In situ surface electrochemical characterizations of Ti and Ti-6Al-4V alloy cultured with osteoblast-like cells

The biocompatibility of metal implants is related to their surface electrochemical characterizations. The in situ growing process of osteoblast-like U-2 OS cells on polished Ti and Ti-6Al-4V alloy during 72h incubation was monitored using the electrochemical impedance spectroscopy (EIS) measurement technique. The results showed that the presence of cells on metals led to an increase in the impedance and polarization resistance (R(p)) of metals. The impedance and R(p) increased as the cells grew (i.e., from adhesion, spreading to proliferation period). A trace amount of V element released from Ti-6Al-4V alloy led to a lower R(p) with respect to Ti metal during cell culture. In this study, a satisfactory equivalent circuit simulating the electrochemical characterizations of Ti and Ti-6Al-4V alloy cultured with cells was proposed. The EIS measurement technique was applied successfully to monitor the in situ growing process of U-2 OS cells on Ti and Ti-6Al-4V alloy.     

钛合金和钴铬合金表面白色念珠菌粘附的研究

目的比较钛合金(Ti-6Al-4V)和钴铬合金(Chromium-Cobaltalloy)表面白色念珠菌粘附能力的大小,研究表面粗糙度与细菌粘附的关系。方法将不同表面粗糙度的钛合金和钴铬合金试件进行白色念珠菌体外粘附试验,采用菌落形成计数法测定试件表面的细菌粘附量。结果各钛合金试件组的细菌粘附量均少于相同表面粗糙度的钴铬合金试件组,两种金属试件表面的细菌粘附量均随表面粗糙度的增大而增加。结论钛合金较钴铬合金更能减少由白色念珠菌引起的义齿性口炎等并发症,同时修复体表面严格的研磨抛光也能有效减少这些并发症。     

Comparative analysis of corrosion resistance between beta titanium and Ti-6Al-4V alloys: A systematic review

BackgroundThe knowledge of the electrochemical property (corrosion resistance) of beta titanium alloys compared to Ti-6Al-4 V for implants is relevant because of the potential cytotoxic effects that the released ions could cause to long-term health.ObjectivesThe objective of this systematic review was to seek information on the electrochemical properties (corrosion resistance) of beta titanium alloys compared to Ti-6Al-4 V since the awareness of the electrochemical behavior of the implant surface in the medium is essential for the best indication of the alloys or compositional changes, which may promote benefits to bone-implant interaction in all areas that this procedure is required.MethodsThe PubMed, LILACS, COCHRANE Library, and Science Direct databases were electronically searched for the terms: dental implants AND beta-titanium AND Ti-6Al-4 V AND electrochemical technics. The inclusion criteria were research articles that studied beta-titanium compared to Ti-6Al-4 V using electrochemical techniques in electrolytes of chemical composition similar to body fluid, published in English, between 2000 and 2020. Articles that did not compare the corrosion resistance of these alloys in electrolytes similar to body fluids were excluded.ResultsA total of 189 articles were restored and selected by title and/or abstract according to the inclusion and exclusion criteria, which resulted in 15 articles that were reduced to 8 after read in full. The studies in vitro evaluated the corrosion resistance in electrolytes Hank, Ringer, SBF, and 0.9 % NaCl, between beta titanium alloys, obtained by arc fusion or bars stock, and Ti-6Al-4 V, for dental or biomedical implants submitted to surface treatments by heat treatment, plasma electrolytic oxidation (PEO), alkaline treatment, and thermomechanical.ConclusionThe evaluated literature allowed to determine that 1) The oxides Nb₂O ₅, Ta₂O _5, and ZrO₂ have higher stability and protection quality than that of TiO₂ modified by the oxides of Al and V; 2) A higher modulus of elasticity of the Ti-6Al-4 V alloy favors protection against corrosion by maintaining a thicker and more firmly adhered oxide layer; 3) The increase in the thickness of the Ti alloys superficial layer contributes to the improvement of the corrosion resistance.     

Effect of Tricalcium Magnesium Silicate Coating on the Electrochemical and Biological Behavior of Ti-6Al-4V Alloys

In the current study, a sol-gel-synthesized tricalcium magnesium silicate powder was coated on Ti-6Al-4V alloys using plasma spray method. Composition of feed powder was evaluated by X-ray diffraction technique before and after the coating process. Scanning electron microscopy and atomic force microscopy were used to study the morphology of coated substrates. The corrosion behaviors of bare and coated Ti-6Al-4V alloys were examined using potentiodynamic polarization test and electrochemical impedance spectroscopy in stimulated body fluids. Moreover, bare and coated Ti-6Al-4V alloys were characterized in vitro by culturing osteoblast and mesenchymal stem cells for several days. Results demonstrated a meaningful improvement in the corrosion resistance of Ti-6Al-4V alloys coated with tricalcium magnesium silicate compared with the bare counterparts, by showing a decrease in corrosion current density from 1.84 μA/cm² to 0.31 μA/cm². Furthermore, the coating substantially improved the bioactivity of Ti-6Al-4Valloys. Our study on corrosion behavior and biological response of Ti-6Al-4V alloy coated by tricalcium magnesium silicate proved that the coating has considerably enhanced safety and applicability of Ti-6Al-4V alloys, suggesting its potential use in permanent implants and artificial joints.     

Response of MG63 Osteoblast Cells to Surface Modification of Ti-6Al-4V Implant Alloy by Laser Interference Lithography

The response of human osteoblast-like osteosarcoma cells (MG63) to surface modification of Ti-6Al-4V implant alloy was investigated by Laser Interference Lithography (LIL).In this work,laser interference lithography was employed to fabricate the microstructures of grooves,dots and dimples onto the surfaces of Ti-6Al-4V samples.Two and three beam LIL systems were developed to carry out the experiments.The laser treatment resulted in the increases of the roughness and the contact angle of water on the implant alloy surfaces.The proliferation of osteoblasts was analyzed by MTT (3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide) assay for the time periods of 4 hours,2 days,3 days,and 6 days.The MTT test results demonstrated that the laser treatment surfaces had a positive impact on the proliferation of osteoblast cells after 24 hours.The alloy surface morphology and the morphological changes of MG63 cells cultured on the laser textured Ti-6Al-4V surface were observed by Scanning Electron Microscope (SEM).The SEM results indicated that the osteoblast cells were aligned on grooved surfaces and they were prolonged with the structures.Enzymatic detachment results showed that the 20 μm grooved structures provided the better cell adhesion to the textured Ti-6Al-4V surfaces.     

Early Staphylococcal Biofilm Formation on Solid Orthopaedic Implant Materials: In Vitro Study

Biofilms forming on the surface of biomaterials can cause intractable implant-related infections. Bacterial adherence and early biofilm formation are influenced by the type of biomaterial used and the physical characteristics of implant surface. In this in vitro research, we evaluated the ability of Staphylococcus epidermidis, the main pathogen in implant-related infections, to form biofilms on the surface of the solid orthopaedic biomaterials, oxidized zirconium-niobium alloy, cobalt-chromium-molybdenum alloy (Co-Cr-Mo), titanium alloy (Ti-6Al-4V), commercially pure titanium (cp-Ti) and stainless steel. A bacterial suspension of Staphylococcus epidermidis strain RP62A (ATCC35984) was added to the surface of specimens and incubated. The stained biofilms were imaged with a digital optical microscope and the biofilm coverage rate (BCR) was calculated. The total amount of biofilm was determined with the crystal violet assay and the number of viable cells in the biofilm was counted using the plate count method. The BCR of all the biomaterials rose in proportion to culture duration. After culturing for 2–4 hours, the BCR was similar for all materials. However, after culturing for 6 hours, the BCR for Co-Cr-Mo alloy was significantly lower than for Ti-6Al-4V, cp-Ti and stainless steel (P<0.05). The absorbance value determined in the crystal violet assay and the number of viable cells on Co-Cr-Mo were not significantly lower than for the other materials (P>0.05). These results suggest that surface properties, such as hydrophobicity or the low surface free energy of Co-Cr-Mo, may have some influence in inhibiting or delaying the two-dimensional expansion of biofilm on surfaces with a similar degree of smoothness.     

Assessment of the genetic risks of a metallic alloy used in medical implants

The use of artificial implants provides a palliative or permanent solution for individuals who have lost some bodily function through disease, an accident or natural wear. This functional loss can be compensated for by the use of medical devices produced from special biomaterials. Titanium alloy (Ti-6Al-4V) is a well-established primary metallic biomaterial for orthopedic implants, but the toxicity of the chemical components of this alloy has become an issue of concern. In this work, we used the MTT assay and micronucleus assay to examine the cytotoxicity and genotoxicity, respectively, of an extract obtained from this alloy. The MTT assay indicated that the mitochondrial activity and cell viability of CHO-K1 cells were unaffected by exposure to the extract. However, the micronucleus assay revealed DNA damage and an increase in micronucleus frequency at all of the concentrations tested. These results show that ions released from Ti-6Al-4V alloy can cause DNA and nuclear damage and reinforce the importance of assessing the safety of metallic medical devices constructed from biomaterials.     

Spark plasma sintering synthesis of porous nanocrystalline titanium alloys for biomedical applications

The reason for the extended use of titanium and its alloys as implant biomaterials stems from their lower elastic modulus, their superior biocompatibility and improved corrosion resistance compared to the more conventional stainless steel and cobalt-based alloys [Niinomi, M., Hattori, T., Niwa, S., 2004. Material characteristics and biocompatibility of low rigidity titanium alloys for biomedical applications. In: Jaszemski, M.J., Trantolo, D.J., Lewandrowski, K.U., Hasirci, V., Altobelli, D.E., Wise, D.L. (Eds.), Biomaterials in Orthopedics. Marcel Dekker Inc., New York, pp. 41-62]. Nanostructured titanium-based biomaterials with tailored porosity are important for cell-adhesion, viability, differentiation and growth. Newer technologies like foaming or low-density core processing were recently used for the surface modification of titanium alloy implant bodies to stimulate bone in-growth and improve osseointegration and cell-adhesion, which in turn play a key role in the acceptance of the implants. We here report preliminary results concerning the synthesis of mesoporous titanium alloy bodies by spark plasma sintering. Nanocrystalline cp Ti, Ti-6Al-4V, Ti-Al-V-Cr and Ti-Mn-V-Cr-Al alloy powders were prepared by high-energy wet-milling and sintered to either full-density (cp Ti, Ti-Al-V) or uniform porous (Ti-Al-V-Cr, Ti-Mn-V-Cr-Al) bulk specimens by field-assisted spark plasma sintering (FAST/SPS). Cellular interactions with the porous titanium alloy surfaces were tested with osteoblast-like human MG-63 cells. Cell morphology was investigated by scanning electron microscopy (SEM). The SEM analysis results were correlated with the alloy chemistry and the topographic features of the surface, namely porosity and roughness.     

Improving stress shielding following total hip arthroplasty by using a femoral stem made of β type Ti-33.6Nb-4Sn with a Young’s modulus gradation

Stress shielding-related bone loss occurs after total hip arthroplasty because the stiffness of metallic implants differs from that of the host femur. Although reducing stem stiffness can ameliorate the bone resorption, it increases stress at the bone–implant interface and can inhibit fixation. To overcome this complication, a novel cementless stem with a gradient in Young’s modulus was developed using Ti-33.6Nb-4Sn (TNS) alloy. Local heat treatment applied at the neck region for increasing its strength resulted in a gradual decrease in Young’s modulus from the proximal to the distal end, from 82.1 to 51.0 GPa as calculated by a heat transfer simulation. The Young’s modulus gradient did not induce the excessive interface stress which may cause the surface debonding. The main purpose of this study was to evaluate bone remodeling with the TNS stem using a strain-adaptive bone remodeling simulation based on finite element analysis. Our predictions showed that, for the TNS stem, bone reduction in the calcar region (Gruen zone 7) would be 13.6% at 2 years, 29.0% at 5 years, and 45.8% at 10 years postoperatively. At 10 years, the bone mineral density for the TNS stem would be 42.6% higher than that for the similar Ti-6Al-4V alloy stem. The stress–strength ratio would be lower for the TNS stem than for the Ti-6Al-4V stem. These results suggest that although proximal bone loss cannot be eliminated completely, the TNS stem with a Young’s modulus gradient may have bone-preserving effects and sufficient stem strength, without the excessive interface stress.     

Influence of material coupling and assembly condition on the magnitude of micromotion at the stem-neck interface of a modular hip endoprosthesis

Hip prostheses with a modular neck exhibit, compared to monobloc prostheses, an additional interface which bears the risk of fretting as well as corrosion. Failures at the neck adapter of modular prostheses have been observed for a number of different designs. It has been speculated that micromotions at the stem-neck interface were responsible for these implant failures. The purpose of this study was to investigate the influence of material combinations and assembly conditions on the magnitude of micromotions at the stem-neck interface during cyclic loading. Modular (n = 24) and monobloc (n = 3) hip prostheses of a similar design (Metha, Aesculap AG, Tuttlingen, Germany) were subjected to mechanical testing according to ISO 7206-4 (F(min) = 230N, F(max) = 2300N, f = 1Hz, n = 10,000 cycles). The neck adapters (Ti-6Al-4V or Co-Cr29-Mo alloy) were assembled with a clean or contaminated interface. The micromotion between stem and neck adapter was calculated at five reference points based on the measurements of the three eddy current sensors. The largest micromotions were observed at the lateral edge of the stem-neck taper connection, which is in accordance with the crack location of clinically failed prostheses. Titanium neck adapters showed significantly larger micromotions than cobalt-chromium neck adapters (p = 0.005). Contaminated interfaces also exhibited significantly larger micromotions (p < 0.001). Since excessive micromotions at the stem-neck interface might be involved in the process of implant failure, special care should be taken to clean the interface prior to assembly and titanium neck adapters with titanium stems should generally be used with caution.     

Microstructure analysis and wear behavior of titanium cermet femoral head with hard TiC layer

Titanium cermet was successfully synthesized and formed a thin gradient titanium carbide coating on the surface of Ti6Al4V alloy by using a novel sequential carburization under high temperature, while the titanium cermet femoral head was produced. The titanium cermet phase and surface topography were characterized with X-ray diffraction (XRD) and backscattered electron imaging (BSE). And then the wear behavior of titanium cermet femoral head was investigated by using CUMT II artificial joint hip simulator. The surface characterization indicates that carbon effectively diffused into the titanium alloys and formed a hard TiC layer on the Ti6Al4V alloys surface with a micro-porous structure. The artificial hip joint experimental results show that titanium cermet femoral head could not only improve the wear resistance of artificial femoral head, but also decrease the wear of UHMWPE joint cup. In addition, the carburized titanium alloy femoral head could effectively control the UHMWPE debris distribution, and increase the size of UHMWPE debris. All of the results suggest that titanium cermet is a prospective femoral head material in artificial joint.     

Role of stem design and material on stress distributions in cemented total hip replacement

The risk of fatigue fractures of the femoral stem in a cemented total hip arthroplasty can be minimized by either increasing the stem cross-section and/or using a very high strength alloy. The object of this study was to compare important mechanical characteristics of five selected stem designs, differing in configuration and material (stainless steel, cast chrome cobalt alloy, nickel based alloy and titanium alloy). The strain pattern on the stem was analysed in a 3-point-bending jig and also after cementing it into cadaver femurs. Regardless of stem type or test method, the typical tensile stress distribution on the lateral stem was a bell shaped curve. For the cobalt-chrome and stainless steel stems, the larger the stem the lower were the stem stresses and the stress gradient, and the higher was the factor of safety. However, the factor of safety was increased even further by the use of super alloys such as MP35N and Ti₆Al₄V. In addition, Ti₆Al₄V alloy allowed the use of larger and stronger stems without the extra penalty of rigidity, which was enforced by either the steel or cobalt based alloy.     

Potential Use of Porous Titanium–Niobium Alloy in Orthopedic Implants: Preparation and Experimental Study of Its Biocompatibility In Vitro

Background

The improvement of bone ingrowth into prosthesis and enhancement of the combination of the range between the bone and prosthesis are important for long-term stability of artificial joints. They are the focus of research on uncemented artificial joints. Porous materials can be of potential use to solve these problems.

Objectives/Purposes

This research aims to observe the characteristics of the new porous Ti-25Nb alloy and its biocompatibility in vitro, and to provide basic experimental evidence for the development of new porous prostheses or bone implants for bone tissue regeneration.

Methods

The Ti-25Nb alloys with different porosities were fabricated using powder metallurgy. The alloys were then evaluated based on several characteristics, such as mechanical properties, purity, pore size, and porosity. To evaluate biocompatibility, the specimens were subjected to methylthiazol tetrazolium (MTT) colorimetric assay, cell adhesion and proliferation assay using acridine staining, scanning electron microscopy, and detection of inflammation factor interleukin-6 (IL-6).

Results

The porous Ti-25Nb alloy with interconnected pores had a pore size of 200 µm to 500 µm, which was favorable for bone ingrowth. The compressive strength of the alloy was similar to that of cortical bone, while with the elastic modulus closer to cancellous bone. MTT assay showed that the alloy had no adverse reaction to rabbit bone marrow mesenchymal stem cells, with a toxicity level of 0 to 1. Cell adhesion and proliferation experiments showed excellent cell growth on the surface and inside the pores of the alloy. According to the IL-6 levels, the alloy did not cause any obvious inflammatory response.

Conclusion

All porous Ti-25Nb alloys showed good biocompatibility regardless of the percentage of porosity. The basic requirement of clinical orthopedic implants was satisfied, which made the alloy a good prospect for biomedical application. The alloy with 70% porosity had the optimum mechanical properties, as well as suitable pore size and porosity, which allowed more bone ingrowth.     

Ultrastructural differences of the interface zone between bone and Ti 6Al 4V or commercially pure titanium

Commercially pure (CP) titanium and Ti 6Al 4V alloy were sputtered onto polycarbonate plastic implants to analyse hard tissue reactions to the two metals. The implants were inserted in the tibial methaphyses of five rabbits. Three months later they were removed and processed for light microscopy (LM) and transmission electron microscopy (TEM) investigations. At the LM level, disordered woven bone was seen in the interface zone of Ti 6Al 4V, whereas organized bone was observed in direct contact with the CP titanium implants. TEM examination of Ti 6Al 4V sections revealed a 500–1000 Å thick collagen-free proeoglycan layer compared to 200–400 Å for CP titanium. A surface analysis test was performed to compare the magnetron sputtered film with bulk Ti 6Al 4V alloy. This test revealed no major differences between the experimental implant and the bulk alloy. More natural-like tissue reactions were observed to CP titanium than to Ti 6Al 4V alloy.     

Controlled cell Adhesion and aCtivity onto TAl6V TItanium alloy by grafting of the SURFace: Elaboration of orthopaedic implants capable of preventing joint prosthesis infection

The project ANR TECSAN “ACTISURF” has for main objective to propose a new generation of joint prosthesis (hip, knee, shoulder) made of TAl6V titanium alloy capable of limiting and even preventing the joint infections. A chemical modification of titanium surfaces has been set up to confer desirable functional and required properties to the joint prostheses. In order to prevent bacteria adhesion and to improve the long-term osteointegration, bioactive polymers bearing ionic groups were covalently grafted onto titanium surfaces by a grafting “from” technique. The bioactive polymer grafted surfaces named “bioactive TAl6V surfaces” (cylinder, prostheses, discs) were extensively characterized in vitro and in vivo to assess the bacteria and cell responses. The chemical treatment was industrialized by Ceraver Society, which is now able to produce the bioactive prosthesis at the industrial level. At the same time, a method to follow and/or to detect inflammation and infection in patient sera has been developed. Results showed that: (1) grafting of ionic polymers was successful by using radicals from titanium peroxides able to initiate the radical polymerization of ionic monomers; (2) anionic polymers successfully prevent bacterial adhesion and favor osteoblast cell adhesion and differentiation in vitro. In vivo results are still in process and will be delivered at the end of the year.     

Influence of Bio-Lubricants on the Tribological Properties of Ti6Al4V Alloy

Titanium alloy is one of the best materials for biomedical applications due to its superior biocompatibility, outstanding corrosion resistance, and low elastic modulus. However, the friction and wear behaviors of titanium alloys were sensitive to the environment including lubrication. In order to clarify the wear mechanism of titanium alloy under different lubrications including deionized water, physiological saline and bovine serum, the friction and wear tests were performed between Ti6Al4V plates and Si₃N₄ ball on a universal multi-functional tester. The friction and the wear rate of titanium alloy were measured under dry friction and three different lubrication conditions. The worn surfaces were examined by scanning electron microscopy. The results revealed that under the dry friction, the wear resistance of titanium alloy was the worst since the wear mechanism was mainly the combination of abrasive wear and oxidation wear. It was also found that Ti6Al4V alloy had low friction coefficient and wear rate under three lubrication conditions, and its wear mechanism was adhesive wear.     

Standardized testing of bone implant surfaces with an osteoblast cell culture cyste. III. PVD hard coatings and Ti6Al4V]

The effect of titanium-based PVD coatings and a titanium alloy on the proliferation and differentiation of osteoblasts was investigated using a standardised cell culture system. Human fetal osteoblasts (hFOB 1.19) were cultured on titanium-niobium-nitride ([Ti,Nb]N), titanium-niobium-oxy-nitride coatings ([Ti,Nb]ON) and titanium-aluminium-vanadium alloy (Ti6Al4V) for 17 days. Cell culture polystyrene (PS) was used as reference. For the assessment of proliferation, the numbers and viability of the cells were determined, while alkaline phosphatase activity, collagen I and osteocalcin synthesis served as differentiation parameters. On the basis of the cell culture experiments, a cytotoxic effect of the materials can be excluded. In comparison with the other test surfaces, [Ti,Nb]N showed greater cell proliferation. The [Ti,Nb]N coating was associated with the highest level of osteocalcin production, while all other differentiation parameters were identical on all three surfaces. The test system described reveals the influence of PVD coatings on the osteoblast differentiation cycle. The higher oxygen content of the [Ti,Nb]ON surface does not appear to have any positive impact on cell proliferation. The excellent biocompatibility of the PVD coatings is confirmed by in vivo findings. The possible use of these materials in the fields of osteosynthesis and articular surfaces is still under discussion.     

In Vitro and In Vivo Evaluation of Zinc-Modified Ca–Si-Based Ceramic Coating for Bone Implants

The host response to calcium silicate ceramic coatings is not always favorable because of their high dissolution rates, leading to high pH within the surrounding physiological environment. Recently, a zinc-incorporated calcium silicate-based ceramic Ca₂ZnSi₂O₇ coating, developed on a Ti-6Al-4V substrate using plasma-spray technology, was found to exhibit improved chemical stability and biocompatibility. This study aimed to investigate and compare the in vitro response of osteoblastic MC3T3-E1 cells cultured on Ca₂ZnSi₂O₇ coating, CaSiO₃ coating, and uncoated Ti-6Al-4V titanium control at cellular and molecular level. Our results showed Ca₂ZnSi₂O₇ coating enhanced MC3T3-E1 cell attachment, proliferation, and differentiation compared to CaSiO₃ coating and control. In addition, Ca₂ZnSi₂O₇ coating increased mRNA levels of osteoblast-related genes (alkaline phosphatase, procollagen α1(I), osteocalcin), insulin-like growth factor-I (IGF-I), and transforming growth factor-β1 (TGF-β1). The in vivo osteoconductive properties of Ca₂ZnSi₂O₇ coating, compared to CaSiO₃ coating and control, was investigated using a rabbit femur defect model. Histological and histomorphometrical analysis demonstrated new bone formation in direct contact with the Ca₂ZnSi₂O₇ coating surface in absence of fibrous tissue and higher bone-implant contact rate (BIC) in the Ca₂ZnSi₂O₇ coating group, indicating better biocompatibility and faster osseointegration than CaSiO₃ coated and control implants. These results indicate Ca₂ZnSi₂O₇ coated implants have applications in bone tissue regeneration, since they are biocompatible and able to osseointegrate with host bone.     

Apatite Formation and Biocompatibility of a Low Young’s Modulus Ti-Nb-Sn Alloy Treated with Anodic Oxidation and Hot Water

Ti-6Al-4V alloy is widely prevalent as a material for orthopaedic implants because of its good corrosion resistance and biocompatibility. However, the discrepancy in Young’s modulus between metal prosthesis and human cortical bone sometimes induces clinical problems, thigh pain and bone atrophy due to stress shielding. We designed a Ti-Nb-Sn alloy with a low Young’s modulus to address problems of stress disproportion. In this study, we assessed effects of anodic oxidation with or without hot water treatment on the bone-bonding characteristics of a Ti-Nb-Sn alloy. We examined surface analyses and apatite formation by SEM micrographs, XPS and XRD analyses. We also evaluated biocompatibility in experimental animal models by measuring failure loads with a pull-out test and by quantitative histomorphometric analyses. By SEM, abundant apatite formation was observed on the surface of Ti-Nb-Sn alloy discs treated with anodic oxidation and hot water after incubation in Hank’s solution. A strong peak of apatite formation was detected on the surface using XRD analyses. XPS analysis revealed an increase of the H₂O fraction in O 1s XPS. Results of the pull-out test showed that the failure loads of Ti-Nb-Sn alloy rods treated with anodic oxidation and hot water was greater than those of untreated rods. Quantitative histomorphometric analyses indicated that anodic oxidation and hot water treatment induced higher new bone formation around the rods. Our findings indicate that Ti-Nb-Sn alloy treated with anodic oxidation and hot water showed greater capacity for apatite formation, stronger bone bonding and higher biocompatibility for osteosynthesis. Ti-Nb-Sn alloy treated with anodic oxidation and hot water treatment is a promising material for orthopaedic implants enabling higher osteosynthesis and lower stress disproportion.     

Modification of form, material and modularity of threaded acetabulum cups]

The fixation principle of threaded cups ensures high primary stability. Inadequate results with first-generation threaded cups led to modifications of surface machining. 10 threaded cups of the first generation, and 27 of the second and third generations were systematically analysed and their shapes measured using a no-touch light section technique. In addition, measurements of surface roughness were performed. Implants of the first generation made of polyethylene, ceramic or cobalt-chrome have an average surface roughness (Ra) of 1.5 microns. Approximately one-half of these implants have a conical shape, and one-third a height that is greater than the radius. Threaded cups of the second generation are made either of CP-titanium or titanium alloy. The average corundum-blasted surface roughness is 4.5 microns. Hydroxyapatite-coated (HA) implants have a surface roughness of 5.0 microns. Approximately 45% of the implants have a conical, biconical or flattened-conical shape, while one-third are of hemispherical shape. Approximately 90% of the cups have a height that is up to 23% smaller than the radius. A few cups have a height that approximates the radius. Implants of the third generation with identical surface structure can be supplied with crosslinked-polyethylene inlays or, optionally, with metal/metal or ceramic/ceramic contact surfaces. Primary stability, biocompatible materials and a structured surface are essential for ensuring osseointegration over the long-term. Corundum-blasted pure titanium or titanium alloys with corundum-blasted or HA-coated implants can be considered standard for these cups.