Table 1.
Summary of Advantages and Limitations of Metallic Antimicrobial Biomaterials from the Past Decade Designed for Orthopedic Implant-Associated Infection Applications
| metals | |||||
|---|---|---|---|---|---|
| composition | tested in vivo? | antimicrobial activity | advantages | limitations | ref |
| titanium oxide nanocoating on titanium | no | bacterial clearance of 80–90% CFUs, inhibit adhesion 80% bacteria | (1) intrinsic activity | (1) leach metal particles (cytotoxicity/genotoxicity) | 49, 50 |
| (2) long-lasting | |||||
| (3) decreased resistance | |||||
| titanium oxide coated titanium and titanium hydride powder coated on porous titanium | no | inhibit adhesion 80% bacteria | (1) intrinsic activity | (1) leach metal particles (cytotoxicity/genotoxicity) | 51 |
| (2) long-lasting | |||||
| (3) decreased resistance | |||||
| silver and copper nanoparticle coated titanium oxide on Ti6Al4V | no | inhibit adhesion 100% bacteria | (1) intrinsic activity | (1) leach metal particles (cytotoxicity/genotoxicity) | 52 |
| (2) long-lasting | |||||
| (3) decreased resistance | |||||
| silver and zinc nanoparticle coated titanium oxide on Ti6Al4V | no | inhibit adhesion 100% bacteria | (1) intrinsic activity | (1) leach metal particles (cytotoxicity/genotoxicity) | 53 |
| (2) long-lasting | |||||
| (3) promotes osseointegration | |||||
| titanium–copper-oxide coated Ti6Al4V | no | 2log10 decrease in bacterial adhesion | (1) intrinsic activity | (1) leach metal particles (cytotoxicity/genotoxicity) | 56 |
| (2) long-lasting | |||||
| fluorine- and phosphorus doped nanostructured Ti6Al4V | yes | not evaluated, used to detect presence of infection | (1) intrinsic activity | (1) leach metal particles (cytotoxicity/genotoxicity) | 40 |
| (2) long-lasting | |||||
| (3) promotes osseointegration | |||||
| magnesium alloy | yes | limited in vivo, requires modification | (1) intrinsic activity | (1) limited duration of activity | 59 |
| (2) antimicrobial activity in vitro superior to in vivo | |||||