In Situ Construction of Black Titanium Oxide with a Multilevel Structure on a Titanium Alloy for Photothermal Antibacterial Therapy.

Postsurgical infection of orthopedic fixation materials is considered to be the main cause of fixation failure. To address the problem, clinical treatment often relies on long-term antibiotics, secondary surgery, and so forth, which cause pain and suffering to patients. Constructing a light-responsive surface structure on the implant has attracted widespread attention for the management of postsurgical infections because of its noninvasiveness and controllability. Nevertheless, the application of light-responsive structures on implants is still limited by their unsafety and instability. In this work, a black titanium oxide layer with a multilevel structure and lattice defects was in situ constructed on a titanium alloy through pulsed laser ablation treatment. Under the synergistic effect of the multilevel structure and crystal defects, the surface of the titanium alloy exhibited good near-infrared light-responsive photothermal ability. The black titanium oxide multilevel structure reached high antibacterial efficiencies of about 99.37 and 99.29% against Staphylococcus aureus and Escherichia coli under 10 min near-infrared light irradiation. Furthermore, the black titanium oxide layer possessed similar biocompatibility compared with the titanium alloy. This near-infrared light-responsive photothermal therapy based on the construction of a multilevel structure and introduction of lattice defects provides an effective strategy for clinical postsurgical infections of orthopedic fixation.