Gentamicin coating of plasma chemical oxidized titanium alloy prevents implant-related osteomyelitis in rats

被引：76

作者：

Diefenbeck, M. ^{[1
]}

Schrader, C. ^{[2
]}

Gras, F. ^{[1
]}

Mueckley, T. ^{[1
]}

Schmidt, J. ^{[2
]}

Zankovych, S. ^{[3
]}

Bossert, J. ^{[3
]}

Jandt, K. D. ^{[3
,4
]}

Voelpel, A. ^{[5
]}

Sigusch, B. W. ^{[5
]}

Schubert, H. ^{[6
]}

Bischoff, S. ^{[6
]}

Pfister, W. ^{[7
]}

Edel, B. ^{[7
]}

Faucon, M. ^{[8
]}

Finger, U. ^{[8
]}

机构：

[1] Univ Hosp Jena, Dept Trauma Hand & Reconstruct Surg, Erlanger Allee 101, D-07747 Jena, Germany

[2] Innovent Technol Dev, Prussingstr 27 B, D-07745 Jena, Germany

[3] Univ Jena, Fac Phys & Astron, Chair Mat Sci, Otto Schott Inst Mat Res OSIM, Lobdergraben 32, D-07743 Jena, Germany

[4] Univ Jena, Excellence Grad Sch Jena Sch Microbial Commun JSM, Neugasse 23, D-07743 Jena, Germany

[5] Univ Hosp Jena, Dept Conservat Dent & Periodontol, Alten Post 4, D-07743 Jena, Germany

[6] Univ Hosp Jena, Inst Expt Anim Sci & Anim Protect, Dornburger Str 23, D-07743 Jena, Germany

[7] Univ Klinikum Jena, Inst Med Microbiol, Erlanger Allee 101, D-07747 Jena, Germany

[8] Konigsee Implantate GmbH, OT Aschau Sand 4, D-07426 Allendorf, Germany

来源：

BIOMATERIALS | 2016年 / 101卷

关键词：

Plasma chemical oxidation; Titanium alloys; Implant-related infection; Animal model; Gentamicin coating; SDS; Tannic acid; TANNIC-ACID; INFECTION; BIOMATERIALS; PROPHYLAXIS; EFFICACY;

D O I：

10.1016/j.biomaterials.2016.05.039

中图分类号：

R318 [生物医学工程];

学科分类号：

0831 ;

摘要：

Implant related infection is one of the most feared and devastating complication associated with the use of orthopaedic implant devices. Development of anti-infective surfaces is the main strategy to prevent implant contamination, biofilm formation and implant related osteomyelitis. A second concern in orthopaedics is insufficient osseointegration of uncemented implant devices. Recently, we reported on a macroporous titanium-oxide surface (bioactive TiOB) which increases osseointegration and implant fixation. To combine enhanced osseointegration and antibacterial function, the TiOB surfaces were, in addition, modified with a gentamicin coating. A rat osteomyelitis model with bilateral placement of titanium alloy implants was employed to analyse the prophylactic effect of gentamicin-sodiumdodecylsulfate (SDS) and gentamicin-tannic acid coatings in vivo. 20 rats were randomly assigned to four groups: (A) titanium alloy; PBS inoculum (negative control), (B) titanium alloy, Staphylococcus aureus inoculum (positive control), (C) bioactive TiOB with gentamicin-SDS and (D) bioactive TiOB plus gentamicin-tannic acid coating. Contamination of implants, bacterial load of bone powder and radiographic as well as histological signs of implant-related osteomyelitis were evaluated after four weeks. Gentamicin-SDS coating prevented implant contamination in 10 of 10 tibiae and gentamicin-tannic acid coating in 9 of 10 tibiae (infection prophylaxis rate 100% and 90% of cases, respectively). In Group (D) one implant showed colonisation of bacteria (swab of entry point and roll-out test positive for S. aureus). The interobserver reliability showed no difference in the histologic and radiographic osteomyelitis scores. In both gentamicin coated groups, a significant reduction of the histological osteomyelitis score (geometric mean values: C = 0.111 +/- 0.023; D = 0.056 +/- 0.006) compared to the positive control group (B: 0.244 +/- 0.015; p < 0.05) was observed. The radiographic osteomyelitis scores confirmed these histological findings. (C) 2016 Elsevier Ltd. All rights reserved.

引用

页码：156 / 164

页数：9

共 29 条

[1] Animal models of orthopedic implant infection [J].

An, YHH ;

Friedman, RJ .

JOURNAL OF INVESTIGATIVE SURGERY, 1998, 11 (02) :139-146

[2] Identification and preoperative optimization of risk factors to prevent periprosthetic joint infection [J].

Baek, Seung-Hoon .

WORLD JOURNAL OF ORTHOPEDICS, 2014, 5 (03) :362-367

[3] A review of the biomaterials technologies for infection-resistant surfaces [J].

Campoccia, Davide ;

Montanaro, Lucio ;

Arciola, Carla Renata .

BIOMATERIALS, 2013, 34 (34) :8533-8554

[4] A review of the clinical implications of anti-infective biomaterials and infection-resistant surfaces [J].

Campoccia, Davide ;

Montanaro, Lucio ;

Arciola, Carla Renata .

BIOMATERIALS, 2013, 34 (33) :8018-8029

[5] Prophylaxis and treatment of implant-related infections by local application of antibiotics [J].

Diefenbeck, Michael ;

Mueckley, Thomas ;

Hofmann, Gunther O. .

INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 2006, 37 :95-104

[6] The effect of plasma chemical oxidation of titanium alloy on bone-implant contact in rats [J].

Diefenbeck, Michael ;

Mueckley, Thomas ;

Schrader, Christian ;

Schmidt, Jurgen ;

Zankovych, Sergiy ;

Bossert, Joerg ;

Jandt, Klaus D. ;

Faucon, Mathilde ;

Finger, Ulrich .

BIOMATERIALS, 2011, 32 (32) :8041-8047

[7] The use of gentamicin-coated nails in the tibia: preliminary results of a prospective study [J].

Fuchs, Thomas ;

Stange, Richard ;

Schmidmaier, Gerhard ;

Raschke, Michael J. .

ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, 2011, 131 (10) :1419-1425

[8] BIOMATERIAL-CENTERED INFECTION - MICROBIAL ADHESION VERSUS TISSUE INTEGRATION [J].

GRISTINA, AG .

SCIENCE, 1987, 237 (4822) :1588-1595

[9] PREVENTION OF INFECTION IN TREATMENT OF 1000 AND 25 OPEN FRACTURES OF LONG BONES - RETROSPECTIVE AND PROSPECTIVE ANALYSES [J].

GUSTILO, RB ;

ANDERSON, JT .

JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1976, 58 (04) :453-458

[10] Impact of 3D Hierarchical Nanostructures on the Antibacterial Efficacy of a Bacteria-Triggered Self-Defensive Antibiotic Coating [J].

Hizal, Ferdi ;

Zhuk, Iryna ;

Sukhishvili, Svetlana ;

Busscher, Henk J. ;

van der Mei, Henny C. ;

Choi, Chang-Hwan .

ACS APPLIED MATERIALS & INTERFACES, 2015, 7 (36) :20304-20313

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