Breakthrough Discovery Spearheaded by Nicholas Bernthal, M.D., Prevents Infections Related to Orthopedic Implants

Oct. 6, 2021 16:38 UTC

Biomedical Engineers and Surgeons at UCLA and Duke University Pave the Way to the Future Through Revolutionary Coating That Protects Implants From Infectious Bacteria

LOS ANGELES--(BUSINESS WIRE)-- Biomedical engineers and surgeons at UCLA and Duke University have developed an antibiotic coating that can be applied to orthopedic implants during surgery to eliminate the chance of an infection around the implant.

“This work represents the future of surgical implants by providing a coating that transforms the implant from a hotspot for infection into a ‘smart’ antimicrobial therapeutic,” said Nicholas Bernthal, M.D. “You only need to treat a single patient with an infected implant to realize how transformational this could be for patient care—saving both life and limbs for many.”

Dr. Bernthal is an orthopaedic oncology surgeon at Los Angeles’ Orthopaedic Institute for Children and Interim Chair and Executive Medical Director of the Department of Orthopaedic Surgery at the David Geffen School of Medicine at UCLA. In those roles, he manages bone and soft tissue tumors in children and has witnessed firsthand the surgical implant infections that had become, for many, an “unavoidable risk.” Dr. Bernthal felt otherwise and 10 years ago began research into how to prevent such infections.

As Dr. Bernthal points out, many children being treated for bone cancer have large portions of bone removed, which then requires large “megaprosthetic” orthopedic implants. But because the patients are usually also undergoing chemotherapy, their immune systems are weak; and they are especially vulnerable to bacteria colonizing the surface of the implant. “The key is to detect and eliminate infectious bacteria before they become harmful to patients,” said Dr. Bernthal. “What we’ve developed—in partnerships with Tatiana Segura, professor of biomedical engineering at Duke—is a point-of-care, antibiotic-releasing coating that can be quickly and safely applied in the operating room to protect implants from bacterial challenges.”

When the coating was trialed in small-animal studies, the coating prevented all subsequent infections even without infusions of antibiotics into the bloodstream, which is the current standard of care. The coating has not yet been tested on humans or other larger animals, which have larger bones and need larger implants and thus more surface area to protect against bacterial infections. Still, Dr. Bernthal and his fellow researchers are confident that their invention is up to the task and plan to pursue the steps needed to commercialize the product.

Implant infections aren’t unique to children or to cancer patients. For joint-replacement surgeries, for example, infection occurs in 1% of primary and up to 7% of revision surgeries, which requires repeated revision surgeries and prolonged intravenous antibiotics. Treatment doesn’t always work as these patients have a higher, five-year mortality risk than those diagnosed with HIV/AIDS or breast cancer. Implant infections are estimated to cost the U.S. health care system more than $8.6 billion annually.

Part of the challenge of treating these infections is that bacteria colonize the surface of the implants themselves. This means that there are no blood vessels flowing through the bacterial colonies to deliver the antibiotics coursing through a patient’s veins. The only recourse is often the removal of the original implant, which is usually the best of what are only bad options.

“By applying our coating on the implant, we are able to stop an infection before it can take hold,” said Dr. Bernthal. “In doing so, we hope to provide a solution that will prevent orthopedic patients from having to endure additional painful surgery, amputations or the other miserable sequelae of post-surgery infections.”

About Orthopaedic Institute for Children

Orthopaedic Institute for Children was founded in 1911 as Los Angeles Orthopaedic Hospital and today is the largest pediatric orthopaedic facility on the West Coast focused solely on musculoskeletal conditions in children. In alliance with UCLA Health and with the support of the OIC Foundation, we advance pediatric orthopaedics worldwide through outstanding patient care, medical education and research. Our locations in downtown Los Angeles, Santa Monica, Westwood and Calexico treat the full spectrum of pediatric orthopaedic disorders and injuries. For more information, visit us at

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Teezal Gaji

Source: Orthopaedic Institute for Children

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