title: Biofilms in periprosthetic orthopedic infections.
abstract: As the number of total joint arthroplasty and internal fixation procedures continues to rise, the threat of infection following surgery has significant clinical implications. These infections may have highly morbid consequences to patients, who often endure additional surgeries and lengthy exposures to systemic antibiotics, neither of which are guaranteed to resolve the infection. Of particular concern is the threat of bacterial biofilm development, since biofilm-mediated infections are difficult to diagnose and effective treatments are lacking. Developing therapeutic strategies have targeted mechanisms of biofilm formation and the means by which these bacteria communicate with each other to take on specialized roles such as persister cells within the biofilm. In addition, prevention of infection through novel coatings for prostheses and the local delivery of high concentrations of antibiotics by absorbable carriers has shown promise in laboratory and animal studies. Biofilm development, especially in an arthoplasty environment, and future diagnostic and treatment options are discussed.
authors.affiliation: Department of Orthopedics, The Ohio State University, Columbus, OH, USA.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: McConoughey
authors.forename: Rob
authors.initials: R
authors.lastname: Howlin
authors.forename: Jeff F
authors.initials: JF
authors.lastname: Granger
authors.forename: Maurice M
authors.initials: MM
authors.lastname: Manring
authors.forename: Jason H
authors.initials: JH
authors.lastname: Calhoun
authors.forename: Mark
authors.initials: M
authors.lastname: Shirtliff
authors.forename: Sandeep
authors.initials: S
authors.lastname: Kathju
authors.forename: Paul
authors.initials: P
authors.lastname: Stoodley
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019643:Arthroplasty, Replacement; D001419:Bacteria / Q000254:growth & development*; D001422:Bacterial Adhesion; D018441:Biofilms / Q000254:growth & development*; D006801:Humans; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000382:microbiology* / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotic resistance; arthroplasty; biofilm; coating; infection; planktonic; prosthesis; treatment