A Study On The Impact Of The Artificial Joint Prosthesis Material Surface Physical Properties On The Adhesion Of Mycobacterium Tuberculosis

Hip and knee joint tuberculosis are the common osteoarticulartuberculosis besides spinal tuberculosis, accounting for10%to15%. Thetraditional treatment was arthrodesis, but disability rate was very high. Asthe technique of artificial joints growing, the patients of hip and kneejoint tuberculosis could reconstruct the joint function through an artificialjoint replacement when the patients received chemotherapy and in stablecondition. The most critical point of treatment is reducing tuberculosisrelapse and improving the efficacy. At present, the controversial point iswhether the presence of the prosthesis will increase the risk of TBrecurrence. Physical and chemical properties of the surface of theprosthesis material have a great impact on bacterial adhesion, such as thesurface chemical composition, surface energy, the role of water-basedsurface hydrophilicity, surface roughness and Brownian motion and vander Waals forces and other physical forces. It is various in clinicalprosthesis surface treatment processes such as sandblasting, polishing,coating of titanium and hydroxyapatite coating. Different approachesmake the material surface topography, surface roughness, surfacehydrophilicity and hydrophobicity quite different, and the differences inphysical properties of the material surface differences will affectpathogen adhesion and aggregation.According to the physical characteristics of the surface material, ourstudy focus on exploring the different physical properties of the surfacematerial of artificial joint prosthesis interface on the adhesion of mycobacterium tuberculosis, provide the basic option of artificial jointreplacement prostheses for patients. By using polished surface coatedwith titanium, titanium coating and hydroxyapatite coating asexperimental material, we analyzed the surface morphology, andmeasured the surface roughness, contact angle and surface energy.Mycobacterium tuberculosis strains were cultured in vitro, and themorphology, adhesion amount of material surfaces were observed byscanning electron microscopy. The impact of the physical characteristicsof artificial joint prosthesis interface material surface on the bacterialproliferation and adhesion was Comprehensive Evaluated. The resultsshowed that the titanium surface after titanium coating andhydroxyapatite coating, performanced as a hydrophobic surface, whilepolished surface was hydrophilic coating. The contact angle and surfaceenergy have significant differences (P<0.05); surface roughness valuesmeasured by the surface roughness (Ra) indicated that the three kinds ofdisplay surface Ra value had a significant difference (P<0.05). It isobserved through the scanning electron microscopy that the polishingcoating, titanium coating and hydroxy apatite coating surface morphologywere related to the roughness and adhesion of Mycobacteriumtuberculosis. M. tuberculosis decreased with the lower of roughness. Inthe process of Mycobacterium tuberculosis cultivation, Bacilli OD(Optical Density) of all3materials had no significant difference (P<0.05),and they had no significant effect on the growth of Mycobacteriumtuberculosis; Interface titanium coating contained the most adhesion of M.tuberculosis, the second one was hydroxyapatite coating, the second andpolishing coating surface the least. The differences had statisticalsignificance (P<0.05). In conclusion, the adhesion of Mycobacteriumtuberculosis on the surface of the artificial joint prosthesis is relevant tothe physical characteristics of the material surface. Materials with highsurface roughness and the hydrophobic surface had a higher adhesion of Mycobacterium tuberculosis.