Methods for the physical and chemical characterisation of surfaces of titanium implants

Bioactive titanium calcium phosphate coating for disc arthroplasty: analysis of 58 vertebral end plates after 6- to 12-month implantation

BACKGROUND CONTEXT

From a biomechanical perspective, the successful outcome of total disc replacement is largely based on the mechanisms of acute fixation obtained at the index procedure and the extent of porous biological osseointegration at the prosthesis-bone interface, ensuring long-term device fixation.

PURPOSE

The present retrospective investigation quantifies the extent of porous osseointegration in cervical and lumbar disc arthroplasty implants containing a bioactive titanium/calcium phosphate coating.

STUDY DESIGN

Based on radiographic analysis and quantitative histomorphometry, the study was designed to determine the extent of porous osseointegration and whether osseointegration was affected by arthroplasty implant position.

OUTCOME MEASURES

Quantitative histomorphometric analysis of trabecular apposition in metallic backed cervical and lumbar arthroplasty devices.

METHODS

Twenty-nine disc arthroplasty devices underwent radiographic and histomorphometric analysis after 6- to 12-month implantation. The specimens included 12 cervical porous-coated motion devices implanted in a caprine model, and 17 lumbar Charité devices implanted in a non-human primate baboon. The two prosthetic-bone surfaces (superior and inferior) of each implant were examined for a total of 58 vertebral end plates. The operative motion segments were processed using undecalcified histologic technique with production of high-resolution light photomicrographs and microradiographs used for histomorphometric quantification of trabecular bone area at the implant interface. Based on plain film radiographs and histologic microradiographs, the technical accuracy of implant placement was classified as Ideal, Suboptimal, or Poor, with alignment referenced to the sagittal and coronal planes.

RESULTS

The technical accuracy of implant placement in the cervical spine based on histologic microradiographs ranged from poor=8% (2 out of 24), suboptimal=17% (4 out of 24), to ideal=75% (18 out of 24), whereas accuracy of lumbar disc arthroplasty ranged from poor=20% (7 out of 34), suboptimal=52% (18 out of 34), and ideal=26% (9 out of 34). Based on histomorphometric analysis of the inferior and superior end plate surfaces, the trabecular apposition ranged from poor placement 21%+/-30% ingrowth, suboptimal 26%+/-33%, to ideal=44%+/-23% (p>.05). Similar findings were observed for the lumbar region; however, the suboptimal and ideal positions were closer in values with regard to trabecular apposition. Poor placement was 34%+/-29%, suboptimal 49%+/-19%, and ideal 51%+/-13%, but this was not statistically significant (p>.05).

CONCLUSIONS

The present study represents the largest analysis to date of any retrieved porous ingrowth disc replacement prostheses. A trend was observed of increase porous osseointegration with improved implant positioning; however, the small sample size and high standard deviations account for lack of statistical significance. Although osseointegration occurs despite nonideal intraoperative positioning, it remains imperative that surgeons strive for Ideal implant position.

The effect of sodium-ion implantation on the properties of titanium

This paper deals with the surface modification of titanium by sodium-ion implantation and with the effect of this modification on structure, corrosion resistance, bioactivity and cytocompatibility. The Na ions were implanted with doses of 1 x 10(17) and 4 x 10(17) ions/cm(2) at an energy of 25 keV. The chemical composition of the surface layers formed during the implantation was examined by secondary-ion mass spectrometry (SIMS) and X-ray photoelectron spectroscopy (XPS), and their microstructure--by transmission electron microscopy (TEM). The corrosion resistance was determined by electrochemical methods in a simulated body fluid (SBF) at a temperature of 37 degrees C, after exposure in SBF for various times. The surfaces of the samples were examined by optical microscopy, by scanning electron microscopy (SEM-EDS), and by atomic force microscopy (AFM). Biocompatibility of the modified surface was evaluated in vitro in a culture of the MG-63 cell line and human osteoblast cells. The TEM results indicate that the surface layers formed during the implantation of Na-ions are amorphous. The results of the electrochemical examinations obtained for the Na-implanted titanium samples indicate that the implantation increases corrosion resistance. Sodium-ion implantation improves bioactivity and does not reduce biocompatibility.

Mathematical correlation between biomaterial and cellular parameters—Critical reflection of statistics

For mathematical modelling of the biomaterial-cell contact, it is necessary to find both parameters characterizing physical and chemical properties of the material surface and also such describing the reaction of the adhering cells. Only those material and cell parameters that correlate with each other are applicable to model this contact mathematically. Only few papers are dealing with this special problem. The aim of this paper is to present results of physical/chemical and biological investigations made on differently modified rough titanium implant surfaces in order to find out only the correlating parameters. Furthermore we discuss several ways to apply statistical methods to the correlation problem. Only few ones of all investigated parameters both on material and on cellular side were applicable for correlation. For example we found in our studies that fractal structure parameter topothesy has influence on the spreading behaviour of the osteoblastic cells. However the value of the correlation coefficient and its statistical significance heavily depend on the method of averaging the available data. Especially the biological data (spreading area) were afflicted with relatively high error up to 30%. Averaging of this data masks the true facts. That is why the correlation coefficient considerably decreases if the biological parameters are not averaged. On the other hand, the statistical reliability increases due to the higher number of investigated cases. Critical error discussion is necessary in statistical correlation between material and biological parameters. Often the results are heavily influenced by the statistical handling of data, especially if only few data are available. May be that new unconventional methods like bootstrap method can show a way out of this dilemma.

Interface Interactions of Osteoblasts with Structured Titanium and the Correlation between Physicochemical Characteristics and Cell Biological Parameters

Cellular behavior at the interface of an implant is influenced by the material's topography. However, little is known about the correlation between the biological parameters and the physicochemical characteristics of the biomaterial. We therefore modified pure titanium surfaces by polishing, machining, blasting with glass spheres, blasting with corundum particles, and vacuum plasma spraying to give progressively higher surface roughness. The material surface was characterized by SEM, surface profiling, and electrochemical methods. We revealed a correlation for integrin expression and formation, adhesion, spreading, proliferation, and bone sialo protein expression with the physicochemical parameters of the titanium surfaces.