Bone apposition to plasma-sprayed cobalt-chromium alloy.

The use of porous metallic coatings for fixation of total joint prostheses by bone ingrowth has become a widespread alternative to fixation with PMMA bone cement. However, concerns about such coatings include long-term effects of metal ion release, potential coating loss, and decreased substrate fatigue strength. The biological fixation capability of a nonporous, high-integrity plasma-sprayed CoCr coating with low surface area was compared to a conventional sintered bead coating in goat cortical and cancellous bone sites after 8 and 16 weeks of implantation. Histological evaluation showed substantial variations in fixation quality between individual animals and between surgical sites with no consistent difference between implant types. Shear testing of bone/implant interfaces showed that although conventional porous coating exhibited higher overall average shear strengths in cortical bone sites at both time periods, the differences were not statistically significant. In cancellous sites, the average shear strengths achieved with conventional porous and plasma-sprayed coatings were essentially equal. Analysis using average paired differences, however, revealed that when porous and plasma-coated implants are placed in identical sites of contralateral limbs, the plasma coatings consistently yielded higher shear strengths in cancellous bone sites at the later time period. Since current design theory for biological fixation favors metaphysical fixation, this surface may offer potential advantages over conventional porous coatings.