Abstract
Prosthetic joint infection (PJI) is a feared complication of total joint arthroplasty associated with increased morbidity and mortality. There is a growing body of evidence that bacterial colonization and biofilm formation are critical pathogenic events in PJI. Thus, the choice of biomaterials for implanted prostheses and their surface modifications may significantly influence the development of PJI. Currently, silver nanoparticle (AgNP) technology is receiving much interest in the field of orthopaedics for its antimicrobial properties and a strong anti-biofilm potential. The great advantage of AgNP surface modification is a minimal release of active substances into the surrounding tissue and a long period of effectiveness. As a result, a controlled release of AgNPs could ensure antibacterial protection throughout the life of the implant. Moreover, the antibacterial effect of AgNPs may be strengthened in combination with conventional antibiotics and other antimicrobial agents. Here, our main attention is devoted to general guidelines for the design of antibacterial biomaterials protected by AgNPs, its benefits, side effects and future perspectives in PJI prevention.
Highlights
Prosthetic joint infection (PJI) is a feared complication of modern orthopaedic surgery that substantially increases morbidity and even mortality following total joint arthroplasty (TJA) [1,2].Generally, PJI leads to implant removal and long-term antibiotic therapy with a permanent, increased risk for PJI development in affected patients [3].Current estimates suggest that up to 3% of primary hip and knee arthroplasties [4], up to 15.4%of revision hip and 25% of knee arthroplasties are complicated by PJI respectively [5]
The leading causes of PJIs are S. aureus and coagulase-negative staphylocci followed by streptococci and enterococci [10,11]
In the study [87], TiO2 nanotubes (NT) on a titanium (Ti) surface were prepared by anodization of the Ti surface and AgNTs were generated on the NT surface by ultraviolet reduction of silver ions
Summary
Prosthetic joint infection (PJI) is a feared complication of modern orthopaedic surgery that substantially increases morbidity and even mortality following total joint arthroplasty (TJA) [1,2]. Of revision hip and 25% of knee arthroplasties are complicated by PJI respectively [5]. The leading causes of PJIs are S. aureus and coagulase-negative staphylocci followed by streptococci and enterococci (all of these account for approximately 10% of PJI cases) [10,11]. Polymicrobial infections can occur in up to 15% of cases [13] despite the fact that some authors reported a substantial increase in the yearly occurrence of polymicrobial infections over the period of six years (2004 to 2010) with a greater increase in the proportion of gram-negative bacteria during the same period [14]
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