Journal
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH
Volume 467, Issue 7, Pages 1678-1687Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1007/s11999-009-0828-4
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- NIAMS NIH HHS [R01 AR051303, AR-051303] Funding Source: Medline
- NIDCR NIH HHS [DE-13319, DE-10875, R01 DE010875, R01 DE013319] Funding Source: Medline
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Periprosthetic infection is increasingly prevalent in orthopaedics with infection rates of 2% to 15% after total hip arthroplasty. To effectively decrease bacterial attachment, colonization, and subsequent development of periprosthetic infection, we previously described a method to covalently bond vancomycin to smooth Ti alloy surfaces. To attach vancomycin, the Ti surface is first passivated to create a fresh oxide layer. Previously, passivation has been achieved with an H2SO4/H2O2 etch that can destroy the topography of the underlying implant. Passivation by hydrothermal aging as well as by H2SO4/H2O2 incubation produced a robust oxide layer, but only hydrothermal aging left the geometry unaltered. These hydrothermally passivated Kirschner wires and smooth or beaded Ti surfaces were chemically coupled with vancomycin. Antibiotic-coupled samples representing all three geometries were uniformly covered with antibiotic, resisted colonization by Staphylococcus aureus for longer than 8 hours, and retained their biocompatibility as assessed by normal attachment and morphology of preosteocytic MLO-A5 cells. Using this technique, we believe it is possible to passivate many complex implant designs/geometries as a first step toward covalent bonding of antibiotics or other bioactive factors.
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