Recent Advances in Antibacterial Coatings to Combat Orthopedic Implant-Associated Infections

Abstract

Implant-associated infections (IAIs) represent a major health burden due to the complex structural features of biofilms and their inherent tolerance to antimicrobial agents and the immune system. Thus, the viable options to eradicate biofilms embedded on medical implants are surgical operations and long-term and repeated antibiotic courses. Recent years have witnessed a growing interest in the development of robust and reliable strategies for prevention and treatment of IAIs. In particular, it seems promising to develop materials with anti-biofouling and antibacterial properties for combating IAIs on implants. In this contribution, we exclusively focus on recent advances in the development of modified and functionalized implant surfaces for inhibiting bacterial attachment and eventually biofilm formation on orthopedic implants. Further, we highlight recent progress in the development of antibacterial coatings (including self-assembled nanocoatings) for preventing biofilm formation on orthopedic implants. Among the recently introduced approaches for development of efficient and durable antibacterial coatings, we focus on the use of safe and biocompatible materials with excellent antibacterial activities for local delivery of combinatorial antimicrobial agents for preventing and treating IAIs and overcoming antimicrobial resistance.

Keywords: antibacterial; biofilm; infections; local antimicrobial agent delivery; lyotropic non-lamellar liquid crystalline phases; orthopedic implants; polymeric coatings.

Figure 1

Bacterial colonization and biofilm formation on a medical implant (created with BioRender.com (accessed on 29 February 2024)).

Figure 2

Biofilm prevention strategies. Design of anti-biofouling superhydrophobic surfaces (a), anti-biofouling superhydrophilic surfaces (b), anti-biofouling polymeric coatings (c), nanopatterned contact killing surfaces (d), contact-killing polymeric coatings (e), and antibiotic coatings (f) (created with BioRender.com (accessed on 15 February 2024)).

Figure 3

Non-lamellar liquid crystalline phases (Q₂ and H₂ nanostructures) for designing next-generation safe and efficient antibacterial coatings (created with BioRender.com (accessed on 15 February 2024)).