Abstract
SummaryTitanium and its alloys have emerged as excellent candidates for use as orthopedic biomaterials. Nevertheless, there are often complications arising after implantation of orthopedic devices, most notably prosthetic joint infection and aseptic loosening. To ensure that implanted devices remain functional in situ, innovation in surface modification has attracted much attention in the effort to develop orthopedic materials with optimal characteristics at the biomaterial-tissue interface. This review will draw together metallurgy, surface engineering, biofilm microbiology, and biomaterial science. It will serve to appreciate why titanium and its alloys are frequently used orthopedic biomaterials and address some of the challenges facing these biomaterials currently, including the significant problem of device-associated infection. Finally, the authors shall consolidate and evaluate surface modification techniques employed to overcome some of these issues by offering a unique perspective as to the direction in which research is headed from a broad, interdisciplinary point of view.
Highlights
As human life expectancy continues to rise, so too does the geriatric population, who are at an increased risk of developing chronic musculoskeletal conditions such as osteoarthritis
Mass commercialization and technological advances over the past thirty years have shifted the dynamic of society toward a more sedentary lifestyle, which is associated with increased body mass index (BMI), a risk factor for numerous diseases, including osteoarthritis in weight-bearing joints such as hips and knees (Musumeci et al, 2015)
We have previously demonstrated fiber laser surface modification of CP-Ti and Ti6Al4V using a continuous wave (CW) 200W fiber laser system at 1064nm, reducing the initial bacterial adhesion of S. aureus and exerting a bactericidal effect (Chan et al, 2017)
Summary
As human life expectancy continues to rise, so too does the geriatric population, who are at an increased risk of developing chronic musculoskeletal conditions such as osteoarthritis. Mass commercialization and technological advances over the past thirty years have shifted the dynamic of society toward a more sedentary lifestyle, which is associated with increased body mass index (BMI), a risk factor for numerous diseases, including osteoarthritis in weight-bearing joints such as hips and knees (Musumeci et al, 2015). When treatment options such as physiotherapy and analgesia can no longer manage the condition, arthroplasty (joint replacement) is a surgical intervention utilized to relieve pain and restore functionality of the joint, in so doing improving the patient’s quality of life. Patients who undergo a total hip replacement have a significantly improved EQ-5D score after surgery, a standardized measure of general health (Jansson and Granath, 2011)
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