19 ो 25 ᳳ 20150618 Chinese Journal of Tissue Engineering Research June 18, 2015 www.CRTER.org Vol.19, No.25 1 1 150001) 2 1(1 1500012 1 !"#$%&'()*+,-% ./01 23456789:; 2 <=>?@ABCDEFGHIJDEFKLMGHINLMFGHIOP G HIDQR SQGHTU:; 3 VWXYZ[7\,-]^_`ab!cdeQGHfghiDQjklmnoKpqr Z[; 1987 !" #$%&#'()*+, -./012345 678 9:;< = >?@A 150001 :R318 :A ᨬ㽕 jksKtuDQlv Iwxy `zc4 !{|}YgVW"#~%Tt XfdeQlmno012789:; zC&'GHI IFTU:; 1990 1 1 2014 1 1 Scopus I (q)lm< m/ Titanium alloyPlantAntibacterialCoating¡deQGH¢; £GH¤F¥$%/DEFGHIJDEFKLMGHINLMFGHI OP GHIDQR SQGH¦¤GH§K¨uDQlv ©ªK¦«¬­®f GH78¯r°g"#>±GH²³´Bcµ¶tu IDQlv I-w · I¸¹ ºr78m¡lB»I¼fg½¾e78N¿_´À?Á EÂ&'GHÃlB»I¼ÄÅ !msE; . 19(25):4069-4075. :2095-4344 (2015)25-04069-07 ࠄߑـġ2015-04-05 http://WWW.crter.org !"#$[J].%&'()*+,2015 doi:10.3969/j.issn.2095-4344.2015.25.026 Titanium surface covered with antimicrobial coating: antibacterial ability and biocompatibility Wang Jia-qi1, Shang Jian1, Sun Ye2, Han Xin-guang1(1Department of Orthopedics, First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China; 2Harbin Institute of Technology, Harbin 150001, Heilongjiang Province, China) Wang Jia-qi, Studying for Abstract master’s degree, Physician, BACKGROUND: Titanium alloy with good biocompatibility, corrosion resistance and mechanical properties have been widely used in clinic. How to give its excellent antibacterial properties so as to cope with plant-associated infections has become a research focus in recent years. OBJECTIVE: To review the principle, techniques, classification and relative merits of antimicrobial coating. METHODS: A computer-based search of Scopus database and VIP database was performed by the first author to retrieve relevant articles published from January 1990 to January 2014 using the keywords of “titanium alloy, plant, antibacterial, coating”. RESULTS AND CONCLUSION: Coatings can be classified into antibiotic coating, non-antibiotic organic antimicrobial coating, inorganic antibacterial coating, anti-adhesion coating, antibacterial bioactive polymer coating, all of which have better biocompatibility, but also have their limitations. Current studies concerning antimicrobial coatings mainly focus on how to enhance the binding force between antimicrobial coating and the substrate as well as how to get a good anti-bacterial ability, biocompatibility, high wear resistance and persistence; antibacterial phase structure and distribution effects on the bacterial colonization. The antibacterial phase structure and distribution is the key factor for the antimicrobial properties of titanium alloys with either entirely added anti-bacterial elements or surface coating. ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH Department of Orthopedics, First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China Corresponding author: Shang Jian, Professor, Chief physician, Master’s supervisor, Department of Orthopedics, First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China Accepted: 2015-04-05 4069 www.CRTER.org . Subject headings: Biocompatible Materials; Titanium; Polymers Wang JQ, Shang J, Sun Y, Han XG. Titanium surface covered with antimicrobial coating: antibacterial ability and biocompatibility. Zhongguo Zuzhi Gongcheng Yanjiu. 2015;19(25):4069-4075. 0 Introduction !"#$%&!'( )*+,-./012345678+9 [1] : ;<=>?@ABC78+23DEF500G [2] H I78+,JKL/MNOPQRSTU VWXYZ [I\]^_`abcdK [3] LefSgh+9:,JKL i;jkl+ [4] 9:,JKLQmg0.5%6% ;nop^YZ qrsLtuvwxyqrz{|}Q< M;~Ck<r!r *v YZ23. KL78+9:gTu +9:,JK [5-6] Lv ; 78+jWT#V 4@¡ y¢qr£-¤¥¦\]^§¨©ª «¬+¤K­78+®<¢QKL¯°q [7] r±ª²%³´µ¶ ;KLQ·¸°qr¥ [8] ¦<78+¹+eº qr»¼½3+ º¾¿§¨ÀÁÂ3I+eº¹MÃÄUe§ [9] ¨ÅÆ ;78+qr¥¦|}|FVÇÈu ÉÊqr!qËV+ÌÍ,ÎÂ3ÉeÏÐ ¦<78+9:Ñqr¥¦ÒÓ§ [10-11] ;qr<¹+eºM}Ô[|} +9:,JKLQÕÖ×Ø Ùu 8¨£-¤ÚÛqrsLqrÜ|FÝÞ!¥º 7 8+{z78+ßàáâãäÓ±+9: [12] ,JKLQ ;å +eº¹æçqr< 78+¥¦ÜWX 78+,JKLQ ;èKL.éQê¨ë|}/ìÆíîïT [13] WXðñ ;ò¼Pxr Õóô õrö÷Pøùrg~ Ckúûüý; røù/þVg¨|Fø! !!z! ô Wr tu9:ø<¨;rú û=<VÇÊrøù23e rXÕó\"røù ¨Pr!+,-!' 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Box 10002, Shenyang 110180 www.CRTER.org www.CRTER.org . ˖ ˖ ˖ ˖!"#$%&'()*+#$%,-./0 1&234(5426$7289:;2<=>?@ABC !"DE FGHI&JK-L!"#$% MNOP QRK+STUV!"&'WXYZ[\]^_`.abcd ef !"Dg.hijk!"&'- qr !"s2tus2vw_s2dxs)yzMN {|}~!"l2" l$m.nop MN.a)$ %!")U&'#$%.!" l2 )!"sE { ,.a.a ¡¢.£¤¥¦.§¨© 4 খ㗗᭛⤂ References [1] Geetha M,Singh AK,Asokamani R,et al.Ti based biomaterials, the ultimate choice for orthopaedic implantsea review. Prog Mater Sci.2009;54:397-425. ,,,.2007-2008 [2] [J].,2009,8(4):117-118. [3] Cristina A.Biomaterial-centered infection:microbial adhesion versus tissue integration.Science.1987; 237(4822): 1588-1595. [4] Campoccia D,Montanaro L,Arciola CR.The significance of infection related to orthopedic devices and issues of antibiotic resistance.Biomaterials.2006;27:2331-2339. [5] Uçkay I,Hoffmeyer P,Lew D,et al.Prevention of surgical site infections in orthopaedic surgery and bone trauma: state-of-the-art update.J Hosp Infect.2013;84(1):5-12. [6] Arciola CR,Campoccia D,Speziale P,et al.Biofilm formation in Staphylococcus implant infections. A review of molecular mechanisms and implications for biofilm-resistant materials. Biomaterials.2012;33(26):5967-5982. [7] Andrej T,Werner Z.Antimicrobial Agents in orthopaedic Surgery. Drugs.2006; 66(5):1089-1105. [8] Williams DL,Sinclair KD,Jeyapalina S,et al.Characterization of a novel active release coating to prevent biofilm implantrelated infections.J Biomed Mater Res B Appl Biomater. 2013; 101(6):1078-1089. [9] Monteiro DR,Gorup LF,Takamiya AS,et al.The growing importance of materials that prevent microbial adhesion: antimicrobial effect of medical devices containing silver. Int J Antimicrob Agents.2009;34:103-110. [10] Speziale P,Pietrocola G,Rindi S,et al.Structural and functional role ofStaphylococcus aureussurface components recognizing adhesive matrix molecules of the host. Future Microbiol.2009;4(10):1337-1352. [11] Campoccia D,Speziale P,Ravaioli S,et al.The presence of both bone sialoprotein-binding protein gene and collagen adhesin gene as a typical virulence trait of the major epidemic cluster in isolates from orthopedic implant infections. Biomaterials.2009;30(34):6621-6628. [12] Buchmann R,Khoury F.The microflora recovered from the outer-surfaces of the Frialit-2 implanto-prosthetic connector.Clin Oral Implants Res.2003;14(1):28-34. ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH [13] Jahoda D,Nyc O,Pokorny D,et al.Antibiotictreatment forpreventionof infectiouscomplications injoint replacement. Acta Chir Orthop Traumatol Cech.2006; 73:108-114 [14] Bos R,Van Der Mei HC,Busscher HJ.Physico-chemistry of initial microbial adhesive interactions- its mechanisms and methods for study.FEMS Microbiol Rev.1999;23:179-229. [15] An YH,Friedman RJ,Draughn RA,et al.Rapid quantification of staphylococci adhered to titanium surfaces using image analyzed epifluorescence microscopy.J Microbiol Methods. 1995;24:29-40. [16] Jahoda D,Nyc O,Pokorny D,et al.Antibiotic treatment for prevention of infectious complications in joint replacement. Acta Chir Orthop Traumatol Cech.2006;73: 108-114. [17] Hetrick EM,Schoenfisch MH.Reducing implant-related infections: active release strategies.Chem Soc Rev.2006; 35(9):780-789. [18] Buchholz HW,Engelbrecht H.Uber die Depotwirkung einiger Antibiotika bei Vermischung mit dem Kunstharz Palacos. Chirurg.1970;41:511-515. [19] Bernthal NM,Stavrakis AI,Billi F,et al.A mousemodel of post-arthroplasty Staphylococcus aureus joint infection to evaluate in vivo the efficacy of antimicrobial implant coatings. PLoS One.2010;5:12580. [20] Alt V,Bitschnau A,Osterling J,et al.The effects of combined gentamicin-hydroxyapatite coating for cementless joint prostheses on the reduction of infection rates in a rabbit infection prophylaxis model.Biomaterials.2006;27:4627-4634. [21] Stigter M,Bezemer J,de Groot K,et al.Incorporation of different antibiotics into carbonated hydroxyapatite coatings on titanium implants,release and antibiotic efficacy.J Control Release.2004;99:127-137. [22] Darouiche BO,Mausouri MD,Zakarevicz D,et al.In vivo efficacy of antimicrobial-coated devices.J Bone Joint Surg Am.2007;89:792-797. [23] Radin S,Campbell JT,Ducheyne P,et al.Calcium phosphate ceramic coatings as carriers of vancomycin.Biomaterials. 1997;18:777-782. [24] Gautier H,Merle C,Auget JL,et al.Isostatic compression, a new process for incorporating vancomycin into biphasic calcium phosphate: Comparison with a classical method. Biomaterials.2000;21:243-249. [25] Jahoda D,Nyc O,Pokorny D,et al.Antibiotic treatment for prevention of infectious complications in joint replacement. Acta Chir Orthop Traumatol Cech.2006;73:108-114. [26] Taylor EN,Webster TJ.The use of superparamagnetic nanoparticles for prosthetic biofilm prevention.Int J Nanomedi. 2009;4:145-152. [27] Maddikeri RR,Tosatti S,Schuler M,et al.Reduced medical infection related bacterial strains adhesion on bioactive RGD odified titanium surfaces: a first step toward cell selective surfacesJ Biomed Mater Res.2008;84A:425-435. [28] Zilberman M,Elsner JJ.Antibiotic-eluting medical devices for various applications.J Controll Release.2008;130: 202-215. [29] Aninwene GE,Yao C,Webster TJ.Enhanced osteoblast adhesion to drug-coated anodized nanotubular titanium surfaces.Int J Nanomedi.2008;3:257-264. [30] Lucke M,Schmidmaier G,Sadoni S,et al.Gentamicin coating of metallic implants reduces implant-related osteomyelitis in rats.Bone.2003;32:521-531. 4073 www.CRTER.org . [31] Radin S,Ducheyne P.Controlled release of vancomycin from thin sol-gel films on titanium alloy fracture plate material. Biomaterials.2007;28:1721-1729. [32] Tunney MM,Ramage G,Patrick S,et al. susceptibility of bacteria isolated from orthopedic implants following revision hip surgery.Antimicrob Agents Chemother.1998;42: 3002-3005 [33] Antoci V Jr,Adams CS,Hickok NJ,et al.Antibiotics for local delivery systems cause skeletal cell toxicity in vitro. Clin Orthop Relat Res.2007;462:200-206. [34] Ince A,Schutze N,Hendrich C,et al.In vitro investigation of orthopedic titanium-coated and brushite-coated surfaces using human osteoblasts in the presence of gentamycin.J Arthroplasty.2008;23:762-771. [35] Kim WH,Lee SB,Oh KT,et al.The release behavior of CHX from polymer-coated titanium surfaces.Surf Interface Anal. 2008;40:202-204. [36] Barbour ME,O’Sullivan DJ,Jagger DC.Chlorhexidine adsorption to anatase and rutile titanium dioxide.Colloids Surf A.2007;307:116-120. [37] Heasman PA,Heasman L Stacey F,et al.Local delivery of chlorhexidine gluconate (PerioChip) in periodontal maintenance patients.J Clin Periodontol.2001;28:90-95. [38] Kozlovsky A,Artzi Z,Moses O,et al.Interaction of chlorhexidine with smooth and rough types of titanium surfaces.J Periodontol. 2006;77:1194-1200. [39] Harris LG,Mead L,Muller-Oberlander E,et al.Bacteria and cell cytocompatibility studies on coated medical grade titanium surfaces.J Biomed Mater Res A.2006;78:50-58. [40] Campbell AA,Song L,Li XS,et al.Development, characterization, and anti-microbial efficacy of hydroxyapatite-chlorhexidine coatings produced by surface-induced mineralization. J Biomed Mater Res.2000;53: 400-407. [41] Morra M,Cassinelli C,Cascardo G,et al.Adsorption of cationic antibacterial on collagen-coated titanium implant devices. Biomed Pharmacother.2004;58:418-422. [42] Ince A,Schutze N,Hendrich C,et al.Effect of polyhexanide and gentamycin on human osteoblasts and endothelial cells.Swiss Med Wkly.2007;137:139-145. [43] Lee D,Cohen RE,Rubner MF.Antibacterial properties of Ag nanoparticle loaded multilayers and formation of magnetically directed antibacterial microparticles. Langmuir.2005;21: 9651-9659. [44] Li JX,Wang J,Shen LR,et al.The influence of polyethylene terephthalate surfaces modified by silver ion implantation on bacterial adhesion behavior. Surf Coat Technol. 2007;201: 8155-8159. [45] Gosheger G,Hardes J,Ahrens H,et al.Silver-coated megaendoprostheses in a rabbit model-an analysis of the infection rate and toxicological side effects.Biomaterials. 2004;25:5547-56. [46] Percival SL,Bowler PG,Russell D.Bacterial resistance to silver in wound care.J Hosp Infect.2005;60:1-7. [47] Rojas IA,Slunt JB,Grainger DW.Polyurethane coatings release bioactive antibodies to reduce bacterial adhesion. J Control Release.2000;63:175-189. [48] Hardes J,Ahrens H,Gebert C,et al.Lack of toxicological side-effects in silvercoated megaprostheses in humans. Biomaterials.2007;28:2869-2875. 4074 [49] Zhang W,Luo Y,Wang H,et al.Ag and Ag/N(2) plasma modification of polyethylene for the enhancement of antibacterial properties and cell growth/proliferation.Acta Biomater.2008;4:2028-2036. [50] Kwok SCH,Zhang W,Wan GJ,et al.Hemocompatibility and anti-bacterial properties of silver-doped diamond-like carbon prepared by pulsed filtered cathodic vacuum arc deposition.Diamond Relat Mater.2007;16:1353-1360. [51] Ewald A,Gluckermann SK,Thull R,et al.Antimicrobial titanium/silver PVD coatings on titanium.Biomed Eng Online.2006;5:22. [52] Chen W,Liu Y,Courtney HS,et al.In vitro anti-bacterial and biological properties of magnetron co-sputtered silver-containing hydroxyapatite coating.Biomaterials. 2006;27:5512-5517. [53] Chung J,Hsieh MF,Huang CW,et al.Antimicrobial effects and human gingival biocompatibility of hydro-xyapatite sol-gel coatings.J Biomed Mater Res B. 2005;76:169-178. [54] Vester H,Wildemann B,Schmidmaier Q,et al.Gentamycin delivered from a PDLLA coating of metallic implants in vivo and in vi-tro characterisation for local prophylaxis of implant-related osteo-myelitis.Injury.2010;41(10): 1053-1059. [55] Wan YZ,Raman S,He F,et al.Surface modification of medical metals by ion implantation of silver and copper.Vacuum. 2007; 81:1114-1118. [56] Ewald A,Gluckermann SK,Thull R,et al.Antimicrobial titanium/silver PVD coatings on titanium.Biomed Eng Online. 2006;5:22. [57] Chen W,Oh S,Ong AP,et al.Antibacterial and osteogenic propeffies of silver-containing hydroxyapatite coatings produced using a sol gel processJ Biomed Mater Res A. 2007;82(4):899-906. [58] Bosetti M,Masse A,Tobin E,et al.Silver coated materials for external fixation devices: In vitro biocompatibility and genotoxicity.Biomaterials.2002;23:887-892. [59] Secinti KD,Ayten M,Kahilogullari G,et al.Antibacterial effects of electrically activated vertebral implants.J Clin Neurosci. 2008; 15:434-439. [60] Feng QL,Wu J,Chen GQ,et al.A mechanistic study of the antibacterial effect of silver ions on Escherichia coli and Staphylococcus aureus.J Biomed Mater Res.2000;52: 662-668 [61] Kim JS,Kuk E,Yu KN,et al.Antimicrobial effects of silver nanoparticles.Nanomedicine.2007;3:95-101. [62] Li WR,Xie XB,Shi QS,et al.Antibacterial activity and mechanism of silver nanoparticles on Escherichia coli.Appl Microbiol Biotechnol.2010;85:1115-1122 [63] Kim KJ,Sung WS,Suh BK,et al.Antifungal activity and mode of action of silver nano-particles on Candida albicans.Biometals. 2009;22:235-242 [64] Yoshinari M,Oda Y,Kato T,et al.Influence of surface modifications to titanium on antibacterial activity in vitro. Biomaterials.2001;22:2043-2048. [65] Petrini P,Arciola CR,Pezzali I,et al.Antibacterial activity of zinc modified titanium oxide surface.Int J Artif Organs.2006; 29: 434-442. [66] Jeyachandran YL,Narayandass SK,Mangalaraj D,et al.A study on bacterial attachment on titanium and hydroxyapatite based films.Surf Coat Technol.2006;201:3462-3474. P.O. Box 10002, Shenyang 110180 www.CRTER.org www.CRTER.org . [67] Wan YZ, Xiong GY, Liang H, et al.Modification of medical metals by ion implantation of copper. Appl Surf Sci 2007; 253:9426-9429. [68] Chin MY,Sandham A,de Vries J,et al.Biofilm formation on surface characterized micro-implants for skeletal anchorage in orthodontics.Biomaterials.2007;28:2032-2040. [69] Gottenbos B,van der Mei HC,Klatter F,et al.Positively charged biomaterials exert antimicrobial effects on gram-negative bacilli in rats.Biomaterials.2003;24:2707-2710. [70] Verran J,Whitehead K.Factors affecting microbial adhesion to stainless steel and other materials used in medical devices.Int J Artif Organs.2005;28:1138-1145. [71] Legeay G,Poncin-Epaillard F,Arciola CR.New surfaces with hydrophilic/hydrophobic characteristics in relation to (no)bioadhesion.Int J Artif Organs.2006;29:453-461. [72] Gallardo-Moreno AM,Pacha-Olivenza MA,Saldana L,et al.In vitro biocompatibility and bacterial adhesion of physicochemically modified Ti6Al4V surface by means of UV irradiation. Acta Biomater.2009;5:181-192. [73] Aita H,Hori N,Takeuchi M,et al.The effect of ultraviolet functionalization of titanium on integration with bone. Biomaterials.2009;30:1015-1025. [74] Del Curto B,Brunella MF,Giordano C,et al.Decreased bacterial adhesion to surface-treated titanium.Int J Artif Organs.2005;28:718-730. [75] Koerner RJ,Butterworth LA,Mayer IV,et al.Bacterial adhesion to titanium-oxy-nitride(TiNOX) coatings with different resistivities: A novel approach for the development of biomaterials.Biomaterials.2002;23:2835-2840. [76] Roosjen A,Kaper HJ,van der Mei HC,et al.Inhibition of adhesion of yeasts and bacteria by poly(ethylene oxide)-brushes on glass in a parallel plateflow chamber. Microbiology.2003;149(Pt 11):3239-3246. [77] Gorth DJ,Puckett S,Ercan B,et al.Decreased bacteria activity on Si(3)N(4) surfaces compared with PEEK or titanium.Int J Nanomed.2012;7:4829-4840. [78] Wang Q,Uzunoglu E,Wu Y,et al.Self-assembled poly(ethylene glycol)-co-acrylic acid microgels to inhibit bacterial colonization of synthetic surfaces.ACS Appl Mater Interfaces. 2012;4(5):2498-2506. [79] Zhang F,Zhang Z,Zhu X,et al.Silk-functionalized titanium surfaces for enhancing osteoblast functions and reducing bacterial adhesion.Biomaterials.2008;29:4751-4759. [80] Harris LG,Tosatti S,Wieland M,et al.Staphylococcus aureus adhesion to titanium oxide surfaces coated with non-functionalized and peptide-functionalized poly(L-lysine)grafted-poly(ethylene glycol) copolymers.Biomaterials. 2004; 25:4135-4148. [81] Singla AK,Chawla MM.Chitosan: Some pharmaceutical and biological aspects-AN update.J Pharm Pharmacol.2001;53: 1047-1067. ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH [82] [83] [84] [85] [86] [87] [88] [89] [90] [91] [92] [93] [94] [95] [96] [97] Chua PH,Neoh KG,Kang ET,et al.Surface functionalization of titanium with hyaluronic acid/chitosan polyelectrolyte multilayers and RGD for promoting osteoblast functions and inhibiting bacterial adhesion.Biomaterials.2008;29: 1412-1421. Kim IY,Seo SJ,Moon HS,et al.Chitosan and its derivatives for tissue engineering applications. Biotechnol Adv.2008;26:1-21. Bumgardner JD,Wiser R,Gerard PD,et al.Chitosan:potential use as a bioactive coating for orthopaedic and craniofacial/ dental implants.J Biomater Sci Polym Ed. 2003;14:423-438. Lahiji A,Sohrabi A,Hungerford DS,et al.Chitosan supports the expression of extracellular matrix proteins in human osteoblasts and chondrocytes.J Biomed Mater Res.2000;51: 586-595. Khor E,Lim LY.Implantable applications of chitin and chitosan. Biomaterials. 2003;24:2339-2349. Martin HJ,Schulz KH,Bumgardner JD,et al.An XPS study on the attachment of triethoxsilylbutyraldehyde to two titanium surfaces as a way to bond chitosan.Appl Surf Sci.2008;254: 4599-4605. Bumgardner JD,Chesnutt BM,Yuan Y,et al.The integration of chitosan-coated titanium in bone: an in vivo study in rabbits. Implant Dent.2007;16:66-79. Milovic NM,Wang J,Lewis K,et al.Immobilized N-alkvlated polyethy- lenimine avidly kills bacteria by rupturing Cell membraves with no resistance developed.Bioeng.2005; 90:715-722 Montanaro L,Campoccia D,Arciola CR.Nanostructured materials for inhibition of bacterial adhesion in orthopedic implants: a minireview.Int J Artif Organs. 2008;31(9):771. Jena P,Mohanty S,Mallick R,et al.Toxicity and antibacterial assessment of chitosan-coated silver nanoparticles on human pathogens and macrophage cells.Int J Nanomed.2012;7: 1805-1818. Wang J,de Boer J,de Groot K.Proliferation and differentiation of MC3T3-E1 cells on calcium phosphate/chitosan coatings.J Dent Res.2008;87:650-654. Stefánsdóttir A,Johansson A,Lidgren L,et al. Bacterialcolonization and resistance patterns in 133 patients undergoing a primary hip- or knee replacement in Southern Sweden. Acta Orthop 2013;84(1). Yasunaga H,Tsuchiya K,Matsuyama Y,et al. Analysis of factors affecting operating time, postoperative complications, and length of stay for total knee arthroplasty: nationwide web-based survey. J Orthop Sci.2009;14(1):10-16. Ridgeway S,Wilson J,Charlet A,et al.Infection of the surgical site after arthroplasty of the hip.J Bone Joint Surg Br.2005; 87(6): 844-850. Hanssen AD.Managing the infected knee: As good as it gets.J Arthroplasty. 2002;17:98-101. Ehrlich GD,Stoodley P,Kathju S,et al.Engineering approaches for the detection and control of orthopaedic biofilm infections.Clin Orthop Relat Res.2005;437:59-66. 4075