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Published on: March 3, 2023
What to Know about Antimicrobial Coatings in Arthroplasty: A Narrative Review
Francesco Onorato1, Virginia Masoni1, Luca Gagliardi1,2
1Department of Orthopedics and Traumatology, University of Turin, Via Zuretti, 29, 10126 Turin, Italy.
Abstract:
Periprosthetic joint infections (PJIs) are one of the most worrying complications orthopedic surgeons could face; thus, methods to prevent them are evolving. Apart from systemic antibiotics, targeted strategies such as local antimicrobial coatings applied to prosthetics have been introduced. This narrative review aims to provide an overview of the main antimicrobial coatings available in arthroplasty orthopedic surgery practice. The search was performed on the PubMed, Web of Science, SCOPUS, and EMBASE databases, focusing on antimicrobial-coated devices used in clinical practice in the arthroplasty world. While silver technology has been widely adopted in the prosthetic oncological field with favorable outcomes, recently, silver associated with hydroxyapatite for cementless fixation, antibiotic-loaded hydrogel coatings, and iodine coatings have all been employed with promising protective results against PJIs. However, challenges persist, with each material having strengths and weaknesses under investigation. Therefore, this narrative review emphasizes that further clinical studies are needed to understand whether antimicrobial coatings can truly revolutionize the field of PJIs.
Insights
Antimicrobial coatings on orthopedic implants show promise for preventing periprosthetic joint infections (PJIs). While silver, hydrogel, and iodine coatings offer protective benefits, further clinical research is essential to confirm their revolutionary potential in PJI management.
Area of Science:
- Orthopedics
- Biomaterials Science
- Infectious Disease
Background:
- Periprosthetic joint infections (PJIs) are a significant complication in orthopedic surgery.
- Systemic antibiotics have limitations, driving the need for targeted prevention strategies.
- Local antimicrobial coatings on prosthetics represent an evolving approach to PJI prevention.
Purpose of the Study:
- To review current antimicrobial coating technologies used in arthroplasty.
- To provide an overview of available antimicrobial coatings in orthopedic practice.
- To assess the clinical relevance and potential of these coatings in preventing PJIs.
Main Methods:
- Narrative review of scientific literature.
- Database searches including PubMed, Web of Science, SCOPUS, and EMBASE.
- Focus on antimicrobial-coated devices in clinical arthroplasty practice.
Main Results:
- Silver coatings are established in oncological prosthetics.
- Emerging coatings include silver-hydroxyapatite, antibiotic-loaded hydrogels, and iodine.
- These newer coatings show promising results in protecting against PJIs.
- Each coating technology presents unique strengths and weaknesses requiring further investigation.
Conclusions:
- Antimicrobial coatings offer a promising avenue for PJI prevention in arthroplasty.
- Further clinical studies are necessary to validate the efficacy and long-term impact of these coatings.
- The potential for antimicrobial coatings to revolutionize PJI management requires continued research and evaluation.
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