Remote Eradication of Bacteria on Orthopedic Implants via Delayed Delivery of Polycaprolactone Stabilized Polyvinylpyrrolidone Iodine

Abstract

Bacteria-associated late infection of the orthopedic devices would further lead to the failure of the implantation. However, present ordinary antimicrobial strategies usually deal with early infection but fail to combat the late infection of the implants due to the burst release of the antibiotics. Thus, to fabricate long-term antimicrobial (early antibacterial, late antibacterial) orthopedic implants is essential to address this issue. Herein, we developed a sophisticated MAO-I2-PCLx coating system incorporating an underlying iodine layer and an upper layer of polycaprolactone (PCL)-controlled coating, which could effectively eradicate the late bacterial infection throughout the implantation. Firstly, micro-arc oxidation was used to form a microarray tubular structure on the surface of the implants, laying the foundation for iodine loading and PCL bonding. Secondly, electrophoresis was applied to load iodine in the tubular structure as an efficient bactericidal agent. Finally, the surface-bonded PCL coating acts as a controller to regulate the release of iodine. The hybrid coatings displayed great stability and control release capacity. Excellent antibacterial ability was validated at 30 days post-implantation via in vitro experiments and in vivo rat osteomyelitis model. Expectedly, it can become a promising bench-to-bedside strategy for current infection challenges in the orthopedic field.

Micro-Arc Oxidation in Titanium and Its Alloys: Development and Potential of Implants

“…The coating with 6.2% Bi displayed good biocompatibility with MG63 cells and demonstrated 1.5 times higher antibacterial efficacy against A. actinomycetemcomitans and 1.9 times higher efficacy against methicillin-resistant Staphylococcus aureus (MRSA) compared to the control group. MAO technology can also incorporate other non-metallic antibacterial ingredients into the coating, such as Ce [139], Se [103], I [140,141], B [142,143], and F [144][145][146].…”

Review of Selected Orthopaedic Implants for their Genotoxicity Potential

“…If the wrong material is used, the implants themselves may cause bone fractures, deformities, or incomplete bone healing (11) . The failure of the implantation would be further increased by bacteria-related late infection of the orthopaedic devices (12) . The two most common complications that arises after the implantations are aseptic loosening and prosthetic joint infection other than the toxicity (13) .…”