Influence of Surface Coating on Metal Ion Release: Evaluation in Patients With Metal Allergy

Abstract

Nickel, chromium, and cobalt in stainless steel and Cobalt-chrome-molybdenum (CoCrMo) alloys may induce allergy. The objectives of this study were to evaluate surface coating regarding ion release, patch test reactivity, and arthroplasty performance. Materials and methods included patch test in 31 patients with metal allergy and 30 patients with no allergy to stainless steel and CoCrMo disks that are uncoated or coated by titanium nitride/zirconium nitride (TiN/ZrN). Assessment include atomic absorption spectrometry of released nickel, cobalt, and chromium from the disks after exposure to distilled water, artificial sweat and culture medium. Results showed that both coatings reduced the nickel and chromium release from stainless steel and CoCrMo disks and mostly the cobalt release from the disks (maximally 11.755 µg/cm(2)/5 d to 1.624 by Ti-N and to 0.442 by ZrN). Six of the 31 patients with metal allergy reacted to uncoated disks, but none reacted to the coated disks. The current authors report on exemplary patients with metal allergy who had symptom relief by revision with surface-coated arthroplasty. The authors concluded that the surface coating may prevent cutaneous and peri-implant allergic reactions. [Orthopedics. 2016; 39(3):S24-S30.].

Hydroxyapatite as a Nanomaterial for Advanced Tissue Engineering and Drug Therapy

“…There have been efforts to treat wear corrosion by developing hard ceramic coatings for the implants. It is possible to use those properly coated conventional metallic implants in patients that have metal allergy [78]. However, the ceramic coatings tend to have low fracture toughness.…”

CoCrMo surface modifications affect biocompatibility, adhesion, and inflammation in human osteoblasts

“…The TiN coating prevents the base material from coming into contact with the tissue in the vicinity, as well as stopping particles and ions from being released due to corrosion and abrasion. Due to the strong reduction in the release of potentially allergenic metal ions from the alloys, the TiN coating is particularly suitable for allericy patients who are highly sensitized for cobalt, chromium or nickel 22,23 . Likewise, the porous coated surface increased the biocompatibility significantly, compared to the untreated CoCrMo alloy.…”

Adhesion and mechanical properties of nanocrystalline hydroxyapatite coating obtained by conversion of atomic layer-deposited calcium carbonate on titanium substrate

“…Modifying the implant surface by using biologically active coating materials [39], such as bioactive glass [40] or hydroxyapatite [14], has proven to be one of the most promising ways to improve the osseointegration of the implant. Bioactive coatings can be also used to protect the substrate surface [10,11] from physiological environment as well as wearing or damaging of the surface in the assembly phase and in long-term use, thus leading to lower amount of metal ions released into the surrounding tissues [41].…”