Antimicrobial technology in orthopedic and spinal implants

Figure 1 Diagram of tibial nail with gentamicin coating (A), visualized on metal implant using scanning electron microscopy (B)[20].

Figure 2 Scanning electron microscopy images of Enterococcus faecalis-infected dentin blocks treated with saline and chlorhexidine. Blocks treated with saline solution for 10 min show many adhering Enterococcus faecalis (A, × 1500) with normal shape (B, × 20000). The group soaked with 2% chlorhexidine shows fewer adhering bacteria (C, × 1500) and chlorhexidine particles attached to bacterial membranes (D, × 20000, white arrows)[28].

Figure 3 Silver nanoparticles of two sizes: Small (A) and Large (B), visualized via transmission electron microscopy[42].

Figure 4 Schematic illustration of proposed photocatalytic and antibacterial mechanisms of a nanocomposite photocatalytic coating[55]. TiO₂: Titanium oxide.

Figure 5 Antibiotic loaded bone cement beads strung on braided stainless steel[58].

Figure 6 Fixation pins with tubular reservoirs for controlled drug release. Diagrams highlighting the principle design of fixation pins: A: Scheme of a drug releasing fixation pin. Note the permeation through the porous wall (arrows)[64]; B: Scheme of implanted fixation pins, each capable of eluting local antibiotics around fixation site[65].

Figure 7 Interaction between surface roughness and bacterial adhesion[69].

Figure 8 Atomic force microscopy of different surface film topography of increasing thickness (A: 50 nm; B: 100 nm; C: 200 nm; D: 300 nm)[68].

Figure 9 Micrograph and apparatus perspective of electrospinning technology. Scanning electron microscopy micrographs of PLGA electrospun coatings containing (A) vancomycin and (B) no drug[74]; C: Schematic of a charged electrospinning apparatus spinning a PLGA coating onto an implant device[71]. PLGA: Poly(lactic-co-glycolic acid).

Figure 10 Integration of antimicrobial biofilms into the implant process[75].