Evidence map›Paper›PMID 32761434›Full record

SynthesisInternational orthopaedics2021

Is coating of titanium implants effective at preventing Staphylococcus aureus infections? A meta-analysis of animal model studies.

Konstantinos Tsikopoulos, Konstantinos Sidiropoulos, Dimitrios Kitridis, Anas Hassan, Lorenzo Drago, Andreas Mavrogenis, Donald McBride

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in International orthopaedics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Antibacterial hydrogel coating in joint mega-prosthesis: results of a comparative series.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2021
    Article
  6. Review
  7. 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

7 authors.

Konstantinos TsikopoulosOrthopaedic Department, Royal Surrey Hospital, Guildford, UK. ktsikopo@auth.gr.ORCID http://orcid.org/0000-0001-5923-4782
Konstantinos SidiropoulosOrthopaedic Department, General Hospital of Serres, Drama, Greece.
Dimitrios Kitridis1st Orthopaedic Department of Aristotle University, G. Papanikolaou General Hospital, Exohi, Thessaloniki, Greece.
Anas HassanOrthopaedic Department, Lister Hospital, Stevenage, East and North Hertfordshire, UK.
Lorenzo DragoLaboratory of Clinical Microbiology, Department of Biochemical Sciences for Health, University of Milan, Milan, Italy.
Andreas MavrogenisOrthopaedic Department, National and Kapodistrian University of Athens, Athens, Greece.
Donald McBrideOrthopaedic Department, University Hospitals of North Midlands, Stoke-on-Trent, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aim of the studyTo assess the effects of the available coating methods against methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) biofilm development on titanium implants.

methodsWe searched the MEDLINE, Embase, and CENTRAL databases until May 18, 2019, for studies that used animal models of infections to evaluate various titanium implant coating methods to prevent S. aureus infection. Twenty-seven studies were eligible for inclusion in qualitative synthesis. Of those, twenty-three were considered in pair-wise meta-analysis. In addition, subgroup analysis of implant protection strategies relative to uncoated controls was performed, and any adverse events stemming from the coating applications were reported. Quality assessment was performed using SYRCLE's risk of bias tool for animal studies.

resultsMeta-analysis showed that active coating with antibiotics was favoured over uncoated controls (standardised mean differences [SMD] for MRSA and MSSA were - 2.71 [95% CI, - 4.24 to - 1.18], p = 0.0005, and - 2.5 [- 3.79 to - 1.22], p = 0.0001, respectively). Likewise, large effect sizes were demonstrated when a combination of active and conventional non-degradable passive coatings was compared with controls (SMDs for MRSA and MSSA were - 0.62 [95% CI, - 1.15 to - 0.08], p = 0.02, and - 1.93 [95% CI, - 2.87 to - 0.98], p < 0.001, respectively). DISCUSSION/

conclusionAs a standalone prevention method, active titanium coating with antibiotics yielded promising results against both MSSA and MRSA. Combinations between active and non-degradable passive coatings, potentially allowing for sustained antimicrobial substance release, provided consistent hardware infection protection. Thus, we recommend that future research efforts focus on combined coating modalities against S. aureus biofilm infections in the presence of titanium implants. SYSTEMATIC REVIEW REGISTRATION: CRD42019123462.

Indexed as

Methicillin-Resistant Staphylococcus aureusStaphylococcal InfectionsAnimalsAnti-Bacterial AgentsProstheses and ImplantsStaphylococcus aureusTitaniumAnti-Bacterial AgentsTitaniumBiofilmCoatingInfection preventionProphylaxisStaphylococcusTitanium

Identifiers

PMID32761434

What OpenQuestion holds

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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.