Evidence map›Paper›PMID 41615966›Full record

ArticlePloS one2026

In vitro assessment of antibacterial and biocompatibility properties of a poly-ε-lysine and hyaluronic acid contact-killing coating to prevent prosthetic joint infection.

Julia L van Agtmaal, Anniek M C Gielen, Sanne W G van Hoogstraten, Laura C W Peeters, Aghilas Akkache, Rajendra Kasinath, Nihal Engin Vrana, Nick R M Beijer, Tim J M Welting, Cynthia Calligaro and 1 more

Abstract read
In one paragraph

Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Review
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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

11 authors.

Julia L van AgtmaalDepartment of Orthopedic Surgery, Research Institute CAPHRI, Maastricht University Medical Center, Maastricht, the Netherlands.ORCID https://orcid.org/0000-0002-3377-7399
Anniek M C GielenNational Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
Sanne W G van HoogstratenDepartment of Orthopedic Surgery, Research Institute CAPHRI, Maastricht University Medical Center, Maastricht, the Netherlands.
Laura C W PeetersDepartment of Orthopedic Surgery, Research Institute CAPHRI, Maastricht University Medical Center, Maastricht, the Netherlands.
Aghilas AkkacheSPARTHA Medical, 1 Rue Eugène Boeckel, Strasbourg, France.
Rajendra KasinathDePuy Synthes Biomaterials, Warsaw, Indiana, United States of America.
Nihal Engin VranaDePuy Synthes Biomaterials, Warsaw, Indiana, United States of America.
Nick R M BeijerNational Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
Tim J M WeltingDepartment of Orthopedic Surgery, Research Institute CAPHRI, Maastricht University Medical Center, Maastricht, the Netherlands.
Cynthia CalligaroSPARTHA Medical, 1 Rue Eugène Boeckel, Strasbourg, France.ORCID https://orcid.org/0000-0002-1730-3695
Jacobus J C ArtsDepartment of Orthopedic Surgery, Research Institute CAPHRI, Maastricht University Medical Center, Maastricht, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Prosthetic joint infection (PJI) is a major adverse outcome following total hip and knee arthroplasties. With the rise of antimicrobial resistance, there is a risk of therapeutic insufficiency in treating PJI. This study determined the potential of a poly-ε-lysine and hyaluronic acid (PEL-10/HA144-1) contact-killing coating as a promising prevention of bacterial attachment. A broader development perspective was integrated through a Safe-by-Design approach by adding relevant in vitro tests for implant-host interactions. The PEL-10/HA144-1 coating was deposited on titanium alloy Ti6Al4V (Ti) and ultra-high-molecular-weight-polyethylene (UHMWPE). A combination of the ISO 22196, ASTM E2180-18, and JIS Z 2801 testing standards using Staphylococcus aureus and Escherichia coli demonstrated a bactericidal effect of the coating, up to a 5-log reduction compared to uncoated samples. A bacterial adhesion test showed a decrease in adherent bacteria up to 4-log after 4 h, and up to 5-log after 24 h between coated and uncoated samples. Saos-2 human osteoblast-like cells and L929 mouse fibroblasts exposed to 72 h extracts of the coating for 24 h showed in vitro cell viability of >70%, indicating no cytotoxicity according to ISO 10993-5. Furthermore, while initial osteoblast attachment to the coating appeared challenging, increased proliferation and metabolic activity over time were observed. After 14 and 21 days, no reduction in osteogenic marker expression was found on the coated samples compared to the uncoated samples. Overall, the PEL-10/HA144-1 coating reduced bacterial adhesion, was not cytotoxic to mammalian cells, and supported osteoblast function in vitro, making it a promising technique for future implantable orthopedic applications.

Indexed as

Anti-Bacterial AgentsCoated Materials, BiocompatibleHyaluronic AcidPolylysineProsthesis-Related InfectionsAlloysAnimalsBacterial AdhesionCell LineEscherichia coliFibroblastsHumansMaterials TestingMiceOsteoblastsPolyethylenesAlloysAnti-Bacterial AgentsCoated Materials, BiocompatibleHyaluronic AcidPolyethylenesPolylysineTitaniumtitanium alloy (TiAl6V4)ultra-high molecular weight polyethylene

Identifiers

PMID41615966
PMCPMC12857985

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Registered trials

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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.