Topographic features retained after antibiotic modification of Ti alloy surfaces: retention of topography with attachment of antibiotics.
Periprosthetic infection is increasingly prevalent in orthopaedics with infection rates of 2% to 15% after total hip arthroplasty. To effectively decrease bacterial attachment, colonization, and subsequent development of periprosthetic infection, we previously described a method to covalently bond vancomycin to smooth Ti alloy surfaces. To attach vancomycin, the Ti surface is first passivated to create a fresh oxide layer. Previously, passivation has been achieved with an H2SO4/H2O2 etch that can destroy the topography of the underlying implant. Passivation by hydrothermal aging as well as by H2SO4/H2O2 incubation produced a robust oxide layer, but only hydrothermal aging left the geometry unaltered. These hydrothermally passivated Kirschner wires and smooth or beaded Ti surfaces were chemically coupled with vancomycin. Antibiotic-coupled samples representing all three geometries were uniformly covered with antibiotic, resisted colonization by Staphylococcus aureus for longer than 8 hours, and retained their biocompatibility as assessed by normal attachment and morphology of preosteocytic MLO-A5 cells. Using this technique, we believe it is possible to passivate many complex implant designs/geometries as a first step toward covalent bonding of antibiotics or other bioactive factors.
Department of Orthopedic Surgery, Thomas Jefferson University, 1015 Walnut Street, Suite 501, Philadelphia, PA 19107, USA.
Constantinos
C
Ketonis
Javad
J
Parvizi
Christopher S
CS
Adams
Irving M
IM
Shapiro
Noreen J
NJ
Hickok
D000900:Anti-Bacterial Agents / Q000737:chemistry*; D001422:Bacterial Adhesion / Q000187:drug effects; D006358:Hot Temperature; D006801:Humans; D006861:Hydrogen Peroxide / Q000737:chemistry; D057927:Hydrophobic and Hydrophilic Interactions; D008422:Materials Testing; D008855:Microscopy, Electron, Scanning; D019637:Orthopedic Procedures; D010084:Oxidation-Reduction; D016459:Prosthesis-Related Infections / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000254:growth & development; D013464:Sulfuric Acids / Q000737:chemistry; D014025:Titanium / Q000737:chemistry*; D014640:Vancomycin / Q000737:chemistry*
D000900:Anti-Bacterial Agents; D013464:Sulfuric Acids; D014640:Vancomycin; D006861:Hydrogen Peroxide; D014025:Titanium