Antimicrobial prosthesis coatings

Background. Antimicrobial coatings have a great potential in the treatment and prevention of periprosthetic joint infection. Objective. To present established and novel concepts of antimicrobial coatings. Methods. A literature review and discussion of published concepts in basic research, pre-clinical animal studies, and clinical practice were carried out. Results. To date there has been a wide range of technical solutions (anti-adhesive surfaces, bioactive surfaces with antimicrobial effects, surfaces releasing antimicrobial substances, nanostructures, bioactive surfaces affecting biofilm development) demonstrating a high potential in pre-clinical studies. Only a few with the bactericidal activity of silver ions have been prepared for the market. Conclusive results with regard to biocompatibility and toxicity are lacking. Discussion. Despite the great potential of antimicrobial coatings, no conclusive decisions can be made because of the limited data and the lack of evidence of their clinical efficacy on the basis of prospective controlled clinical studies. In addition to their unlimited biocompatibility, innovative concepts have to be feasible in everyday clinical routine.