The contribution of coating microstructure to degradation and particle release in hydroxyapatite coated prostheses

Structural and Chemical Hierarchy in Hydroxyapatite Coatings

Hydroxyapatite coatings need similarly shaped splats as building blocks and then a homogeneous microstructure to unravel the structural and chemical hierarchy for more refined improvements to implant surfaces. Coatings were thermally sprayed with differently sized powders (20–40, 40–63 and 63–80 µm) to produce flattened homogeneous splats. The surface was characterized for splat shape by profilometry and Atomic force microscopy (AFM), crystal size by AFM, crystal orientation by X-ray diffraction (XRD) and structural variations by XRD. Chemical composition was assessed by phase analysis, but variations in chemistry were detected by XRD and Raman spectroscopy. The resulting surface electrical potential was measured by Kelvin probe AFM. Five levels of structural hierarchy were suggested: the coating, the splat, oriented crystals, alternate layers of oxyapatite and hydroxyapatite (HAp) and the suggested anion orientation. Chemical hierarchy was present over a lower range of order for smaller splats. Coatings made from smaller splats exhibited a greater electrical potential, inferred to arise from oxyapatite, and supplemented by ordered OH⁻ ions in a rehydroxylated surface layer. A model has been proposed to show the influence of structural hierarchy on the electrical surface potential. Structural hierarchy is proposed as a means to further refine the properties of implant surfaces.

On the fate of particles liberated from hydroxyapatite coatings in vivo

PURPOSE

Hydroxyapatite (HA) has been used as a coating for orthopaedic implants for over 30 years to help promote the fixation of orthopaedic implants into the surrounding bone. However, concerns exist about the fate of the hydroxyapatite coating and hydroxyapatite particles in vivo, especially in the wake of recent concerns about particulates from metal-on-metal bearings.

METHODS

Here, we assess the mechanisms of particle detachment from coated orthopaedic devices as well as the safety and performance concerns and biomedical implications arising from the liberation of the particles by review of the literature.

FINDINGS

The mechanisms that can result in the detachment of the HA coating from the implant can be mechanical or biochemical, or both. Mechanical mechanisms include implant insertion, abrasion, fatigue and micro-motion. Biochemical mechanisms that contribute to the liberation of HA particles include dissolution into extra-cellular fluid, cell-mediated processes and crystallisation of amorphous phases. The form the particles take once liberated is influenced by a number of factors such as coating method, the raw powder morphology, processing parameters, coating thickness and coating structure.

CONCLUSIONS

This review summarises and discusses each of these factors and concludes that HA is a safe biomimetic material to use as a coating and does not cause any problems in particulate form if liberated as debris from an orthopaedic implant.

A hip simulator study of metal-on-metal hip joint device using acetabular cups with different fixation surface conditions

In vitro wear data for hip joint devices reported in the literature vary in a wide range from one simulator study to another sometimes for the same type of device tested under identical physiological testing conditions. We hypothesized that non-bearing surface condition of the testing components could be an important factor affecting the simulator wear results. To confirm this hypothesis, fifteen 50 mm metal-on-metal hip resurfacing devices with identical bearing specifications were tested in a ProSim hip wear simulator for 5 million cycles. The heads were standard Birmingham Hip Resurfacing (BHR) heads; whilst the pairing acetabular cups were identical to the standard BHR cup except their different back surface conditions, including: (a) off-the-shelf products after removing the hydroxyapatite (HA) coating; (b) semi-finished products without HA coating; and (c) purposely-made cups without cast-in beads and HA coating. Results showed that the different back surfaces of the cups used indeed caused significantly large variations in the gravimetrically measured wear loss. We postulated that materials loss from the non-bearing surface of the testing components could contribute to the gravimetrically measured wear loss during a wear simulator test both directly and indirectly. The results presented in this paper pertain to In vitro wear simulator study and have little clinical relevance to the performance of any implant in vivo.

Characterization and dissolution of functionalized amorphous calcium phosphate biolayers using single-splat technology

New processing routes and characterization techniques underpin further growth of biomaterials for improved performance and multifunctionality. This study investigates the characteristics and solubility of amorphous calcium phosphate (ACP) printed splats. Splats made from 20 to 60 μm molten hydroxyapatite particles were classified for shape (rounded/splashed) and cracking. Recoil of the spread droplet created a bowl-shaped splat. This has previously not been observed and could be related to the longer solidification time associated with solidification to an ACP. A central depression was created from 20 μm particles, but a bowl-shaped splat from 60 μm particles. Cracking was more prevalent for splats that solidified with an edge discontinuity. Splats immersed in pH 7.3 tris buffer displayed dissolution followed by cracking. Cracking continued over a period of 15 min as dissolution induced more cracks. Further degradation occurred by delamination of splat segments. Delamination accelerated the process of splat removal. Applied to thermal spray coatings, this highlights topography and dissolution at the splat level. The use of separate splats can potentially be used as a biolayer where splats are separate, in a line or on top of each other.

Engineering an in vitro model of a functional ligament from bone to bone

For musculoskeletal tissues that transmit loads during movement, the interfaces between tissues are essential to minimizing injury. Therefore, the reproduction of functional interfaces within engineered musculoskeletal tissues is critical to the successful transfer of the technology to the clinic. The goal of this work was to rapidly engineer ligament equivalents in vitro that contained both the soft tissue sinew and a hard tissue bone mimetic. This goal was achieved using cast brushite (CaHPO(4)·2H(2)O) anchors to mimic bone and a fibrin gel embedded with fibroblasts to create the sinew. The constructs formed within 7 days. Fourteen days after seeding, the interface between the brushite and sinew could withstand a stress of 9.51 ± 1.7  kPa before failure and the sinew reached a Young's modulus value of 0.16 ± 0.03  MPa. Treatment with ascorbic acid and proline increased the collagen content of the sinew (from 1.34% ± 0.2% to 8.34% ± 0.37%), strength of the interface (29.24 ± 6  kPa), and modulus of the sinew (2.69 ± 0.25  MPa). Adding transforming growth factor-β resulted in a further increase in collagen (11.25% ± 0.39%), interface strength (42 ± 8  kPa), and sinew modulus (5.46 ± 0.68  MPa). Both scanning electron and Raman microscopy suggested that the interface between the brushite and sinew mimics the in vivo tidemark at the enthesis. This work describes a major step toward the development of tissue-engineered ligaments for the repair of ligament ruptures in humans.

In vivo bone response and mechanical evaluation of electrosprayed CaP nanoparticle coatings using the iliac crest of goats as an implantation model

Recent trends in clinical implantology include the use of endosseous dental implant surfaces embellished with nano-sized modifications. The current study was initiated to evaluate the mechanical properties, as well as the potential beneficial effects, of electrosprayed CaP nanoparticle-coated (nano-CaP) implants on the in vivo osteogenic response, compared with grit-blasted, acid-etched (GAE) implant surfaces as controls. For this purpose nano-CaP coatings were deposited on cylindrical screw-type (St) implants and implanted bilaterally into the iliac crest of goats for 6weeks. In addition to histological and histomorphometrical analyses, insertion torque and removal torque values were measured on implant placement and retrieval, respectively. The present study showed similar insertion and removal torque values for nano-CaP-coated and GAE control implants, with no statistically significant increase in torque value during the implant period for either group. With regard to bone-implant contact and peri-implant bone volume, no significant differences were found between nano-CaP-coated and GAE implants after 6weeks implantation. In conclusion, this study has demonstrated that in situations in which implants are placed in a non-compromised situation using a standard press fit implantation strategy the performance of electrosprayed nano-CaP coatings is comparable with GAE implants, both with respect to implant fixation and bone healing response.

Electrophoretic deposition of HA/MWNTs composite coating for biomaterial applications

A composite coating of hydroxyapatite (HA)/multi-walled carbon nanotubes (MWNTs) has been fabricated by electrophoretic deposition (EPD). The nano powders of HA and MWNTs were dispersed in ethanol with total concentration of 0.005 g/mL and MWNTs 20% and 30% contents (wt). And the pH value of suspension was adjusted in a range from 4 to 5. After stabilization the mixture was ultrasonically treated for 3 h to form a stable suspension. Prior to the electrophoretic deposition, the titanium substrate was hydrothermally treated at 140 in NaOH (10 mol/L) solution for 6 h. A titanium sheet and circinal net of stainless steel were used as a cathode and an anode respectively, and a constant deposition voltage of 30 V was applied for 50-60 s in the EPD process. The thickness of the coatings was controlled from 10 microm to 20 microm. The samples of composite coating were then sintered in a resistance tube furnace in flowing argon at 700 for 2 h. The structure of the as prepared coating was characterized by SEM and XRD, and the bonding force of the coating/substrate was measured by an interfacial shear strength test. It is shown that the bonding strengths between the coating and the titanium substrate is as high as 35 MPa. The cell culture experiments indicate that the prepared composite coating of HA/MWNTs possesses good biocompatibility.

In vitro and in vivo reactivity of porous, electrosprayed calcium phosphate coatings

The dissolution and/or precipitation behaviour of porous calcium phosphate (CaP) coatings, deposited using electrostatic spray deposition (ESD), was investigated (a) in vitro after soaking in simulated body fluid (SBF) for several time periods (2, 4, 8, and 12 weeks), and (b) in vivo after subcutaneous implantation of CaP-coated implants in the back of goats for identical time periods. Physical and chemical properties of coatings were characterized before and after in vitro/vivo testing by means of scanning electron microscopy, X-ray diffraction, Fourier-transform infrared spectroscopy, and energy dispersive spectroscopy. Moreover, part of the explants was prepared for light microscopical evaluation of the tissue response. In vitro, all apatitic ESD-coatings induced the formation of homogeneous and adherent CaP precipitation layers. Amorphous CaP, however, displayed a delayed precipitation of poorly adherent CaP layers, whereas heterogeneous calcification was observed on top of beta-TCP-coated substrates, indicating that beta-TCP and amorphous CaP coatings exhibit a poor ability of inducing calcification in SBF as compared to crystalline apatitic coatings. In vivo, no adverse tissue reactions (toxic effects/inflammatory cells) were observed using light microscopy, and all coatings became surrounded by a dense, fibrous tissue capsule after implantation. All ESD-coatings degraded gradually at a dissolution rate depending on the chemical phase (order of relative solubility: amorphous CaP approximately carbonate apatite>beta-TCP>carbonated hydroxyapatite), thereby enabling synthesis of CaP coatings with a tailored degradation rate.

Precipitation of hydroxyapatite nanoparticles: effects of precipitation method on electrophoretic deposition

Electrophoretic deposition is a low-cost, simple, and flexible coating method for producing hydroxyapatite (HA) coatings on metal implants with a broad range of thicknesses, from < 1 microm to > 500 microm. As for many other HA coating techniques, densification of electrophoretically deposited coatings involves heating the coated metal to temperatures above 1000 degrees C. Metal substrates tend to react with HA coatings at such temperatures inducing decomposition at temperatures below 1050 degrees C (decomposition for pure HA normally occurs above 1300 degrees C). Therefore, densification of these coatings needs to be conducted at temperatures lower than 1050 degrees C, and this necessitates the use of high-surface-area HA nano-precipitates, rather than commercially available pre-calcined powders, which densify at temperatures typically higher than 1200 degrees C. HA nano-precipitates were prepared by three methods and deposited on metal substrates by electrophoresis: (1) the acid base method, which produced plate-like nano-particles with a 2.5:1 aspect ratio, and severely cracked coatings; (2) the calcium acetate method, which produced needle-like nano-particles with a 10:1 aspect ratio, and slightly cracked coatings; (3) the metathesis method, which produced rounded nano-particles with a 2:1 aspect ratio, and high-quality crack-free coatings. The results suggested that the less equiaxed the nano-particles, the more cracked the coatings obtained by the electrophoretic deposition technique.

Surface immobilized bisphosphonate improves stainless-steel screw fixation in rats

An increase in the mechanical fixation in bone of metallic biomaterials is considered advantageous in joint replacement and fracture surgery. Different approaches to improve fixation may be e.g. surface roughening, Ca-mineral coating or surface immobilization of growth factors or drugs. In the present work, bisphosphonate, a class of drugs that inhibit bone resorption, was immobilized onto stainless-steel screws. The screws were first roughened and coated with immobilized and cross-linked fibrinogen. Subsequently, an N-bisphosphonate, pamidronate, was immobilized onto fibrinogen, and another N-bisphosphonate, ibandronate, adsorbed on top of this. The so coated screws were inserted into the tibiae of eight male Sprague-Dawley rats. Another eight rats received screws prepared in the same way, but without the bisphosphonate coating. Pullout strength tests were performed after 2 weeks of implantation. The results showed a 28% (p=0.0009) higher pullout force and 90% increased pullout energy for the bisphosphonate coated screws, and support the idea that surface immobilized bisphosphonates can be used to improve biomaterials fixation in bone.