Orthopedic implant biomaterials with both osteogenic and anti-infection capacities and associated in vivo evaluation methods

Osteogenicity (i.e., properties that promote new bone formation on and around the implant) has long been a clinical requirement for most orthopedic implants. Recently, anti-infection or antibacterial properties have become critical for orthopedic implants (especially without the use of antibiotics). Ideally, orthopedic implant materials with simultaneous anti-infection and osteogenic capacities are extremely promising for orthopedic applications, but such materials are not widely available to date and have only recently been researched. In the first part of this review, numerous attractive material formulations that exhibit both antibacterial and osteogenic capacities as well as surface modification strategies that enhance such capacities are introduced. Several possible mechanisms underlying simultaneous antibacterial and osteogenic properties are also discussed. In the second part of this review, evaluation methods including animal models, analytical tools and available guidelines for assessing antibacterial and osteogenic properties of implantable materials in vivo are summarized and discussed.