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Surface Treatments: Microporous Structures, Nanoscale and Additive Manufacturing

The future of surface treatments relies not only on how new technologies will encourage implant and bone ingrowth, but on the way that these technologies are smartly manufactured. Additive manufacturing and nanotechnology continue to arise in conversations; surface treatments and coatings are no exception. As you research the best fit for your next device, a handful of experts weigh in on several coating technologies to consider, including their strengths and common hindrance—cost. 

Additive Manufacturing

Titanium flame spray and hydroxyapatite (HA) remain the preferable coatings in orthopaedics, says Robert Lynch, Vice President of Research & Development at Tecomet. Looking at the horizon, though, he is struck by the emergence of additive manufacturing (also referred to as 3D printing) in this sector.

“What’s going on now is the integral coating, and that comes from 3D printing. Much of the 3D printing you see today incorporates the bony ingrowth surface onto the implant itself. That is very much in its infancy, but it has legs. If 3D printing is going to take hold in this industry, then I believe that’s where it’s going to get its good roots,” Lynch says.

Implants that are relatively small and need a bony ingrowth surface will be initial targets for additive manufacturing. Lynch believes that the process will work for pieces that can be arrayed and many pieces that can be made in one build. The process will avoid larger components, like hip stems that require flex fatigue.

“That will be one of the later applications for a 3D printer. Right now it’s producing some components for spine, some acetabular shells—things that have fewer strength requirements, all compressive loads, not a lot of flex fatigue and they all need great bony ingrowth surfaces,” Lynch says. “You can add in some beautiful, engineered surfaces that mimic bone almost identically, that bone just falls in love with.”

The method requires refinement before it becomes competitive on price. Lynch says that flame sprays are still one of the most economical ways to apply a surface to an implant.

Interest in additive manufacturing may be driven by another trend in the segment: microporous coating that allows for bone ingrowth on a micron scale.

Gianfranco Viola, Director of Global Sales and Marketing for Eurocoating and Surface Dynamics, says that porous coating is popular for a number of reasons. “You provide a structure, but the coating has open pores that go well into the depths of the coating. The bone can actually grow into those pores. In that case, you don’t just have a bone that is growing onto the surface; it penetrates the coating. Bone integration is even better in that case,” he says. “That type of surface treatment is becoming more popular. It’s much better than using cement. You have a bone implant situation that is very stable.”

Viola says that the next frontier for bone/implant interface is providing a porous structure that allows actual bone growth into a porous titanium structure.

On the market, one of those microporous standards is trabecular metal, a metallic sponge that is soldered onto the surface of an implant to provide fixation, Viola says. Trabecular metal has two issues. One, it is proprietary; the technology is owned by Zimmer Biomet. Two, Viola says, trabecular metal can be expensive compared to other technologies.

Other treatments marketed by major OEMs can create a similar effect as trabecular metal.

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