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Zhu Y, Xu Y, Ling Z, Zhao C, Xu A, He F. The biofilm removal effect and osteogenic potential on the titanium surface by electrolytic cleaning: An in vitro comparison of electrolytic parameters and five techniques. Clin Oral Implants Res 2024; 35:454-466. [PMID: 38345170 DOI: 10.1111/clr.14245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 01/23/2024] [Accepted: 01/30/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVES To determine the optimal current and time of electrolytic cleaning (EC), compare its biofilm removal effect with generic treatments and evaluate the influence of EC to surface characteristics and osteogenic potential of SLA titanium (Ti) discs. MATERIALS AND METHODS The six-species biofilm-covered Ti discs were placed as cathodes in physiologic saline and subjected to various current and time treatments. The residual biofilms were evaluated to determine the optimal parameters. The contaminated Ti discs were randomized and treated by rotating Ti brush; ultrasonic-scaling with metal tips; ultrasonic-scaling with PEEK tips; air-polishing and EC. The residual biofilms were compared using a lipopolysaccharide kit (LPS), scanning electron microscope (SEM), confocal laser scanning microscopy and colony-forming unit counting. Non-contaminated Ti discs were treated and characterized. The bone marrow mesenchymal stem cells (BMSCs) were cultured on treated non-contaminated Ti discs. The adhesion, proliferation, alkaline phosphatase (ALP) activity and osteocalcin level of BMSCs were assessed. RESULTS The parameters at 0.6A5min were considered optimal. For LPS and SEM, EC promoted a significantly greater biofilm removal than the other groups. There were no changes in the Ti discs' colour, topography, roughness and chemical elements after EC, and the electrolysis-treated Ti discs obtained a super-hydrophilic surface. EC positively impacted the proliferation and ALP activity of BMSCs, surpassing the efficacy of alternative treatments. CONCLUSIONS EC achieves a near-complete eradication of contaminants on the SLA surface, causes no surface damage with improved hydrophilicity, and promotes the early osteogenic response of BMSCs, which makes it a promising treatment for peri-implantitis.
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Affiliation(s)
- Yun Zhu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Oral Disease, Hangzhou, Zhejiang, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yangbo Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Oral Disease, Hangzhou, Zhejiang, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Zhaoting Ling
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Oral Disease, Hangzhou, Zhejiang, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Congrui Zhao
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Oral Disease, Hangzhou, Zhejiang, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Antian Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Oral Disease, Hangzhou, Zhejiang, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Fuming He
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Oral Disease, Hangzhou, Zhejiang, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, China
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Gupta TT, Zumpano B, Opalinski J, Ritchey R, Winter N, Nodzo SR, Canty M. Cathodic voltage-controlled electrical stimulation and betadine decontaminate nosocomial pathogens from implant surfaces. mSphere 2024; 9:e0058323. [PMID: 38299852 PMCID: PMC10900904 DOI: 10.1128/msphere.00583-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/21/2023] [Indexed: 02/02/2024] Open
Abstract
Periprosthetic joint infection (PJI) after total joint arthroplasty is a major concern requiring multiple surgeries and antibiotic interventions. Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli are the predominant causes of these infections. Due to biofilm formation, antibiotic treatment for patients with PJI can prolong resistance, further complicating the use of current treatments. Previous research has shown that cathodic voltage-controlled electrical stimulation (CVCES) is an effective technique to prevent/treat implant-associated biofilm infections on titanium (Ti) surfaces. This study thus evaluated the efficacy of CVCES via the use of 10% betadine alone and in combination with CVCES to eradicate lab-grown biofilms on cemented and cementless cobalt-chromium (CoCr) and Ti surfaces. CVCES treatment alone for 24 hours demonstrated no detectable CFU for E. coli and P. aeruginosa biofilms on cementless CoCr implants. In the presence of cement, E. coli biofilms had 106 CFUs/implant remaining after CVCES treatment alone; however, P. aeruginosa biofilms on cemented implants were reduced to below detectable limits. The use of 10% betadine treatment for 3 minutes followed by 24-hour CVCES treatment brought CFU levels to below detectable limits in E. coli and P. aeruginosa. The same was true for S. aureus biofilms on cementless patellofemoral implants as well as femoral and tibial implants. These treatment methods were not sufficient for eradication of S. aureus biofilms on cemented implants. These results suggest that CVCES alone and CVCES with 10% betadine are effective approaches to treating biofilms formed by certain bacterial species potentially leading to the treatment of PJI.IMPORTANCEPeriprosthetic joint infections (PJIs) are problematic due to requiring multiple surgeries and antibiotic therapies that are responsible for increased patient morbidity and healthcare costs. These infections become resistant to antibiotic treatment due to the formation of biofilms on the orthopedic surfaces. Cathodic voltage-controlled electrical stimulation (CVCES) has previously been shown to be an effective technique to prevent and treat biofilm infections on different surfaces. This study shows that CVCES can increase the efficacy of 10% betadine irrigation used in debridement, antibiotics, and implant retention by 99.9% and clear infection to below detection limits. PJI treatments are at times limited, and CVCES could be a promising technology to improve patient outcomes.
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Affiliation(s)
| | | | | | - Riley Ritchey
- Garwood Medical Devices, LLC, Buffalo, New York, USA
| | - Nathan Winter
- Department of Orthopedics & Sports Medicine, University at Buffalo, Buffalo, New York, USA
| | - Scott R Nodzo
- Department of Orthopedics & Sports Medicine, University at Buffalo, Buffalo, New York, USA
| | - Mary Canty
- Garwood Medical Devices, LLC, Buffalo, New York, USA
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3
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Weeks K, Clark C, McDermott E, Mohanraj G, Tobias M, Titus A, Duquin T, Ehrensberger MT. In vitro and in vivo assessment of extended duration cathodic voltage-controlled electrical stimulation for treatment of orthopedic implant-associated infections. J Orthop Res 2023; 41:2756-2764. [PMID: 37203783 DOI: 10.1002/jor.25625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/21/2023] [Accepted: 05/16/2023] [Indexed: 05/20/2023]
Abstract
Effective treatment of orthopedic implant-associated infections (IAIs) remains a clinical challenge. The in vitro and in vivo studies presented herein evaluated the antimicrobial effects of applying cathodic voltage-controlled electrical stimulation (CVCES) to titanium implants inoculated with preformed bacterial biofilms of methicillin-resistant Staphylococcus aureus (MRSA). The in vitro studies showed that combining vancomycin therapy (500 µg/mL) with application of CVCES at -1.75 V (all voltages are with respect to Ag/AgCl unless otherwise stated) for 24 h resulted in 99.98% reduction in the coupon-associated MRSA colony-forming units (CFUs) (3.38 × 103 vs. 2.14 × 107 CFU/mL, p < 0.001) and a 99.97% reduction in the planktonic CFU (4.04 × 104 vs. 1.26 × 108 CFU/mL, p < 0.001) as compared with the no treatment control samples. The in vivo studies utilized a rodent model of MRSA IAIs and showed a combination of vancomycin therapy (150 mg/kg twice daily) with CVCES of -1.75 V for 24 h had significant reductions in the implant associated CFU (1.42 × 101 vs. 1.2 × 106 CFU/mL, p < 0.003) and bone CFU (5.29 × 101 vs. 4.48 × 106 CFU/mL, p < 0.003) as compared with the untreated control animals. Importantly, the combined 24 h CVCES and antibiotic treatments resulted in no implant-associated MRSA CFU enumerated in 83% of the animals (five out of six animals) and no bone-associated MRSA CFU enumerated in 50% of the animals (three out of six animals). Overall, the outcomes of this study have shown that extended duration CVCES therapy is an effective adjunctive therapy to eradicate IAIs.
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Affiliation(s)
- Kyle Weeks
- Department of Biomedical Engineering, University at Buffalo, Buffalo, New York, USA
| | - Caelen Clark
- Department of Biomedical Engineering, University at Buffalo, Buffalo, New York, USA
| | - Eric McDermott
- Department of Biomedical Engineering, University at Buffalo, Buffalo, New York, USA
| | - Gowtham Mohanraj
- Department of Biomedical Engineering, University at Buffalo, Buffalo, New York, USA
| | - Menachem Tobias
- Department of Orthopaedic Surgery, University at Buffalo, Buffalo, New York, USA
| | - Albert Titus
- Department of Biomedical Engineering, University at Buffalo, Buffalo, New York, USA
| | - Thomas Duquin
- Department of Orthopaedic Surgery, University at Buffalo, Buffalo, New York, USA
| | - Mark T Ehrensberger
- Department of Biomedical Engineering, University at Buffalo, Buffalo, New York, USA
- Department of Orthopaedic Surgery, University at Buffalo, Buffalo, New York, USA
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Conforte JJ, Sousa CA, da Silva ACR, Ribeiro AV, Duque C, Assunção WG. Effect of Enterococcus faecalis Biofilm on Corrosion Kinetics in Titanium Grade 4 Alloys with Different Surface Treatments. MATERIALS (BASEL, SWITZERLAND) 2023; 16:4532. [PMID: 37444846 DOI: 10.3390/ma16134532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/09/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023]
Abstract
E. faecalis has been associated with bacteremia, sepsis, and bacterial endocarditis and peri-implantitis. This microorganism can remain in the alveolus even after extraction of the root remnant. This study aimed to evaluate the corrosion on different surfaces of commercially pure titanium (Ti) grade 4 (Ticp-G4) as a function of the bacterial biofilm effect of Enterococcus faecalis. A total of 57 discs were randomly divided according to their surface finish (n = 19). For microbiological analysis (n = 9), the discs were placed in 12-well plates containing E. faecalis culture and incubated at 37 °C for 7 days. The results show that for the intergroup analysis, considering the "electrolyte" factor, there was a difference between the groups. There was greater biofilm formation for the D.A.Zir group, with greater electrochemical exchange for Biofilm, and the presence of biofilm favored greater electrochemical exchange with the medium.
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Affiliation(s)
- Jadison Junio Conforte
- Department of Dental Materials and Prosthodontic, Araçatuba School of Dentistry, São Paulo State University (UNESP), Sao Paulo 16015-050, Brazil
| | - Cecília Alves Sousa
- Department of Dental Materials and Prosthodontic, Araçatuba School of Dentistry, São Paulo State University (UNESP), Sao Paulo 16015-050, Brazil
| | - Ana Claudia Rodrigues da Silva
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (UNESP), Sao Paulo 16015-050, Brazil
| | | | - Cristiane Duque
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (UNESP), Sao Paulo 16015-050, Brazil
| | - Wirley Gonçalves Assunção
- Department of Dental Materials and Prosthodontic, Araçatuba School of Dentistry, São Paulo State University (UNESP), Sao Paulo 16015-050, Brazil
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Luo X, Chen H, Song Y, Qin Z, Xu L, He N, Tan Y, Dessie W. Advancements, challenges and future perspectives on peptide-based drugs: Focus on antimicrobial peptides. Eur J Pharm Sci 2023; 181:106363. [PMID: 36529161 DOI: 10.1016/j.ejps.2022.106363] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
Among other health related issues, the rising concerns on drug resistance led to look for alternative pharmaceutical drugs that are effective both against infectious and noninfectious diseases. Antimicrobial peptides (AMPs) emerged as potential therapeutic molecule with wide range of applications. With their limitations, AMPs have gained reputable attentions in research as well as in the pharmaceutical industry. This review highlighted the historical background, research trends, technological advancements, challenges, and future perspectives in the development and applications of peptide drugs. Some vital questions related with the need for pharmaceutical production, factors for the slow and steady journey, the importance of oral bioavailability, and the drug resistance possibilities of AMPs were raised and addressed accordingly. Therefore, the current study is believed to provide a profound understanding in the past and current scenarios and future directions on the therapeutic impacts of peptide drugs.
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Affiliation(s)
- Xiaofang Luo
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou 412007, China; Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, 425199 Yongzhou, China
| | - Huifang Chen
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou 412007, China; Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, 425199 Yongzhou, China
| | - Yannan Song
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou 412007, China; Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, 425199 Yongzhou, China
| | - Zuodong Qin
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou 412007, China; Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, 425199 Yongzhou, China
| | - Lijian Xu
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou 412007, China
| | - Nongyue He
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou 412007, China
| | - Yimin Tan
- Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou 412007, China.
| | - Wubliker Dessie
- Hunan Engineering Technology Research Center for Comprehensive Development and Utilization of Biomass Resources, College of Chemistry and Bioengineering, Hunan University of Science and Engineering, 425199 Yongzhou, China.
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6
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Physical Approaches to Prevent and Treat Bacterial Biofilm. Antibiotics (Basel) 2022; 12:antibiotics12010054. [PMID: 36671255 PMCID: PMC9854850 DOI: 10.3390/antibiotics12010054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/11/2022] [Accepted: 12/20/2022] [Indexed: 12/30/2022] Open
Abstract
Prosthetic joint infection (PJI) presents several clinical challenges. This is in large part due to the formation of biofilm which can make infection eradication exceedingly difficult. Following an extensive literature search, this review surveys a variety of non-pharmacological methods of preventing and/or treating biofilm within the body and how they could be utilized in the treatment of PJI. Special attention has been paid to physical strategies such as heat, light, sound, and electromagnetic energy, and their uses in biofilm treatment. Though these methods are still under study, they offer a potential means to reduce the morbidity and financial burden related to multiple stage revisions and prolonged systemic antibiotic courses that make up the current gold standard in PJI treatment. Given that these options are still in the early stages of development and offer their own strengths and weaknesses, this review offers an assessment of each method, the progress made on each, and allows for comparison of methods with discussion of future challenges to their implementation in a clinical setting.
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7
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Bhowmik A, Chunhavacharatorn P, Bhargav S, Malhotra A, Sendrayakannan A, Kharkar PS, Nirmal NP, Chauhan A. Human Milk Oligosaccharides as Potential Antibiofilm Agents: A Review. Nutrients 2022; 14:nu14235112. [PMID: 36501142 PMCID: PMC9737902 DOI: 10.3390/nu14235112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/24/2022] [Accepted: 11/27/2022] [Indexed: 12/04/2022] Open
Abstract
Surface-associated bacterial communities called biofilms are ubiquitous in nature. Biofilms are detrimental in medical settings due to their high tolerance to antibiotics and may alter the final pathophysiological outcome of many healthcare-related infections. Several innovative prophylactic and therapeutic strategies targeting specific mechanisms and/or pathways have been discovered and exploited in the clinic. One such emerging and original approach to dealing with biofilms is the use of human milk oligosaccharides (HMOs), which are the third most abundant solid component in human milk after lactose and lipids. HMOs are safe to consume (GRAS status) and act as prebiotics by inducing the growth and colonization of gut microbiota, in addition to strengthening the intestinal epithelial barrier, thereby protecting from pathogens. Moreover, HMOs can disrupt biofilm formation and inhibit the growth of specific microbes. In the present review, we summarize the potential of HMOs as antibacterial and antibiofilm agents and, hence, propose further investigations on using HMOs for new-age therapeutic interventions.
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Affiliation(s)
- Ankurita Bhowmik
- Department of Microbiology, Tripura University, Agartala 799022, India
| | | | - Sharanya Bhargav
- Department of Molecular Biology, Yuvaraja’s College, Mysuru 570005, India
| | - Akshit Malhotra
- Department of Microbiology, Tripura University, Agartala 799022, India
- Invisiobiome, New Delhi 110066, India
| | - Akalya Sendrayakannan
- Department of Food Engineering and Technology, Institute of Chemical Technology (ICT), Nathalal Parekh Marg, Matunga, Mumbai 400019, India
| | - Prashant S. Kharkar
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology (ICT), Nathalal Parekh Marg, Matunga, Mumbai 400019, India
- Correspondence: (P.S.K.); (N.P.N.); (A.C.)
| | - Nilesh Prakash Nirmal
- Institute of Nutrition, Mahidol University, Salaya, Nakhon Pathom 73170, Thailand
- Correspondence: (P.S.K.); (N.P.N.); (A.C.)
| | - Ashwini Chauhan
- Department of Microbiology, Tripura University, Agartala 799022, India
- Correspondence: (P.S.K.); (N.P.N.); (A.C.)
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8
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Huang S, Fu Y, Mo A. Electrophoretic-deposited MXene titanium coatings in regulating bacteria and cell response for peri-implantitis. Front Chem 2022; 10:991481. [PMID: 36247682 PMCID: PMC9558740 DOI: 10.3389/fchem.2022.991481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Two-dimensional(2D)MXenes have continued to receive increasing interest from researchers due to their graphene-like properties, in addition to their versatile properties for applications in electronic devices, power generation, sensors, drug delivery, and biomedicine. However, their construction and biological properties as titanium coatings to prevent peri-implantitis are still unclear. Materials and methods: In this work, few-layer Ti3C2Tx MXene coatings with different thicknesses at varied depositing voltages (30, 40, and 50 V) were constructed by anodic electrophoretic deposition without adding any electrolytic ions. In vitro cytocompatibility assay was performed on preosteoblasts (MC3T3-E1) cell lines after the characterization of the coating. Meanwhile, the antibacterial activity against bacteria which are closely related to peri-implantitis including Staphylococcus aureus (S. aureus) and its drug-resistant strain MRSA was further investigated. Results: MXene-coated titanium models with different thicknesses were successfully assembled by analyzing the results of characterization. The compounding of Ti3C2Tx could significantly improve the initial adhesion and proliferation of MC3T3-E1 cells. Moreover, the coating can effectively inhibit the adhesion and cell activity of S. aureus and MRSA, and MRSA expressed greater restricting behavior than S. aureus. The ability to promote antibacterial activity is proportional to the content of Ti3C2Tx. Its antioxidant capacity to reduce ROS in the culture environment and bacterial cells was first revealed. Conclusion: In summary, this work shows a new avenue for MXene-based nano-biomaterials under the clinical problem of multiple antibiotic resistance.
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Affiliation(s)
- Si Huang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
- Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yu Fu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
- Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Anchun Mo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
- Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- *Correspondence: Anchun Mo,
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9
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Visperas A, Santana D, Klika AK, Higuera‐Rueda CA, Piuzzi NS. Current treatments for biofilm-associated periprosthetic joint infection and new potential strategies. J Orthop Res 2022; 40:1477-1491. [PMID: 35437846 PMCID: PMC9322555 DOI: 10.1002/jor.25345] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 04/11/2022] [Accepted: 04/16/2022] [Indexed: 02/04/2023]
Abstract
Periprosthetic joint infection (PJI) remains a devastating complication after total joint arthroplasty. Bacteria involved in these infections are notorious for adhering to foreign implanted surfaces and generating a biofilm matrix. These biofilms protect the bacteria from antibiotic treatment and the immune system making eradication difficult. Current treatment strategies including debridement, antibiotics, and implant retention, and one- and two-stage revisions still present a relatively high overall failure rate. One of the main shortcomings that has been associated with this high failure rate is the lack of a robust approach to treating bacterial biofilm. Therefore, in this review, we will highlight new strategies that have the potential to combat PJI by targeting biofilm integrity, therefore giving antibiotics and the immune system access to the internal network of the biofilm structure. This combination antibiofilm/antibiotic therapy may be a new strategy for PJI treatment while promoting implant retention.
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Affiliation(s)
- Anabelle Visperas
- Department of Orthopaedic SurgeryCleveland Clinic FoundationClevelandOhioUSA
| | - Daniel Santana
- Department of Orthopaedic SurgeryCleveland Clinic FoundationClevelandOhioUSA
- Cleveland Clinic Lerner College of MedicineCase Western Reserve UniversityClevelandOhioUSA
| | - Alison K. Klika
- Department of Orthopaedic SurgeryCleveland Clinic FoundationClevelandOhioUSA
| | | | - Nicolas S. Piuzzi
- Department of Orthopaedic SurgeryCleveland Clinic FoundationClevelandOhioUSA
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10
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Potter BK. CORR Insights®: What Are the Risk Factors for Mechanical Failure and Loosening of a Transfemoral Osseointegrated Implant System in Patients with a Lower-limb Amputation? Clin Orthop Relat Res 2022; 480:732-734. [PMID: 35020624 PMCID: PMC8923605 DOI: 10.1097/corr.0000000000002112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/22/2021] [Indexed: 01/31/2023]
Affiliation(s)
- Benjamin K Potter
- Uniformed Services University-Walter Reed Department of Surgery, Bethesda, MD, USA
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11
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Clark CM, Vishnoi P, Swihart MT, Ehrensberger MT. The effect of cathodic voltage-controlled electrical stimulation of titanium on the surrounding microenvironment pH: An experimental and computational study. Electrochim Acta 2021. [DOI: 10.1016/j.electacta.2021.138853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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Ehrensberger MT, Clark CM, Canty MK, McDermott EP. Electrochemical methods to enhance osseointegrated prostheses. Biomed Eng Lett 2020; 10:17-41. [PMID: 32175128 PMCID: PMC7046908 DOI: 10.1007/s13534-019-00134-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 10/11/2019] [Accepted: 10/20/2019] [Indexed: 12/19/2022] Open
Abstract
Osseointegrated (OI) prosthetic limbs have been shown to provide an advantageous treatment option for amputees. In order for the OI prosthesis to be successful, the titanium implant must rapidly achieve and maintain proper integration with the bone tissue and remain free of infection. Electrochemical methods can be utilized to control and/or monitor the interfacial microenvironment where the titanium implant interacts with the biological system (host bone tissue or bacteria). This review will summarize the current understanding of how electrochemical modalities can influence bone tissue and bacteria with specific emphasis on applications where the metallic prosthesis itself can be utilized directly as a stimulating electrode for enhanced osseointegration and infection control. In addition, a summary of electrochemical impedance sensing techniques that could be used to potentially assess osseointegration and infection status of the metallic prosthesis is presented.
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Affiliation(s)
- Mark T. Ehrensberger
- Department of Biomedical Engineering, University at Buffalo, 445 Biomedical Research Building, 3435 Main Street, Buffalo, NY 14214 USA
- Department of Orthopaedics, University at Buffalo, Buffalo, NY USA
| | - Caelen M. Clark
- Department of Biomedical Engineering, University at Buffalo, 445 Biomedical Research Building, 3435 Main Street, Buffalo, NY 14214 USA
| | - Mary K. Canty
- Department of Biomedical Engineering, University at Buffalo, 445 Biomedical Research Building, 3435 Main Street, Buffalo, NY 14214 USA
- Department of Microbiology and Immunology, University at Buffalo, Buffalo, NY USA
| | - Eric P. McDermott
- Department of Biomedical Engineering, University at Buffalo, 445 Biomedical Research Building, 3435 Main Street, Buffalo, NY 14214 USA
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13
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Wang H, Tampio AJF, Xu Y, Nicholas BD, Ren D. Noninvasive Control of Bacterial Biofilms by Wireless Electrostimulation. ACS Biomater Sci Eng 2019; 6:727-738. [DOI: 10.1021/acsbiomaterials.9b01199] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Hao Wang
- Department of Biomedical and Chemical Engineering, Syracuse University, 329 Link Hall, Syracuse, New York 13244, United States
- Syracuse Biomaterials Institute, Syracuse University, 318 Bowne Hall, Syracuse, New York 13244, United States
| | - Alex J. F. Tampio
- Department of Otolaryngology, Upstate Medical University, 750 East Adams Street, 241 Campus West, Syracuse, New York 13210, United States
| | - Yikang Xu
- Department of Biomedical and Chemical Engineering, Syracuse University, 329 Link Hall, Syracuse, New York 13244, United States
- Syracuse Biomaterials Institute, Syracuse University, 318 Bowne Hall, Syracuse, New York 13244, United States
| | - Brian D. Nicholas
- Department of Otolaryngology, Upstate Medical University, 750 East Adams Street, 241 Campus West, Syracuse, New York 13210, United States
| | - Dacheng Ren
- Department of Biomedical and Chemical Engineering, Syracuse University, 329 Link Hall, Syracuse, New York 13244, United States
- Syracuse Biomaterials Institute, Syracuse University, 318 Bowne Hall, Syracuse, New York 13244, United States
- Department of Civil and Environmental Engineering, Syracuse University, 151 Link Hall, Syracuse, New York 13244, United States
- Department of Biology, Syracuse University, 110 Life Sciences Complex, 107 College Place, Syracuse, New York 13244, United States
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