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Bacterial Signaling01:30

Bacterial Signaling

Bacterial signaling can occur within bacteria (intracellular) or between bacteria (intercellular). At times, a group of bacteria behaves like a community. To achieve this, they engage in quorum sensing, the perception of higher cell density that causes changes in gene expression. Quorum sensing involves both extracellular and intracellular signaling. The signaling cascade starts with a molecule called an autoinducer (AI). Individual bacteria produce AIs that move out of the bacterial cell...

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Bioelectric Analyses of an Osseointegrated Intelligent Implant Design System for Amputees
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Osseointegrated titanium implants for limb prostheses attachments: infectious complications.

Jonatan Tillander1, Kerstin Hagberg, Lars Hagberg

  • 1Department of Infectious Diseases, University of Gothenburg, SE-416 85, Göteborg, Sweden. jonatan.tillander@vgregion.se

Clinical Orthopaedics and Related Research
|May 18, 2010
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This study on titanium osseointegrated implants for amputees found that despite bacterial colonization, few infections led to implant removal or disability. The bone-anchored prosthetic system showed a low rate of serious infectious complications.

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Area of Science:

  • Biomedical Engineering
  • Orthopedic Surgery
  • Infectious Disease

Background:

  • Osseointegration involves direct bone-titanium implant contact for stable fixation in transcutaneous prosthetic systems.
  • Transcutaneous implants often fail due to infection, posing a significant challenge for amputees.
  • This study investigates a novel titanium implant system for bone-anchored prostheses.

Purpose of the Study:

  • To determine the frequency and presentation of infectious complications associated with transcutaneous osseointegrated titanium implants.
  • To evaluate the bacterial flora at the skin-penetration site and its correlation with local and implant-related infections.
  • To assess the long-term outcomes of titanium implants in amputees regarding infection and prosthetic function.

Main Methods:

  • A prospective follow-up of 39 patients with arm and leg amputations fitted with transcutaneous osseointegrated titanium implants.
  • Patients were evaluated at inclusion and after a 3-year follow-up period, with a mean follow-up of 56 months.
  • Implant infection was classified as definite, probable, or possible based on clinical, radiologic, and microbiologic evidence.

Main Results:

  • Implant infection frequency increased from 5% at inclusion to 18% at follow-up.
  • The most common bacteria identified were Staphylococcus aureus and coagulase-negative staphylococci.
  • Most infections had low activity, and only one implant was removed due to infection; prosthetic use was unaffected in most cases.

Conclusions:

  • Despite frequent colonization by virulent bacteria like Staphylococcus aureus and coagulase-negative staphylococci, the titanium implant system resulted in few infections.
  • The bone-anchored prosthetic system demonstrated a low incidence of infections leading to significant disability or implant removal.
  • This titanium implant system offers a viable option for stable, long-term fixation in amputees with a manageable risk of infection.