PubMed · 14661700
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Yasumasa Akagawa, Yasuhiko Abe. 2003. Titanium: the ultimate solution or an evolutionary step?. https://pubmed.ncbi.nlm.nih.gov/14661700/
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Wear debris-induced osteolysis is the major cause of aseptic loosening and failure of hip implants. One of the promising therapeutic interventions to improve the longevity of hip implants is to administrate bisphosphonate drug to inhibit osteoclastic bone resorption. This study aimed at developing new techniques of directly combining bisphosphonate with implants to achieve local delivery and controlled release of the drug. Instead of using soluble sodium salt, we proposed to apply sparingly soluble calcium salt of bisphosphonate as a potential long-term antiosteolysis coating on hip implants. Calcium salt of etidronate, a member of the bisphosphonate family of potent osteoclast inhibitors, was used in this pilot study. By adopting the electrolytic deposition (ELD) technique, which was developed for ceramic coatings including calcium phosphates, we demonstrated that a thin layer of calcium bisphosphonate could be deposited onto titanium surface. The drug coating is amorphous as characterized with X-ray diffraction, and has globular morphology under the scanning electron microscope. Electrospray-ionization mass-spectrometry (ESI-MS) and Fourier-transformed infrared spectroscopy confirmed that the molecular structure of the etidronate (m/z 205, H3L-, the single dissociated form of parent etidronic acid, denoted as H4L) was preserved after the ELD process. In vitro release into a "physiological" buffer solution confirmed that the etidronate concentration was limited by its low solubility. The etidronate concentration was 8 x 10(-5) M at day 1 and kept relatively stable at approximately 6 x 10(-5) M from day 2 to day 8. The deposition mechanisms of the drug coating and its potential efficacy as an antiosteolytic release source were discussed.
Due to the large reversible strains achievable through the stress-induced austenite-martensite phase transformation in NiTi alloys, NiTi has replaced stainless steel in the majority of large-strain biomedical applications such as root canal enlargement. However, the pseudoelasticity of NiTi is currently overshadowed by the short fatigue life of NiTi wires used in this low cycle (200-2000 rpm), high amplitude (epsilon(a) > 2.5%) application, resulting in in vivo fracture or premature retirement of otherwise reusable NiTi-based wire devices. In this study, the failure of pseudoelastic 55.8 wt % Ni-Ti wire is investigated experimentally, as a function of experimental parameters that include the clinically relevant regime. The effects of radius of curvature, angle of curvature, wire diameter, strain amplitude, cyclic frequency, volume under strain, and specific heat of the surrounding environmental fluid are considered systematically. These data indicate that the lifetime or cycles to failure N(f) of a rotating NiTi wire can be predicted via a modified Coffin-Manson relation that is a strong function of both strain amplitude and volume under strain, and a weaker function of frequency and fluid specific heat. The resulting quantitative relation can be used to predict useful device lifetime under clinically relevant conditions and thereby reduce incidences of in vivo failure.
The in vivo behavior of a porous Ti6Al4V material that was produced by a positive replica technique, with and without an octacalcium phosphate (OCP) coating, has been studied both in the back muscle and femur of goats. Macro- and microporous biphasic calcium phosphate (BCP) ceramic, known to be both osteoconductive and able to induce ectopic bone formation, was used for comparison purpose. The three groups of materials (Ti6Al4V, OCP Ti6Al4V and BCP) were implanted transcortically and intramuscularly for 6 and 12 weeks in 10 adult Dutch milk goats in order to study their osteointegration and osteoinductive potential. In femoral defects, both OCP Ti6Al4V and BCP were performing better than the uncoated Ti6Al4V, at both time points. BCP showed a higher bone amount than OCP Ti6Al4V after 6 weeks of implantation, while after 12 weeks, this difference was no longer significant. Ectopic bone formation was found in both OCP Ti6Al4V and BCP implants after 6 and 12 weeks. The quantity of ectopically formed bone was limited as was the amount of animals in which the bone was observed. Ectopic bone formation was not found in uncoated titanium alloy implants, suggesting that the presence of calcium phosphate (CaP) is important for bone induction. This study showed that CaPs in the form of coating on metal implants or in the form of bulk ceramic have a significantly positive effect on the bone healing process.