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Evaluation of silver‐titanium implants activated by low intensity direct current for orthopedic infection control: An in vitro and in vivo study
Author(s) -
Cavanaugh Daniel L.,
Tan Zhuo George,
Norris James P.,
Hardee Amelia,
Weinhold Paul S.,
Dahners Laurence E.,
Orndorff Paul E.,
Shirwaiker Rohan A.
Publication year - 2016
Publication title -
journal of biomedical materials research part b: applied biomaterials
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.665
H-Index - 108
eISSN - 1552-4981
pISSN - 1552-4973
DOI - 10.1002/jbm.b.33451
Subject(s) - in vivo , titanium , implant , antimicrobial , in vitro , microbiology and biotechnology , materials science , staphylococcus aureus , biomedical engineering , medicine , chemistry , bacteria , surgery , biology , biochemistry , metallurgy , genetics
Silver is an alternative antimicrobial of interest for the prophylaxis of prosthetic infections and electrical activation is known to augment its oligodynamic efficacy. In this study, we evaluated the in vitro and in vivo efficacy of a silver (Ag)‐titanium (Ti) implant activated by 30 µA direct current compared with three controls – passive Ag‐Ti, active Ti‐Ti, and passive Ti‐Ti. We hypothesized that the experimental group would provide better resistance to pathogenic colonization on the implant. Modified Kirby‐Bauer technique was used to evaluate in vitro efficacy of the four groups against five bacteria and one fungus. For in vivo evaluation, forty‐eight rats were divided into four groups. The implant was secured in a wound cavity along the posterior margin of the femur. The wound was inoculated with 7.5 × 10 5 CFU of Staphylococcus aureus . Rats were euthanized 14 days postsurgery and quantitative cultures were performed on the implant segments and the wound cavity tissue. In vitro tests showed that the growth of all six pathogens was inhibited around the active Ag anodes of the experimental group. In vivo , none of the four groups were able to prevent wound infection, but the experimental group resulted in reduced colonization. The mean bacterial loads on Ti segments were significantly lower in the implants which also had an Ag segment ( p = 0.0007), and this effect was more pronounced with electrical activation ( p = 0.0377). The results demonstrate the antimicrobial potential of LIDC‐activated Ag‐Ti implants. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1023–1031, 2016.