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Fibronectin, a glycoprotein secreted by connective tissue cells is found inthe human plasma as well as in the ECM. It is known to have an adhesiveproperty and plays a role in cell-to-cell and cell-to-substratum adhesions. Inrheumatoid arthritis (RA) and osteoarthritis (OA), fibronectin is locallysynthesized by the synovial cells, and the synovial fluid level of fibronectinis found to be double that in plasma. The concentration of fibronectin in thesynovial fluid under such conditions is found escalate to 2-3 times higher thanin the corresponding plasma. The present article demonstrates that the proteinhas a strong tendency to get adsorbed on biomaterials after an implant surgeryin preference to lighter proteins like albumin, which in turn enhances thegrowth of robust biofilms. The present article demonstrates that, heightenedrisk of dangerous implant infections due to the formation of such biofilmscoupled with the degrading immunity levels of the geriatric patients have thepotential to transform an implant surgery to a 'life threatening' event.

Vulnerability of geriatric patients to biomaterial associated  infections: in vitro study of biofilm formation by Pseudomonas aeruginosa on  orthopedic implants