Laser-engineered net shaping (LENS) of coated surfaces can overcome the limitations of conventional coating technologies. We compared the The Objectives
Methods
We conducted a prospective study of a delta ceramic total hip
arthroplasty (THA) to determine the rate of ceramic fracture, to
characterise post-operative noise, and to evaluate the mid-term
results and survivorship. Between March 2009 and March 2011, 274 patients (310 hips) underwent
cementless THA using a delta ceramic femoral head and liner. At
each follow-up, clinical and radiological outcomes were recorded.
A Kaplan-Meier analysis was undertaken to estimate survival.Aims
Patients and Methods
The plasma spray(TPS) has come to be accepted as one of the more reliable methods of porous coating of prosthesis, it is not without some technical limitations, especially with regard to precise modulation of pore size, porosity, and roughness. However, the plasma spray(TPS) not often but seriously faces problems such as bead detachment related poor osteointegration, weakness of metal strength and high manufacturing costs in addition to its various technical limitations. Currently, there has been much research into developing a more economical and effective method for porous coating of the prosthesis. In light of such demand, 3D Printing with DMT Technology has been introduced into the field of surface treatment of prosthesis with promising expectations. DMT technology -an additive fabrication process that uses high-power laser and various metal powders in order to produce fully dense and geometrically complex metal components, molds, and dies directly from digital CAD model data of 3D subjects aims to help overcome many of the problems associated with plasma spray and thereby open a new chapter of endless possibilities for coating technology. In this study, the porous coating specimen using 3-D DMT metal printing was characterized morphologically as well as biomechanically, in terms of 1) pore size 2) porosity 3) tensile strength 4) shear strength 5) roughness respectively. The biological cyto-compatibility was evaluated by culturing human osteoblast-like cells(Saos-2: ATCC HTB85) on the surface of round discs with porous coating to demonstrate the biological influence on the porosity of the specimens with different surface treatment for comparative analysis. The evaluation was accompanied by assessment of cell proliferation and morphology with arrangement of actin filament and expression of adhesion molecule with αvβ3 integrin. While 3-D DMT coating specimen showed relatively regular porosity in the range of 150–500µm with the increase of porosity about 83%, the mechanical behavior remarkably improved, compared to TPS: shear strength 13%, fatigue failure 30%, roughness 16%, respectively. Also worth noting, the tensile strength was unable to be measured because the glue for test had fallen off. (Fig. 1) There is no transitional zone underneath the porous coating layer.(Fig. 2) From the aspect of biocompatibility, 3-D coating showed better cell attachment, spreading of cytoskeleton, cell proliferation, and expression of osteogenic markers than TPS, even if not significantly.(Fig. 3) Additionally, cell migration assay was performed with double chamber study, and gene expression was evaluated by measuring alkaline phosphatase(ALP) levels and analyzing mRNA expression for ostepontin(OPG) and osteocalcin(OC). In conclusion, the study reinforces the popular stance that the implementation of 3-D DMT could open up new possibilities for coating technology and form a new chapter in the history of prosthesis development.
