title: Silver-coated megaprostheses: review of the literature.
abstract: Periprosthetic infection remains one of the most serious complications following megaendoprostheses. Despite a large number of preventive measures that have been introduced in recent years, it has not been possible to further reduce the rate of periprosthetic infection. With regard to metallic modification of implants, silver in particular has been regarded as highly promising, since silver particles combine a high degree of antimicrobial activity with a low level of human toxicity. This review provides an overview of the history of the use of silver as an antimicrobial agent, its mechanism of action, and its clinical application in the field of megaendoprosthetics. The benefits of silver-coated prostheses could not be confirmed until now. However, a large number of retrospective studies suggest that the rate of periprosthetic infections could be reduced by using silver-coated megaprostheses.
authors.affiliation: Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany. Tom.Schmidt-Braekling@ukmuenster.de.
authors.forename: Tom
authors.initials: T
authors.lastname: Schmidt-Braekling
authors.affiliation: Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany.
authors.forename: Arne
authors.initials: A
authors.lastname: Streitbuerger
authors.affiliation: Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Gosheger
authors.affiliation: Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY, USA.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Boettner
authors.affiliation: Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Nottrott
authors.affiliation: Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany.
authors.forename: Helmut
authors.initials: H
authors.lastname: Ahrens
authors.affiliation: Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Dieckmann
authors.affiliation: Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany.
authors.forename: Wiebke
authors.initials: W
authors.lastname: Guder
authors.affiliation: Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany.
authors.forename: Dimosthenis
authors.initials: D
authors.lastname: Andreou
authors.affiliation: Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany.
authors.forename: Gregor
authors.initials: G
authors.lastname: Hauschild
authors.affiliation: Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany.
authors.forename: Burkhard
authors.initials: B
authors.lastname: Moellenbeck
authors.affiliation: Department of Orthopedics, Vienna General Hospital, Medical University of Vienna, Vienna, Austria.
authors.forename: Wenzel
authors.initials: W
authors.lastname: Waldstein
authors.affiliation: Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, Germany.
authors.forename: Jendrik
authors.initials: J
authors.lastname: Hardes
mesh_terms: D020099:Coated Materials, Biocompatible; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D019736:Prostheses and Implants / Q000592:standards* / Q000639:trends; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000379:methods; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000517:prevention & control*; D018570:Risk Assessment; D012834:Silver / Q000494:pharmacology*; D016896:Treatment Outcome
chemical_list: D020099:Coated Materials, Biocompatible; D012834:Silver
keywords: Infection prevention; Megaprosthesis; Periprosthetic infection; Silver