Silver nanoparticles and their orthopaedic applications

Abstract

Implant-associated infection is a major source of morbidity in orthopaedic surgery. There has been extensive research into the development of materials that prevent biofilm formation, and hence, reduce the risk of infection. Silver nanoparticle technology is receiving much interest in the field of orthopaedics for its antimicrobial properties, and the results of studies to date are encouraging. Antimicrobial effects have been seen when silver nanoparticles are used in trauma implants, tumour prostheses, bone cement, and also when combined with hydroxyapatite coatings. Although there are promising results with in vitro and in vivo studies, the number of clinical studies remains small. Future studies will be required to explore further the possible side effects associated with silver nanoparticles, to ensure their use in an effective and biocompatible manner. Here we present a review of the current literature relating to the production of nanosilver for medical use, and its orthopaedic applications. Silver is a soft, white, lustrous transition metal which is recognised to have antimicrobial properties and has assumed an important role in the treatment of infections.1-3 As a non-specific biocidal agent, in suitable doses silver is not toxic to mammalian cells and disinfects a broad spectrum of bacterial and fungal species, including antibiotic-resistant strains.1-3 Silver and silver nanoparticles are used as antimicrobials in a variety of industrial, healthcare and domestic applications. 4,5 Silver has been incorporated into wound dressings, and as an antimicrobial coating on medical devices in order to prevent biofilm formation.6 The clinical potential of silver nanotechnology is of particular interest to the field of orthopaedics, where infection of implanted devices represents a persistent threat. In this paper we provide a review of the literature on the use of silver nanoparticles and their application in the field of orthopaedics. In addition, we review the potential for toxicity if silver is not used with caution.

Nanotoxicity of Inert Materials: The Case of Gold, Silver and Iron

“…DNA (106)(107)(108). In addition, they can also synergize efficacy of many antibiotics and has opened new horizon to treat MDR infections (109). Now, various orthopedic devices and wound dressings are available in market with AgNPs coatings to prevent against microbial contamination of underlying wound (110).…”

Atomic layer deposition of nano-TiO_2 thin films with enhanced biocompatibility and antimicrobial activity for orthopedic implants

“…For example, silver nanoparticle technology is receiving much interest in the field of orthopedics for its antimicrobial properties; however, at present, concerns have been raised regarding their toxic effect on mammalian cells. 7,8 For a successful implant, strong osseointegration and antiinfection properties are indispensable, necessitating implant designs to satisfy both simultaneously. 9 It is clear that both chemical and physical properties of the surface play a major role in modulating the biological events directly at the tissue-implant interface.…”

Antimicrobial and antibiofilm activities of MTA supplemented with bismuth lipophilic nanoparticles

“…Early reports show adhesives and composites supplemented with nanoparticles to provide bactericidal and remineralizing properties 27,28) . 32,33) . However bismuth nanoparticles have several advantages; are non-carcinogenic, less bioaccumulative and cytotoxic than other "heavy" metals including antimony, lead and silver 7,8,34) .…”