vivo wound healing assay indicated that the assembly could promote the healing of uninfected, E. coli-infected, and even methicillin-resistant staphylococcus aureus-infected wounds. The current research provides a novel approach to construct a supramolecular assembly by electrospinning mechanically induced strong noncovalent interaction.
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Affiliation(s)
- Wenshi Xu
- College of Chemistry, State Key Laboratory of Elemento-Organic Chemistry, Nankai University, Tianjin 300071, P. R. China
| | - Yong Chen
- College of Chemistry, State Key Laboratory of Elemento-Organic Chemistry, Nankai University, Tianjin 300071, P. R. China
| | - Bing Zhang
- College of Chemistry, State Key Laboratory of Elemento-Organic Chemistry, Nankai University, Tianjin 300071, P. R. China
| | - Wenwen Xu
- College of Chemistry, State Key Laboratory of Elemento-Organic Chemistry, Nankai University, Tianjin 300071, P. R. China
| | - Jie Niu
- College of Chemistry, State Key Laboratory of Elemento-Organic Chemistry, Nankai University, Tianjin 300071, P. R. China
| | - Yu Liu
- College of Chemistry, State Key Laboratory of Elemento-Organic Chemistry, Nankai University, Tianjin 300071, P. R. China
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Hodges NA, Sussman EM, Stegemann JP. Aseptic and septic prosthetic joint loosening: Impact of biomaterial wear on immune cell function, inflammation, and infection. Biomaterials 2021; 278:121127. [PMID: 34564034 DOI: 10.1016/j.biomaterials.2021.121127] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 09/01/2021] [Accepted: 09/07/2021] [Indexed: 12/17/2022]
Abstract
The success of total joint replacements has led to consistent growth in the use of arthroplasty in progressively younger patients. However, more than 10 percent of patients require revision surgeries due to implant failure caused by osteolytic loosening. These failures are classified as either aseptic or septic and are associated with the presence of particulate wear debris generated by mechanical action between implant components. Aseptic loosening results from chronic inflammation caused by activation of resident immune cells in contact with implant wear debris. In contrast, septic loosening is defined by the presence of chronic infection at the implant site. However, recent findings suggest that subclinical biofilms may be overlooked when evaluating the cause of implant failure, leading to a misdiagnosis of aseptic loosening. Many of the inflammatory pathways contributing to periprosthetic joint infections are also involved in bone remodeling and resorption. In particular, wear debris is increasingly implicated in the inhibition of the innate and adaptive immune response to resolve an infection or prevent hematogenous spread. This review examines the interconnectivity of wear particle- and infection-associated mechanisms of implant loosening, as well as biomaterials-based strategies to combat infection-related osteolysis.
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Affiliation(s)
- Nicholas A Hodges
- University of Michigan, Department of Biomedical Engineering, Ann Arbor, MI, 48109, USA; Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, FDA, Silver Spring, MD, 20993, USA.
| | - Eric M Sussman
- Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, FDA, Silver Spring, MD, 20993, USA.
| | - Jan P Stegemann
- University of Michigan, Department of Biomedical Engineering, Ann Arbor, MI, 48109, USA.
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Watanabe K, Fukuzaki S, Sugino A, Benson N, Metcalf N, Nakamura M, Matsumoto M. Cobalt-Chromium Alloy Has Superior Antibacterial Effect Than Titanium Alloy: In Vitro and In Vivo Studies. Spine (Phila Pa 1976) 2021; 46:E911-E915. [PMID: 34384089 PMCID: PMC8357039 DOI: 10.1097/brs.0000000000003970] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/09/2020] [Accepted: 12/11/2020] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN In vitro and in vivo laboratory studies. OBJECTIVE This study aimed to compare bacterial survival on titanium alloy (Ti) and cobalt-chromium alloy (CC) using in vitro and in vivo experiments. SUMMARY OF BACKGROUND DATA Spinal implants are frequently manufactured from Ti and CC. These foreign materials are thought to be susceptible to biofilm formation that contributes to the development of surgical site infections. Certain metals (i.e., silver, cobalt) are known to have antibacterial properties. METHODS In the in vitro study, discs made of Ti or CC were incubated with one of two common bacteria: Staphylococcus aureus (S. aureus) and Propionibacterium acnes (P. acnes). After incubation, discs were assessed to determine the number of viable bacterial cells. In the in vivo study, the discs that were made of CC or Ti were implanted into the subcutaneous layer of BALB/c mice. After skin closure, a suspension including either S. aureus or P. acnes was directly inoculated on the implanted discs. The discs were retrieved and analyzed to determine the number of viable bacteria at 0.5, 1, and 3 days after inoculation. RESULTS The number of viable S. aureus cultured from the CC discs was 0.9 ± 0.2 × 103 CFU/disc, which was significantly lower than the cultured Ti discs (114.8 ± 18.3 × 103 CFU/disc). Moreover, a significantly lower mean number of P. acnes were cultured with CC (1.9 ± 1.2 × 103 CFU/disc) compared with the Ti (180.0 ± 72.1 × 103 CFU/disc). The in vivo infection model testing against S. aureus or P. acnes showed a significantly lower number of viable S. aureus or P. acnes on CC discs than Ti discs. The result was seen at all measured time points. CONCLUSION CC suppressed S. aureus and P. acnes proliferation compared with Ti in vitro and in an in vivo infection model.Level of Evidence: N/A.
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Affiliation(s)
- Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | | | | | | | | | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
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12
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An antibacterial coated polymer prevents biofilm formation and implant-associated infection. Sci Rep 2021; 11:3602. [PMID: 33574464 PMCID: PMC7878515 DOI: 10.1038/s41598-021-82992-w] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 01/18/2021] [Indexed: 11/09/2022] Open
Abstract
To prevent infections associated with medical implants, various antimicrobial silver-coated implant materials have been developed. However, these materials do not always provide consistent antibacterial effects in vivo despite having dramatic antibacterial effects in vitro, probably because the antibacterial effects involve silver-ion-mediated reactive oxygen species generation. Additionally, the silver application process often requires extremely high temperatures, which damage non-metal implant materials. We recently developed a bacteria-resistant coating consisting of hydroxyapatite film on which ionic silver is immobilized via inositol hexaphosphate chelation, using a series of immersion and drying steps performed at low heat. Here we applied this coating to a polymer, polyetheretherketone (PEEK), and analyzed the properties and antibacterial activity of the coated polymer in vitro and in vivo. The ionic silver coating demonstrated significant bactericidal activity and prevented bacterial biofilm formation in vitro. Bio-imaging of a soft tissue infection mouse model in which a silver-coated PEEK plate was implanted revealed a dramatic absence of bacterial signals 10 days after inoculation. These animals also showed a strong reduction in histological features of infection, compared to the control animals. This innovative coating can be applied to complex structures for clinical use, and could prevent infections associated with a variety of plastic implants.
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Evaluation of Antibacterial and Cytotoxic Properties of a Fluorinated Diamond-Like Carbon Coating for the Development of Antibacterial Medical Implants. Antibiotics (Basel) 2020; 9:antibiotics9080495. [PMID: 32784861 PMCID: PMC7459999 DOI: 10.3390/antibiotics9080495] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/27/2020] [Accepted: 08/07/2020] [Indexed: 12/14/2022] Open
Abstract
Peri-implant infection is a serious complication in surgical procedures involving implants. We conducted an in vitro study to determine whether the use of a fluorinated diamond-like carbon (F-DLC) coating on a titanium alloy surface can prevent peri-implant infection. After applying the F-DLC, we evaluated its antibacterial and cytotoxic properties. The coating groups, containing controlled fluorine concentrations of 5.44%, 17.43%, 24.09%, and 30%, were examined for the presence of Staphylococcus aureus and Escherichia coli according to ISO 22196 for the measurement of antibacterial activity on plastics and other nonporous surfaces. Biological toxicity was evaluated using Chinese hamster V79 cells according to ISO 10993-5 for the biological evaluation of medical devices. In the control group, populations of S. aureus and E. coli substantially increased from 2.4 × 104 to (1.45 ± 1.11) × 106 colony-forming units (CFUs) and from 2.54 × 104 to (4.04 ± 0.44) × 106 CFUs, respectively. However, no bacteria colonies were detected in any F-DLC group with a fluorine concentration of ≥ 17.43%. In the biological toxicity study, an F-DLC coating with a fluorine concentration of 30% showed a colony formation rate of 105.8 ± 24.1%, which did not differ significantly from the colony formation rate of 107.5 ± 31.1% in the nontoxic control group. An F-DLC coating on titanium alloy discs showed excellent in vitro antibacterial activity with no biological toxicity.
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14
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The Impact of Engineered Silver Nanomaterials on the Immune System. NANOMATERIALS 2020; 10:nano10050967. [PMID: 32443602 PMCID: PMC7712063 DOI: 10.3390/nano10050967] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 01/07/2023]
Abstract
Over the last decades there has been a tremendous volume of research efforts focused on engineering silver-based (nano)materials. The interest in silver has been mostly driven by the element capacity to kill pathogenic bacteria. In this context, the main area of application has been medical devices that are at significant risk of becoming colonized by bacteria and subsequently infected. However, silver nanomaterials have been incorporated in a number of other commercial products which may or may not benefit from antibacterial protection. The rapid expansion of such products raises important questions about a possible adverse influence on human health. This review focuses on examining currently available literature and summarizing the current state of knowledge of the impact of silver (nano)materials on the immune system. The review also looks at various surface modification strategies used to generate silver-based nanomaterials and the immunomodulatory potential of these materials. It also highlights the immune response triggered by various silver-coated implantable devices and provides guidance and perspective towards engineering silver nanomaterials for modulating immunological consequences.
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15
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Urinary Catheter Coating Modifications: The Race against Catheter-Associated Infections. COATINGS 2019. [DOI: 10.3390/coatings10010023] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Urinary catheters are common medical devices, whose main function is to drain the bladder. Although they improve patients’ quality of life, catheter placement predisposes the patient to develop a catheter-associated urinary tract infection (CAUTI). The catheter is used by pathogens as a platform for colonization and biofilm formation, leading to bacteriuria and increasing the risk of developing secondary bloodstream infections. In an effort to prevent microbial colonization, several catheter modifications have been made ranging from introduction of antimicrobial compounds to antifouling coatings. In this review, we discuss the effectiveness of different coatings in preventing catheter colonization in vitro and in vivo, the challenges in fighting CAUTIs, and novel approaches targeting host–catheter–microbe interactions.
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16
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Bargon R, Bruenke J, Carli A, Fabritius M, Goel R, Goswami K, Graf P, Groff H, Grupp T, Malchau H, Mohaddes M, Novaes de Santana C, Phillips KS, Rohde H, Rolfson O, Rondon A, Schaer T, Sculco P, Svensson K. General Assembly, Research Caveats: Proceedings of International Consensus on Orthopedic Infections. J Arthroplasty 2019; 34:S245-S253.e1. [PMID: 30348560 DOI: 10.1016/j.arth.2018.09.076] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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17
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Wyatt MC, Foxall-Smith M, Roberton A, Beswick A, Kieser DC, Whitehouse MR. The use of silver coating in hip megaprostheses: a systematic review. Hip Int 2019; 29:7-20. [PMID: 30442019 DOI: 10.1177/1120700018811070] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Retrospective studies of silver-coated hip implants have demonstrated promising results and safety profile, however, the potential benefits are so far unproven in prospective studies. Silver-coated implants may have a role in patients undergoing revision or primary surgery with a high risk of infection but as yet there are no human studies investigating silver in primary hip arthroplasty. Adequately powered robust prospective studies are needed in this area to determine if silver-coated implants would be efficacious and cost-effective. The purpose of this systematic review article is to review the current literature regarding the use of silver in hip arthroplasty. Our review showed that there is some encouraging evidence that silver coatings can reduce infection.
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Affiliation(s)
- Michael C Wyatt
- 1 Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago Christchurch, New Zealand
| | - Michael Foxall-Smith
- 2 Musculoskeletal Research Unit, Southmead Hospital, Bristol, UK.,3 North Devon District Hospital, Barnstaple, UK
| | - Andrew Roberton
- 2 Musculoskeletal Research Unit, Southmead Hospital, Bristol, UK.,3 North Devon District Hospital, Barnstaple, UK
| | - Andrew Beswick
- 2 Musculoskeletal Research Unit, Southmead Hospital, Bristol, UK
| | - David C Kieser
- 1 Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago Christchurch, New Zealand
| | - Michael R Whitehouse
- 4 National Institute for Health Research Bristol Biomedical Research Centre, Bristol, UK.,5 Faculty of Health Sciences, University of Bristol, UK
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18
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Zhu Z, Wang Z, Li S, Yuan X. Antimicrobial strategies for urinary catheters. J Biomed Mater Res A 2018; 107:445-467. [PMID: 30468560 DOI: 10.1002/jbm.a.36561] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/03/2018] [Accepted: 10/04/2018] [Indexed: 01/12/2023]
Abstract
Over 75% of hospital-acquired or nosocomial urinary tract infections are initiated by urinary catheters, which are used during the treatment of 16% of hospitalized patients. Taking the United States as an example, the costs of catheter-associated urinary tract infections (CAUTI) are in excess of $451 million dollars/year. The biofilm formation by pathogenic microbes that protects pathogens from host immune defense and antimicrobial agents is the leading cause for CAUTI. Thus, tremendous efforts have been devoted to antimicrobial coating for urinary catheters in the past few decades, and it has been demonstrated to be one of the most direct and efficient strategies to reduce infections. In this article, we briefly summarize the current methods for preparation of antimicrobial coatings based on different stages in the biofilm formation, highlight recent progress in the urinary catheter coating material design and selection, discuss approaches to improving their long-term antimicrobial efficacy, biocompatibility, multidrug resistance and recurrent infections, and finally outline future requirements and prospects in antimicrobial coating material design. The scope of the works surveyed is confined to antimicrobial urinary catheters. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 445-467, 2019.
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Affiliation(s)
- Zhiling Zhu
- School of Materials Science and Engineering, Qingdao University of Science and Technology, Qingdao, Shandong 266042, China
| | - Ziping Wang
- Shandong Peninsula Engineering Research Center of Comprehensive Brine Utilization, Weifang University of Science and Technology, Weifang, Shandong 262700, China
| | - Siheng Li
- Department of Chemistry, University of Houston, Houston, Texas 77204, USA
| | - Xun Yuan
- School of Materials Science and Engineering, Qingdao University of Science and Technology, Qingdao, Shandong 266042, China
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19
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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.
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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
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20
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Yeo CK, Vikhe YS, Li P, Guo Z, Greenberg P, Duan H, Tan NS, Chan-Park MB. Hydrogel Effects Rapid Biofilm Debridement with ex situ Contact-Kill to Eliminate Multidrug Resistant Bacteria in vivo. ACS APPLIED MATERIALS & INTERFACES 2018; 10:20356-20367. [PMID: 29806938 DOI: 10.1021/acsami.8b06262] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Multidrug resistance and the refractory character of bacterial biofilms are among the most difficult challenges in infection treatment. Current antimicrobial strategies typically are much more effective for prevention of biofilm formation than for eradication of established biofilms; these strategies also leave dead bacteria and endotoxin in the infection site, which impairs healing. We report a novel hydrogel that eradicates biofilm bacteria by non-leaching-based debridement followed by ex situ contact-killing (DESCK) away from the infection site. The debridement effect is likely due to the high water swellability and microporosity of the cross-linked network which is made from polyethylene glycol dimethacrylate tethered with a dangling polyethylenimine (PEI) star copolymer. The large pore size of the hydrogel makes the cationic pore walls highly accessible to bacteria. The hydrogel also degrades in the presence of infection cells, releasing star cationic PEI into the infection site to contact-kill bacteria remaining there. DESCK hydrogel effectively kills (>99.9% reduction) biofilms of methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant Pseudomonas aeruginosa (CR-PA) and Acinetobacter baumannii in a murine excisional wound infection model. Silver-based wound dressings (controls) showed almost no killing of CR-PA and MRSA biofilms. This DESCK hydrogel greatly reduces the bioburden and inflammation and promotes wound healing. It has great potential for diverse infection treatment applications.
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Affiliation(s)
- Chun Kiat Yeo
- NTU Institute for Health Technologies, Interdisciplinary Graduate School , Nanyang Technological University , 637553 , Singapore
- School of Chemical and Biomedical Engineering , Nanyang Technological University , 62 Nanyang Drive , 637459 , Singapore
| | - Yogesh Shankar Vikhe
- School of Chemical and Biomedical Engineering , Nanyang Technological University , 62 Nanyang Drive , 637459 , Singapore
- Centre for Antimicrobial Bioengineering , Nanyang Technological University , 637459 , Singapore
| | - Peng Li
- School of Chemical and Biomedical Engineering , Nanyang Technological University , 62 Nanyang Drive , 637459 , Singapore
| | - Zanru Guo
- School of Chemical and Biomedical Engineering , Nanyang Technological University , 62 Nanyang Drive , 637459 , Singapore
| | - Peter Greenberg
- Department of Microbiology , University of Washington School of Medicine , Seattle , Washington 98195-7735 , United States
| | - Hongwei Duan
- School of Chemical and Biomedical Engineering , Nanyang Technological University , 62 Nanyang Drive , 637459 , Singapore
- Centre for Antimicrobial Bioengineering , Nanyang Technological University , 637459 , Singapore
| | - Nguan Soon Tan
- School of Biological Sciences , Nanyang Technological University , 637551 , Singapore
| | - Mary B Chan-Park
- School of Chemical and Biomedical Engineering , Nanyang Technological University , 62 Nanyang Drive , 637459 , Singapore
- Centre for Antimicrobial Bioengineering , Nanyang Technological University , 637459 , Singapore
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21
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Zhang Y, Dong C, Yang S, Chiu TW, Wu J, Xiao K, Huang Y, Li X. Enhanced silver loaded antibacterial titanium implant coating with novel hierarchical effect. J Biomater Appl 2018; 32:1289-1299. [PMID: 29417864 DOI: 10.1177/0885328218755538] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In this study, we present a novel strategy for hierarchical antibacterial implant coating by controlling structural and componential features as regulators of surface bactericidal property. Anodized titanium dioxide nanotubes and self-polymerized polydopamine were both used as preliminary antibacterial agents with a significant positive effect on surface bioactivity. At the same time, the storage capacity of nanotubes and the in situ reduction activity of polydopamine can introduce large amounts of strong attached silver nanoparticles for enhanced stable antibacterial performance. The surface morphology, chemical composition, and hydrophilicity had been thoroughly characterized. The sustained silver release performances were continuously monitored. The successively in vitro inhibition on Staphylococcus aureus growth of titanium dioxide nanotube, polydopamine layer and silver nanoparticles demonstrated the hierarchical antibacterial property of the final silver nanoparticles-incorporated polydopamine-modified titanium dioxide nanotube coating (silver/polydopamine/nanotube). Moreover, the bioactivity investigation indicated the vital role of polydopamine-modified titanium dioxide nanotube coating on preserving healthy osteoblast activity at the implant interface. The unique hierarchical coating for titanium implant may be a promising method to maximize antibacterial capacity and maintain good cellular activity at the same time.
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Affiliation(s)
- Yanxian Zhang
- 1 Corrosion and Protection Center, Key Laboratory for Corrosion and Protection (MOE), 12507 University of Science and Technology, Beijing , China
| | - Chaofang Dong
- 1 Corrosion and Protection Center, Key Laboratory for Corrosion and Protection (MOE), 12507 University of Science and Technology, Beijing , China
| | - Sefei Yang
- 2 Department of Stomatology, The PLA General Hospital, Beijing, China
| | - Te-Wei Chiu
- 3 Department of Materials and Mineral Resources Engineering, National Taipei University of Technology, Zhongxiao E. Rd., Taipei, Taiwan
| | - Junsheng Wu
- 1 Corrosion and Protection Center, Key Laboratory for Corrosion and Protection (MOE), 12507 University of Science and Technology, Beijing , China
| | - Kui Xiao
- 1 Corrosion and Protection Center, Key Laboratory for Corrosion and Protection (MOE), 12507 University of Science and Technology, Beijing , China
| | - Yunhua Huang
- 1 Corrosion and Protection Center, Key Laboratory for Corrosion and Protection (MOE), 12507 University of Science and Technology, Beijing , China
| | - Xiaogang Li
- 1 Corrosion and Protection Center, Key Laboratory for Corrosion and Protection (MOE), 12507 University of Science and Technology, Beijing , China
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22
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Rizwan M, Alias R, Zaidi UZ, Mahmoodian R, Hamdi M. Surface modification of valve metals using plasma electrolytic oxidation for antibacterial applications: A review. J Biomed Mater Res A 2017; 106:590-605. [PMID: 28975693 DOI: 10.1002/jbm.a.36259] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 09/13/2017] [Accepted: 09/26/2017] [Indexed: 01/15/2023]
Abstract
Plasma electrolytic oxidation (PEO) is an advance technique to develop porous oxidation layer on light metals, primarily to enhance corrosion and wear resistance. The oxidation layer can also offer a wide variety of mechanical, biomedical, tribological, and antibacterial properties through the incorporation of several ions and particles. Due to the increasing need of antimicrobial surfaces for biomedical implants, antibacterial PEO coatings have been developed through the incorporation of antibacterial agents. Metallic nanoparticles that have been employed most widely as antibacterial agents are reported to demonstrate serious health and environmental threats. To overcome the current limitations of these coatings, there is a significant need to develop antibacterial surfaces that are not harmful for patient's health and environment. Attention of the readers has been directed to utilize bioactive glasses as antibacterial agents for PEO coatings. Bioactive glasses are well known for their excellent bioactivity, biocompatibility, and antibacterial character. PEO coatings incorporated with bioactive glasses can provide environment-friendly antimicrobial surfaces with exceptional bioactivity, biocompatibility, and osseointegration. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 590-605, 2018.
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Affiliation(s)
- Muhammad Rizwan
- Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, 50603, Malaysia.,Department of Metallurgical Engineering, Faculty of Chemical and Process Engineering, NED University of Engineering and Technology, Karachi, 75270, Pakistan
| | - Rodianah Alias
- Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, 50603, Malaysia.,Department of Manufacturing Technology, Faculty of Innovative Design and Technology, University Sultan Zainal Abidin (UNISZA), Kuala Terengganu, 21030, Malaysia
| | - Umi Zhalilah Zaidi
- Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, 50603, Malaysia.,Centre of Advanced Manufacturing and Material Processing, University of Malaya, Kuala Lumpur, 50603, Malaysia
| | - Reza Mahmoodian
- Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, 50603, Malaysia.,Centre of Advanced Manufacturing and Material Processing, University of Malaya, Kuala Lumpur, 50603, Malaysia.,Department of Research and Development, Azarin Kar Ind. Co., Industrial Park 1, Kerman, 7635168361, Iran
| | - Mohd Hamdi
- Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, 50603, Malaysia.,Centre of Advanced Manufacturing and Material Processing, University of Malaya, Kuala Lumpur, 50603, Malaysia
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23
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Gao F, Wang Q, Gao N, Yang Y, Cai F, Yamane M, Gao F, Tanaka H. Hydroxyapatite/chemically reduced graphene oxide composite: Environment-friendly synthesis and high-performance electrochemical sensing for hydrazine. Biosens Bioelectron 2017; 97:238-245. [PMID: 28601789 DOI: 10.1016/j.bios.2017.06.005] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 05/31/2017] [Accepted: 06/04/2017] [Indexed: 01/16/2023]
Abstract
It is unexpectedly found that, the in-situ growth of hydroxyapatite (HAP) on graphene oxide (GO) under a moderate temperature (85°C) can effectively trigger the reduction of GO, which needs neither extra reducing agents nor high-temperature thermal treatment. The transmission electron microscope (TEM) experiment demonstrates that the rod-like HAP particles are well attached on the surface of reduced GO (rGO) to form the composite. Electrochemical sensing assays show that the synthesized HAP-rGO nanocomposite presents excellent electrocatalytic capacity for the oxidation of a toxic chemical of hydrazine. When the HAP-rGO modified electrode was utilized as an electrochemical sensor for hydrazine detection, outstanding performances in the indexes of low fabrication cost, short response time (~2s), wide linear range, low detection limit (0.43μM), and good selectivity were achieved. The developed sensor also shows satisfactory results for the detection of hydrazine in real industrial wastewater sample were achieved.
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Affiliation(s)
- Feng Gao
- College of Chemistry and Environment, Fujian Province Key Laboratory of Morden Analytical Science and Separation Technology, Minnan Normal University, Zhangzhou 363000, PR China; Department of Chemistry, Graduate School of Science and Engineering, Shimane University, 1060 Nishikawatsu, Matsue, Shimane 690-8504, Japan
| | - Qingxiang Wang
- College of Chemistry and Environment, Fujian Province Key Laboratory of Morden Analytical Science and Separation Technology, Minnan Normal University, Zhangzhou 363000, PR China.
| | - Ningning Gao
- College of Chemistry and Environment, Fujian Province Key Laboratory of Morden Analytical Science and Separation Technology, Minnan Normal University, Zhangzhou 363000, PR China
| | - Yizhen Yang
- College of Chemistry and Environment, Fujian Province Key Laboratory of Morden Analytical Science and Separation Technology, Minnan Normal University, Zhangzhou 363000, PR China
| | - Fuxian Cai
- College of Chemistry and Environment, Fujian Province Key Laboratory of Morden Analytical Science and Separation Technology, Minnan Normal University, Zhangzhou 363000, PR China
| | - Mayoka Yamane
- Department of Chemistry, Graduate School of Science and Engineering, Shimane University, 1060 Nishikawatsu, Matsue, Shimane 690-8504, Japan
| | - Fei Gao
- College of Chemistry and Environment, Fujian Province Key Laboratory of Morden Analytical Science and Separation Technology, Minnan Normal University, Zhangzhou 363000, PR China
| | - Hidekazu Tanaka
- Department of Chemistry, Graduate School of Science and Engineering, Shimane University, 1060 Nishikawatsu, Matsue, Shimane 690-8504, Japan.
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24
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Brett E, Flacco J, Blackshear C, Longaker MT, Wan DC. Biomimetics of Bone Implants: The Regenerative Road. Biores Open Access 2017; 6:1-6. [PMID: 28163982 PMCID: PMC5248549 DOI: 10.1089/biores.2016.0044] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The current strategies for healing bone defects are numerous and varied. At the core of each bone healing therapy is a biomimetic mechanism, which works to enhance bone growth. These range from porous scaffolds, bone mineral usage, collagen, and glycosaminoglycan substitutes to transplanted cell populations. Bone defects face a range of difficulty in their healing, given the composite of dense outer compact bone and blood-rich inner trabecular bone. As such, the tissue possesses a number of inherent characteristics, which may be clinically harnessed as promoters of bone healing. These include mechanical characteristics, mineral composition, native collagen content, and cellular fraction of bone. This review charts multiple biomimetic strategies to help heal bony defects in large and small osseous injury sites, with a special focus on cell transplantation.
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Affiliation(s)
- Elizabeth Brett
- Hagey Laboratory for Pediatric Regenerative Medicine, Plastic and Reconstructive Surgery Division, Department of Surgery, Stanford University School of Medicine , Stanford, California
| | - John Flacco
- Hagey Laboratory for Pediatric Regenerative Medicine, Plastic and Reconstructive Surgery Division, Department of Surgery, Stanford University School of Medicine , Stanford, California
| | - Charles Blackshear
- Hagey Laboratory for Pediatric Regenerative Medicine, Plastic and Reconstructive Surgery Division, Department of Surgery, Stanford University School of Medicine , Stanford, California
| | - Michael T Longaker
- Hagey Laboratory for Pediatric Regenerative Medicine, Plastic and Reconstructive Surgery Division, Department of Surgery, Stanford University School of Medicine, Stanford, California.; Institute for Stem Cell Biology and Regenerative Medicine, Stanford University, Stanford, California
| | - Derrick C Wan
- Hagey Laboratory for Pediatric Regenerative Medicine, Plastic and Reconstructive Surgery Division, Department of Surgery, Stanford University School of Medicine , Stanford, California
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25
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Townsend L, Williams RL, Anuforom O, Berwick MR, Halstead F, Hughes E, Stamboulis A, Oppenheim B, Gough J, Grover L, Scott RAH, Webber M, Peacock AFA, Belli A, Logan A, de Cogan F. Antimicrobial peptide coatings for hydroxyapatite: electrostatic and covalent attachment of antimicrobial peptides to surfaces. J R Soc Interface 2017; 14:20160657. [PMID: 28077764 PMCID: PMC5310730 DOI: 10.1098/rsif.2016.0657] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 12/06/2016] [Indexed: 01/19/2023] Open
Abstract
The interface between implanted devices and their host tissue is complex and is often optimized for maximal integration and cell adhesion. However, this also gives a surface suitable for bacterial colonization. We have developed a novel method of modifying the surface at the material-tissue interface with an antimicrobial peptide (AMP) coating to allow cell attachment while inhibiting bacterial colonization. The technology reported here is a dual AMP coating. The dual coating consists of AMPs covalently bonded to the hydroxyapatite surface, followed by deposition of electrostatically bound AMPs. The dual approach gives an efficacious coating which is stable for over 12 months and can prevent colonization of the surface by both Gram-positive and Gram-negative bacteria.
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Affiliation(s)
- Leigh Townsend
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
| | - Richard L Williams
- School of Chemical Engineering, University of Birmingham, Birmingham B15 2TT, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham B15 2TH, UK
| | - Olachi Anuforom
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
| | - Matthew R Berwick
- School of Chemistry, University of Birmingham, Birmingham B15 2TT, UK
| | - Fenella Halstead
- University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TH, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham B15 2TH, UK
| | - Erik Hughes
- School of Chemical Engineering, University of Birmingham, Birmingham B15 2TT, UK
| | - Artemis Stamboulis
- School of Metallurgy and Materials, University of Birmingham, Birmingham B15 2TT, UK
| | - Beryl Oppenheim
- University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TH, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham B15 2TH, UK
| | - Julie Gough
- School of Materials, University of Manchester, Manchester M1 7HS, UK
| | - Liam Grover
- School of Chemical Engineering, University of Birmingham, Birmingham B15 2TT, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham B15 2TH, UK
| | - Robert A H Scott
- Royal Centre for Defence Medicine, Birmingham B15 2TH, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham B15 2TH, UK
| | - Mark Webber
- Institute of Microbiology and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham B15 2TH, UK
| | - Anna F A Peacock
- School of Chemistry, University of Birmingham, Birmingham B15 2TT, UK
| | - Antonio Belli
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham B15 2TH, UK
| | - Ann Logan
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham B15 2TH, UK
| | - Felicity de Cogan
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham B15 2TH, UK
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26
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Xu D, Xu T, Guo X, Liu Q, Liu J, Lv W, Jing X, Zhang H, Wang J. Effect of the synthesis method on the performance of Fe3O4–inositol hexaphosphate as a drug delivery vehicle for combination therapeutics with doxorubicin. NEW J CHEM 2017. [DOI: 10.1039/c7nj00599g] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Fe3O4–IP6 was fabricated via layer-by-layer electrostatic self-assembly following a solvothermal synthesis method and via a one-step co-precipitation method.
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Affiliation(s)
- Dandan Xu
- Key Laboratory of Superlight Material and Surface Technology
- Ministry of Education
- Harbin Engineering University
- Harbin 150001
- China
| | - Tongying Xu
- Department of Cardiology
- Centre of Vascular Diseases
- Fourth Affiliated Hospital of Harbin Medical University
- Harbin 150001
- China
| | - Xuejie Guo
- Key Laboratory of Superlight Material and Surface Technology
- Ministry of Education
- Harbin Engineering University
- Harbin 150001
- China
| | - Qi Liu
- Key Laboratory of Superlight Material and Surface Technology
- Ministry of Education
- Harbin Engineering University
- Harbin 150001
- China
| | - Jingyuan Liu
- Key Laboratory of Superlight Material and Surface Technology
- Ministry of Education
- Harbin Engineering University
- Harbin 150001
- China
| | - Weizhong Lv
- Centre for Biomedical Materials and Engineering
- Harbin Engineering University
- Harbin 150001
- China
| | - Xiaoyan Jing
- Key Laboratory of Superlight Material and Surface Technology
- Ministry of Education
- Harbin Engineering University
- Harbin 150001
- China
| | - Hongsen Zhang
- Key Laboratory of Superlight Material and Surface Technology
- Ministry of Education
- Harbin Engineering University
- Harbin 150001
- China
| | - Jun Wang
- Key Laboratory of Superlight Material and Surface Technology
- Ministry of Education
- Harbin Engineering University
- Harbin 150001
- China
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Delayed Propionibacterium acnes surgical site infections occur only in the presence of an implant. Sci Rep 2016; 6:32758. [PMID: 27615686 PMCID: PMC5018724 DOI: 10.1038/srep32758] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/15/2016] [Indexed: 11/09/2022] Open
Abstract
Whether Propionibacterium acnes (P. acnes) causes surgical-site infections (SSI) after orthopedic surgery is controversial. We previously reported that we frequently find P. acnes in intraoperative specimens, yet none of the patients have clinically apparent infections. Here, we tracked P. acnes for 6 months in a mouse osteomyelitis model. We inoculated P. acnes with an implant into the mouse femur in the implant group; the control group was treated with the bacteria but no implant. We then observed over a 6-month period using optical imaging system. During the first 2 weeks, bacterial signals were detected in the femur in the both groups. The bacterial signal completely disappeared in the control group within 28 days. Interestingly, in the implant group, bacterial signals were still present 6 months after inoculation. Histological and scanning electron-microscope analyses confirmed that P. acnes was absent from the control group 6 months after inoculation, but in the implant group, the bacteria had survived in a biofilm around the implant. PCR analysis also identified P. acnes in the purulent effusion from the infected femurs in the implant group. To our knowledge, this is the first report showing that P. acnes causes SSI only in the presence of an implant.
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28
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Gallo J, Panacek A, Prucek R, Kriegova E, Hradilova S, Hobza M, Holinka M. Silver Nanocoating Technology in the Prevention of Prosthetic Joint Infection. MATERIALS (BASEL, SWITZERLAND) 2016; 9:E337. [PMID: 28773461 PMCID: PMC5503077 DOI: 10.3390/ma9050337] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 04/26/2016] [Accepted: 04/27/2016] [Indexed: 02/06/2023]
Abstract
Prosthetic joint infection (PJI) is a feared complication of total joint arthroplasty associated with increased morbidity and mortality. There is a growing body of evidence that bacterial colonization and biofilm formation are critical pathogenic events in PJI. Thus, the choice of biomaterials for implanted prostheses and their surface modifications may significantly influence the development of PJI. Currently, silver nanoparticle (AgNP) technology is receiving much interest in the field of orthopaedics for its antimicrobial properties and a strong anti-biofilm potential. The great advantage of AgNP surface modification is a minimal release of active substances into the surrounding tissue and a long period of effectiveness. As a result, a controlled release of AgNPs could ensure antibacterial protection throughout the life of the implant. Moreover, the antibacterial effect of AgNPs may be strengthened in combination with conventional antibiotics and other antimicrobial agents. Here, our main attention is devoted to general guidelines for the design of antibacterial biomaterials protected by AgNPs, its benefits, side effects and future perspectives in PJI prevention.
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Affiliation(s)
- Jiri Gallo
- Department of Orthopaedics, Faculty of Medicine and Dentistry, Palacký University Olomouc, I. P. Pavlova 6, Olomouc 779 00, Czech Republic.
| | - Ales Panacek
- Regional Centre of Advanced Technologies and Materials, Palacký University Olomouc, Šlechtitelů 27, Olomouc 783 71, Czech Republic.
| | - Robert Prucek
- Regional Centre of Advanced Technologies and Materials, Palacký University Olomouc, Šlechtitelů 27, Olomouc 783 71, Czech Republic.
| | - Eva Kriegova
- Department of Immunology, Faculty of Medicine and Dentistry, Palacký University Olomouc, Hněvotínská 3, Olomouc 779 00, Czech Republic.
| | - Sarka Hradilova
- Regional Centre of Advanced Technologies and Materials, Palacký University Olomouc, Šlechtitelů 27, Olomouc 783 71, Czech Republic.
| | - Martin Hobza
- Department of Orthopaedics, Faculty of Medicine and Dentistry, Palacký University Olomouc, I. P. Pavlova 6, Olomouc 779 00, Czech Republic.
| | - Martin Holinka
- Department of Orthopaedics, Faculty of Medicine and Dentistry, Palacký University Olomouc, I. P. Pavlova 6, Olomouc 779 00, Czech Republic.
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