Titanium-Based Hip Stems with Drug Delivery Functionality through Additive Manufacturing.
Postoperative infections are a major concern in patients that receive implants. These infections generally occur in areas with poor blood flow and pathogens do not always respond to antibiotic treatment. With the latest developments in nanotechnology, the incorporation of antibiotics into prosthetic implants may soon become a standard procedure. The success will, however, depend on the ability to control the release of antibiotics at concentrations high enough to prevent the development of antibiotic-resistant strains. Through additive manufacturing, antibiotics can be incorporated into cementless femoral stems to produce prosthetic devices with antimicrobial properties. With the emerging increase in resistance to antibiotics, the incorporation of antimicrobial compounds other than antibiotics, preferably drugs with a broader spectrum of antimicrobial activity, will have to be explored. This review highlights the microorganisms associated with total hip arthroplasty (THA), discusses the advantages and disadvantages of the latest materials used in hip implants, compares different antimicrobial agents that could be incorporated, and addresses novel ideas for future research.
Rapid Product Development Laboratory, Department of Industrial Engineering, University of Stellenbosch, Stellenbosch 7600, South Africa.
Martin B
MB
Bezuidenhout
Rapid Product Development Laboratory, Department of Industrial Engineering, University of Stellenbosch, Stellenbosch 7600, South Africa.
Dimitar M
DM
Dimitrov
Department of Microbiology, University of Stellenbosch, Stellenbosch 7600, South Africa.
Anton D
AD
van Staden
Rapid Product Development Laboratory, Department of Industrial Engineering, University of Stellenbosch, Stellenbosch 7600, South Africa.
Gert A
GA
Oosthuizen
Department of Microbiology, University of Stellenbosch, Stellenbosch 7600, South Africa.
Leon M T
LM
Dicks
D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000737:chemistry; D001424:Bacterial Infections / Q000209:etiology / Q000517:prevention & control*; D003692:Delayed-Action Preparations / Q000008:administration & dosage / Q000737:chemistry; D015195:Drug Design; D004343:Drug Implants / Q000008:administration & dosage* / Q000138:chemical synthesis; D019544:Equipment Failure Analysis; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D066192:Manufacturing Industry / Q000379:methods*; D053769:Nanocapsules / Q000008:administration & dosage / Q000737:chemistry; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D003692:Delayed-Action Preparations; D004343:Drug Implants; D053769:Nanocapsules