Titanium nanostructures for biomedical applications.

Titanium and titanium alloys exhibit a unique combination of strength and biocompatibility, which enables their use in medical applications and accounts for their extensive use as implant materials in the last 50 years. Currently, a large amount of research is being carried out in order to determine the optimal surface topography for use in bioapplications, and thus the emphasis is on nanotechnology for biomedical applications. It was recently shown that titanium implants with rough surface topography and free energy increase osteoblast adhesion, maturation and subsequent bone formation. Furthermore, the adhesion of different cell lines to the surface of titanium implants is influenced by the surface characteristics of titanium; namely topography, charge distribution and chemistry. The present review article focuses on the specific nanotopography of titanium, i.e. titanium dioxide (TiO2) nanotubes, using a simple electrochemical anodisation method of the metallic substrate and other processes such as the hydrothermal or sol-gel template. One key advantage of using TiO2 nanotubes in cell interactions is based on the fact that TiO2 nanotube morphology is correlated with cell adhesion, spreading, growth and differentiation of mesenchymal stem cells, which were shown to be maximally induced on smaller diameter nanotubes (15 nm), but hindered on larger diameter (100 nm) tubes, leading to cell death and apoptosis. Research has supported the significance of nanotopography (TiO2 nanotube diameter) in cell adhesion and cell growth, and suggests that the mechanics of focal adhesion formation are similar among different cell types. As such, the present review will focus on perhaps the most spectacular and surprising one-dimensional structures and their unique biomedical applications for increased osseointegration, protein interaction and antibacterial properties.

Special modes of corrosion under physiological and simulated physiological conditions.

The aim of this article is to review those aspects of corrosion behaviour that are most relevant to the clinical application of implant alloys. The special modes of corrosion encountered by implant alloys are presented. The resistance of the different materials against the most typical corrosion modes (pitting corrosion, crevice corrosion and fretting corrosion) is compared, together with observations of metal ion release from different biomaterials. A short section is dedicated to possible galvanic effects in cases when different types of materials are combined in a biomedical device. The different topics covered are introduced from the viewpoint of materials science, and then placed into the context of medicine and clinical experience.

Long-term survival of a cemented titanium-aluminium-vanadium alloy straight-stem femoral component.

We present a retrospective series of 170 cemented titanium straight-stem femoral components combined with two types of femoral head: cobalt-chromium (CoCr) alloy (114 heads) and alumina ceramic (50 heads). Of the study group, 55 patients (55 stems) had died and six (six stems) were lost to follow-up. At a mean of 13.1 years (3 to 15.3) 26 stems had been revised for aseptic loosening. The mean follow-up time for stable stems was 15.1 years (12.1 to 16.6). Survival of the stem at 15 years was 75.4% (95% confidence interval (CI) 67.3 to 83.5) with aseptic failure (including radiological failure) as the end-point, irrespective of the nature of the head and the quality of the cement mantle. Survival of the stem at 15 years was 79.1% (95% CI 69.8 to 88.4) and 67.1% (95% CI 51.3 to 82.9) with the CoCr alloy and ceramic heads, respectively. The quality of the cement mantle was graded as a function of stem coverage: stems with complete tip coverage (type 1) had an 84.9% (95% CI 77.6 to 92.2) survival at 15 years, compared with those with a poor tip coverage (type 2) which had a survival of only 22.4% (95% CI 2.4 to 42.4). The poor quality of the cement mantle and the implantation of an alumina head substantially lowered the survival of the stem. In our opinion, further use of the cemented titanium alloy straight-stem femoral components used in our series is undesirable.

Polyethylene wear in total hip prostheses: the influence of direction of linear wear on volumetric wear determined from radiographic data.

PURPOSE: To develop a new mathematical model for calculating the volumetric wear of polyethylene cups from known values of the radius of the prosthesis head, the extent of linear wear and the direction of linear wear determined from standard antero-posterior radiographs. METHOD: A new mathematical model was developed. The results of this new mathematical model were compared with the results obtained using the standard, frequently used mathematical model, which takes into consideration only the radius of the prosthesis head and the extent of linear wear of the polyethylene cups. The results of both mathematical models were further compared with the results obtained by direct measurement of volumetric wear using the fluid displacement method. RESULTS: Comparison of the mathematical models shows that the average volumetric wear calculated using the new mathematical model is 8.5% smaller than the average volumetric wear determined by the fluid displacement method, while the average volumetric wear calculated by standard mathematical model is 17.5% higher. The results of the new mathematical model are, thus, notably less biased than those of the standard one. CONCLUSION: In calculating the volumetric wear from antero-posterior radiographs, not only the radius of the prosthesis head and the extent of the linear wear but also the direction of the latter has to be considered.

Corrosion of Cu-xZn alloys in slightly alkaline chloride solutions studied by stripping voltammetry and microanalysis.

The mechanism of corrosion of Cu-xZn alloys (x = 10-40 wt %) in slightly alkaline chloride solutions was investigated by analysing solid reaction products by energy dispersive X-ray analysis (EDS) and dissolved reaction products by differential anodic pulse stripping (DAPS) voltammetry. The corrosion process was studied under open circuit and under potentiostatic conditions at selected potentials. Pure metals were studied comparatively so that an interacting effect of particular metal components in the alloy could be determined. All four Cu-xZn alloys show an improved behaviour compared to pure metals. Under open-circuit condition both components dissolve simultaneously in the solution. With increasing immersion time the preferential, dissolution of zinc in the solution becomes pronounced. It is the highest for Cu-10Zn and the lowest for Cu-30Zn alloy. Under potentiostatic control the dissolution mechanism depends on the electrode potential and changes from exclusive dissolution of zinc to simultaneous dissolution of both components with preferential dissolution of zinc. The latter decreases, as the electrode potential becomes more positive.

Platinum stimulating electrodes in physiological media.

The study reported here seeks to characterize behaviour of platinum electrodes of the 45-electrode spiral nerve cuff for selective electrical stimulation of different superficial regions of peripheral nerves in physiological solution (0.9% NaCl) and Eliott's buffered solution. Each electrode of the spiral cuff had a flat geometric surface of 2 mm2. To delineate an operational potential window between hydrogen and oxygen evolution during stimulation the electrochemical technique of cyclic voltammetry was used. In a typical cyclic voltammetry experiment, the potential of the tested electrode was cycled at an appropriate rate between two potential limits. The surfaces of the electrodes, obtained after injection of the biphasic charge as defined in a physiological solution (0.9% NaCl), thus simulating long-term electrical stimulation, were investigated using a high resolution Auger electron spectroscopy (AES) method.

Passive film on orthopaedic TiAlV alloy formed in physiological solution investigated by X-ray photoelectron spectroscopy.

The passive film formed by electrochemical oxidation on TiAlV alloy in physiological solution was studied using X-ray photoelectron spectroscopy (XPS) and electrochemical impedance spectroscopy (EIS). The alloy was polarised at different oxidation potentials in the electrochemical chamber attached to the spectrometer. Thus the composition of the layer formed by oxidation was analysed by XPS without prior exposure to air (quasi-in situ). The oxide layer was predominantly TiO2, which contained a small amount of suboxides TiO and Ti2O3 closer to the inner metal/oxide interface. With increasing potential the content of Ti4+ species increased and that of Ti3+ and Ti2+ decreased. The content of titanium in TiO2 was lower than theoretically predicted due to the incorporation of Al2O3 in TiO2 matrix. Vanadium oxide was not identified by XPS. Angular resolved XPS analysis confirmed that Al2O3 is located mainly at the outer oxide/solution interface. The thickness of the oxide layer was dependent on the oxidation potential and after oxidation at 2.5 V reached 9 nm. EIS measurements were used to in situ characterise electronic properties of passive films over seven decades of frequency. A link between electronic, electrochemical and physiochemical properties was established.

The behavior of stainless steels in physiological solution containing complexing agent studied by X-ray photoelectron spectroscopy.

The passive film formed by electrochemical oxidation on two different stainless steels differing in molybdenum (Mo) content in physiological solution with and without the addition of complexing agent, i.e., citrate, was studied using X-ray photoelectron spectroscopy. The alloys were polarized at different oxidation potentials in the electrochemical chamber attached to the spectrometer. Thus, the composition of the film formed by oxidation was analyzed by X-ray photoelectron spectroscopy without prior exposure to air (quasi in situ). The passive film formed in physiological solution consists of two predominant oxides, i.e., chromium and iron oxides. Oxides of alloying elements nickel and Mo are also detected in the film. It seems that the strong enrichment of oxidized chromium and Mo in the passive layer, and strong enrichment of Mo and depletion of iron at the metal surface underneath the passive layer, are responsible for the outstanding corrosion resistance of orthopedic stainless steel in physiological solution. Commercial AISI 304 is not suitable for orthopedic applications. The addition of complexing agent affects significantly the passivation behavior of orthopedic stainless steel, because it changes the distribution of the elements within the passive layer and at the metal surface underneath.