Human tissue is structured mainly of self-assembled polymers (proteins) and ceramics (bone minerals), with metals present as trace elements with molecular scale functions. However, metals and their alloys have played a predominant role as structural biomaterials in reconstructive surgery, especially orthopedics, with more recent uses in non-osseous tissues, such as blood vessels. With the successful routine use of a large variety of metal implants clinically, issues associated with long-term maintenance of implant integrity have also emerged. This review focuses on metallic implant biomaterials, identifying and discussing critical issues in their clinical applications, including the systemic toxicity of released metal ions due to corrosion, fatigue failure of structural components due to repeated loading, and wearing of joint replacements due to movement. This is followed by detailed reviews on specific metallic biomaterials made from stainless steels, alloys of cobalt, titanium and magnesium, as well as shape memory alloys of nickel–titanium, silver, tantalum and zirconium. For each, the properties that affect biocompatibility and mechanical integrity (especially corrosion fatigue) are discussed in detail. Finally, the most critical challenges for metallic implant biomaterials are summarized, with emphasis on the most promising approaches and strategies.

Metallic implant biomaterials

In vitro and in vivo corrosion measurements of magnesium alloys.

Bioceramics of calcium orthophosphates

Zero-dimensional, one-dimensional, two-dimensional and three-dimensional nanostructured materials for advanced electrochemical energy devices

Calcium phosphate (CaP) bioceramics are widely used in the field of bone regeneration, both in orthopedics and in dentistry, due to their good biocompatibility, osseointegration and osteoconduction. The aim of this article is to review the history, structure, properties and clinical applications of these materials, whether they are in the form of bone cements, paste, scaffolds, or coatings. Major analytical techniques for characterization of CaPs, in vitro and in vivo tests, and the requirements of the US Food and Drug Administration (FDA) and international standards from CaP coatings on orthopedic and dental endosseous implants, are also summarized, along with the possible effect of sterilization on these materials. CaP coating technologies are summarized, with a focus on electrochemical processes. Theories on the formation of transient precursor phases in biomineralization, the dissolution and reprecipitation as bone of CaPs are discussed. A wide variety of CaPs are presented, from the individual phases to nano-CaP, biphasic and triphasic CaP formulations, composite CaP coatings and cements, functionally graded materials (FGMs), and antibacterial CaPs. We conclude by foreseeing the future of CaPs.

Calcium Phosphate Bioceramics: A Review of Their History, Structure, Properties, Coating Technologies and Biomedical Applications.

Chemical stability, mechanical behaviour and biocompatibility in body fluids and tissues are the basic requirements for successful application of implant materials in bone fractures and replacements. Corrosion is one of the major processes affecting the life and service of orthopaedic devices made of metals and alloys used as implants in the body. Among the metals and alloys known, stainless steels (SS), Co-Cr alloys and titanium and its alloys are the most widely used for the making of biodevices for extended life in human body. Incidences of failure of stainless steel implant devices reveal the occurrence of significant localised corroding viz., pitting and crevice corrosion. Titanium forms a stable TiO2 film which can release titanium particles under wear into the body environment. To reduce corrosion and achieve better biocompatibility, bulk alloying of stainless steels with titanium and nitrogen, surface alloying by ion implantation of stainless steels and titanium and its alloys, and surface modification of stainless steel with bioceramic coatings are considered potential methods for improving the performance of orthopaedic devices. This review discusses these issues in depth and examines emerging directions.

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Corrosion of bio implants

Synthesis and characterization of nickel tungsten alloys by electrodeposition

Preparation and characterisation of electrophoretically deposited hydroxyapatite coatings on type 316L stainless steel

The basic calcium phosphate mineral, hydroxyapatite (HAP) (Ca10(PO4)6(OH)2), is the prototype of one of the major constituents of bone and teeth. Thin layers of HAP were coated on the surface of type 316L stainless steel by electrophoretic deposition (EPD) from a 2·5% suspension in isopropyl alcohol, and this was followed by vacuum sintering at 800°C for 1 h. The development of HAP coatings was affected by the applied potential and time. In addition, HAP coatings were synthesised on pure Ti by electrochemical deposition and fully characterised to validate their use in orthopaedic implants. Electrodeposition was carried out from a bath containing low concentrations of Ca(NO3)2 and NH4H2PO4 at pH 6·0 by cathodic polarisation. Both types of HAP coating were fully characterised, including with respect to corrosion resistance. The advantages of these techniques include: (i) control over the composition and structure of the coating; and (ii) the ability to coat irregular surfaces easily.

T. M. Sridhar

Papers

Corrosion of bio implants

Synthesis and characterization of nickel tungsten alloys by electrodeposition

Preparation and characterisation of electrophoretically deposited hydroxyapatite coatings on type 316L stainless steel

Electrochemical and electrophoretic deposition of hydroxyapatite for orthopaedic applications

Sintering atmosphere and temperature effects on hydroxyapatite coated type 316L stainless steel