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BioMed Research International
Volume 2015, Article ID 134093, 11 pages
Review Article

Titanium-Based Hip Stems with Drug Delivery Functionality through Additive Manufacturing

1Rapid Product Development Laboratory, Department of Industrial Engineering, University of Stellenbosch, Stellenbosch 7600, South Africa
2Department of Microbiology, University of Stellenbosch, Stellenbosch 7600, South Africa

Received 18 May 2015; Revised 14 August 2015; Accepted 16 August 2015

Academic Editor: Iulian Antoniac

Copyright © 2015 Martin B. Bezuidenhout et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Postoperative infections are a major concern in patients that receive implants. These infections generally occur in areas with poor blood flow and pathogens do not always respond to antibiotic treatment. With the latest developments in nanotechnology, the incorporation of antibiotics into prosthetic implants may soon become a standard procedure. The success will, however, depend on the ability to control the release of antibiotics at concentrations high enough to prevent the development of antibiotic-resistant strains. Through additive manufacturing, antibiotics can be incorporated into cementless femoral stems to produce prosthetic devices with antimicrobial properties. With the emerging increase in resistance to antibiotics, the incorporation of antimicrobial compounds other than antibiotics, preferably drugs with a broader spectrum of antimicrobial activity, will have to be explored. This review highlights the microorganisms associated with total hip arthroplasty (THA), discusses the advantages and disadvantages of the latest materials used in hip implants, compares different antimicrobial agents that could be incorporated, and addresses novel ideas for future research.