Drug release from polymer-coated TiO2 nanotubes on additively manufactured Ti-6Al-4V bone implants: a feasibility study

Construction of Local Drug Delivery System on Titanium-Based Implants to Improve Osseointegration

Titanium and its alloys are the most widely applied orthopedic and dental implant materials due to their high biocompatibility, superior corrosion resistance, and outstanding mechanical properties. However, the lack of superior osseointegration remains the main obstacle to successful implantation. Previous traditional surface modification methods of titanium-based implants cannot fully meet the clinical needs of osseointegration. The construction of local drug delivery systems (e.g., antimicrobial drug delivery systems, anti-bone resorption drug delivery systems, etc.) on titanium-based implants has been proved to be an effective strategy to improve osseointegration. Meanwhile, these drug delivery systems can also be combined with traditional surface modification methods, such as anodic oxidation, acid etching, surface coating technology, etc., to achieve desirable and enhanced osseointegration. In this paper, we review the research progress of different local drug delivery systems using titanium-based implants and provide a theoretical basis for further research on drug delivery systems to promote bone–implant integration in the future.

Cellular studies and sustained drug delivery via nanostructures fabricated on 3D printed porous Neovius lattices of Ti6Al4V ELI

Site-specific drug delivery has the potential to reduce drug dosage by 3 to 5-folds. Given the propensity of drugs used in the treatment of tuberculosis and cancers, the increased drug dosages via oral ingestion for several months to a few years of medication is often detrimental to the health of patients. In this study, the sustained delivery of drugs with multiscale structured novel Neovius lattices was achieved. 3D Neovius Open Cell Lattices (NOCL) with porosities of 40, 45, and 50 % were fabricated layer-by-layer on the laser bed fusion process. Micron-sized Ti6Al4V Eli powder was used for 3D printing. The Young's modulus achieved from the novel Neovius lattices were in the range of 1.2 to 1.6 GPa, which is comparable to human cortical bone and helps to improve implant failure due to the stress shielding effect. To provide sustained drug delivery, nanotubes (NTs) were fabricated on NOCLs via high-voltage anodisation. The osteogenic agent icariin was loaded onto the NOCL-NT samples and their release profiles were studied for 7 days. A significantly steady and slow release rate of 0.05% per hour of the drug was achieved using NOCL-NT. In addition, the initial burst release of NOCL-NT was 4 fold lower than that of the open-cell lattices without nanotubes. Cellular studies using MG63 human osteoblast-like cells were performed to determine their biocompatibility and osteogenesis which were analysed using Calcein AM staining and Alamar Blue after 1, 5, and 7 days. 3D printed NOCL samples with NTs and with Icariin loaded NTs demonstrated a significant increase in cell proliferation as compared to as printed NOCL samples.

Tuning the Biointerface: Low-Temperature Surface Modification Strategies for Orthopedic Implants to Enhance Osteogenic and Antimicrobial Activity

As both the average life expectancy and incidence of bone tissue reconstruction increases, development of load-bearing implantable materials that simultaneously enhance osseointegration while preventing postoperative infection is crucial. To address this need, significant research efforts have been dedicated to developing surface modification strategies for metallic load-bearing implants and scaffolds. Despite the abundance of strategies reported, many address only one factor, for example, surface chemistry or topography. Furthermore, the incorporation of surface features to increase osteocompatibility can increase the probability of infection, by encouraging the formation of bacterial biofilms. To truly advance this field, research efforts must focus on developing multifunctional coatings that concurrently address these complex and competing requirements. In addition, particular emphasis should be placed on utilizing surface modification processes that are versatile, low cost, and scalable, for ease of translation to mass manufacturing and clinical use. The aim of this short Review is to highlight recent advances in scalable and multifunctional surface modification techniques that obtain a programmed response at the bone tissue/implant interface. Low-temperature approaches based on macromolecule immobilization, electrochemical techniques, and solution processes are discussed. Although the strategies discussed in this Review have not yet been approved for clinical use, they show great promise toward developing the next generation of ultra-long-lasting biomaterials for joint and bone tissue repair.