Role of Electrochemically Activated Solution in Asepsis in Osteoblasts and Chondrocytes in vitro

ABSTRACT

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.

Keywords::

• antiseptics
• electrochemically activated solution
• implant-associated infection
• biofilm
• antimicrobial effect
• cytotoxicity on musculoskeletal system

ACKNOWLEDGMENTS

The authors would like to thank AQUIS GmbH for providing the ECAS Anosteralyth®. Furthermore, we would like to thank Michael Hellwig for his support during SEM analysis as well as Claudia Trier for her assistance with the bacterial cultivation.

Partial results of the present investigation were presented at the 60th VSOU Congress in Baden- Baden, Germany.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.