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Potential New Way to Prevent Bacterial Infections in Total Joint Replacement Surgery

What new coating may protect joint replacement patients from serious bacterial infections?

Research with mice at Johns Hopkins University shows that a coating of antibiotic-releasing nanofibers has the potential to prevent at least some serious bacterial infections related to total joint replacement surgery. The research is preliminary, labeled a “proof of concept” study, meaning that its purpose is to verify the possible validity of the concept in question, but it is still quite promising.

Because of the constant innovations in technology like the above-mentioned, it is essential that you connect with a highly skilled surgeon who is always up-to-date on new methodologies if you are considering having total joint replacement surgery.

The first report on the above study was published online in Proceedings of the National Academy of Sciences. Although the study was conducted on the rodents’ knee joints, researchers predict that the technology will have “broad applicability,” not only in the use of orthopaedic prostheses, such as hip as well as knee joints, but in the use of other implantable devices, such as pacemakers and stents. What makes this coating different from other coatings being developed is that the new substance can release many antibiotics in a timed-release program. This strategy appears to be capable of providing much more extensive protection against infection.

This new finding is exciting because for years surgeons and biomedical engineers have been looking for improved ways to reduce the risk of infections after joint replacement surgeries. According to one of the senior authors of the study, Dr. Lloyd S. Miller, “We can potentially coat any metallic implant that we put into patients, from prosthetic joints, rods, screws and plates to pacemakers, implantable defibrillators and dental hardware.”

Presently, an estimated 1 to 2 percent of the more than 1 million hip and knee replacement surgeries performed in the U.S. are followed by infections linked to biofilms — layers of bacteria that adhere to a surface. While acute postsurgical infections can usually be treated successfully with intravenous antibiotics, some patients develop low-grade chronic infections that can last for months. Unfortunately, these infections can lead to loosening and eventual failure of the newly implanted prostheses. Such infections are very difficult to treat; often, prostheses must be removed during treatment before new replacement joints can be implanted. This process is, of course, painful for the patient, time-consuming for the surgeon, and extremely expensive.

Over 3 years, the Johns Hopkins’ research team had concentrated on developing a thin, biodegradable plastic coating, composed of a nanofiber mesh embedded in a thin film that could release multiple antibiotics at desired rates. To their delight, they found that, while most other approaches only decreased the number of bacteria present, this new coating “completely eradicate[d]” the infection. Although there is also good news in the fact the polymers used to generate the nanofiber coating have already been used in many FDA-approved devices, more research is required before this invention can be fully implemented in joint replacement surgeries.

 

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