PDF(Pubmed)
Abstract：
Background: Despite the expanding use of orthopedic devices and the application of strict pre- and postoperative protocols, the elimination of postoperative implant-related infections remains a challenge. Objectives: To identify and assess the in vitro and in vivo properties of antimicrobial-, silver- and iodine-based implants, as well as to present novel approaches to surface modifications of orthopedic implants. Methods: A systematic computer-based review on the development of these implants, on PubMed and Web of Science databases, was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Overall, 31 in vitro and 40 in vivo entries were evaluated. Regarding the in vitro studies, antimicrobial-based coatings were assessed in 12 entries, silver-based coatings in 10, iodine-based in 1, and novel-applied coating technologies in 8 entries. Regarding the in vivo studies, antimicrobial coatings were evaluated in 23 entries, silver-coated implants in 12, and iodine-coated in 1 entry, respectively. The application of novel coatings was studied in the rest of the cases (4). Antimicrobial efficacy was examined using different bacterial strains, and osseointegration ability and biocompatibility were examined in eukaryotic cells and different animal models, including rats, rabbits, and sheep. Conclusions: Assessment of both in vivo and in vitro studies revealed a wide antimicrobial spectrum of the coated implants, related to reduced bacterial growth, inhibition of biofilm formation, and unaffected or enhanced osseointegration, emphasizing the importance of the application of surface modification techniques as an alternative for the treatment of orthopedic implant infections in the clinical settings.
摘要：
背景：尽管骨科设备的使用越来越广泛，并且应用了严格的术前和术后协议，消除术后植入物相关感染仍是一项挑战.目的：鉴定和评估抗菌药物的体外和体内特性，银基和碘基植入物，以及提出骨科植入物表面改性的新方法。方法：对这些植入物的发展进行系统的基于计算机的回顾，在PubMed和WebofScience数据库上，根据系统评价和荟萃分析指南的首选报告项目进行。结果：总体而言，评估了31个体外条目和40个体内条目。关于体外研究，在12个条目中评估了基于抗菌的涂料，银基涂层在10个中，碘基涂层在1个中，新型涂层技术在8个条目中。关于体内研究，抗菌涂料在23个条目中进行了评估，镀银植入物12个，碘涂层1个，分别。在其余情况(4)中研究了新型涂层的应用。使用不同的细菌菌株检查抗菌效果，在真核细胞和不同动物模型中检查骨整合能力和生物相容性，包括老鼠,兔子,和羊。结论：体内和体外研究的评估表明，涂层植入物具有广泛的抗菌谱，与减少细菌生长有关，抑制生物膜的形成，和不受影响或增强的骨整合，强调在临床环境中应用表面改性技术作为治疗骨科植入物感染的替代方法的重要性。
