Abstract
Fluorinated diamond-like carbon (F-DLC) coating is biologically safe, provides superior antibacterial properties, and shows promise in preventing postoperative peri-implant infections. However, potential negative effects of this coating on in vivo bone formation and resorption have not been studied. The authors investigated the effects of F-DLC coatings on bone union in beagle dogs. Seventy-two solid columns of titanium alloy were prepared with equally spaced slits. Half of these columns were coated with F-DLC (Group F), and the others were left uncoated as controls (Group C). Columns were implanted in the femurs of beagle dogs, and in vivo bone formation and resorption were assessed 4, 8, and 12 weeks after implantation. In comparison to Group C, Group F showed significantly greater bone volume and trabecular thickness at Week 8 (p < 0.05) and Week 12 (p < 0.005) and significantly lower bone resorption activity, measured by the ratio of osteoclasts to bone surface and of eroded surface to bone surface, at Week 12 (p < 0.05). The F-DLC coating encouraged bone formation in vivo more effectively than uncoated titanium alloy, suggesting that F-DLC will prove to be a useful coating material for antibacterial intraosseous implants.
Highlights
Orthopedic implant surgeries have become increasingly routine, including artificial joint replacement, spinal instrumentation, and fracture repair
At Week 8, fibroblasts and fibrous osteoids were visible in Group C, while in Group F, trabeculae were forming deep in the slits and no immature cells were visible
At Week 8, fibroblast and fibrous osteoids were visible in Group C, while in Group F, trabeculae were forming deep in the slits and no immature cells were visible
Summary
Orthopedic implant surgeries have become increasingly routine, including artificial joint replacement, spinal instrumentation, and fracture repair. Such procedures can do much to improve the patient’s quality of life, but they are accompanied by the risk of complications. The incidence rate of peri-implant infection is reported at 2.6% to 11.9% for spinal instrumentation surgery [1,2] and 0.2% to 8.5% for implant arthroplasty [3,4,5,6,7,8]. Methods have been investigated for applying coatings containing silver, gold, iodine, or antibiotics such as gentamycin or vancomycin to the metal surface of an implant, with the aim of preventing peri-implant infection [9,10,11,12,13,14,15,16,17,18].
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