Evaluation of Ti implants coated with Ag-containing borate bioactive glass for simultaneous eradication of infection and fracture fixation in a rabbit tibial model

The ability of silver (Ag)-containing borate bioactive glass (BG) coatings to improve the biocompatibility and antibacterial properties of titanium (Ti) implants was investigated in vitro and in vivo in a rabbit tibial fracture model. Dense coatings of borate BG (thickness ≈ 20 μm) containing 0, 0.75, and 1.0 wt% Ag2O were prepared by depositing a layer of particles on Ti plates, followed by sintering at 900 °C. The as-prepared coatings had an adhesive strength of 10 ± 1 MPa, and when immersed in an aqueous phosphate (K2HPO4) solution, the coatings converted to hydroxyapatite, releasing Ag+ ions continuously for over 4 wk. After implantation of BG-coated Ti constructs in a rabbit tibial fracture model and of methicillin-resistant Staphylococcus aureus-induced osteomyelitis, the BG coating doped with 1.0 wt% Ag2O was most effective for the simultaneous eradication of the infection and fracture fixation. Implants coated with Ag-containing BG coatings could provide an approach for reducing implant-related bone infection.