{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T08:28:04Z","timestamp":1791188884690,"version":"4.1.0"},"reference-count":84,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2006,6,15]],"date-time":"2006-06-15T00:00:00Z","timestamp":1150329600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2006,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The purpose of this study was to acquire information about the effect of an antibacterial and biodegradable poly\u2010L\u2010lactide (PLLA) coated titanium plate osteosynthesis on local infection resistance. For our in vitro and in vivo experiments, we used six\u2010hole AO DC minifragment titanium plates. The implants were coated with biodegradable, semiamorphous PLLA (coating about 30 \u00b5m thick). This acted as a carrier substance to which either antibiotics or antiseptics were added. The antibiotic we applied was a combination of Rifampicin and fusidic acid; the antiseptic was a combination of Octenidin and Irgasan. This produced the following groups: Group I: six\u2010hole AO DC minifragment titanium plate <jats:italic>without<\/jats:italic> PLLA; Group II: six\u2010hole AO DC minifragment titanium plate <jats:italic>with<\/jats:italic> PLLA <jats:italic>without<\/jats:italic> antibiotics\/antiseptics; Group III: six\u2010hole AO DC minifragment titanium plate <jats:italic>with<\/jats:italic> PLLA\u2009+\u20093% Rifampicin and 7% fusidic acid; Group IV: six\u2010hole AO DC minifragment titanium plate <jats:italic>with<\/jats:italic> PLLA\u2009+\u20092% Octenidin and 8% Irgasan. In vitro, we investigated the degradation and the release of the PLLA coating over a period of 6 weeks, the bactericidal efficacy of antibiotics\/antiseptics after their release from the coating and the bacterial adhesion of <jats:italic>Staphylococcus aureus<\/jats:italic> to the implants. In vivo, we compared the infection rates in white New Zealand rabbits after titanium plate osteosynthesis of the tibia with or without antibacterial coating after local percutaneous bacterial inoculations at different concentrations (2\u2009\u00d7\u200910<jats:sup>5<\/jats:sup>\u20132\u2009\u00d7\u200910<jats:sup>8<\/jats:sup>): The plate, the contaminated soft tissues and the underlying bone were removed under sterile conditions after 28 days and quantitatively evaluated for bacterial growth. A stepwise experimental design with an \u201cup\u2010and\u2010down\u201d dosage technique was used to adjust the bacterial challenge in the area of the ID50 (50% infection dose). Statistical evaluation of the differences between the infection rates of both groups was performed using the two\u2010sided Fisher exact test (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Over a period of 6 weeks, a continuous degradation of the PLLA coating of 13%, on average, was seen in vitro in 0.9% NaCl solution. The elution tests on titanium implants with antibiotic or antiseptic coatings produced average release values of 60% of the incorporated antibiotic or 62% of the incorporated antiseptic within the first 60 min. This was followed by a much slower, but nevertheless continuous, release of the incorporated antibiotic and antiseptic over days and weeks. At the end of the test period of 42 days, 20% of the incorporated antibiotic and 15% of the incorporated antiseptic had not yet been released from the coating. The antibacterial effect of the antibiotic\/antiseptic is not lost by integrating it into the PLLA coating. The overall infection rate in the in vivo investigation was 50%. For Groups I and II the infection rate was both 83% (10 of 12 animals). In Groups III and IV with antibacterial coating, the infection rate was both 17% (2 of 12 animals). The ID50 in the antibacterial coated Groups III and IV was recorded as 1\u2009\u00d7\u200910<jats:sup>8<\/jats:sup> CFU, whereas the ID50 values in the Groups I and II without antibacterial coating were a hundred times lower at 1\u2009\u00d7\u200910<jats:sup>6<\/jats:sup> CFU, respectively. The difference between the groups with and without antibacterial coating was statistically significant (<jats:italic>p<\/jats:italic>\u2009=\u20090.033). Using an antibacterial biodegradable PLLA coating on titanium plates, a significant reduction of infection rate in an in vitro and in vivo investigation could be demonstrated. For the first time, to our knowledge, we were able to show, under standardized and reproducible conditions, that an antiseptic coating leads to the same reduction in infection rate as an antibiotic coating. Taking the problem of antibiotic\u2010induced bacterial resistance into consideration, we thus regard the antiseptic coating, which shows the same level of effectiveness, as advantageous. \u00a9 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. 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