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Published on: May 11, 2011
Silver-coated megaendoprostheses in a rabbit model--an analysis of the infection rate and toxicological side effects
Georg Gosheger1, Jendrik Hardes, Helmut Ahrens
1Department of Orthopedics, University of Muenster, Albert-Schweitzer-Str. 33, 48149 Muenster, Germany. goshegg@uni-muenster.de
Abstract:
Deep infection of megaprostheses remains a serious complication in orthopedic tumor surgery. Despite the use of systemic and local antibiotic prophylaxis the reported infection rate is between 5% and 35%. Silver-coated medical devices proved their effectiveness in reducing infections. The objective of this study was to examine in vivo the antimicrobial efficacy and possible side-effects of a silver-coated megaprosthesis. In a first study, 30 rabbits (15 titanium versus 15 silver-coated Mutars-endoprostheses) were infected with Staphylococcus aureus. In a second study, toxicological side effects were analyzed in 10 rabbits with a silver-coated megaprosthesis. The silver group showed significantly (p<0.05) lower infection rates (7% versus 47%) in comparison with the titanium group. Measurements of the C-reactive-protein, neutrophilic leukocytes, rectal temperature and body weight showed significant (p<0.05) lower signs of inflammation in the silver group. The analysis of the silver concentration in blood (median 1.883ppb) and in organs (0.798-86.002ppb) showed elevated silver concentrations without pathologic changes in laboratory parameters and without histological changes of organs. In conclusion, the new silver-coated Mutars-megaprosthesis resulted in reduced infection rates without toxicological side effects, suggesting that this prosthesis might be a promising device in tumor surgery exhibiting antimicrobial activity.
Insights
Silver-coated megaprostheses significantly reduced deep infections in orthopedic tumor surgery compared to titanium implants. This antimicrobial coating shows promise for reducing complications without toxic side effects.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Infectious Disease
Background:
- Deep infection of megaprostheses is a significant complication in orthopedic tumor surgery, with infection rates ranging from 5% to 35% despite antibiotic prophylaxis.
- Silver-coated medical devices have demonstrated effectiveness in reducing infections.
Purpose of the Study:
- To evaluate the in vivo antimicrobial efficacy of a silver-coated megaprosthesis.
- To assess potential toxicological side effects associated with the silver-coated implant.
Main Methods:
- A comparative study in rabbits infected with Staphylococcus aureus, using titanium versus silver-coated Mutars-endoprostheses.
- Toxicological evaluation of silver-coated megaprostheses in a separate rabbit cohort.
- Monitoring infection rates, inflammatory markers (C-reactive protein, leukocytes, temperature, body weight), and silver concentrations in blood and organs.
Main Results:
- The silver-coated group exhibited significantly lower infection rates (7%) compared to the titanium group (47%).
- Reduced signs of inflammation were observed in the silver group, indicated by lower C-reactive protein, neutrophilic leukocytes, and normalized temperature and body weight.
- Elevated silver concentrations were detected in blood and organs, but without pathological or histological changes.
Conclusions:
- The silver-coated Mutars-megaprosthesis demonstrated significant antimicrobial activity, reducing infection rates in a rabbit model.
- No toxicological side effects were observed, suggesting the implant is safe for use.
- The silver-coated megaprosthesis represents a promising antimicrobial device for orthopedic tumor surgery.