Evaluation of silver-titanium implants activated by low intensity direct current for orthopedic infection control: An in vitro and in vivo study

Daniel L. Cavanaugh, Zhuo (George) Tan, James P. Norris, Amelia Hardee, Paul S. Weinhold, Laurence E. Dahners, Paul E. Orndorff, Rohan A. Shirwaiker

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Silver is an alternative antimicrobial of interest for the prophylaxis of prosthetic infections and electrical activation is known to augment its oligodynamic efficacy. In this study, we evaluated the in vitro and in vivo efficacy of a silver (Ag)-titanium (Ti) implant activated by 30 µA direct current compared with three controls – passive Ag-Ti, active Ti-Ti, and passive Ti-Ti. We hypothesized that the experimental group would provide better resistance to pathogenic colonization on the implant. Modified Kirby-Bauer technique was used to evaluate in vitro efficacy of the four groups against five bacteria and one fungus. For in vivo evaluation, forty-eight rats were divided into four groups. The implant was secured in a wound cavity along the posterior margin of the femur. The wound was inoculated with 7.5 × 105 CFU of Staphylococcus aureus. Rats were euthanized 14 days postsurgery and quantitative cultures were performed on the implant segments and the wound cavity tissue. In vitro tests showed that the growth of all six pathogens was inhibited around the active Ag anodes of the experimental group. In vivo, none of the four groups were able to prevent wound infection, but the experimental group resulted in reduced colonization. The mean bacterial loads on Ti segments were significantly lower in the implants which also had an Ag segment (p = 0.0007), and this effect was more pronounced with electrical activation (p = 0.0377). The results demonstrate the antimicrobial potential of LIDC-activated Ag-Ti implants.

Original languageEnglish
Pages (from-to)1023-1031
Number of pages9
JournalJournal of Biomedical Materials Research - Part B Applied Biomaterials
Volume104
Issue number5
DOIs
StatePublished - Jul 1 2016

Keywords

  • antimicrobial implant
  • electrical activation
  • oligodynamic silver
  • prosthetic infection

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