Electrical Stimulation for Eradication and Prevention of Implant-Associated Infections

Infection following orthopaedic interventions is a devastating complication associated with increased patient morbidity, longer hospital stays, and increased costs to the health care system. One of the primary mechanisms by which bacteria resist decontamination and persist in wounds and on implants is through the formation of biofilms. Bacteria in biofilms are highly resistant to antibiotics and necessitate that new strategies be developed for the eradication and/or prevention of device-related biofilm infections.

We have developed an electrical stimulation method and have provided proof-of-principle data showing that it can effectively prevent formation of and/or eradicate bacterial biofilms on implantable orthopaedic devices. We utilize a potentiostatic three-electrode configuration to precisely modulate the voltage-dependent electrochemical processes at the surface of the metallic implant to elicit the antimicrobial response, while maintaining biocompatibility with the bone tissue.  We are currently engaged in studies to further optimize this technology and treatment protocols.

Related Reports:

  • Canty MK, Luke-Marshall NR, Campagnari AA, Ehrensberger MT. “Cathodic voltage-controlled electrical stimulation of titanium for prevention of methicillin-resistant Staphylococcus aureus and Acinetobacter baumannii biofilm infections” Acta Biomaterialia, 48, 451-460, 2017

  • Nodzo SR, Tobias ME, Ahn R, Hansen LA, Luke-Marshall NR, Wild LM, Campagnari AA, Ehrensberger MT. “Cathodic Voltage-controlled Electrical Stimulation Plus Prolonged Vancomycin Reduce Bacterial Burden of a Titanium Implant-Associated Infection in a Rodent Model” Clinical Orthopedics and Related Research, 474(7): 1668-1675, 2016

  • Nodzo SR, Tobias ME, Nodzo SR, Hansen LA, Luke-Marshall NR, Cole RF, Wild LM, Campagnari AA, Ehrensberger MT. “ Cathodic Electrical Stimulation Combined With Vancomycin Enhances Treatment of Methicillin-Resistant Staphylococcus aureus Implant-associated Infections” Clinical Orthopedics and Related Research, 473:2856–2864, 2015

 

  • Ehrensberger MT, Tobias ME, Nodzo SR, Hansen LA, Luke-Marshall NR, Cole RF, Wild LM, Campagnari AA. “ Cathodic Voltage-Controlled Electrical Stimulation of Titanium Implants as Treatment for Methicillin-Resistant Periprosthetic Infections” Biomaterials, 41:97-105, 2015

Biodegradable Metallic Orthopedic Implants

Magnesium and many of its alloys are bioresorbable metals with mechanical properties closely aligned to natural bone and whose degradation (corrosion) products are postulated to stimulate osteogenic differentiation of mesenchymal stem cells. As such, these materials hold great promise for developing a new generation of orthopaedic devices and bone tissue engineering scaffolds with biomimetic mechanical properties, tailored corrosive degradation and resorption, and preferential stimulation of osteogenesis. Since the implant would eventually degrade away this also eliminates the need for a second surgery for hardware removal and would minimize the risk of a chronic foreign body reaction that can lead to fibrous bone healing and encapsulation of implants. 

Related Reports:

  • Brooks EK, Ahn R, Tobias ME, Hansen LA, Luke-Marshall NR, Campagnari AA, Ehrensberger MT. “Magensium Alloy AZ91 Exhibits Antimicrobial Properties In Vitro But Not In Vivo” Journal of Biomedical Materials Research, Part B- Applied Biomaterials, Online 1/1/2017

  • Brooks EK, Der S, Ehrensberger MT. “Corrosion and Mechanical Performance of AZ91 Exposed to Simulated Inflammatory Conditions” Materials Science and Engineering: C, Materials for Biological Applications 60:427-436, 2016.

  • Brooks EK, Tobias ME, Yang S, Bone LB, Ehrensberger MT. “ Influence of MC3T3-E1 Preosteoblast Culture on the Corrosion of a T6 Heat Treated AZ91 Alloy” Journal of Biomedical Materials Research, Part B- Applied Biomaterials, 104(2):253-262, 2016

Corrosion and Biocompatibility of Permanently Implantable Metallic Implants

Description

Related Reports:

  • Brooks EK, Brooks RP, Ehrensberger MT. “Effects of Simulated Inflammation on the Corrosion of 316L Stainless Steel” Materials Science and Engineering: C, Materials for Biological Applications 71, 200-205, 2017

  • Ciolko AA, Tobias ME, Ehrensberger MT. “The Effect of Fretting Associated Potential Shifts on The Electrochemistry and In Vitro Biocompatibility of Titanium” in Journal of Biomedical Materials Research, Part B. 104(8):1591-1601, 2016

  • Prasad S, Ehrensberger MT, Kim H, Monaco EA. “Review: Biomaterial Properties of Titanium in Dentistry” Journal of Oral Biosciences 57 (4), 192-199, 2015.

  • Brooks EK, Tobias ME, Krautsak K, Ehrensberger MT. “The Influence of Cathodic Polarization and Simulated Inflammation on Titanium Electrochemistry” Journal of Biomedical Materials Research, Part B-Applied Biomaterials 102(7):1445-1453, 2014

  • Ehrensberger MT, Sivan S, Gilbert JL. “Titanium is NOT “the Most Biocompatible Metal” Under Cathodic Potential: The Relationship Between Voltage and MC3T3 Pre-Osteoblast Behavior on Electrically Polarized cpTi Surfaces” Journal of Biomedical Materials Research, Part A 93A:1500–1509, 2010

  • Ehrensberger MT, Gilbert JL. “The Effect of Scanning Electrical Potential on the Short-Term Impedance of Commercially Pure Titanium in Simulated Biological Conditions”Journal of Biomedical Materials Research, Part B-Applied Biomaterials 94(3):781-9, 2010

  • Ehrensberger MT, Gilbert JL. “The Effect of Static Applied Potential on the 24 Hour Impedance of Commercially Pure Titanium in Simulated Biological Conditions”Journal of Biomedical Materials Research, Part B-Applied Biomaterials 93B: 106–112, 2010.

  • Ehrensberger MT, Gilbert JL. “A Time-Based Potential Step Analysis of Electrochemical Impedance Incorporating a Constant Phase Element: A Study of Commercially Pure Titanium in Phosphate Buffered Saline” Journal of Biomedical Materials Research, Part A 93A: 576–584, 2010