Silver Nanocoating Technology in the Prevention of Prosthetic Joint Infection

Abstract

Prosthetic joint infection (PJI) is a feared complication of total joint arthroplasty associated with increased morbidity and mortality. There is a growing body of evidence that bacterial colonization and biofilm formation are critical pathogenic events in PJI. Thus, the choice of biomaterials for implanted prostheses and their surface modifications may significantly influence the development of PJI. Currently, silver nanoparticle (AgNP) technology is receiving much interest in the field of orthopaedics for its antimicrobial properties and a strong anti-biofilm potential. The great advantage of AgNP surface modification is a minimal release of active substances into the surrounding tissue and a long period of effectiveness. As a result, a controlled release of AgNPs could ensure antibacterial protection throughout the life of the implant. Moreover, the antibacterial effect of AgNPs may be strengthened in combination with conventional antibiotics and other antimicrobial agents. Here, our main attention is devoted to general guidelines for the design of antibacterial biomaterials protected by AgNPs, its benefits, side effects and future perspectives in PJI prevention.

Facile preparation of a novel biogenic silver-loaded Nanofilm with intrinsic anti-bacterial and oxidant scavenging activities for wound healing

“…Fortunately, the qualitative and quantitative analyses confirmed a concentration-dependent "bactericidal" activity of AgNPs. This type of nanoparticles has exhibited the positive effects on wound healing, suppressing local skin inflammation and preventing pathogens from entering the skin 52,53 . Mechanistically, silver is toxic to many bacterial components such as (i) cell wall where it causes transport blockage and plasma membrane collapse, (ii) enzymatic systems such as respiratory cytochromes, and (iii) microbial DNA and RNA where it prevents transcription and division 54,55 .…”

Colonization of medical devices by staphylococci

“…As the attachment of bacteria to indwelling devices depends at least partially on the properties of the device surface, optimization of device polymer chemistry or coating with antiadhesive or antibacterial compounds, such as metal ions (silver, copper, zinc), and nanoparticle technology have been used (Swartjes et al, 2015;Gallo et al, 2016). However, these strategies have not had complete clinical success, most likely due to the fact that the devices are covered by human matrix proteins largely independently of their chemistry, an effect also prone to diminish the efficacy of device surfaceattached antibacterials.…”

Evaluation of the temporary effect of physical vapor deposition silver coating on resistance to infection in transdermal skin and bone integrated pylon with deep porosity

“…Romano et al divided antibacterial coatings of the implants into three groups: (1) passive surface modification that prevents biofilm formation; (2) active surface modification that contains pharmacologically active bactericidal agents (that is, metals or non‐metal elements, organic substances); and (3) local carriers or coatings that are applied at the time of the surgical procedure. Antibacterial coatings employing metals (i.e., silver, copper, zinc) proved to be an effective and cost‐effective strategy in reducing the risk of infectious complications…”

“…While many studies demonstrated clinical efficacy and safety of the implication of the silver‐coated implants, recent reports suggest that silver may negatively affect patient health…”