Atomic Layer Deposition of a Silver Nanolayer on Advanced Titanium Orthopedic Implants Inhibits Bacterial Colonization and Supports Vascularized de Novo Bone Ingrowth.
Joint replacement surgery is associated with significant morbidity and mortality following infection with either methicillin-resistant Staphylococcus aureus (MRSA) or Staphylococcus epidermidis. These organisms have strong biofilm-forming capability in deep wounds and on prosthetic surfaces, with 103-104microbes resulting in clinically significant infections. To inhibit biofilm formation, we developed 3D titanium structures using selective laser melting and then coated them with a silver nanolayer using atomic layer deposition. On bare titanium scaffolds, S. epidermidis growth was slow but on silver-coated implants there were significant further reductions in both bacterial recovery (p < 0.0001) and biofilm formation (p < 0.001). MRSA growth was similarly slow on bare titanium scaffolds and not further affected by silver coating. Ultrastructural examination and viability assays using either human bone or endothelial cells, demonstrated strong adherence and growth on titanium-only or silver-coated implants. Histological, X-ray computed microtomographic, and ultrastructural analyses revealed that silver-coated titanium scaffolds implanted into 2.5 mm defects in rat tibia promoted robust vascularization and conspicuous bone ingrowth. We conclude that nanolayer silver of titanium implants significantly reduces pathogenic biofilm formation in vitro, facilitates vascularization and osseointegration in vivo making this a promising technique for clinical orthopedic applications.
Centre for Molecular Biosciences (CMB), School of Biomedical Sciences, Ulster University, Coleraine, BT521SA, UK.
Aine
A
Devlin-Mullin
Centre for Molecular Biosciences (CMB), School of Biomedical Sciences, Ulster University, Coleraine, BT521SA, UK.
Naomi M
NM
Todd
School of Engineering, University of Liverpool, Liverpool, L69 3GH, UK.
Zahra
Z
Golrokhi
School of Materials, The University of Manchester, Oxford Rd, Manchester, M13 9PL, UK.
Hua
H
Geng
Institute of Functional and Clinical Anatomy, Johannes Gutenberg University, Mainz, 55128, Germany.
Moritz A
MA
Konerding
Centre for Molecular Biosciences (CMB), School of Biomedical Sciences, Ulster University, Coleraine, BT521SA, UK.
Nigel G
NG
Ternan
Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, L7 8TX, UK.
John A
JA
Hunt
School of Engineering, University of Liverpool, Liverpool, L69 3GH, UK.
Richard J
RJ
Potter
School of Engineering, University of Liverpool, Liverpool, L69 3GH, UK.
Chris
C
Sutcliffe
School of Engineering, University of Liverpool, Liverpool, L69 3GH, UK.
Eric
E
Jones
School of Materials, The University of Manchester, Oxford Rd, Manchester, M13 9PL, UK.
Peter D
PD
Lee
Centre for Molecular Biosciences (CMB), School of Biomedical Sciences, Ulster University, Coleraine, BT521SA, UK.
Christopher A
CA
Mitchell
D000818:Animals; D018786:Bone Substitutes / Q000737:chemistry*; D045744:Cell Line, Tumor; D020099:Coated Materials, Biocompatible / Q000737:chemistry*; D006801:Humans; D020007:Implants, Experimental / Q000382:microbiology*; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000254:growth & development*; D049329:Nanostructures / Q000737:chemistry*; D018919:Neovascularization, Physiologic; D051381:Rats; D017208:Rats, Wistar; D012834:Silver / Q000737:chemistry*; D013212:Staphylococcus epidermidis / Q000254:growth & development*; D013977:Tibia / Q000293:injuries / Q000378:metabolism / Q000382:microbiology / Q000473:pathology; D014025:Titanium / Q000737:chemistry*
D018786:Bone Substitutes; D020099:Coated Materials, Biocompatible; D012834:Silver; D014025:Titanium
Staphylococcus epidermidis; angiogenesis; atomic layer deposition; bone; methicillin-resistant Staphylococcus aureus; silver; titanium