The correlation between osseointegration and bonding strength at the bone-implant interface: In-vivo & ex-vivo investigations on hydroxyapatite and hydroxyapatite/titanium coatings.

This study investigated the effects of hydroxyapatite (HA) and hydroxyapatite/titanium (HA/Ti) coatings on osseointegration and bonding strength at the bone-implant interface. The coatings were made using air plasma spray (APS), and three study groups were examined: 1) Uncoated commercial pure titanium (CP-Ti) rods; 2) HA-coated CP-Ti rods, and 3) Composite of 50 %wt HA + 50 %wt Ti coated CP-Ti rods. The rods were implanted into the distal femurs and proximal tibias of fifteen New Zealand white rabbits, and 8 weeks after the implantation, the samples were harvested. The results of pull-out tests showed that the ultimate strength of HA and HA/Ti coatings were significantly greater than the uncoated samples (P < 0.05). Moreover, even though the histological evaluations showed significantly greater osseointegration of HA/Ti composite coatings compared with HA coatings (P < 0.05), nonetheless, the composite of HA/Ti offers no significant increase in the ultimate strength, stiffness, and bonding strength at the bone-implant interface, compared with the HA group (P > 0.05). Thus, in an eight-week study, there was no linear correlation between the osseointegration and the bonding strength at the bone-implant interface. The results of this work may imply that the extent of osseointegration at the bone-implant interface does not necessarily determine the value of the bonding strength at the bone-implant interface. It is speculated that, in a longer-term study, a greater quality of bone formation may occur during osseointegration, between the implant and its adjacent bone, which can lead to a more enhanced bonding strength, compared with the 8-weeks post-surgery follow up.