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. Author manuscript; available in PMC: 2016 Apr 7.
Published in final edited form as: J Orthop Res. 2015 Dec 29;34(2):177–186. doi: 10.1002/jor.23068

Table 2.

Strategies to Prevent Prosthetic Joint Infections by Improving the Antimicrobial Surface Properties of Titanium-Based Orthopaedic Implant Materials

Method Organism(s) Antibacterial System Observation(s) Ref
Oxidative nanopatterning of Ti MRSA, Candida albicans Surface topography in vitro S. aureus adhesion reduced; C. albicans aggregations reduced 90
Antibiotic impregnated microspheres S. aureus Tobramycin in vivo Total absence of infection; no effect on bone ingrowth 99
Covalently tethered vancomycin S. epidermidis Vancomycin in vitro Prevention of colonization and biofilm formation 100
Antiseptic dye coating S. aureus Gendine (chlorhexidine) in vitro Total prevention of bacterial adherence 110
Galvanic Cu deposition S. aureus Inactivate catabolic pathways in vitro Total clearing of adherent bacteria 95
HA-chitosan polyelectrolyte with RGD S. aureus Chitosan in vitro Adhesion reduced by 80% for 21 days 108
Antibiotic loaded hydrogel coating S. aureus, S. epidermidis Various antibiotics in vitro Inhibition of biofilm and planktonic growth 104
UV irradiation S. aureus, S. epidermidis Spontaneous wettability in vitro Bacteria adhere, not firmly attached 85
UV C irradiation S. aureus, S. epidermidis Increased ROS in vitro Bacteria killed for 60 min after UV treatment 86
Zn TiO2 E. coli, S. aureus ZnO mediated ROS in vitro Inhibition attachment 115
Zn-implanted Ti E. coli, S. aureus Zn ions in vitro Partial antibacterial effect; E. coli more inhibited than S. aureus 116
Alkali treatment S. aureus, E. coli Nanoroughness, increase local pH in vitro Bacteriostatic effect, reduced proliferation 117
Ag coating Staphylococcus sp., Bacillus sp., Enterococcus sp., Corneybacterium Ag ions in vivo Reduced infection rate 97
Material painting of N,N-dodecyl, methyl-PEI coating S. aureus Immobilized hydrophobic polycationic chains both Total absence of infection 107
Superhydrophobic TiO2 nanotube S. aureus Superhydrophobic surface in vitro Reduced adhesion 118
Mesoporous TiO2 coating E. coli Cephalothin controlled release in vitro All bacteria killed on contact 119
Photocatalytic TiO2 layer S. aureus, S. epidermidis, P. aeruginosa Increased ROS in vitro Antibacterial effect after 60 min UV treatment 120
Silk Sericin surface S. aureus, S. epidermidis Silk sericin in vitro Reduced adhesion 121
Ag-doped TiO2 nanotube S. aureus Ag ions in vitro Planktonic clearing, reduced adhesion 91