Review on common antibacterial elements loaded-hydroxyapatite as a coating on orthopedic Schanz surface for reduction infection in orthopedic surgery.

Fixators are the basic equipment for fractures that are divided into two categories, internal and external. The success of clinical applications of external fixators has decreased due to their infection after orthopedic surgery. Meanwhile, the loosening of the pin embedded in the bone occurs due to the presence of bacteria and the formation of biofilm on the pin, and this infection will progress to the joint surface of the bone and the pin. Natural elements with antibacterial activity attract much attention as a coating on implants surface in orthopedics surgery. This article reviewed common elements with antibacterial activity that can be loaded into the HA structure as a coating for improving their clinical efficiency. Substitution ions such as copper, silver, magnesium, strontium, zinc, silicon, and fluoride in an appetite network can stimulate bone formation at the fracture site. In this article, common antibacterial ions in the form of loading -HA have been investigated as coating orthopedic fixators. good strength and antibacterial activity presented for silver, and corrosion resistance and high porosity are advantages of copper. Also, magnesium with favorable biocompatibility and biodegradability, zinc with high strength, and silicon and fluorine with high flexibility, favorable mechanical properties, and corrosion resistance are introduced. Among the mentioned elements, silver and fluoride, due to having more favorable antibacterial activity and excellent bone regeneration, can be more suitable candidates for loading in the HA structure with the application of the coating on the orthopedic surface.