{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T07:35:13Z","timestamp":1772696113186,"version":"3.50.1"},"reference-count":67,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T00:00:00Z","timestamp":1584662400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Materials"],"abstract":"<jats:p>Due to increasing rates of periprosthetic joint infections (PJI), new approaches are needed to minimize the infection risk. The first goal of this study was to modify a well-established infection model to test surface-active antimicrobial systems. The second goal was to evaluate the antimicrobial activity of a silver multilayer (SML) coating. In vitro tests with SML items showed a &gt;4 Log reduction in a proliferation assay and a 2.2 Log reduction in an agar immersion test (7 d). In the in vivo model blank and SML coated K-wires were seeded with ~2 \u00d7 104 CFU of a methicillin-sensitive Staphylococcus epidermidis (MSSE) and inserted into the intramedullary tibial canal of rabbits. After 7 days, the animals were sacrificed and a clinical, microbiological and histological analysis was performed. Microbiology showed a 1.6 Log pathogen reduction on the surface of SML items (p = 0.022) and in loosely attached tissue (p = 0.012). In the SML group 7 of 12 SML items were completely free of pathogens (cure rate = 58%, p = 0.002), while only 1 of 12 blank items were free of pathogens (cure rate = 8%, p = 0.110). No silver was detected in the blood or urine of the SML treated animals and only scarcely in the liver or adjacent lymph nodes. In summary, an in vivo infection model to test implants with bacterial pre-incubation was established and the antimicrobial activity of the SML coating was successfully proven.<\/jats:p>","DOI":"10.3390\/ma13061415","type":"journal-article","created":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T11:42:11Z","timestamp":1584704531000},"page":"1415","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Antimicrobial Silver Multilayer Coating for Prevention of Bacterial Colonization of Orthopedic Implants"],"prefix":"10.3390","volume":"13","author":[{"given":"Martin","family":"Fabritius","sequence":"first","affiliation":[{"name":"Aesculap AG, Research and Development, Am Aesculap-Platz, 78532 Tuttlingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amir Andreas","family":"Al-Munajjed","sequence":"additional","affiliation":[{"name":"Bio-Gate AG, Neumeyerstra\u00dfe 28-34, 90411 Nuremberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christiane","family":"Freytag","sequence":"additional","affiliation":[{"name":"FREY_TOX GmbH, 04916 Herzberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henriette","family":"J\u00fclke","sequence":"additional","affiliation":[{"name":"FREY_TOX GmbH, 04916 Herzberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Zehe","sequence":"additional","affiliation":[{"name":"QualityLabs, Neumeyerstr. 46a, 90411 Nuremberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1227-1436","authenticated-orcid":false,"given":"Thomas","family":"Lemarchand","sequence":"additional","affiliation":[{"name":"TPL Path Labs, Sasbacher Stra\u00dfe 10, 79111 Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacobus J.","family":"Arts","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Research School CAPHRI, Maastricht University Medical Centre, 6202 Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Detlef","family":"Schumann","sequence":"additional","affiliation":[{"name":"Aesculap AG, Research and Development, Am Aesculap-Platz, 78532 Tuttlingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Volker","family":"Alt","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrin","family":"Sternberg","sequence":"additional","affiliation":[{"name":"Aesculap AG, Research and Development, Am Aesculap-Platz, 78532 Tuttlingen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,3,20]]},"reference":[{"key":"ref_1","unstructured":"National Joint Registry for England, Wales, Northern Ireland and the Isle of Man (2018). 15th Annual Report 2018, National Joint Registry for England."},{"key":"ref_2","unstructured":"Australian Orthopaedic Association (2019). 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