Remote Eradication of Delayed Infection on Orthopedic Implants via Magnesium-based Total Morphosynthesis of Biomimetic Mineralization Strategy

Abstract Background: Orthopedic delayed and late infections are devastating afflictions for patients who have undergone implantation. Even though versatile antibacterial modification on medical devices brought the hope of eradicating pathogenic bacteria. The synthesis of late-term antibacterial properties with total morphosynthesis on medical devices nonetheless remains an elusive goal. Methods: Herein, we utilize a mineralized strategy coupled with ion exchange to generate lamellar-type magnesium calcium phosphate thin films with a three-step pathway: Construction of nanofiber porous structure on the substrate as ions reservoir, incorporation of magnesium substitutional transition sodium titanate layer, and mineralization of a lamellar calcium phosphate coating. Results: Synthetic lamellar coatings exhibit excellent osteointegration effects in infectious scenarios. More importantly, the underlying transition layer can blow up the possible delayed infection like a landmine after the upper calcium phosphate coating is degraded under the physiological environment. Conclusions: This work highlights the pivotal role of the magnesium ions in mediating the growth of the total morphosynthesis of calcium phosphate coating and the underlying magnesium titanate layer in ensuring the possibility to eliminate delayed infections under time-dependent degradation.