Clinical Orthopaedics and Related Research®

, Volume 471, Issue 8, pp 2532–2539

A Silver Ion-doped Calcium Phosphate-based Ceramic Nanopowder-coated Prosthesis Increased Infection Resistance

  • Nusret Kose
  • Ali Otuzbir
  • Ceren Pekşen
  • Abdurrahman Kiremitçi
  • Aydın Doğan
Symposium: Nanoscience in Musculoskeletal Medicine

DOI: 10.1007/s11999-013-2894-x

Cite this article as:
Kose, N., Otuzbir, A., Pekşen, C. et al. Clin Orthop Relat Res (2013) 471: 2532. doi:10.1007/s11999-013-2894-x

Abstract

Background

Despite progress in surgical techniques, 1% to 2% of joint arthroplasties become complicated by infection. Coating implant surfaces with antimicrobial agents have been attempted to prevent initial bacterial adhesion to implants with varying success rates. We developed a silver ion-containing calcium phosphate-based ceramic nanopowder coating to provide antibacterial activity for orthopaedic implants.

Questions/purposes

We asked whether titanium prostheses coated with this nanopowder would show resistance to bacterial colonization as compared with uncoated prostheses.

Methods

We inserted titanium implants (uncoated [n = 9], hydroxyapatite-coated [n = 9], silver-coated [n = 9]) simulating knee prostheses into 27 rabbits’ knees. Before implantation, 5 × 102 colony-forming units of Staphylococcus aureus were inoculated into the femoral canal. Radiology, microbiology, and histology findings were quantified at Week 6 to define the infection, microbiologically by increased rate of implant colonization/positive cultures, histologically by leukocyte infiltration, necrosis, foreign-body granuloma, and devitalized bone, and radiographically by periosteal reaction, osteolysis, or sequestrum formation.

Results

Swab samples taken from medullary canals and implants revealed a lower proportion of positive culture in silver-coated implants (one of nine) than in uncoated (eight of nine) or hydroxyapatite-coated (five of nine) implants. Silver-coated implants also had a lower rate of colonization. No cellular inflammation or foreign-body granuloma was observed around the silver-coated prostheses.

Conclusions

Silver ion-doped ceramic nanopowder coating of titanium implants led to an increase in resistance to bacterial colonization compared to uncoated implants.

Clinical Relevance

Silver-coated orthopaedic implants may be useful for resistance to local infection but will require in vivo confirmation.

Copyright information

© The Association of Bone and Joint Surgeons® 2013

Authors and Affiliations

  • Nusret Kose
    • 1
  • Ali Otuzbir
    • 1
  • Ceren Pekşen
    • 2
  • Abdurrahman Kiremitçi
    • 3
  • Aydın Doğan
    • 2
  1. 1.Department of Orthopaedics and Traumatology, Medical FacultyOsmangazi UniversityEskisehirTurkey
  2. 2.Department of Materials Science and EngineeringAnadolu UniversityEskisehirTurkey
  3. 3.Department of Microbiology, Medical FacultyOsmangazi UniversityEskisehirTurkey