Functionalization of Ceramic Coatings for Enhancing Integration in Osteoporotic Bone: A Systematic Review

Abstract

Background: The success of reconstructive orthopaedic surgery strongly depends on the mechanical and biological integration between the prosthesis and the host bone tissue. Progressive population ageing with increased frequency of altered bone metabolism conditions requires new strategies for ensuring an early implant fixation and long-term stability. Ceramic materials and ceramic-based coatings, owing to the release of calcium phosphate and to the precipitation of a biological apatite at the bone-implant interface, are able to promote a strong bonding between the host bone and the implant. Methods: The aim of the present systematic review is the analysis of the existing literature on the functionalization strategies for improving the implant osteointegration in osteoporotic bone and their relative translation into the clinical practice. The review process, conducted on two electronic databases, identified 47 eligible preclinical studies and 5 clinical trials. Results: Preclinical data analysis showed that functionalization with both organic and inorganic molecules usually improves osseointegration in the osteoporotic condition, assessed mainly in rodent models. Clinical studies, mainly retrospective, have tested no functionalization strategies. Registered trademarks materials have been investigated and there is lack of information about the micro- or nano- topography of ceramics. Conclusions: Ceramic materials/coatings functionalization obtained promising results in improving implant osseointegration even in osteoporotic conditions but preclinical evidence has not been fully translated to clinical applications.

Calcium fructoborate coating of titanium–hydroxyapatite implants by chemisorption deposition improves implant osseointegration in the femur of New Zealand White rabbit experimental model

“…Functionalization strategies significantly improve osseointegration, representing an interesting option for the treatment of osteoporotic fracture or other bone defects. Although these advances are yet to be fully applied clinically, functionalization represents a promising strategy to help improve the implant stability and to ensure fast, functional improvement in patient quality of life [ 30 ].…”

Special Issue on Surfaces Modification and Analysis for Innovative Biomaterials

“…The review article authored by Sartori et al analyzed current literature on strategies for implant osseointegration enhancement, focusing on osteoporotic bones [6]. Their survey highlighted that organic and inorganic films (i.e., ceramic coatings) promoted osseointegration in osteoporotic bones, but the main data were related to animal models.…”

Analytical Model of Deformation of a Functionally Graded Ceramic Coating under Local Load

“…Here, their main role is to form an effective fire-resistant barrier between the sand substrate and the flow of liquid metal at the stages of casting, hardening and forming castings [9,10]. Ceramic coatings have proven themselves well for improving the osteointegration and biomechanical fixation of implants in bone tissue [11,12]. Another important field of application is ceramic functional coatings used in lenses, optical filters and solar cells and catalytic coatings for the chemical industry, which contribute to the development of environmental protection technologies [13,14].…”