In vivo reduction of biofilm seeded on orthopaedic implants: safety and efficacy of portable electromagnetic induction heating
Aims: Electromagnetic induction heating has demonstrated in vitro antibacterial efficacy over biofilms on metallic biomaterials, although no in vivo studies have been published. Assessment of side effects, including thermal necrosis of adjacent tissue, would determine transferability into clinical...
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The British Editorial Society of Bone & Joint Surgery
2024-12-01
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| Series: | Bone & Joint Research |
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| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.1312.BJR-2024-0111.R2 |
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| author | Enrique Cordero García-Galán Marina Medel-Plaza José J. Pozo-Kreilinger Héctor Sarnago Óscar Lucía Alicia Rico-Nieto Jaime Esteban Enrique Gomez-Barrena |
| author_facet | Enrique Cordero García-Galán Marina Medel-Plaza José J. Pozo-Kreilinger Héctor Sarnago Óscar Lucía Alicia Rico-Nieto Jaime Esteban Enrique Gomez-Barrena |
| author_sort | Enrique Cordero García-Galán |
| collection | DOAJ |
| description | Aims: Electromagnetic induction heating has demonstrated in vitro antibacterial efficacy over biofilms on metallic biomaterials, although no in vivo studies have been published. Assessment of side effects, including thermal necrosis of adjacent tissue, would determine transferability into clinical practice. Our goal was to assess bone necrosis and antibacterial efficacy of induction heating on biofilm-infected implants in an in vivo setting. Methods: Titanium-aluminium-vanadium (Ti6Al4V) screws were implanted in medial condyle of New Zealand giant rabbit knee. Study intervention consisted of induction heating of the screw head up to 70°C for 3.5 minutes after implantation using a portable device. Both knees were implanted, and induction heating was applied unilaterally keeping contralateral knee as paired control. Sterile screws were implanted in six rabbits, while the other six received screws coated with Staphylococcus aureus biofilm. Sacrifice and sample collection were performed 24, 48, or 96 hours postoperatively. Retrieved screws were sonicated, and adhered bacteria were estimated via drop-plate. Width of bone necrosis in retrieved femora was assessed through microscopic examination. Analysis was performed using non-parametric tests with significance fixed at p ≤ 0.05. Results: The width of necrosis margin in induction heating-treated knees ranged from 0 to 650 μm in the sterile-screw group, and 0 to 517 μm in the biofilm-infected group. No significant differences were found between paired knees. In rabbits implanted with sterile screws, no bacteria were detected. In rabbits implanted with infected screws, a significant bacterial load reduction with median 0.75 Log10 colony-forming units/ml was observed (p = 0.016). Conclusion: Induction heating was not associated with any demonstrable thermal bone necrosis in our rabbit knee model, and might reduce bacterial load in S. aureus biofilms on Ti6Al4V implants. Cite this article: Bone Joint Res 2024;13(12):695–702. |
| format | Article |
| id | doaj-art-442f8652e18240a8a4214539ef47ce3e |
| institution | Kabale University |
| issn | 2046-3758 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
| record_format | Article |
| series | Bone & Joint Research |
| spelling | doaj-art-442f8652e18240a8a4214539ef47ce3e2025-01-28T06:54:06ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Research2046-37582024-12-01131269570210.1302/2046-3758.1312.BJR-2024-0111.R2In vivo reduction of biofilm seeded on orthopaedic implants: safety and efficacy of portable electromagnetic induction heatingEnrique Cordero García-Galán0https://orcid.org/0000-0001-8103-703XMarina Medel-Plaza1https://orcid.org/0000-0002-2870-1306José J. Pozo-Kreilinger2https://orcid.org/0000-0001-5895-4112Héctor Sarnago3https://orcid.org/0000-0001-8399-4650Óscar Lucía4https://orcid.org/0000-0002-1284-9007Alicia Rico-Nieto5https://orcid.org/0000-0002-4364-2973Jaime Esteban6https://orcid.org/0000-0002-8971-3167Enrique Gomez-Barrena7https://orcid.org/0000-0003-1065-6137Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Príncipe de Asturias, Madrid, SpainDepartment of Clinical Microbiology, IIS-Fundacion Jimenez Diaz, Madrid, SpainDepartment of Anathomopathology, Hospital La Paz-IdPAZ, Universidad Autónoma de Madrid, Madrid, SpainDepartment of Electronic Engineering and Communications, I3A Universidad de Zaragoza, Zaragoza, SpainDepartment of Electronic Engineering and Communications, I3A Universidad de Zaragoza, Zaragoza, SpainDepartment of Infectious Diseases, Hospital La Paz-IdPAZ, Universidad Autónoma de Madrid, Madrid, SpainDepartment of Clinical Microbiology, IIS-Fundacion Jimenez Diaz, Madrid, SpainDepartment of Orthopaedic Surgery and Traumatology, Hospital La Paz-IdPAZ, Universidad Autónoma de Madrid, Madrid, SpainAims: Electromagnetic induction heating has demonstrated in vitro antibacterial efficacy over biofilms on metallic biomaterials, although no in vivo studies have been published. Assessment of side effects, including thermal necrosis of adjacent tissue, would determine transferability into clinical practice. Our goal was to assess bone necrosis and antibacterial efficacy of induction heating on biofilm-infected implants in an in vivo setting. Methods: Titanium-aluminium-vanadium (Ti6Al4V) screws were implanted in medial condyle of New Zealand giant rabbit knee. Study intervention consisted of induction heating of the screw head up to 70°C for 3.5 minutes after implantation using a portable device. Both knees were implanted, and induction heating was applied unilaterally keeping contralateral knee as paired control. Sterile screws were implanted in six rabbits, while the other six received screws coated with Staphylococcus aureus biofilm. Sacrifice and sample collection were performed 24, 48, or 96 hours postoperatively. Retrieved screws were sonicated, and adhered bacteria were estimated via drop-plate. Width of bone necrosis in retrieved femora was assessed through microscopic examination. Analysis was performed using non-parametric tests with significance fixed at p ≤ 0.05. Results: The width of necrosis margin in induction heating-treated knees ranged from 0 to 650 μm in the sterile-screw group, and 0 to 517 μm in the biofilm-infected group. No significant differences were found between paired knees. In rabbits implanted with sterile screws, no bacteria were detected. In rabbits implanted with infected screws, a significant bacterial load reduction with median 0.75 Log10 colony-forming units/ml was observed (p = 0.016). Conclusion: Induction heating was not associated with any demonstrable thermal bone necrosis in our rabbit knee model, and might reduce bacterial load in S. aureus biofilms on Ti6Al4V implants. Cite this article: Bone Joint Res 2024;13(12):695–702.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.1312.BJR-2024-0111.R2biofilmperiprostheticinfectionelectromagneticinductionbiofilmsorthopaedic implantskneesrabbitsbacteriafemorathermal necrosisstaphylococcus aureuscontralateral kneemedial condyle |
| spellingShingle | Enrique Cordero García-Galán Marina Medel-Plaza José J. Pozo-Kreilinger Héctor Sarnago Óscar Lucía Alicia Rico-Nieto Jaime Esteban Enrique Gomez-Barrena In vivo reduction of biofilm seeded on orthopaedic implants: safety and efficacy of portable electromagnetic induction heating Bone & Joint Research biofilm periprosthetic infection electromagnetic induction biofilms orthopaedic implants knees rabbits bacteria femora thermal necrosis staphylococcus aureus contralateral knee medial condyle |
| title | In vivo reduction of biofilm seeded on orthopaedic implants: safety and efficacy of portable electromagnetic induction heating |
| title_full | In vivo reduction of biofilm seeded on orthopaedic implants: safety and efficacy of portable electromagnetic induction heating |
| title_fullStr | In vivo reduction of biofilm seeded on orthopaedic implants: safety and efficacy of portable electromagnetic induction heating |
| title_full_unstemmed | In vivo reduction of biofilm seeded on orthopaedic implants: safety and efficacy of portable electromagnetic induction heating |
| title_short | In vivo reduction of biofilm seeded on orthopaedic implants: safety and efficacy of portable electromagnetic induction heating |
| title_sort | in vivo reduction of biofilm seeded on orthopaedic implants safety and efficacy of portable electromagnetic induction heating |
| topic | biofilm periprosthetic infection electromagnetic induction biofilms orthopaedic implants knees rabbits bacteria femora thermal necrosis staphylococcus aureus contralateral knee medial condyle |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.1312.BJR-2024-0111.R2 |
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