Defensive antibacterial coating in orthopaedic surgery: Current evidence and future direction

doi:10.5312/wjo.v16.i7.107575

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World Journal of Orthopedics

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2218-5836

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Orthop. Jul 18, 2025; 16(7): 107575
Published online Jul 18, 2025. doi: 10.5312/wjo.v16.i7.107575

Defensive antibacterial coating in orthopaedic surgery: Current evidence and future direction

Richard Henry Randall Roberts, Charles Gamble, Ibrahim Malek

Richard Henry Randall Roberts, Charles Gamble, Ibrahim Malek, Department of Trauma and Orthopaedics, Wrexham Maelor Hospital, Wrexham LL13 7TD, United Kingdom

Ibrahim Malek, Faculty of Social and Life Sciences, Wrexham University, Wrexham LL11 2AW, United Kingdom

Author contributions: Roberts RHR conceptualised the review; Roberts RHR and Malek I contributed the planning process; Roberts RHR undertook the writing process; Roberts RHR; Gamble C and Malek I contributed significantly to the editing and refining of the manuscript for clarity and consistency. All authors reviewed the final manuscript before submission.

Conflict-of-interest statement: The authors declare that there are no conflicts of interest related to this manuscript.

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: Richard Henry Randall Roberts, Research Fellow, Department of Trauma and Orthopaedics, Wrexham Maelor Hospital, Croesnewydd Rd, Wrexham LL13 7TD, United Kingdom. richard.roberts@doctors.org.uk

Received: March 26, 2025
Revised: April 18, 2025
Accepted: June 3, 2025
Published online: July 18, 2025
Processing time: 113 Days and 5.1 Hours

Core Tip

Core Tip: Orthopaedic implant-related infections, including prosthetic joint and osteosynthesis-associated infections, significantly burden healthcare systems clinically and economically. Defensive antibacterial coating (DAC^®) hydrogel emerges as a promising bioresorbable adjunct to traditional prophylactic strategies, effectively reducing infection rates and antibiotic overuse in orthopaedic surgery. While robust evidence supports DAC^® in revision arthroplasty and trauma surgery, further high-quality studies are needed to confirm its role in primary joint replacement and expand applications to diverse patient populations and anatomical sites.