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Evaluation of bacterial adherence and biofilm development on an anodized stainless-steel surface for the prevention of osteosynthesis-associated infections

Marina Medel-Plaza, María Angeles Arenas, John j. Aguilera-Correa, Amber De Bleeckere (UGent) , Aranzazu Mediero, Ignacio García, Juan j. De Damborenea, Jaime Esteban, Tom Coenye (UGent) and Ana Conde
(2025) JOURNAL OF BONE AND JOINT INFECTION. 10(6). p.581-595
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Abstract
Background: Implant-associated infections remain a major challenge in orthopaedic surgery. This study aimed to evaluate the anti-adherent and anti-biofilm properties of a novel anodized 316L stainless-steel (A 316L SS) surface against common pathogens in osteosynthesis-associated infections (OAIs). Methods: Bacterial adherence and biofilm formation of Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis, Cutibacterium acnes, Escherichia coli, and Pseudomonas aeruginosa were assessed on A 316L SS and non-anodized 316L stainless steel (Ref 316L SS). Adherence was evaluated after 90 min using fluorescence microscopy. Biofilm development was examined after 24-48 h in synthetic synovial fluid (SSF) using colony counts and scanning electron microscopy (SEM). Results: A 316L SS significantly reduced bacterial adherence and surface coverage for all species tested compared to Ref 316L SS. In biofilm assays, A 316L SS exhibited notable anti-biofilm properties, with significantly reduced biofilm formation for all species. E. faecalis and C. acnes also showed lower planktonic bacterial counts. Imaging confirmed decreased bacterial presence and extracellular matrix on A 316L SS. Conclusions: A 316L SS shows strong anti-adherent and anti-biofilm properties against common orthopaedic pathogens, even under in vivo-like conditions. This surface modification strategy holds significant potential for reducing implant-associated infections and warrants further investigation for clinical applications.
Keywords
STAPHYLOCOCCUS-EPIDERMIDIS, JOINT INFECTION, SYNOVIAL-FLUID, AGGREGATION, ADHESION

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MLA
Medel-Plaza, Marina, et al. “Evaluation of Bacterial Adherence and Biofilm Development on an Anodized Stainless-Steel Surface for the Prevention of Osteosynthesis-Associated Infections.” JOURNAL OF BONE AND JOINT INFECTION, vol. 10, no. 6, 2025, pp. 581–95, doi:10.5194/jbji-10-581-2025.
APA
Medel-Plaza, M., Angeles Arenas, M., Aguilera-Correa, J. j., De Bleeckere, A., Mediero, A., García, I., … Conde, A. (2025). Evaluation of bacterial adherence and biofilm development on an anodized stainless-steel surface for the prevention of osteosynthesis-associated infections. JOURNAL OF BONE AND JOINT INFECTION, 10(6), 581–595. https://doi.org/10.5194/jbji-10-581-2025
Chicago author-date
Medel-Plaza, Marina, María Angeles Arenas, John j. Aguilera-Correa, Amber De Bleeckere, Aranzazu Mediero, Ignacio García, Juan j. De Damborenea, Jaime Esteban, Tom Coenye, and Ana Conde. 2025. “Evaluation of Bacterial Adherence and Biofilm Development on an Anodized Stainless-Steel Surface for the Prevention of Osteosynthesis-Associated Infections.” JOURNAL OF BONE AND JOINT INFECTION 10 (6): 581–95. https://doi.org/10.5194/jbji-10-581-2025.
Chicago author-date (all authors)
Medel-Plaza, Marina, María Angeles Arenas, John j. Aguilera-Correa, Amber De Bleeckere, Aranzazu Mediero, Ignacio García, Juan j. De Damborenea, Jaime Esteban, Tom Coenye, and Ana Conde. 2025. “Evaluation of Bacterial Adherence and Biofilm Development on an Anodized Stainless-Steel Surface for the Prevention of Osteosynthesis-Associated Infections.” JOURNAL OF BONE AND JOINT INFECTION 10 (6): 581–595. doi:10.5194/jbji-10-581-2025.
Vancouver
1.
Medel-Plaza M, Angeles Arenas M, Aguilera-Correa J j., De Bleeckere A, Mediero A, García I, et al. Evaluation of bacterial adherence and biofilm development on an anodized stainless-steel surface for the prevention of osteosynthesis-associated infections. JOURNAL OF BONE AND JOINT INFECTION. 2025;10(6):581–95.
IEEE
[1]
M. Medel-Plaza et al., “Evaluation of bacterial adherence and biofilm development on an anodized stainless-steel surface for the prevention of osteosynthesis-associated infections,” JOURNAL OF BONE AND JOINT INFECTION, vol. 10, no. 6, pp. 581–595, 2025.
@article{01KEGY3PDPYEX69Y9RVHTA31EX,
  abstract     = {{Background: Implant-associated infections remain a major challenge in orthopaedic surgery. This study aimed to evaluate the anti-adherent and anti-biofilm properties of a novel anodized 316L stainless-steel (A 316L SS) surface against common pathogens in osteosynthesis-associated infections (OAIs). Methods: Bacterial adherence and biofilm formation of Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis, Cutibacterium acnes, Escherichia coli, and Pseudomonas aeruginosa were assessed on A 316L SS and non-anodized 316L stainless steel (Ref 316L SS). Adherence was evaluated after 90 min using fluorescence microscopy. Biofilm development was examined after 24-48 h in synthetic synovial fluid (SSF) using colony counts and scanning electron microscopy (SEM). Results: A 316L SS significantly reduced bacterial adherence and surface coverage for all species tested compared to Ref 316L SS. In biofilm assays, A 316L SS exhibited notable anti-biofilm properties, with significantly reduced biofilm formation for all species. E. faecalis and C. acnes also showed lower planktonic bacterial counts. Imaging confirmed decreased bacterial presence and extracellular matrix on A 316L SS. Conclusions: A 316L SS shows strong anti-adherent and anti-biofilm properties against common orthopaedic pathogens, even under in vivo-like conditions. This surface modification strategy holds significant potential for reducing implant-associated infections and warrants further investigation for clinical applications.}},
  author       = {{Medel-Plaza, Marina and Angeles Arenas, María and Aguilera-Correa, John j. and De Bleeckere, Amber and Mediero, Aranzazu and García, Ignacio and De Damborenea, Juan j. and Esteban, Jaime and Coenye, Tom and Conde, Ana}},
  issn         = {{2206-3552}},
  journal      = {{JOURNAL OF BONE AND JOINT INFECTION}},
  keywords     = {{STAPHYLOCOCCUS-EPIDERMIDIS,JOINT INFECTION,SYNOVIAL-FLUID,AGGREGATION,ADHESION}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{581--595}},
  title        = {{Evaluation of bacterial adherence and biofilm development on an anodized stainless-steel surface for the prevention of osteosynthesis-associated infections}},
  url          = {{http://doi.org/10.5194/jbji-10-581-2025}},
  volume       = {{10}},
  year         = {{2025}},
}
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