Role of Electrochemically Activated Solution in Asepsis in Osteoblasts and Chondrocytes in vitro.
PURPOSE
Implant infections are severe complications in orthopedic surgery. Treatment using antibiotics is often unsuccessful without removing the implant due to biofilm formation. In this context, antiseptics may be a potential option. These solutions have a wide antimicrobial spectrum but often cause damage to the local cell populations. In these cases, electrochemically activated solutions (ECAS) may be an alternative.


METHODS
Staphylococcus aureus was cultured overnight on polyethylene platelets under different growing conditions (standard-/-different biofilm inducing conditions). The samples were treated with an ECAS (0%-30%) and analyzed with regard to their antimicrobial efficacy and their effect on biofilm structures by determining the living bacterial count and scanning electron microscopy. Osteoblast and chondrocyte cell lines (MG-63, and CAL-78, respectively) were cultured to confluence and treated with an ECAS. Total cell count, metabolic activity using FDA staining, and proliferation using Ki67 staining were analyzed.


RESULTS
ECAS showed antimicrobial activity in concentrations <1%. In cases of biofilm formation, bacterial toxicity could be detected at concentrations from 3.75 -7.5%. At these same concentrations, a visible change in biofilm structure was observed. Regarding biocompatibility rates, up to 7.5% (of osteoblasts) and 3.75% (of chondrocytes) had little influence on metabolic activity and proliferation.


CONCLUSION
ECAS provide good antimicrobial efficacy while maintaining high biocompatibility. These results suggest that these solutions may provide promising alternatives in the treatment of implant-associated infections.
['Michel|Nathalie S D|NS|', 'Paletta|Jürgen R J|JR|', 'Kerwart|Martina|M|', 'Skwara|Adrian|A|']
D000891:Anti-Infective Agents, Local D019643:Arthroplasty, Replacement D001207:Asepsis D058491:Bacterial Load D018441:Biofilms D002452:Cell Count D002460:Cell Line D049109:Cell Proliferation D019902:Chondrocytes D055664:Electrochemical Techniques D006801:Humans D008855:Microscopy, Electron, Scanning D010006:Osteoblasts D016459:Prosthesis-Related Infections D012996:Solutions D013203:Staphylococcal Infections D013211:Staphylococcus aureus
electrochemically activated solution biofilm antiseptics implant-associated infection antimicrobial effect cytotoxicity on musculoskeletal system