Abstract
Periprosthetic infection remains one of the most serious complications following megaendoprostheses. Despite a large number of preventive measures that have been introduced in recent years, it has not been possible to further reduce the rate of periprosthetic infection. With regard to metallic modification of implants, silver in particular has been regarded as highly promising, since silver particles combine a high degree of antimicrobial activity with a low level of human toxicity. This review provides an overview of the history of the use of silver as an antimicrobial agent, its mechanism of action, and its clinical application in the field of megaendoprosthetics. The benefits of silver-coated prostheses could not be confirmed until now. However, a large number of retrospective studies suggest that the rate of periprosthetic infections could be reduced by using silver-coated megaprostheses.
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Acknowledgements
A. Streitbuerger receives research support from Implantcast. G. Gosheger obtains royalties for patent with Implantcast. F. Boettner is a consultant for Smith and Nephew, OrthoDevelopement and DePuy.
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G. Gosheger has patent silver with royalties paid. F. Boettner is a consultant for Smith and Nephew, OrthoDevelopement and DePuy. The other authors (T.S.B., A.S., M.N., H.A., R.D., W.G., D.A., G.H., B.M., W.W., and J.H.) declare that there is no conflict of interest regarding the publication of this paper.
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Schmidt-Braekling, T., Streitbuerger, A., Gosheger, G. et al. Silver-coated megaprostheses: review of the literature. Eur J Orthop Surg Traumatol 27, 483–489 (2017). https://doi.org/10.1007/s00590-017-1933-9
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DOI: https://doi.org/10.1007/s00590-017-1933-9