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Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction

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Bacterial comparison study of prosthetic liners.

Keera L Dupler¹, Hailey C Miller, Esther C Seeland

¹Messiah University, Mechanicsburg, PA, USA.

Prosthetics and Orthotics International

|November 27, 2024

Summary

Amputee prosthetic liners, including novel silicone options, showed similar bacterial growth in a new skin-interface model. This indicates no increased infection risk, supporting their use in low-resource settings.

Keywords:

bacteria comparison liner low-resource prosthetic silicone

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Area of Science:

Biomedical Engineering
Infectious Disease Research
Prosthetics and Orthotics

Background:

Amputees in low-resource settings are prone to skin infections at the prosthetic limb's skin-liner interface.
Previous prosthetic liner research prioritized mechanical and aesthetic factors, neglecting bacterial growth potential.
The propensity of different prosthetic liner materials to support bacterial colonization remains understudied.

Purpose of the Study:

To compare bacterial growth on traditional sock-EVA, advanced silicone, and novel silicone prosthetic liners.
To evaluate the suitability of innovative prosthetic materials for low-resource environments.
To introduce a novel in vitro model for simulating the skin-liner interface and assessing bacterial proliferation.

Main Methods:

A novel physical model simulating the skin-liner interface was developed, featuring a replicate skin layer over a heat source.
Staphylococcus aureus was cultured for 24 hours within the model across three different prosthetic liner types.
Bacterial cell concentration in solution was quantified post-incubation for comparative analysis.

Main Results:

Statistical analysis of nine trials indicated consistent bacterial growth across all tested liner types (traditional sock-EVA, advanced silicone, novel silicone).
No significant difference in bacterial growth was observed, suggesting comparable infection risk among the evaluated liners.
The findings imply that none of the tested liners present a heightened risk of infection relative to the others.

Conclusions:

Innovative prosthetic liner materials, including novel silicone options, appear safe for use in low-resource settings.
The developed in vitro skin-liner model and bacterial growth assessment method can aid future dermatological simulations.
This research supports the consideration of advanced prosthetic materials to improve amputee care in resource-limited areas.