[Nanoparticulate silver. A new antimicrobial substance for bone cement]

Area of Science:

• Biomaterials Science
• Infectious Disease Research
• Orthopedic Surgery

Context:

• Prosthetic joint infections (PJIs) are a growing concern due to multiresistant bacteria.
• Gentamicin, a common antibiotic in bone cement, is frequently ineffective against these resistant strains.
• Novel prophylactic strategies are essential to combat antibiotic resistance in PJIs.

Purpose:

• To evaluate the in vitro antibacterial activity of polymethyl methacrylate (PMMA) bone cement loaded with nanoparticulate silver (NanoSilver) against gentamicin-resistant bacteria.
• To compare the efficacy of NanoSilver-loaded cement with plain and gentamicin-loaded PMMA cement.
• To assess the potential cytotoxic effects of NanoSilver bone cement.

Summary:

• PMMA-cement loaded with 1% nanoparticulate silver demonstrated complete inhibition of Methicillin-resistant Staphylococcus epidermidis (MRSE) and Methicillin-resistant Staphylococcus aureus (MRSA) proliferation in vitro.
• Plain PMMA-cement and cement loaded with 2% gentamicin showed no antibacterial activity against the tested resistant strains.
• Quantitative elution testing indicated that NanoSilver bone cement did not exhibit significant cytotoxic effects compared to a non-toxic control group.

Impact:

• NanoSilver-loaded bone cement shows promise as an effective prophylactic agent against multiresistant bacteria in total joint arthroplasty.
• These findings suggest a potential new therapeutic option for preventing and treating PJIs.
• Successful in vivo validation could significantly improve patient outcomes in orthopedic surgery.