Antibacterial Surface Design of Titanium-Based Biomaterials for Enhanced Bacteria-Killing and Cell-Assisting Functions Against Periprosthetic Joint Infection

Abstract

Periprosthetic joint infection (PJI) is one of the formidable and recalcitrant complications after orthopedic surgery, and inhibiting biofilm formation on the implant surface is considered crucial to prophylaxis of PJI. However, it has recently been demonstrated that free-floating biofilm-like aggregates in the local body fluid and bacterial colonization on the implant and peri-implant tissues can coexist and are involved in the pathogenesis of PJI. An effective surface with both contact-killing and release-killing antimicrobial capabilities can potentially abate these concerns and minimize PJI caused by adherent/planktonic bacteria. Herein, Ag nanoparticles (NPs) are embedded in titania (TiO2) nanotubes by anodic oxidation and plasma immersion ion implantation (PIII) to form a contact-killing surface. Vancomycin is then incorporated into the nanotubes by vacuum extraction and lyophilization to produce the release-killing effect. A novel clinical PJI model system involving both in vitro and in vivo use of methicillin-resistant Staphylococcus aureus (MRSA) ST239 is established to systematically evaluate the antibacterial properties of the hybrid surface against planktonic and sessile bacteria. The vancomycin-loaded and Ag-implanted TiO2 nanotubular surface exhibits excellent antimicrobial and antibiofilm effects against planktonic/adherent bacteria without appreciable silver ion release. The fibroblasts/bacteria cocultures reveal that the surface can help fibroblasts to combat bacteria. We first utilize the nanoarchitecture of implant surface as a bridge between the inorganic bactericide (Ag NPs) and organic antibacterial agent (vancomycin) to achieve total victory in the battle of PJI. The combination of contact-killing and release-killing together with cell-assisting function also provides a novel and effective strategy to mitigate bacterial infection and biofilm formation on biomaterials and has large potential in orthopedic applications.

Highly Effective and Noninvasive Near‐Infrared Eradication of a Staphylococcus aureus Biofilm on Implants by a Photoresponsive Coating within 20 Min

“…[57] Figure 7C showed the hematoxylin and eosin (H&E) staining results, and in Ti implant group, the typical features of soft tissue infections included significant acute inflammation and neutrophil infiltration into tissues (marked by yellow arrows) after 808 nm light irradiation for 20 min and after treatment in the dark. [57] Figure 7C showed the hematoxylin and eosin (H&E) staining results, and in Ti implant group, the typical features of soft tissue infections included significant acute inflammation and neutrophil infiltration into tissues (marked by yellow arrows) after 808 nm light irradiation for 20 min and after treatment in the dark.…”

A functionalized surface modification with vanadium nanoparticles of various valences against implant-associated bloodstream infection

“…To investigate the antimicrobial behavior and mechanism of the vanadium-nanoparticle films, we adopted a comparative study method of using GSH antioxidant to evaluate antibacterial ability, with reference to in vitro antibacterial tests in previous studies, 20,35 which usually focused on exploring the effects that the materials exerted on planktonic and sessile bacteria. After 24 hours of culture on glass, V0, V3, V4, and V5 with/without GSH coincubation, the planktonic bacteria (MRSA and P. aeruginosa) were firstly collected and recultivated on SBA overnight.…”

Preparing and immobilizing antimicrobial osteogenic growth peptide on titanium substrate surface

“…It is well known that once the bacteria adhere and proliferate to form a biofilm on the implant surface, the protective and polymeric extracellular substance will render these bacteria substantially difficult to eradicate, so then cause implant‐associated infection . But if the host's cells can occupy the implant surface first, it will not only be beneficial to stronger tissue integration, but also establish a defensive barrier to against bacteria attachment and colonization . Therefore, it is necessary to functionalize pure Ti surface for both strong osseointegration and effective antibacterial property which are required for a successful implant.…”