Titanium-Based Hip Stems with Drug Delivery Functionality through Additive Manufacturing

Abstract

Postoperative infections are a major concern in patients that receive implants. These infections generally occur in areas with poor blood flow and pathogens do not always respond to antibiotic treatment. With the latest developments in nanotechnology, the incorporation of antibiotics into prosthetic implants may soon become a standard procedure. The success will, however, depend on the ability to control the release of antibiotics at concentrations high enough to prevent the development of antibiotic-resistant strains. Through additive manufacturing, antibiotics can be incorporated into cementless femoral stems to produce prosthetic devices with antimicrobial properties. With the emerging increase in resistance to antibiotics, the incorporation of antimicrobial compounds other than antibiotics, preferably drugs with a broader spectrum of antimicrobial activity, will have to be explored. This review highlights the microorganisms associated with total hip arthroplasty (THA), discusses the advantages and disadvantages of the latest materials used in hip implants, compares different antimicrobial agents that could be incorporated, and addresses novel ideas for future research.

Impact of Laser Structuring on Medical-Grade Titanium: Surface Characterization and In Vitro Evaluation of Osteoblast Attachment

“…Meanwhile, Kurtz et al [3] predicted a considerable increase in orthopedic procedures of 0.57 million hip arthroplasties and 3.48 million primary total knee arthroplasties until the year 2030, which will further increase the demand. The phase composition (alpha, beta, or alpha + beta) of titanium alloys [4] must especially be taken into account in the implant design to prevent wear and potential recalls by notified bodies [5]. Even though titanium alloys are currently in clinical use, they contain leachable toxic elements such as vanadium and aluminum, which could be released due to corrosion or wear.…”

Icariin attenuates titanium particle‐induced inhibition of osteogenic differentiation and matrix mineralization via miR‐21‐5p

“…Total joint arthroplasty (TJA) is a highly successful surgical procedure for the treatment of joint dysfunction (Li et al, ). Among all implant materials, titanium (Ti) alloy is commonly used due to its excellent properties, including biocompatibility, high strength, ductility and corrosion resistance (Bezuidenhout et al, ; Shi et al, ). Despite this, wear and corrosion are still the main causes of the generation of wear particles in the peri‐prosthetic tissues (Bitar and Parvizi, ).…”

Pharmaceutical applications of 3D printing technology: current understanding and future perspectives

“…EBM can provide higher throughput and more uniform thermal field distribution than SLS, but its accuracy and surface quality are lower (Bikas et al 2016). EBM and SLM are widely used in drug-loaded implants (Bezuidenhout et al 2015).…”