In vitro and in vivo performance of Ti6Al4V implants with plasma-sprayed osteoconductive hydroxylapatite-bioinert titania bond coat "duplex" systems: an experimental study in sheep.

To evaluate the in vivo performance of "duplex" hydroxylapatite top coat/TiO(2) bond coat systems, cylindrical Ti6Al4V rods of 130 mm in length and 11-13 mm in diameter were coated by atmospheric plasma spray (APS) technique with both a standard hydroxylapatite (HAp) layer and a HAp+TiO(2) bond coat "duplex" layer. In this pilot study coated and uncoated rods serving as controls were implanted into the femur of sheep so that their distal ends were freely suspended in the medulla of the femur. After an observation time of six months it was found that bone apposition and bone ingrowth were considerably increased in the presence of a osteoconductive coating. In particular, in vivo spalling and delamination frequently observed with HAp coatings was virtually absent in duplex coatings owing to the strong adhesion of the bond coat to the HAp top coat that anchored the latter solidly to the metallic surface of the implant. Some tentative mechanisms leading to this improved coating adhesion will be discussed.