Enhancing mechanical and biomedical properties of protheses - Surface and material design

The long-term success of prosthetics greatly relies on the biomechanical/medical properties of the implanted material. Inadequate biocompatibility or poor wear resistance can lead to devastating repercussions including osteolysis, tissue inflammation, and implant failure, which require revisionary surgery, thus being costly and painful for the patient. Therefore, special attention has been given to the modification/treatment of prosthetic surfaces to enhance cell proliferation and bio-tribological performance as well as to improve tendon-growth and mobility. The advanced usage of porous structures and surface textures represents an innovative approach towards promoting the growth of healthy soft tissue rather than cicatricial tissue as well as enhancing wear and the lubricative performance. Other prosthetic surface modifications including plasma immersion ion implantation (PIII), the application of bio-tribologically effective coatings or the introduction of carbon nanotubes (CNTs) as reinforcement have also emerged. The identification of the optimal prosthetic materials (UHMWPE, HXLPE, Ti6Al4V, or CoCrMo) as well as the application of relevant surface modifications or treatments serves as a vital opportunity in enhancing the protheses' longevity and performance. Therefore, this article seeks to compile recent and fundamental research trends surrounding these methods with a special emphasis towards improving the tribological properties, cell proliferation, and overall prosthetic success of biomaterials.