Silver and copper as additives of various biomaterials have been reported as the potential solutions for biomedicine applications, mostly because of inducing bactericidal effects. The application of those admixtures in diamond-like carbon (DLC) coatings may be desirable for orthopedic implants. In the present manuscript, the biological effect of coatings with up to about 7 at.% and 14 at.% of, respectively, Cu and Ag is compared. The morphology, chemical structure, and composition of films deposited on AISI 316LVM and Ti6Al7Nb is characterized. The live/dead analysis conducted with Escherichia coli shows a higher bactericidal potential of silver than copper. Although the Cu-doped coatings can positively affect the proliferation of Saos-2 and EA.hy926 cell lines, the results of XTT test are on the verge of 70% of viability. Biological effect of silver on EA.hy926 cell lines is negative but that admixture ensures high proliferation of osteoblasts in contact with coatings deposited on titanium alloy (over 20% better than for substrate material). In that case, the viability is reaching about 85% for Ag-doped coatings on AISI 316LVM and 75% on Ti6Al7Nb. The results indicate that for the sake of bactericidal coatings that may promote osteointegration, the candidates are DLC with silver content no higher than 10 at.%.

Progress in orthopaedics has now made it possible to improve the functional status of damaged hip joints with hip arthroplasty and eliminate the associated pain. The constantly growing number of hip replacement procedures is, however, associated with a proportional rise in the number of subsequent surgery-related complications. The most important complication is septic loosening of the implant. The treatment of septic complications is often ineffective and recovery becomes impossible. In that setting, an awareness of the risk factors of septic complications and an ability to prevent periprosthetic joint infection (PJI) are becoming necessary. The aim of the study was to analyse the risk factors of PJI as an essential element of the prophylaxis of septic complications. We analysed the data of 142 patients treated for PJI at the Ward of Bone and Joint Infections, Department of Orthopaedics, Medical Centre of Postgraduate Education in Otwock, between 2008 and 2010. Their medical records were analysed retrospectively. The diagnosis was evidence-based, relying on case histories, physical examination and accessory investigations, including imaging studies and biochemical and microbiological testing. The analysis of clinical data served to identify factors that appeared repetitively in the patients with PJI treated at the Ward. Those elements constitute the combination of risk factors for PIJ. 1. An awareness of risk factors for septic complications and their early elimination are necessary in daily orthopaedic care. 2. The pre-surgery checklist is a very effective tool to eliminate the most common risk factors of PJI.

Replacement of large joints in the lower limbs is a commonly accepted and used method for the treatment of osteoarthritis. Like any other intervention, this treatment method also involves the risk of complications. Periprosthetic joint infection is one of the most serious ones. It qualifies patients for further procedures, which significantly impairs their daily activity and the comfort of life. Osteoarticular infections represent a major therapeutic challenge. This is associated with both, poor penetration of antibiotics into the osteoarticular compartment (system) as well as with the increasing drug resistance of pathogens. Osteoarticular infections require several weeks of antibiotic therapy, as an adjunct treatment, which is an additional financial burden. The implementation of primary prevention scheme in periprosthetic joint infection allows for a significant reduction in the risk of this complication. The article discusses the different nature of the infection within joints and orthopaedic implants. We have presented the key principles for the prevention of septic complications associated with total hip and knee replacement, by discussing the most common sources of primary infection. We have proposed a treatment algorithm based on diagnostic tests reducing the risk of infectious complications and increasing the safety of surgical intervention (surgical procedure) as well as the chances for good long-term treatment outcomes.

Background Complications after arthroplasty often result in irreversible disability. In some cases for the extremity to be salvaged, the permanent knee joint arthrodesis is the last-chance procedure. Modular implant design simplifies surgical technique but modularity may potentially compromise mechanical strength of an implant. Mechanical properties of the implant are particularly important in case of knee arthrodesis without bone-on-bone contact where forces during gait and weight bearing are transmitted directly through the nail. The aim of this article was to perform comparative analysis of the mechanical properties of modular nail CHARFIX2 FN, when compared to the femoral nail, used for knee arthrodesis; and to analyze the effectiveness of treatment with use of this nail based on the observations of clinical cases. Methods Comparative analysis of: the static 4-point bending test, dynamic 4-point bending test and static torsion test. All tests were performed in accordance with requirements of ASTM F 1264. A clinical analysis of 5 cases, in which CHARFIX2 FN nails were used, was also performed. Results Based on the results of mechanical tests, the strength characteristics of CHARFIX2 FN nail have been found superior and more advantageous than corresponding features of the standard femoral nail. For CHARFIX2 FN nail, the median for flexural stiffness was almost 4 times higher and for maximum torque value was almost 2 times higher when compared to the femoral nail. Observations of the clinical cases gave satisfactory results. Conclusions The obtained mechanical tests present significant differences between CHARFIX2 FN and the femoral nail in mechanical strength and, therefore, its improved stability and safety for patients during walking. It can be used for permanent knee immobilization with satisfactory clinical results. The functional outcomes and subjective measurements of pain in patients treated with CHARFIX2 FN group are satisfying.