Infections @ Trauma/Orthopedic Implants: Recent Advances on Materials, Methods, and Microbes-A Mini-Review.

Britt Wildemann,Klaus D Jandt

doi:10.3390/ma14195834

Abstract

Implants and materials are indispensable in trauma and orthopedic surgery. The continuous improvements of implant design have resulted in an optimized mechanical function that supports tissue healing and restoration of function. One of the still unsolved problems with using implants and materials is infection. Trauma and material implantation change the local inflammatory situation and enable bacterial survival and material colonization. The main pathogen in orthopedic infections is Staphylococcus aureus. The research efforts to optimize antimicrobial surfaces and to develop new anti-infective strategies are enormous. This mini-review focuses on the publications from 2021 with the keywords S. aureus AND (surface modification OR drug delivery) AND (orthopedics OR trauma) AND (implants OR nails OR devices). The PubMed search yielded 16 original publications and two reviews. The original papers reported the development and testing of anti-infective surfaces and materials: five studies described an implant surface modification, three developed an implant coating for local antibiotic release, the combination of both is reported in three papers, while five publications are on antibacterial materials but not metallic implants. One review is a systematic review on the prevention of stainless-steel implant-associated infections, the other addressed the possibilities of mixed oxide nanotubes. The complexity of the approaches differs and six of them showed efficacy in animal studies.

Highlights

Due to the advances in orthopedic and trauma-care, such as modern imaging methods, improved surgical techniques, and optimized design of implants and materials, patients are successfully treated [1]
This review summarizes the latest research on anti-infective strategies in the field of orthopedics and trauma surgery focusing on materials, their modifications, and the most relevant microbe: S. aureus
The analysis showed that passive or active coating of stainless-steel implants reduces MRSA

Summary

Introduction

Due to the advances in orthopedic and trauma-care, such as modern imaging methods, improved surgical techniques, and optimized design of implants and materials, patients are successfully treated [1]. Despite these advances, infection is still a potential complication and often difficult to treat [2,3]. S. aureus are Gram-positive bacteria, which can be methicillin-sensitive (MSSA) or methicillin-resistant (MRSA). They produce virulence factors to interact with proteins of the host extracellular matrix (ECM)

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Conclusion