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Nanoparticle ultrasonication outperforms conventional irrigation solutions in eradicating Staphylococcus aureus biofilm from titanium surfaces: an in vitro study

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Bacterial biofilms create a challenge in the treatment of prosthetic joint infection (PJI), and failure to eradicate biofilms is often implicated in the high rates of recurrence. In this study, we aimed to compare the effectiveness of a novel nanoparticle ultrasonication technology on Staphylococcus aureus biofilm eradication compared to commonly used orthopedic irrigation solutions.

Methods

Twenty-four sterile, titanium alloy discs were inoculated with a standardized concentration of methicillin-resistant S. aureus and cultured for seven days to allow for biofilm formation. Discs were then treated with either ultrasonicated nanoparticle therapy or irrigation with chlorhexidine gluconate, povidone-iodine or normal saline. The remaining bacteria on each surface was subsequently plated for colony-forming units of S. aureus. Bacterial eradication was reported as a decrease in CFUs relative to the control group. Mann–Whitney U tests were used to compare between groups.

Results

Treatment with ultrasonicated nanoparticles resulted in a significant mean decrease in CFUs of 99.3% compared to controls (p < 0.0001). Irrigation with povidone-iodine also resulted in a significant 77.5% reduction in CFUs compared to controls (p < 0.0001). Comparisons between ultrasonicated nanoparticles and povidone-iodine demonstrated a significantly higher reduction in bacterial CFUs in the nanoparticle group (p < 0.0001).

Conclusion

Ultrasonicated nanoparticle were superior to commonly used bactericidal irrigation solutions in the eradication of S. aureus from a titanium surface. Future clinical studies are warranted to evaluate this ultrsonication technology in the treatment of PJI.

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Acknowledgements

Dr. Ran Schwarzkopf an unpaid advisor to Dimoveo Medical. He is a paid consultant for Smith + Nephew and Intellijoint. He receives research support from Smith + Nephew, Osteal and Aerobix as well as royalties from Smith + Nephew related to design. He also has stock options related to Intellijoint, Gauss Surgical and PSI. Yair Ramot is the CEO of Dimoveo Medical and Roi Ramot is the R&D manager of Dimoveo Medical which are directly relevant to this study. The rest of the authors listed have no financial or otherwise relevant disclosures.

Funding

There was no outside funding for this study.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, 301 East 17Th Street, New York, NY, 10003, USA

    Benjamin C. Schaffler & Ran Schwarzkopf

  2. Center for Excellence in Biofilm Research, Allegheny Health Network Research Institute, Pittsburgh, PA, USA

    Mark Longwell, Barbara Byers, Rachel Kreft, Roi Ramot & Yair Ramot

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  1. Benjamin C. Schaffler
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  2. Mark Longwell
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Contributions

Roi Ramot and Yair Ramot are cofounders of the startup, Dimoveo Medical™, which developed and is the proprieter for some of the new technology discussed in this manuscript. Ran Schwarzkopf is an unpaid consultant for Dimoveo Medical ™. Dimoveo donated samples of the technology for in vitro testing, however, did not supply additional funding. No other authors have disclosures relevant to the current manuscript and topic. 

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Correspondence to Ran Schwarzkopf.

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Schaffler, B.C., Longwell, M., Byers, B. et al. Nanoparticle ultrasonication outperforms conventional irrigation solutions in eradicating Staphylococcus aureus biofilm from titanium surfaces: an in vitro study. Eur J Orthop Surg Traumatol (2024). https://doi.org/10.1007/s00590-024-03982-y

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