Antibacterial and Anti-Inflammatory Coating Materials for Orthopedic Implants: A Review

Orthopedic implant failure is the most common complication of orthopedic surgery, causing serious trauma and resulting in a tremendous economic burden for patients. There are many reasons for implant failure, among which peri-implant infection (or implant-related infection) and aseptic loosening are the most important. At present, orthopedic doctors have many methods to treat these complications, such as revision surgery, which have shown good results. However, if peri-implant infection can be prevented, this will bring about significant social benefits. Many studies have focused on adding antibacterial substances to the implant coating, and with a deeper understanding of the mechanism of implant failure, adding such substances by different modification methods has become a research hot spot. This review aims to summarize the antibacterial and anti-inflammatory substances that can be used as coating materials in orthopedic implants and to provide a reference for the prevention and treatment of implant failure caused by implant-related infection and excessive inflammation.

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Antibacterial Effect of Ginseng/polyaniline Encapsulated in Poly(Lactic-co-glycolic Acid) Microcapsules Coating on Stainless Steel 316L

MATEC Web of Conferences ◽

10.1051/matecconf/201925303001 ◽

2019 ◽

Vol 253 ◽

pp. 03001

Author(s):

Siti Khadijah Lukman ◽

Syafiqah Saidin

Keyword(s):

Stainless Steel ◽

Glycolic Acid ◽

Antibacterial Effect ◽

Bacterial Count ◽

Stainless Steel 316L ◽

Coating Materials ◽

Implant Infection ◽

Electro Deposition ◽

Implant Coating ◽

Implant Restoration

Implant infection is one the current complications of implant restoration. Incorporation of a material that possesses antibacterial property is crucial in combating implant infection. In this study, polyaniline (PANI) is incorporated in ginseng encapsulated poly (lactic-co-glycolic acid) (PLGA) microcapsules to equip the microcapsules with an antibacterial effect. The microcapsules are intended for drug delivery purpose as the ginseng is comprised of abundant therapeutic values and the PLGA is known for its degradation property. The microcapsules were coated on stainless steel 316L using an electro-deposition technique. The chemical composition, morphology and antibacterial activity of the samples were analyzed through ATR-FTIR, SEM and bacterial count test. A greater volume of microcapsules was coated on the stainless steel 316L with the addition of PANI through the appearance of intense ginseng (O–H and C=C bands) and PLGA (C=O) peaks on the ATR-FTIR spectra and through the visualization of spherical morphology of microcapsules on the pre-treated metal. The incorporation of PANI also has induced the antibacterial efficacy of the microcapsules to 87.64%. Therefore, PANI has served as an antibacterial agent that could be useful in the development of implant coating materials while driving the formation of ginseng encapsulated PLGA microcapsules.

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Effect of Metal Substrate Nanometer Topography on Osteoblast Metabolic Activities

MRS Proceedings ◽

10.1557/proc-823-w13.6 ◽

2004 ◽

Vol 823 ◽

Cited By ~ 2

Author(s):

Brian C. Ward ◽

Thomas J. Webster

Keyword(s):

Metal Surfaces ◽

Orthopedic Implants ◽

Metal Substrate ◽

Implant Failure ◽

Orthopedic Implant ◽

Energy Dispersion Spectroscopy ◽

Metal Substrates ◽

Cell Functions ◽

Metabolic Activities

AbstractSurgeons and bioengineers have continuously been challenged by implant failure. Many of these engineers and surgeons trace implant failure to poor osseointegration (the bonding of an orthopedic implant to juxtaposed bone) and to the inability of implants to match the physical properties of surrounding bone. Researchers have recently shown that nanostructured materials (or materials with fundamental length scales less than 100 nm) enhance cell functions pertinent to effectively regenerating the tissue of numerous organs. Specifically, in a recent study, researchers demonstrated that metal surfaces utilizing low-micron to nanophase topography fostered increased adhesion of osteoblasts, the cells that create the matrix of bone. In this study, Ti, Ti6Al4V, and CoCrMo alloys were investigated, and these alloys were identical to current orthopedic implant alloys except for surface topography. The objective of this in vitro research was to determine whether these same nanophase metal surfaces not only foster osteoblast adhesion but also increase osteoblast metabolic activities leading to bone regeneration. Light microscopy and Energy Dispersion Spectroscopy (EDS) were used to verify the presence of calcium and phosphorous deposition by osteoblasts cultured on the metal substrates. Results indicated that both calcium and phosphorous are being deposited on several of the metal substrates. More importantly, compared to conventional metals, results provided the first evidence that more calcium and phosphorous was deposited by osteoblasts cultured on respective nanophase metals (Ti, Ti6Al4V, and CoCrMo). Nanophase CoCrMo had the most calcium and phosphorous minerals deposited by osteoblasts compared to any other metal substrate. Thus, the results of this study continue to provide evidence for the use of nanophase metals for the design of the next generation of more successful orthopedic implants.

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Implant Complications in 20 Triple Pelvic Osteotomies

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1633059 ◽

1993 ◽

Vol 06 (04) ◽

pp. 202-207 ◽

Cited By ~ 19

Author(s):

Cindy Fries ◽

Audrey Remedios

Keyword(s):

Postoperative Complication ◽

Hip Dysplasia ◽

Pelvic Osteotomy ◽

Implant Failure ◽

Screw Loosening ◽

Common Complication ◽

Implant Complications ◽

Gait Abnormalities

SummaryIn 12 dogs with hip dysplasia, 20 triple pelvic osteotomies (eight bilateral and four unilateral) were performed. Screw loosening, occurring in six of 12 dogs (seven of 20 osteotomies), was the most common complication after surgery. Implants loosened from the cranial ilium in six hemipelvises (30%) and from both fragments in one hemipelvis, two to six weeks (mean — three) after the operation. Medial acetabular displace-ment caused pelvic narrowing (6 to 9%, mean = 8%) in three of four dogs. Medial ischial displacement decreased pelvic diameter (11 to 21%, mean = 17%) in four of seven osteotomies. All of the dogs with implant failure were treated conservatively with cage rest and in two cases Ehmer slings were used. Although none were lame, gait abnormalities were evident in three of seven dogs on follow-up examinations four to 12 months (mean = six) later.Screw loosening, occurring in seven of 20 hemipelvises, was the most common postoperative complication associated with triple pelvic osteotomy. Fixation failures were managed conservatively. Despite decreased pelvic diameter in four of seven animals, none were lame or showed signs of pelvic obstruction at follow-up examinations four to 12 months later.

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Recent Developments in Coatings for Orthopedic Metallic Implants

Coatings ◽

10.3390/coatings11070791 ◽

2021 ◽

Vol 11 (7) ◽

pp. 791

Author(s):

Muzamil Hussain ◽

Syed Hasan Askari Rizvi ◽

Naseem Abbas ◽

Uzair Sajjad ◽

Muhammad Rizwan Shad ◽

...

Keyword(s):

Stress Shielding ◽

Orthopedic Implant ◽

Coating Materials ◽

Implant Materials ◽

Metallic Implants ◽

Common Causes ◽

Recent Developments ◽

Orthopedic Applications ◽

The Impact ◽

Cocrmo Alloys

Titanium, stainless steel, and CoCrMo alloys are the most widely used biomaterials for orthopedic applications. The most common causes of orthopedic implant failure after implantation are infections, inflammatory response, least corrosion resistance, mismatch in elastic modulus, stress shielding, and excessive wear. To address the problems associated with implant materials, different modifications related to design, materials, and surface have been developed. Among the different methods, coating is an effective method to improve the performance of implant materials. In this article, a comprehensive review of recent studies has been carried out to summarize the impact of coating materials on metallic implants. The antibacterial characteristics, biodegradability, biocompatibility, corrosion behavior, and mechanical properties for performance evaluation are briefly summarized. Different effective coating techniques, coating materials, and additives have been summarized. The results are useful to produce the coating with optimized properties.

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Infections @ Trauma/Orthopedic Implants: Recent Advances on Materials, Methods, and Microbes—A Mini-Review

Materials ◽

10.3390/ma14195834 ◽

2021 ◽

Vol 14 (19) ◽

pp. 5834

Author(s):

Britt Wildemann ◽

Klaus D. Jandt

Keyword(s):

Surface Modification ◽

Animal Studies ◽

Orthopedic Implants ◽

Implant Design ◽

Bacterial Survival ◽

Implant Surface ◽

Antimicrobial Surfaces ◽

Pubmed Search ◽

Implant Coating ◽

Antibiotic Release

Implants and materials are indispensable in trauma and orthopedic surgery. The continuous improvements of implant design have resulted in an optimized mechanical function that supports tissue healing and restoration of function. One of the still unsolved problems with using implants and materials is infection. Trauma and material implantation change the local inflammatory situation and enable bacterial survival and material colonization. The main pathogen in orthopedic infections is Staphylococcus aureus. The research efforts to optimize antimicrobial surfaces and to develop new anti-infective strategies are enormous. This mini-review focuses on the publications from 2021 with the keywords S. aureus AND (surface modification OR drug delivery) AND (orthopedics OR trauma) AND (implants OR nails OR devices). The PubMed search yielded 16 original publications and two reviews. The original papers reported the development and testing of anti-infective surfaces and materials: five studies described an implant surface modification, three developed an implant coating for local antibiotic release, the combination of both is reported in three papers, while five publications are on antibacterial materials but not metallic implants. One review is a systematic review on the prevention of stainless-steel implant-associated infections, the other addressed the possibilities of mixed oxide nanotubes. The complexity of the approaches differs and six of them showed efficacy in animal studies.

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Magnesium-containing layered double hydroxides as orthopaedic implant coating materials-Anin vitroandin vivostudy

Journal of Biomedical Materials Research Part B Applied Biomaterials ◽

10.1002/jbm.b.33422 ◽

2015 ◽

Vol 104 (3) ◽

pp. 525-531 ◽

Cited By ~ 13

Author(s):

Andreas Weizbauer ◽

Marc Kieke ◽

Muhammad Imran Rahim ◽

Gian Luigi Angrisani ◽

Elmar Willbold ◽

...

Keyword(s):

Layered Double Hydroxides ◽

Orthopaedic Implant ◽

Coating Materials ◽

Implant Coating ◽

Double Hydroxides

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C-Reactive Protein, Erythrocyte Sedimentation Rate and Orthopedic Implant Infection

Yearbook of Orthopedics ◽

10.1016/j.yort.2011.04.137 ◽

2011 ◽

Vol 2011 ◽

pp. 343-345

Author(s):

P.M. Huddleston

Keyword(s):

Erythrocyte Sedimentation Rate ◽

Sedimentation Rate ◽

Orthopedic Implant ◽

C Reactive Protein ◽

Implant Infection ◽

Reactive Protein ◽

Erythrocyte Sedimentation

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Research: Recovery of Microorganisms in Nonsterile, Reusable, Loaned Orthopedic Implants

Biomedical Instrumentation & Technology ◽

10.2345/0899-8205-53.5.351 ◽

2019 ◽

Vol 53 (5) ◽

pp. 351-354

Author(s):

Carla Moraes ◽

Camila Q.M. Bruna ◽

Cristiane de Lion Botero Couto Lope ◽

Kazuko U. Graziano

Keyword(s):

Antimicrobial Agents ◽

Orthopedic Implants ◽

Orthopedic Implant ◽

Organic Residues ◽

Coagulase Negative Staphylococci ◽

Service Department ◽

Important Note ◽

Joint Prostheses ◽

To Receive

Abstract Currently, there are two orthopedic implant types: (1) Sterile implants (e.g., joint prostheses) are distributed in a ready-for-use sterile fashion, and (2) nonsterile implants (e.g., plates, screws, Schanz pins, intramedullary rods) are processed by a healthcare facility's central sterile service department (CSSD). The current study evaluated processed implants for presence of coagulase-negative staphylococci, which was observed in 30% of the cortical screws, spongy screws, and Schanz pins (37 total samples) processed by a CSSD. Some samples were resistant to antimicrobial agents, thereby demonstrating that risk exists in the current methods used in the processing of nonsterile implants. Also of important note, nonsterile implants are commonly loaned worldwide. Loaned implantable materials should not be processed in the same manner as materials routinely prepared in the CSSD, as it is not possible to know the quality of the cleaning performed before the materials are returned to the loaning company. It is not uncommon for hospitals to receive loaned materials with organic residues.

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