Search Results (292)

The aim of this review is to investigate the possibility of fabricating coatings functionalized with bioactive molecules. These coatings are interesting when applied to biomedical devices, particularly in the orthopedic field. In fact, the application of calcium phosphate-based coatings on the surface of implanted devices is an effective strategy to increase their osteoinductive and osseointegrative properties. Several coating fabrication technologies are presented, including chemical deposition and physical methods. The application of bioactive molecules in combination with calcium phosphate coatings may improve their osteointegrative, antibacterial, and antitumor properties, therefore increasing the performance of implantable devices. Full article

Titanium (Ti) alloys, renowned for their exceptional physicochemical properties and high biocompatibility, are widely utilized in orthopedic and dental implants; however, their lack of intrinsic antimicrobial activity significantly increases the risk of implant-associated infections, often leading to severe complications and implant failure. Developing antimicrobial coatings on Ti implants is therefore a promising strategy. In this study, tannic acid (TA) coatings were deposited by immersing Ti alloy surfaces—beforehand activated by low-temperature oxygen plasma—in TA solutions at 2, 5, and 8 wt%. Coatings were characterized by scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), water contact angle (WCA) measurements, and Folin–Ciocalteu release assays, and their cytocompatibility and antimicrobial performance were assessed in vitro. Surface characterization confirmed the formation of uniform TA layers, and WCA measurements indicated enhanced hydrophilicity relative to unmodified Ti (82.0° ± 3.6°), with values decreasing as TA concentration increased (from 35.2° ± 3.2° for 2% TA to 26.6° ± 2.8° for 8% TA). TA release profiles exhibited an initial burst followed by sustained diffusion, with 5% and 8% coatings releasing significantly more TA than 2% coatings. Coatings containing ≥ 5% TA demonstrated bactericidal activity—achieving > 2-log₁₀ reductions—against Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa, and also showed inhibitory effects against Candida albicans. Importantly, all coatings remained cytocompatible with NIH/3T3 fibroblasts, and the released tannic acid hydrolysis products (particularly gallic acid) enhanced their proliferation. These findings indicate that plasma-activated titanium surfaces coated with ≥5 wt% tannic acid impart broad-spectrum antimicrobial efficacy and hold potential to reduce implant-associated infections and improve long-term outcomes in orthopedic and dental applications. Full article

Hydroxyapatite (HA) has become a widely used material for bone grafting and surface modification of titanium-based orthopedic implants due to its excellent biocompatibility. Among various coating techniques, microplasma spraying (MPS) has gained significant industrial relevance. However, the clinical success of HA coatings also depends on their adhesion to the implant substrate. Achieving durable fixation and reliable biological integration of orthopedic implants remains a major challenge due to insufficient coating adhesion and limited osseointegration. This study addresses challenges in dental and orthopedic implantology by evaluating the microstructure, mechanical properties, and biological behavior of bilayer coatings composed of a zirconium (Zr) sublayer and an HA top layer, applied via MPS onto titanium alloy. Surface roughness, porosity, and adhesion were characterized, and pull-off and shear tests were used to assess mechanical performance. In vitro biocompatibility was tested using rat mesenchymal stem cells (MSCs) to model osteointegration. The results showed that the MPS-fabricated Zr–HA bilayer coatings achieved a pull-off strength of 28.0 ± 4.2 MPa and a shear strength of 32.3 ± 3.2 MPa, exceeding standard requirements. Biologically, the HA top layer promoted a 45% increase in MSC proliferation over three days compared to the uncoated titanium substrate. Antibacterial testing also revealed suppression of E. coli growth after 14 h. These findings support the potential of MPS-applied Zr-HA coatings to enhance both the mechanical integrity and biological performance of titanium-based orthopedic implants. Full article

To improve implant osseointegration while preventing infection, we developed a strontium (Sr)-doped Ti₃C₂T_x MXene coating on titanium, aiming to synergistically enhance bone integration and antibacterial performance. MXene is a family of two-dimensional transition-metal carbides/nitrides whose abundant surface terminations endow high hydrophilicity and bioactivity. The coating was fabricated via anodic electrophoretic deposition (40 V, 2 min) of Ti₃C₂T_x nanosheets, followed by SrCl₂ immersion to incorporate Sr²⁺. The coating morphology, phase composition, chemistry, hydrophilicity, mechanical stability, and Sr²⁺ release were characterized. In vitro bioactivity was assessed with rat bone marrow mesenchymal stem cells (BMSCs)—with respect to viability, proliferation, migration, alkaline phosphatase (ALP) staining, and Alizarin Red S mineralization—while the antibacterial efficacy was evaluated against Staphylococcus aureus (S. aureus) via live/dead staining, colony-forming-unit enumeration, and AlamarBlue assays. The Sr-doped MXene coating formed a uniform lamellar structure, lowered the water-contact angle to ~69°, and sustained Sr²⁺ release (0.36–1.37 ppm). Compared to undoped MXene, MXene/Sr enhanced BMSC proliferation on day 5, migration by 51%, ALP activity and mineralization by 47%, and reduced S. aureus viability by 49% within 24 h. Greater BMSCs activity accelerates early bone integration, whereas rapid bacterial suppression mitigates peri-implant infection—two critical requirements for implant success. Sr-doped Ti₃C₂T_x MXene thus offers a simple, dual-function surface-engineering strategy for dental and orthopedic implants. Full article

Stainless steel (SS) is one of the materials most commonly utilized for fabrication of medical implants and its properties are often improved by deposition of protective coatings. This study investigates certain physico-chemical and biological properties of SS substrate coated with multilayer thin film consisting of titanium nitride and silver layers (TiN-Ag film). TiN-Ag films were deposited on the surface of AISI 316 SS substrate by a combination of cathodic arc evaporation and DC magnetron sputtering. SS substrate was analyzed by TEM, while deposited coatings were analyzed by SEM, EDS and wettability measurements. Also, mitochondrial activity assay, and osteogenic and chondrogenic differentiation were performed on dental pulp stem cells (DPSCs). SEM and EDS revealed excellent adhesion between coatings’ layers, with the top layer predominantly composed of Ag, which is responsible for antibacterial properties. TiN-Ag film exhibited moderately hydrophilic behaviour which is desirable for orthopedic implant applications. Biological assays revealed significantly higher mitochondrial activity and enhanced osteogenic and chondrogenic differentiation of DPSC on TiN-Ag films compared to TiN films. The newly designed TiN-Ag coatings showed a great potential for the surface modification of SS implants, and further detailed investigations will explore their suitability for application in clinical practice. Full article

Background/Objectives: Ketorolac is commonly used for pain management after orthopedic surgery, but concerns regarding its effects on postoperative complications remain. This study evaluates the impact of ketorolac use on short- and long-term outcomes in adult patients undergoing uncemented primary total hip arthroplasty (THA), where implant stability relies on biological fixation through bone ingrowth into a porous-coated prosthesis rather than bone cement. Methods: A retrospective cohort study was conducted using the TriNetX Research Network. Patients aged 18 years or older who underwent uncemented primary THA between 1 January 2004 and 1 January 2024 were included. Two cohorts were compared: those who received ketorolac on the day of or within one week of surgery and those who did not. Cohorts were propensity score-matched. Outcomes were assessed at 30 days, 1 year, and 5 years postoperatively. Results: At 30 days, ketorolac use was associated with significantly lower risks of transfusion (RR: 0.6, p < 0.01). However, it was linked to higher rates of acute posthemorrhagic anemia (RR: 1.2, p < 0.01) and periprosthetic fracture (RR: 1.4, p < 0.01). At 1 year, ketorolac use was associated with reduced risks of death (RR: 0.8, p < 0.01) and transfusion (RR: 0.7, p < 0.01), but increased risks of acute posthemorrhagic anemia (RR: 1.2, p < 0.01), deep surgical site infection (SSI) (RR: 1.8, p = 0.01), superficial SSI (RR: 1.9, p < 0.01), periprosthetic joint infection (RR: 1.1, p < 0.01), wound dehiscence (RR: 1.2, p < 0.01), periprosthetic mechanical complication (RR: 1.2, p < 0.01), and periprosthetic fracture (RR: 1.5, p < 0.01). Conclusions: Our findings highlight the complex risk profile of ketorolac in uncemented THA patients and suggest that clinicians should carefully consider individual patient factors and engage in shared decision-making when counseling patients on the use of ketorolac in the perioperative setting. Full article

This study presents the development and comprehensive evaluation of magnesium-based implants with surface modifications using selected polymers and bioactive compounds. The implants were fabricated via plasma electrolytic oxidation (PEO), followed by the application of chitosan, polydopamine (PDA), and gold nanoparticles as bioactive surface coatings. In vitro experiments, including FT-IR spectroscopy, scanning electron microscopy (SEM), wettability tests, biodegradation assays in simulated body fluid (SBF), electrochemical corrosion analysis, and cytotoxicity tests using MG-63 osteoblast-like cells, were employed to assess the physicochemical and biological properties of the materials. The PEO + PDA-modified samples demonstrated the highest corrosion resistance (−1.15 V corrosion potential), enhanced cell viability (~95%), and favorable surface wettability (contact angle ~12.5°), outperforming other tested configurations. These findings suggest that PEO combined with PDA offers a synergistic effect, leading to superior biocompatibility and degradation control compared to unmodified magnesium or single-coating strategies. The developed implants hold promise for orthopedic applications requiring biodegradable, bioactive, and cytocompatible materials. Full article

Bone regeneration demands biomaterials capable of supporting tissue integration and mimicking the native piezodynamic properties of bone. In this study, hydroxyapatite–barium titanate (HA-BT) composite coatings with varying BT content (10, 30, and 50 wt%) were developed to enhance the piezoelectric response and corrosion resistance of Ti6Al4V implants. The coatings were synthesized via high-energy ball milling and atmospheric plasma spraying (APS). XRD analysis with Rietveld refinement confirmed the presence of HA along with secondary phases (TTCP, β-TCP, CaO). Electrochemical tests revealed lower corrosion current densities for the coatings containing ≤30% BT, indicating improved stability in physiological environments. Cytotoxicity assays (MTT) demonstrated biocompatibility across all formulations. Piezoresponse force microscopy (DART-SS-PFM) confirmed enhanced d₃₃-eff values for the 50% BT coating (>15 pm/V); however, biological assays under low-intensity pulsed ultrasound (LIPUS) stimulation showed increased osteocalcin expression for ≤30% BT, while 50% BT induced cellular stress. Overall, HA-BT coatings with up to 30% BT exhibited optimal electrochemical stability, favorable piezoelectric performance, and enhanced biological response, underscoring their potential for orthopedic implant applications and regenerative tissue engineering. Full article

The surface electric charge of biomaterials plays a pivotal role in determining their bioactivity and biocompatibility, especially in orthopedic and dental applications. This review analyzes recent progress (2015–2024) in understanding how electric properties, particularly surface charge and zeta potential, modulate cellular adhesion, proliferation, and differentiation. Negatively charged surfaces (−20 to −30 mV) were consistently associated with enhanced osteoblast activity and calcium mineralization, while positively charged surfaces often induced pro-inflammatory responses. We explore theoretical models of the electric double layer (EDL), methods for quantifying surface charge, and strategies for modifying surface potential to enhance biological outcomes. A comparative analysis of materials—hydroxyapatite coatings, PCL scaffolds, titanium surfaces, and piezoceramics—is provided. Finally, we highlight knowledge gaps in mechanistic understanding and emphasize the need for standardized protocols in evaluating the electric properties of biomaterials. Full article

A critical barrier to the clinical translation of biodegradable magnesium (Mg)-based materials lies in their rapid degradation rate in physiological environment, which leads to premature structural failure and compromised cytocompatibility. Micro-arc oxidation (MAO) coatings offer preliminary corrosion mitigation for Mg alloys, while their inherent structural porosity compromises long-term durability in physiological environment. To address this limitation, we developed a hierarchical coating system consisting of a dense Mg(OH)₂ interlayer (MAO/HT) superimposed on the MAO-treated substrate, followed by a functional polydopamine (PDA) topcoat to create a MAO/HT/PDA composite architecture. The surface characteristics and crystalline structures of these coatings were systematically characterized using field-emission scanning electron microscopy (FE-SEM), energy-dispersive X-ray spectroscopy (EDS), and X-ray diffraction (XRD). The corrosion resistance and interfacsial stability in physiological environment were quantitatively assessed through electrochemical analyses and long-term immersion tests in simulated body fluid (SBF). The cytocompatibility of the coatings was assessed by directly culturing osteoblast on the coated samples. The results reveal that the Mg(OH)₂ film possesses a bulk-like structure and effectively seals the micro-pores of the MAO coating. The current density of MAO/HT/PDA sample decreases by two orders of magnitude compared to that of MAO sample, indicating excellent corrosion resistance. The PDA layer not only acts as a strong barrier to improve the corrosion performance of the coating but also helps maintain the stability of the coating, thus delaying coating destruction in SBF. Moreover, the osteoblast culture results suggest that the MAO/HT/PDA coating promotes cell spread and proliferation noticeably compared to both the MAO and MAO/HT coatings. This study provides compelling evidence that the Mg(OH)₂/PDA composite coating is biodegradable and offers outstanding protection for micro-arc oxidized magnesium. As a result, it holds great promise for significant applications in the field of orthopedic medicine. Full article

The success of orthopedic implants critically depends on achieving mechanical and biological compatibility with bone tissue. Traditional titanium implants often suffer from high stiffness, which induces stress shielding, a phenomenon that compromises implant integration and accelerates prosthetic loosening. This study introduces an innovative approach to mitigate these limitations by engineering a porous titanium substrate with a controlled microstructure. Utilizing sodium chloride as a spacer holder, an elution and sintering process was applied at 1250 °C under high vacuum conditions to reduce the material’s elastic modulus. By manipulating NaCl volume fractions (20%, 25%, 30%, and 35%), porous titanium samples were created with elastic moduli between 16.37 and 22.56 GPa, closely matching cortical bone properties (4 to 20 GPa). A hydroxyapatite coating applied via plasma thermal spraying further enhanced osseointegration of the material. Comprehensive characterization through X-ray diffraction, scanning electron microscopy, and compression testing validated the material’s structural integrity. In vitro cytotoxicity assessments using osteoblast cells demonstrated exceptional cell viability exceeding 70%, confirming the material’s biocompatibility. These findings represent a significant advancement in biomaterial design, offering a promising strategy for developing next-generation joint prostheses with superior mechanical and biological adaptation to bone tissue. Full article

The increasing demand for orthopedic and neurosurgical implants has driven advancements in biomaterials, additive manufacturing, and antimicrobial strategies. With an increasingly aging population, and a high incidence of orthopedic trauma in developing countries, the need for effective, biocompatible, and infection-resistant implants is more critical than ever. This review explores the role of polymers in 3D printing for medical applications, focusing on their use in orthopedic and neurosurgical implants. Polylactic acid (PLA), polycaprolactone (PCL), and polyetheretherketone (PEEK) have gained attention due to their biocompatibility, mechanical properties, and potential for antimicrobial modifications. A major challenge in implantology is the risk of periprosthetic joint infections (PJI) and surgical site infections (SSI). Current strategies, such as antibiotic-loaded polymethylmethacrylate (PMMA) spacers and bioactive coatings, aim to reduce infection rates, but limitations remain. Additive manufacturing enables the creation of customized implants with tailored porosity for enhanced osseointegration while allowing for the incorporation of antimicrobial agents. Future perspectives include the integration of artificial intelligence for implant design, nanotechnology for smart coatings, and bioresorbable scaffolds for improved bone regeneration. Advancing these technologies will lead to more efficient, cost-effective, and patient-specific solutions, ultimately reducing infection rates and improving long-term clinical outcomes. Full article

Orthopedic implants are essential for treating severe fractures and incomplete bone regeneration. However, metal-based implants often suffer from corrosion and biocompatibility issues. This study developed 3D-printed Polylactic Acid Plus (PLA+) bone screws coated with molybdenum and zirconia (ZrO₂) nanocomposites using the dip-coating method. The Taguchi method optimized five coating parameters: molybdenum weight, zirconia weight, ethanol volume, incubation time, and coating duration. The Taguchi method and Response Surface Methodology (RSM) were used for data analysis, while NSGA-II and TOPSIS determined the optimal parameters. Molybdenum weight significantly increased compressive strength (35.45%), while coating time had the greatest effect on density (25.88%). Optimization improved compressive strength/Ec (Modulus of elasticity) to 315.808 MPa and density to 1.141 g/cm³. Compressive strength was significantly improved through optimized coating parameters; however, the achieved value of 315.808 MPa requires validation due to its relatively high magnitude compared to typical PLA materials reported in the literature. The study concludes that combining the Taguchi and NSGA-II methods effectively enhances the mechanical performance and biocompatibility of biodegradable bone screws. The optimal dip-coating parameters were 0.101 g molybdenum, 0.100 g zirconia, 59.523 mL ethanol, 6.025 h of incubation, and 7.907 min of coating time. However, the study is limited to in vitro mechanical testing, and further in vivo evaluations are necessary to confirm long-term biocompatibility and performance. Full article

Black phosphorus (BP) nanoflakes have attracted interest as an antimicrobial material for wound healing and implant-associated infections due to their bactericidal activity without the use of antibiotics. Hydrogels are frequently used as a delivery system; however, most research uses photonic activation in the form of near-infrared (NIR) laser stimulation to cause rapid BP degradation, reactive oxygen species (ROS) generation, and a localized photothermal effect. For implant-coating applications, using NIR laser stimulation could be challenging in practice, especially for porous orthopedic implants. This article investigates whether BP nanoflakes, suspended in Pluronic F127 (F127) hydrogels, remain effective against Staphylococcus aureus without photonic activation. The experimental results showed 89.4 ± 7.6% bacterial inhibition from BP nanoflakes at a 5120 µg/mL concentration via passive diffusion in F127; however, it could not kill all the bacteria present. It is hypothesized that the F127 gel interface could create a barrier between the bacteria, which continue to multiply in media, and the antimicrobial black phosphorus compound, which degrades in the F127. Full article

Implant-associated infections (IAIs) are major complications in dental and orthopedic implants, potentially compromising osseointegration and eventually causing implant loosening or removal. Thus, early prevention of bacterial adhesion and biofilm formation is critical for successful long-term osseointegration. Polyetheretherketone (PEEK) exhibits excellent physicochemical properties and an elastic modulus similar to bone tissue, making it a promising material for dental and orthopedic implants. However, its inherent lack of antibacterial properties limits its ability to prevent IAIs. Herein, an antibacterial coating with controlled drug release and excellent biocompatibility is designed by immobilizing minocycline (Mino)-doped carboxymethyl chitosan (CMCS) onto the PEEK surface via a polydopamine (PDA)-mediated Michael addition and Schiff base reaction. The coating is characterized by SEM, XPS, water contact angle measurements, and in vitro Mino release assays. Antibacterial activity is evaluated using the zone of inhibition (ZOI), turbidity, and colony counting assays, while biocompatibility is assessed through a SEM analysis of cell morphology and CCK-8 assay. The results show that the Mino-modified coating is successfully fabricated on the PEEK surface, achieving sustained Mino release for up to 14 days. Among the three Mino concentrations, the PEEK-0.5Mino group demonstrates the best balance of antibacterial activity and biocompatibility, highlighting its potential for preventing IAIs in orthopedic and dental applications. Full article