Occupational exposure to whole‐body vibration is associated with the development of musculoskeletal, neurological, and other ailments. Low back pain and other spine disorders are prevalent among those exposed to whole‐body vibration in occupational and military settings. Although standards for limiting exposure to whole‐body vibration have been in place for decades, there is a lack of understanding of whole‐body vibration‐associated risks among safety and healthcare professionals. Consequently, disorders associated with whole‐body vibration exposure remain prevalent in the workforce and military. The relationship between whole‐body vibration and low back pain in humans has been established largely through cohort studies, for which vibration inputs that lead to symptoms are rarely, if ever, quantified. This gap in knowledge highlights the need for the development of relevant in vivo, ex vivo, and in vitro models to study such pathologies. The parameters of vibrational stimuli (eg, frequency and direction) play critical roles in such pathologies, but the specific cause‐and‐effect relationships between whole‐body vibration and spinal pathologies remain mostly unknown. This paper provides a summary of whole‐body vibration parameters; reviews in vivo, ex vivo, and in vitro models for spinal pathologies resulting from whole‐body vibration; and offers suggestions to address the gaps in translating injury biomechanics data to inform clinical practice.

Titanium (Ti) is the material of choice for orthopaedic applications because it is biocompatible and encourages osteoblast ingrowth. It was shown that the biocompatibility of Ti metal is due to the presence of a thin native sub-stoichiometric titanium oxide layer which enhances the adsorption of mediating proteins on the surface [1]. The present studies were devised to evaluate the adhesion, survival, and growth of cells on the surface of new engineered nano-crystal films of titanium and titanium oxides and compare them with orthopaedic-grade titanium with microcrystals. The engineered nano-crystal films with hydrophilic properties are produced by employing an ion beam assisted deposition (IBAD) technique. IBAD combines physical vapor deposition with concurrent ion beam bombardment in a high vacuum environment to produce films (with 3 to 70 nm grain size) with superior properties. These films are “stitched” to the artificial orthopaedic implant materials with characteristics that affect the wettability and mechanical properties of the coatings.To characterize the biocompatibility of these nano-engineered surfaces, we have studied osteoblast function including cell adhesion, growth, and differentiation on different nanostructured samples. Cell responses to surfaces were examined using SAOS-2 osteoblast-like cells. We also studied a correlation between the surface nanostructures and the cell growth by characterizing the SAOS-2 cells with immunofluorescence and measuring the amount alizarin red concentration produced after 7 and 14 days. The number of adherent cells was determined by means of nuclei quantification on the nanocrystalline Ti, TiO2, and microcrystalline Ti and analysis was performed with Image J. Our experimental results indicated that nanocrystalline TiO2 is superior to both nano and microcrystalline Ti in supporting growth, adhesion, and proliferation. Improving the quality of surface oxide, i.e. fabricating stoichiometric oxides as well as nanoengineering the surface topology, is crucial for increasing the biocompatibility of Ti implant materials.

This paper addresses the application of engineered nanocrystalline ultrahydrophilic titanium oxide films to artificial orthopaedic implants. Titanium (Ti) is the material of choice for orthopaedic applications and has been used for over fifty years because of its known bio-compatibility. Recently it was shown that biocompatibility of Ti metal is due to the presence of a thin native sub-stoichiometric titanium oxide layer [1] which enhances the adsorption of mediating proteins on the surface thus enhancing cell adhesion and growth [2,3,4]. Improving the quality of surface oxide, i.e. fabricating stoichiometric oxides as well as nanoengineering the surface topology that matches the dimensions of adhesive proteins, is crucial for the increase of protein adsorption [2] and, as a result, the biocompatibility of Ti implant materials. We have fabricated ultrahydrophilic nano-crystalline transparent films of anatase phase of titania (TiO2) by ion beam assisted deposition (IBAD) processes in an ultrahigh vacuum system. Source material was 99.9% pure rutile TiO2. Various ion beam conditions were used to produce these coatings with different grain sizes (4 to 70 nm) that affect the wettability, roughness, and the mechanical and optical properties of the coating [5]. Our biological experiments have shown that biocompatibility of these ultrahydrophilic nanoengineered TiO2 coatings are superior to commonly used orthopaedic titanium and even hydroxyapatite.

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Biomaterials with enhanced biocompatibility are favored in implant studies to improve the outcomes of total joint replacement surgeries. This study tested the hypothesis that nano-structured surfaces for orthopedic applications, produced by the ion beam–assisted deposition method, would enhance osteointegration by altering the expression of bone-associated genes in osteoblasts. The ion beam–assisted deposition technique was employed to deposit nano-films on glass or titanium substrates. The effects of the ion beam–assisted deposition produced surfaces on the human osteosarcoma cell line SAOS-2 at the molecular level were investigated by assays of adhesion, proliferation, differentiation, and apoptosis on coated surfaces versus uncoated cobalt–chrome, as the control. Ion beam–assisted deposition nano-coatings enhanced bone-associated gene expression at initial cell adhesion, proliferation, and differentiation compared to cobalt–chrome surfaces as assessed by polymerase chain reaction techniques. Increased cell proliferation was observed using a nuclear cell proliferation–associated antigen. Moreover, enhanced cell differentiation was determined by alkaline phosphatase activity, an indicator of bone formation. In addition, programmed cell death assessed by annexin V staining and flow cytometry was lower on nano-surfaces compared to cobalt–chrome surfaces. Overall, the results indicate that nano-coated surfaces produced by the ion beam–assisted deposition technique for use on implants were superior to orthopedic grade cobalt–chrome in supporting bone cell adhesion, proliferation, and differentiation and reducing apoptosis. Thus, surface properties altered by the ion beam–assisted deposition technique should enhance bone formation and increase the biocompatibility of bone cell–associated surfaces.