Bernaus M, Guillem-Marti J, Bermúdez-Castel A, Calero JA, Torres D, Veloso M, Font-Vizcarra L. Reducing bacterial adhesion to titanium surfaces using low intensity alternating electrical pulses. World J Orthop 2022; 13(6): 578-586 [PMID: 35949710 DOI: 10.5312/wjo.v13.i6.578]
Corresponding Author of This Article
Marti Bernaus, MD, Surgeon, Department of Orthopedics and Traumatology, Osteoarticular Infection Unit, Hospital Universitari Mutua Terrassa, Plaça Dr. Robert 5, Terrassa 08221, Spain. mbernaus@mutuaterrassa.cat
Research Domain of This Article
Orthopedics
Article-Type of This Article
Basic Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Jun 18, 2022; 13(6): 578-586 Published online Jun 18, 2022. doi: 10.5312/wjo.v13.i6.578
Reducing bacterial adhesion to titanium surfaces using low intensity alternating electrical pulses
Marti Bernaus, Jordi Guillem-Marti, Adrian Bermúdez-Castel, Jose Antonio Calero, Diego Torres, Margarita Veloso, Lluís Font-Vizcarra
Marti Bernaus, Margarita Veloso, Lluís Font-Vizcarra, Department of Orthopedics and Traumatology, Osteoarticular Infection Unit, Hospital Universitari Mutua Terrassa, Terrassa 08221, Spain
Jordi Guillem-Marti, Department of Materials Science and Metallurgical Engineering, Universitat Politecnica de Catalunya, Barcelona 08930, Spain
Jordi Guillem-Marti, Barcelona Research Center in Multiscale Science and Engineering, Universitat Politecnica de Catalunya, Barcelona 08930, Spain
Adrian Bermúdez-Castel, Lluís Font-Vizcarra, Innovative Minds, S.L., Terrassa 08224, Spain
Jose Antonio Calero, Diego Torres, AMES PM Tech Center, Sant Vicenç dels Horts 08980, Spain
Author contributions: Bernaus M, Guillem-Martí J, and Font-Vizcarra L have made substantial contributions to research design, acquisition, analysis, interpretation of data, and drafting the manuscript; Bermúdez A, Calero JA, Torres D, and Veloso M have made substantial contributions to interpretation of data and critically revising the manuscript; All authors have read and approved the final submitted manuscript.
Conflict-of-interest statement: Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/Licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marti Bernaus, MD, Surgeon, Department of Orthopedics and Traumatology, Osteoarticular Infection Unit, Hospital Universitari Mutua Terrassa, Plaça Dr. Robert 5, Terrassa 08221, Spain. mbernaus@mutuaterrassa.cat
Received: December 25, 2021 Peer-review started: December 25, 2021 First decision: March 7, 2022 Revised: March 20, 2022 Accepted: May 22, 2022 Article in press: May 22, 2022 Published online: June 18, 2022 Processing time: 173 Days and 16.5 Hours
Abstract
BACKGROUND
Orthopedic implant-related infection remains one of the most serious complications after orthopedic surgery. In recent years, there has been an increased scientific interest to improve prevention and treatment strategies. However, many of these strategies have focused on chemical measures.
AIM
To analyze the effect of alternating current electrical fields on bacterial adherence to titanium surfaces.
METHODS
Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) were exposed to 6.5 V electrical currents at different frequencies: 0.5 Hz, 0.1 Hz, and 0.05 Hz. After exposure, a bacterial count was then performed and compared to the control model. Other variables registered included the presence of electrocoagulation of the medium, electrode oxidation and/or corrosion, and changes in pH of the medium.
RESULTS
The most effective electrical model for reducing S. aureus adhesion was 6.5 V alternating current at 0.05 Hz achieving a 90% adhesion reduction rate. For E. coli, the 0.05 Hz frequency model also showed the most effective results with a 53% adhesion reduction rate, although these were significantly lower than S. aureus. Notable adhesion reduction rates were observed for S. aureus and E.coli in the studied conditions. However, the presence of electrode oxidation makes us presume these conditions are not optimal for in vivo use.
CONCLUSION
Although our findings suggest electrical currents may be useful in preventing bacterial adhesion to metal surfaces, further research using other electrical conditions must be examined to consider their use for in vivo trials.
Core Tip: Current strategies to prevent orthopedic implant infections have focused on chemical measures. Our data suggest electrical currents may be useful in preventing Staphylococcus aureus and Escherichia coli adhesion to titanium surfaces. Reduction in adhesion rates of up to 90% were observed when applying low intensity alternating currents on titanium surfaces. Further research is needed to consider the use of electrical currents for infection prevention in an in vivo scenario.
