An in vivo evaluation of surface polishing of TAN intermedullary nails for ease of removal.

Fractures of the tibia and femoral diaphysis are commonly repaired by intra-medullary (IM) nailing. Currently IM nails are available in either electropolished stainless steel (SS) or in Titanium-Aluminium-Niobium (TAN). After healing, removal of the nails still is common but removal of TAN IM nails often has complications whereas SS IM nails of the same design are less often associated with problems. We believe the differences in removal are due to the ability of TAN to promote strong bone on-growth. We have previously shown in vivo that polishing cortical screws reduces removal torque and the percentage of bone-implant contact. Therefore, we postulate that bony on-growth onto IM nails can be reduced by means of surface polishing, for ease of removal. Here we aim to compare the pull-out forces for removal of standard TAN (TAN-S) compared to experimental paste polished TAN (TAN-PP) IM nails from a bilateral non-fracture sheep tibia model after 12 months implantation. Histological analysis was also performed to assess tissue on-growth to the nails. We show that polishing significantly reduces (p=0.05) the extraction force required for TAN IM nail removal. This effect in part is attributable to the distinct tissue-material reaction produced. For TAN-S nails direct bone contact was observed while for TAN-PP nails a fibrous tissue interface was noted. Since TAN is preferred over SS for IM nailing due to superior biocompatibility and mechanical properties, we believe these findings could be used to recommend changes to current surface technologies of intramedullary nails to reduce complications seen with nail removal especially in rapidly growing bone in children.

New titanium alloys for biomaterials: a study of mechanical and corrosion properties and cytotoxicity.

Three new titanium alloys with Zr, Nb, Ta, Pd and In as alloying elements were developed and compared with currently used implant metals, namely, pure Ti and Ti-6Al-4V alloy, in terms of mechanical and corrosion properties, and cytotoxicity. New alloys showed comparable mechanical properties with that of the Ti-6Al-4V alloy, but increased corrosion potential, somewhat decreased breakdown potential and increased corrosion rate. There were no significant differences in cell growth on the surface of the various metal specimens, indicating that the cells cannot differentiate between the passivated surfaces of the various Ti metals.