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
ARTICLE HIGHLIGHTS
Research 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. Many of these strategies have focused on chemical measures to reduce and treat infections.
Research motivation
Our study group has been developing novel strategies for the treatment and prevention of orthopedic implant-related infections. These have been focused on the application of electrical currents to surface metals in the presence of bacteria to prevent adhesion and disrupt biofilm formation.
Research objectives
The objective of our study was to analyze the effect of alternating current electrical fields on bacterial adherence to a titanium surface for gram-positive and gram-negative bacteria.
Research methods
Using a self-designed 12-well culture plate, we analyzed the potential effect of electrical currents in reducing bacterial adhesion to a titanium metal surface. Gram-positive bacteria, represented by Staphylococcus aureus (S. aureus), and gram-negative bacteria, represented by 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, colony-forming units per milliliter were counted and compared to a control without exposure to electrical currents.
Research 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.
Research conclusions
Our results demonstrate electrical fields may have promising applications in preventing bacterial adhesion to titanium metal surfaces. However, the presence of electrolysis and electrode oxidation lead us to presume these conditions may not be optimal for in vivo use.
Research perspectives
Further research using other electrical conditions must be examined to consider their use for in vivo trials.
