The Current Trend of Antibacterial Prostheses and Prosthetic Surface Coating Technologies to Prevent Prosthetic Joint Infection for Artificial Joint Replacement

Prosthetic joint infection is a severe complication following joint replacement surgery, with a notable impact on patient morbidity, quality of life, and healthcare costs. The advent of advanced biomaterials aims to mitigate infection risks by incorporating antimicrobial properties into prosthetic devices. This review examines the development and challenges associated with various antimicrobial modifications of prosthetic joint components, with a focus on both metallic materials like antibacterial stainless steel, titanium-based, cobalt- based, and tantalum alloys, as well as ultra-high molecular weight polyethylene composites. Additionally, surface modification techniques such as antifouling coatings, antibiotic coatings, inorganic and polymeric antimicrobial coatings, and innovative antimicrobial composite coatings, are explored. Despite the promise shown in in vitro and animal studies, there is a need for in vivo data, and several issues persist, including the variability in the antibacterial mechanisms, implant integration, cytotoxic effects, and the longevity of antibacterial efficacy. The review highlights the necessity for further research into the safety and mechanisms of new antibacterial alloys to optimize clinical outcomes in joint replacement surgeries.