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The interfacial shear strength and bone tissue response was investigated for an arc deposited (AD) commercially pure titanium implant surface, with (AD/HA) and without (AD) plasma-sprayed hydroxyapatite (HA) coating. Ten purpose bred coonhounds received bilateral femoral stem implantation (AD and AD/HA) in the proximal femurs (hemiarthroplasty). The femoral prosthesis consisted of a modular CoCr alloy head, modular Ti-6Al-4V neck, and a 10-mm diameter cylindrical Ti-6Al-4V femoral stem. The AD surface had 30-35% greater surface roughness than the AD/HA surface. The HA coating had a purity greater than 90% and a crystallinity greater than 65%. After 6, 12, and 24 weeks, the implants were retrieved and analyzed with mechanical testing, qualitative and quantitative histology, and electron microscopy. The AD/HA implants had equivalent interfacial shear strengths to the AD implants at all time periods. The AD/HA implants had significantly greater linear bone contact than the AD implants. The 6-week implants had significantly thicker cortical bone than the 12- and 24-week implants. The HA coating was very stable in vivo, evidenced by no thickness reduction at any time period. Qualitatively, the AD/HA implants primarily had bone contacting the implant surface with little fibrous tissue present, and the AD implants had bone and fibrous tissue contacting the implant surface. The electron microscopy analysis showed that the mechanically tested implants exhibited a mixed failure mode at the bone, HA coating, and titanium interfaces.

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Sublaminar multistrand cable may be a rational alternative to monofilament wire in segmental spinal instrumentation because it provides less encroachment into the spinal canal. Further, cadaveric spines instrumented with wire and cable display equivalent mechanical behavior, statically and under cyclic loading. The potential advantages of cable, however, must be balanced against a substantial increase in cost relative to wire.