Evidence map›Paper›PMID 27440566›Full record

ArticleThe Journal of bone and joint surgery. American volume2016

In Vivo Efficacy of a "Smart" Antimicrobial Implant Coating.

Alexandra I Stavrakis, Suwei Zhu, Vishal Hegde, Amanda H Loftin, Alyssa G Ashbaugh, Jared A Niska, Lloyd S Miller, Tatiana Segura, Nicholas M Bernthal

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of bone and joint surgery. American volume, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed
5.0field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 51 citations in OpenAlex.

  1. Article
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  3. Review
  4. Electrophoretic Deposition of Gentamicin Into Titania Nanotubes Prevents Evidence of Infection in a Mouse Model of Periprosthetic Joint Infection.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2025
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  14. Article
  15. Article
  16. Novel in vivo mouse model of shoulder implant infection.Journal of shoulder and elbow surgery · 2020
    Article
  17. Biomaterials against Bone Infection.Advanced healthcare materials · 2020
    Review
  18. Article
  19. Antimicrobial coatings for orthopaedic implants - Ready for use?Journal of bone and joint infection · 2020
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Alexandra I StavrakisDepartment of Orthopaedic Surgery, Orthopaedic Hospital Research Center, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.
Suwei ZhuDepartment of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, California.
Vishal HegdeDepartment of Orthopaedic Surgery, Orthopaedic Hospital Research Center, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.
Amanda H LoftinDepartment of Orthopaedic Surgery, Orthopaedic Hospital Research Center, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.
Alyssa G AshbaughDepartment of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Jared A NiskaDepartment of Orthopaedic Surgery, Orthopaedic Hospital Research Center, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.
Lloyd S MillerDepartment of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Tatiana SeguraDepartment of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, California.
Nicholas M BernthalDepartment of Orthopaedic Surgery, Orthopaedic Hospital Research Center, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California nbernthal@mednet.ucla.edu.
University of California, Los Angeles · USJohns Hopkins Medicine · USJohns Hopkins University · US

Funding

UCLA Clinical and Translational Science InstituteKL2TR000122 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI DUBINETT, STEVEN M. · 2012 to 2015
$4.5M
Modifying and Delivering Antimicrobials to Prevent Orthopaedic Implant InfectionsK08AR069112 · NIAMS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI BERNTHAL, NICHOLAS M. · 2016 to 2019
$704k
NCATS NIH HHS KL2 TR000122NIAMS NIH HHS K08 AR069112
6 · The paper itself

Abstract

backgroundPostoperative infection is a devastating complication following arthroplasty. The goals of this study were to introduce a "smart" implant coating that combines passive elution of antibiotic with an active-release mechanism that "targets" bacteria, and to use an established in vivo mouse model of post-arthroplasty infection to longitudinally evaluate the efficacy of this polymer implant coating in decreasing bacterial burden.

methodsA novel, biodegradable coating using branched poly(ethylene glycol)-poly(propylene sulfide) (PEG-PPS) polymer was designed to deliver antibiotics both passively and actively. In vitro-release kinetics were studied using high-performance liquid chromatography (HPLC) quantification in conditions representing both the physiologic environment and the more oxidative, hyperinflammatory environment of periprosthetic infection. The in vivo efficacy of the PEG-PPS coating delivering vancomycin and tigecycline was tested using an established mouse model of post-arthroplasty infection. Noninvasive bioluminescence imaging was used to quantify the bacterial burden; radiography, to assess osseointegration and bone resorption; and implant sonication, for colony counts.

resultsIn vitro-release kinetics confirmed passive elution above the minimum inhibitory concentration (MIC). A rapid release of antibiotic was noted when challenged with an oxidative environment (p < 0.05), confirming a "smart" active-release mechanism. The PEG-PPS coating with tigecycline significantly lowered the infection burden on all days, whereas PEG-PPS-vancomycin decreased infection on postoperative day (POD) 1, 3, 5, and 7 (p < 0.05). A mean of 0, 9, and 2.6 × 10(2) colony-forming units (CFUs) grew on culture from the implants treated with tigecycline, vancomycin, and PEG-PPS alone, respectively, and a mean of 1.2 × 10(2), 4.3 × 10(3), and 5.9 × 10(4) CFUs, respectively, on culture of the surrounding tissue (p < 0.05).

conclusionsThe PEG-PPS coating provides a promising approach to preventing periprosthetic infection. This polymer is novel in that it combines both passive and active antibiotic-release mechanisms. The tigecycline-based coating outperformed the vancomycin-based coating in this study. CLINICAL RELEVANCE: PEG-PPS polymer provides a controlled, "smart" local delivery of antibiotics that could be used to prevent postoperative implant-related infections.

Indexed as

Absorbable ImplantsAnimalsAnti-Bacterial AgentsColony Count, MicrobialDisease Models, AnimalMiceMinocyclineProsthesis-Related InfectionsStaphylococcal InfectionsStaphylococcus aureusSurgical Wound InfectionTigecyclineVancomycinAnti-Bacterial AgentsMinocyclineTigecyclineVancomycin

Identifiers

PMID27440566
PMCPMC4994856
OpenAlexW2487376717

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.