Effect of hydroxyapatite impregnation on skeletal bonding of porous coated implants.

Skeletal fixation of permanent implants by new methods such as fixation by mechanical interlocking of bone with porous prosthetic coatings or chemical bonding with bioactive materials shows growing potential. This paper reports on the resulting skeletal fixation of a combined porous and bioactive material. Metal plugs with a porous metal fiber coating impregnated with hydroxyapatite were implanted for 2, 4, and 12 weeks and were compared to the parent porous, nonbioactive, metal fiber material. Statistical analysis of the interfacial failure shear stress, as obtained by mechanical testing, shows there is a marked influence of hydroxyapatite impregnation on the rate of bone ingrowth and the strength of the interfacial bond the few weeks following surgery. Microscopical examination reveals that the apparent stimulation of bone ingrowth into the surface pores of the implant is the reason for the increased rate of bond formation. The results are of particular clinical interest: with an increased rate of bone ingrowth, weight bearing might be allowed much earlier, thus reducing the recuperation period.