Table of Contents Author Guidelines Submit a Manuscript
BioMed Research International
Volume 2015 (2015), Article ID 134093, 11 pages
http://dx.doi.org/10.1155/2015/134093
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.

Linked References

  1. M. S. Lehil and K. J. Bozic, “Trends in total hip arthroplasty implant utilisation in the United States,” The Journal of Arthroplasty, vol. 29, no. 10, pp. 1915–1918, 2014. View at Publisher · View at Google Scholar · View at Scopus
  2. OECD, Health at a Glance 2013: OECD Indicators, OECD Publishing, 2013.
  3. G. Garellick, J. Kärrholm, H. Lindahl, H. Malchau, C. Rogmark, and O. Rolfson, “Swedish hip arthroplasty register annual report 2013,” 2014.
  4. M. Geetha, A. K. Singh, R. Asokamani, and A. K. Gogia, “Ti based biomaterials, the ultimate choice for orthopaedic implants—a review,” Progress in Materials Science, vol. 54, no. 3, pp. 397–425, 2009. View at Publisher · View at Google Scholar · View at Scopus
  5. T. Niinimäki, J. Junila, and P. Jalovaara, “A proximal fixed anatomic femoral stem reduces stress shielding,” International Orthopaedics, vol. 25, no. 2, pp. 85–88, 2001. View at Publisher · View at Google Scholar · View at Scopus
  6. R. Huiskes, H. Weinans, and B. Van Rietbergen, “The relationship between stress shielding and bone resorption around total hip stems and the effects of flexible materials,” Clinical Orthopaedics and Related Research, vol. 274, pp. 124–134, 1992. View at Google Scholar · View at Scopus
  7. Y. Okazaki and E. Gotoh, “Comparison of metal release from various metallic biomaterials in vitro,” Biomaterials, vol. 26, no. 1, pp. 11–21, 2005. View at Publisher · View at Google Scholar · View at Scopus
  8. M. Browne and P. J. Gregson, “Surface modification of titanium alloy implants,” Biomaterials, vol. 15, no. 11, pp. 894–898, 1994. View at Publisher · View at Google Scholar · View at Scopus
  9. C. Hinüber, C. Kleemann, R. J. Friederichs et al., “Biocompatibility and mechanical properties of diamond-like coatings on cobalt-chromium-molybdenum steel and titanium-aluminum-vanadium biomedical alloys,” Journal of Biomedical Materials Research Part A, vol. 95, no. 2, pp. 388–400, 2010. View at Publisher · View at Google Scholar · View at Scopus
  10. S. M. Kurtz, E. Lau, H. Watson, J. K. Schmier, and J. Parvizi, “Economic burden of periprosthetic joint infection in the United States,” The Journal of Arthroplasty, vol. 27, no. 8, supplement 1, pp. 61.e1–65.e1, 2012. View at Publisher · View at Google Scholar · View at Scopus
  11. T. Töppel, M. Gebauer, B. Müller, and R. Neugebauer, “Neue funktionen in endoprothesen durch generative fertigung mit strahlschmelzen,” in Tagungsband. Fachmesse und Anwendertagung für Rapid-Technologie (Rapid Tech '11), Fachforum Medizintechnik, Erfurt, Germany, May 2011.
  12. M. Varga and K.-J. Wolter, “Sensors and imaging methods for detecting loosening of orthopedic implants—a review,” in Proceedings of the 20th IEEE International Symposium for Design and Technology in Electronic Packaging (SIITME '14), pp. 333–335, IEEE, Bucharest, Romania, October 2014. View at Publisher · View at Google Scholar
  13. M. B. Bezuidenhout, A. D. van Staden, G. A. Oosthuizen, D. M. Dimitrov, and L. M. Dicks, “Delivery of antibiotics from cementless titanium-alloy cubes may be a novel way to control postoperative infections,” BioMed Research International, vol. 2015, Article ID 856859, 7 pages, 2015. View at Publisher · View at Google Scholar
  14. D. Campoccia, L. Montanaro, and C. R. Arciola, “A review of the biomaterials technologies for infection-resistant surfaces,” Biomaterials, vol. 34, no. 34, pp. 8533–8554, 2013. View at Publisher · View at Google Scholar · View at Scopus
  15. O. L. A. Harrysson, O. Cansizoglu, D. J. Marcellin-Little, D. R. Cormier, and H. A. West II, “Direct metal fabrication of titanium implants with tailored materials and mechanical properties using electron beam melting technology,” Materials Science and Engineering C, vol. 28, no. 3, pp. 366–373, 2008. View at Publisher · View at Google Scholar · View at Scopus
  16. N. W. Hrabe, P. Heinl, B. Flinn, C. Körner, and R. K. Bordia, “Compression-compression fatigue of selective electron beam melted cellular titanium (Ti-6Al-4V),” Journal of Biomedical Materials Research Part B: Applied Biomaterials, vol. 99, no. 2, pp. 313–320, 2011. View at Publisher · View at Google Scholar · View at Scopus
  17. P. Dérand III, L.-E. Rännar, and J.-M. Hirsch, “Imaging, virtual planning, design, and production of patient-specific implants and clinical validation in craniomaxillofacial surgery,” Craniomaxillofacial Trauma and Reconstruction, vol. 5, no. 3, pp. 137–144, 2012. View at Publisher · View at Google Scholar
  18. M. Rana, C. H. Chui, M. Wagner, R. Zimmerer, M. Rana, and N. Gellrich, “Increasing the accuracy of orbital reconstruction with selective laser-melted patient-specific implants combined with intraoperative navigation,” Journal of Oral and Maxillofacial Surgery, vol. 73, no. 6, pp. 1113–1118, 2015. View at Publisher · View at Google Scholar
  19. B. Braun, “Produktion_Huefte,” 2014, http://www.bbraun.de/documents/Company/Produktion_Huefte.pdf.
  20. B. Mueller, T. Toeppel, M. Gebauer, and R. Neugebauer, “Innovative features in implants through beam melting—a new approach for additive manufacturing of endoprostheses,” in Innovative Developments in Virtual and Physical Prototyping, P. J. Bartolo, A. C. S. DeLemos, A. P. O. Tojeira et al., Eds., pp. 519–523, Taylor & Francis Group, London, UK, 2011. View at Google Scholar
  21. W. Zimmerli, “Prosthetic-joint-associated infections,” Best Practice & Research: Clinical Rheumatology, vol. 20, no. 6, pp. 1045–1063, 2006. View at Publisher · View at Google Scholar · View at Scopus
  22. I. Ofek, D. L. Hasty, and R. J. Doyle, “Role of adhesion in biofilm formation,” in Bacterial Adhesion to Animal Cells and Tissues, chapter 10, pp. 147–156, ASM Press, Washington, DC, USA, 1st edition, 2003. View at Google Scholar
  23. K. E. Beenken, L. N. Mrak, L. M. Griffin et al., “Epistatic relationships between sarA and agr in Staphylococcus aureus biofilm formation,” PLoS ONE, vol. 5, no. 5, Article ID e10790, 2010. View at Publisher · View at Google Scholar · View at Scopus
  24. T. Bjarnsholt, K. Kirketerp-Møller, S. Kristiansen et al., “Silver against Pseudomonas aeruginosa biofilms,” APMIS, vol. 115, no. 8, pp. 921–928, 2007. View at Publisher · View at Google Scholar · View at Scopus
  25. M. R. Kiedrowski and A. R. Horswill, “New approaches for treating staphylococcal biofilm infections,” Annals of the New York Academy of Sciences, vol. 1241, no. 1, pp. 104–121, 2011. View at Publisher · View at Google Scholar · View at Scopus
  26. J. Gallo, M. Kolár, A. V. Florschütz, R. Novotný, R. Pantůcek, and M. Kesselová, “In vitro testing of gentamicin-vancomycin loaded bone cement to prevent prosthetic joint infection,” Biomedical Papers, vol. 149, no. 1, pp. 153–158, 2005. View at Publisher · View at Google Scholar · View at Scopus
  27. S. G. Giulieri, P. Graber, P. E. Ochsner, and W. Zimmerli, “Management of infection associated with total hip arthroplasty according to a treatment algorithm,” Infection, vol. 32, no. 4, pp. 222–228, 2004. View at Google Scholar · View at Scopus
  28. H. Sharma, J. De Leeuw, and D. I. Rowley, “Girdlestone resection arthroplasty following failed surgical procedures,” International Orthopaedics, vol. 29, no. 2, pp. 92–95, 2005. View at Publisher · View at Google Scholar · View at Scopus
  29. R. O. Darouiche, “Treatment of infections associated with surgical implants,” The New England Journal of Medicine, vol. 350, no. 14, pp. 1422–1429, 2004. View at Publisher · View at Google Scholar · View at Scopus
  30. K. R. Berend, A. V. Lombardi Jr., M. J. Morris, A. G. Bergeson, J. B. Adams, and M. A. Sneller, “Two-stage treatment of hip periprosthetic joint infection is associated with a high rate of infection control but high mortality,” Clinical Orthopaedics and Related Research, vol. 471, no. 2, pp. 510–518, 2013. View at Publisher · View at Google Scholar · View at Scopus
  31. M. Rezapoor and J. Parvizi, “Prevention of periprosthetic joint infection,” The Journal of Arthroplasty, vol. 30, no. 6, pp. 902–907, 2015. View at Publisher · View at Google Scholar
  32. P. B. McKenna, K. O'Shea, and E. L. Masterson, “Two-stage revision of infected hip arthroplasty using a shortened post-operative course of antibiotics,” Archives of Orthopaedic and Trauma Surgery, vol. 129, no. 4, pp. 489–494, 2009. View at Publisher · View at Google Scholar · View at Scopus
  33. J. G. E. Hendriks, J. R. van Horn, H. C. van der Mei, and H. J. Busscher, “Backgrounds of antibiotic-loaded bone cement and prosthesis-related infection,” Biomaterials, vol. 25, no. 3, pp. 545–556, 2004. View at Publisher · View at Google Scholar · View at Scopus
  34. A. D. van Staden, A. M. Brand, and L. M. T. Dicks, “Nisin F-loaded brushite bone cement prevented the growth of Staphylococcus aureusin vivo,” Journal of Applied Microbiology, vol. 112, no. 4, pp. 831–840, 2012. View at Publisher · View at Google Scholar · View at Scopus
  35. S. Nag and R. Banarjee, “Fundamentals of medical implant materials,” in ASM Handbook, Volume 23: Materials for Medical Devices, pp. 6–17, ASM International, 2012. View at Google Scholar
  36. T. Wohlers, Wohlers Report 2012: Additive Manufacturing and 3D Printing State of the Industry Annual Worldwide Progress Report, edited by T. Wohlers, Wohlers Associates, Fort Collins, Colo, USA, 2012.
  37. FDA, 510(k) Premarket Notification for Medical Devices, 2015, http://www.accessdata.fda.gov/scripts/cdrh/devicesatfda/index.cfm.
  38. International Organization for Standardization, “Implants for surgery—partial and total hip joint prostheses—part4: determination of endurance properties of stemmed femoral components,” ISO 7206-4, International Organization for Standardization, London, UK, 2002. View at Google Scholar
  39. W. Zimmerli and P. E. Ochsner, “Management of infection associated with prosthetic joints,” Infection, vol. 31, no. 2, pp. 99–108, 2003. View at Publisher · View at Google Scholar · View at Scopus
  40. E. F. Berbari, A. D. Hanssen, M. C. Duffy et al., “Risk factors for prosthetic joint infection: case-control study,” Clinical Infectious Diseases, vol. 27, no. 5, pp. 1247–1254, 1998. View at Publisher · View at Google Scholar · View at Scopus
  41. W. Zimmerli, A. F. Widmer, M. Blatter, R. Frei, and P. E. Ochsner, “Role of rifampin for treatment of orthopedic implant-related staphylococcal infections,” Journal of the American Medical Association, vol. 279, no. 19, pp. 1537–1541, 1998. View at Publisher · View at Google Scholar · View at Scopus
  42. C. M. Brandt, W. W. Sistrunk, M. C. Duffy et al., “Staphylococcus aureus prosthetic joint infection treated with debridement and prosthesis retention,” Clinical Infectious Diseases, vol. 24, no. 5, pp. 914–919, 1997. View at Publisher · View at Google Scholar · View at Scopus
  43. B. A. Masri and E. A. Salvati, “Sepsis: two-stage exchange,” in The Adult Hip: Volume II, J. J. Callaghan, A. G. Rosenberg, and H. E. Rubash, Eds., chapter 81, pp. 1317–1330, Lippincott-Raven, Philadelphia, Pa, USA, 1998. View at Google Scholar
  44. A. Scharfenberger, M. Clark, G. Lavoie, G. O'Connor, E. Massen, and L. A. Beaupre, “Treatment of an infected total hip replacement with the PROSTALAC system part 1: infection resolution,” Canadian Journal of Surgery, vol. 50, no. 1, pp. 24–28, 2007. View at Google Scholar · View at Scopus
  45. H. W. Buchholz, R. A. Elson, E. Engelbrecht, H. Lodenkämper, J. Röttger, and A. Siegel, “Management of deep infection of total hip replacement,” The Journal of Bone & Joint Surgery Series B, vol. 63, no. 3, pp. 342–353, 1981. View at Google Scholar · View at Scopus
  46. ASTM, “F136-08: standard specification for wrought titanium-6 aluminium-4 vanadium ELI (extra low interstitial) alloy for surgical implant application (UNS R56401),” in Section 13.01: Medical and Surgical Materials and Devices, pp. 61–65, ASTM, West Conshohocken, Pa, USA, 2010. View at Google Scholar
  47. M. Van Rooyen, Material characterisation of lasercusing manufactured Ti-6Al-4V [Bachelor Thesis], Stellenbosch University, Stellenbosch, South Africa, 2013.
  48. C. Qiu, N. J. E. Adkins, and M. M. Attallah, “Microstructure and tensile properties of selectively laser-melted and of HIPed laser-melted Ti–6Al–4V,” Materials Science & Engineering A, vol. 578, pp. 230–239, 2013. View at Publisher · View at Google Scholar · View at Scopus
  49. B. Vrancken, L. Thijs, J.-P. Kruth, and J. Van Humbeeck, “Heat treatment of Ti6Al4V produced by selective laser melting: microstructure and mechanical properties,” Journal of Alloys and Compounds, vol. 541, pp. 177–185, 2012. View at Publisher · View at Google Scholar · View at Scopus
  50. G. Chahine, M. Koike, T. Okabe, P. Smith, and R. Kovacevic, “The design and production of Ti-6Al-4V ELI customized dental implants,” JOM, vol. 60, no. 11, pp. 50–55, 2008. View at Publisher · View at Google Scholar · View at Scopus
  51. H. K. Rafi, N. V. Karthik, H. Gong, T. L. Starr, and B. E. Stucker, “Microstructures and mechanical properties of Ti6Al4V parts fabricated by selective laser melting and electron beam melting,” Journal of Materials Engineering and Performance, vol. 22, no. 12, pp. 3872–3883, 2013. View at Publisher · View at Google Scholar · View at Scopus
  52. M. Svensson and U. Ackelid, “Titanium alloys manufactured with electron beam melting mechanical and chemical properties,” in Proceedings of the Materials and Processes for Medical Devices Conference, J. Gilbert, Ed., pp. 189–194, ASM International, Minneapolis, Minn, USA, August 2009.
  53. R. J. Carangelo and S. F. Schutzer, “Resection arthroplasty,” in The Adult Hip: Volume I, J. J. Callaghan, A. G. Rosenberg, and H. E. Rubash, Eds., chapter 44, pp. 737–747, Lippincott-Raven, Philadelphia, Pa, USA, 1998. View at Google Scholar
  54. H. Sharma, C. R. Dreghorn, and E. R. Gardner, “Girdlestone resection arthroplasty of the hip: current perspectives,” Current Orthopaedics, vol. 19, no. 5, pp. 385–392, 2005. View at Publisher · View at Google Scholar · View at Scopus
  55. G. S. Kantor, J. A. Osterkamp, L. D. Dorr, D. Fischer, J. Perry, and J. P. Conaty, “Resection arthroplasty following infected total hip replacement arthroplasty,” The Journal of Arthroplasty, vol. 1, no. 2, pp. 83–89, 1986. View at Publisher · View at Google Scholar · View at Scopus
  56. Sigma-Aldrich, “48760 Gentamicin sulfate from Micromonospora,” 2014, http://www.sigmaaldrich.com/content/dam/sigma-aldrich/docs/Sigma/Datasheet/6/48760dat.pdf.
  57. T. Grimm, User's Guide to Rapid Prototyping, R. Csizmadia, Ed., Society of Manufacturing Engineers, Dearborn, Mich, USA, 1st edition, 2004.
  58. V. Petrovic, J. V. H. Gonzalez, O. J. Ferrando, J. D. Gordillo, J. R. B. Puchades, and L. P. Grinan, “Additive layered manufacturing: sectors of industrial application shown through case studies,” International Journal of Production Research, vol. 49, no. 4, pp. 1061–1079, 2011. View at Publisher · View at Google Scholar · View at Scopus
  59. E. Yasa and J. Kruth, “Application of laser re-melting on selective laser melting parts,” Advances in Production Engineering and Management, vol. 6, no. 4, pp. 259–270, 2011. View at Google Scholar
  60. W. A. Jiranek, A. D. Hanssen, and A. S. Greenwald, “Current concepts review: antibiotic-loaded bone cement for infection prophylaxis in total joint replacement,” The Journal of Bone & Joint Surgery Series A, vol. 88, no. 11, pp. 2487–2500, 2006. View at Publisher · View at Google Scholar · View at Scopus
  61. L. Esteban-Tejeda, B. Cabal, F. Malpartida et al., “Soda-lime glass-coating containing silver nanoparticles on Ti-6Al-4V alloy,” Journal of the European Ceramic Society, vol. 32, no. 11, pp. 2723–2729, 2012. View at Publisher · View at Google Scholar · View at Scopus
  62. G. Lewis, “Properties of antibiotic-loaded acrylic bone cements for use in cemented arthroplasties: a state-of-the-art review,” Journal of Biomedical Materials Research Part B: Applied Biomaterials, vol. 89, no. 2, pp. 558–574, 2009. View at Publisher · View at Google Scholar · View at Scopus
  63. Heraeus Medical, “Palacos: Excellence in modern cementing technique,” 2014, http://heraeusmedical.com/media/webmedia_local/dc/dc_en/PALACOS_Primary_Accessories_Folder_UK.pdf.
  64. P. Veyssier and A. Bryskier, “Aminocyclitol aminoglycosides,” in Antimicrobial Agen, 2015ts: Antibacterials and Antifungals, A. Bryskier, Ed., chapter 16, pp. 453–469, ASM Press, Washington, DC, USA, 2005. View at Google Scholar
  65. P. F. Cabanillas, E. D. Peña, J. M. Barrales-Rienda, and G. Frutos, “Validation and in vitro characterization of antibiotic-loaded bone cement release,” International Journal of Pharmaceutics, vol. 209, no. 1-2, pp. 15–26, 2000. View at Publisher · View at Google Scholar · View at Scopus
  66. H. van de Belt, D. Neut, D. R. A. Uges et al., “Surface roughness, porosity and wettability of gentamicin-loaded bone cements and their antibiotic release,” Biomaterials, vol. 21, no. 19, pp. 1981–1987, 2000. View at Publisher · View at Google Scholar · View at Scopus
  67. D. Neut, H. van de Belt, I. Stokroos, J. R. van Horn, H. C. van der Mei, and H. J. Busscher, “Biomaterial-associated infection of gentamicin-loaded PMMA beads in orthopaedic revision surgery,” Journal of Antimicrobial Chemotherapy, vol. 47, no. 6, pp. 885–891, 2001. View at Publisher · View at Google Scholar · View at Scopus
  68. L. M. Perez, P. Lalueza, M. Monzon, J. A. Puertolas, M. Arruebo, and J. Santamaría, “Hollow porous implants filled with mesoporous silica particles as a two-stage antibiotic-eluting device,” International Journal of Pharmaceutics, vol. 409, no. 1-2, pp. 1–8, 2011. View at Publisher · View at Google Scholar · View at Scopus
  69. P. Wu and D. W. Grainger, “Drug/device combinations for local drug therapies and infection prophylaxis,” Biomaterials, vol. 27, no. 11, pp. 2450–2467, 2006. View at Publisher · View at Google Scholar · View at Scopus
  70. M. D. Kramer, “Combination products: Challenges and progress,” Regulatory Affairs Focus, pp. 30–35, 2005, http://www.fda.gov/downloads/combinationproducts/meetingsconferencesworkshops/ucm116723.pdf.
  71. M. A. Z. Hupcey and S. Ekins, “Improving the drug selection and development process for combination devices,” Drug Discovery Today, vol. 12, no. 19-20, pp. 844–852, 2007. View at Publisher · View at Google Scholar · View at Scopus
  72. D. Dimitrov, K. Schreve, A. Taylor, and B. Vincent, “Rapid prototyping driven design and realisation of large components,” Rapid Prototyping Journal, vol. 13, no. 2, pp. 85–91, 2007. View at Publisher · View at Google Scholar · View at Scopus
  73. T. J. Horn and O. L. A. Harrysson, “Overview of current additive manufacturing technologies and selected applications,” Science Progress, vol. 95, no. 3, pp. 255–282, 2012. View at Publisher · View at Google Scholar · View at Scopus
  74. M. Cronskär, M. Bäckström, and L.-E. Rännar, “Production of customized hip stem prostheses—a comparison between conventional machining and electron beam melting (EBM),” Rapid Prototyping Journal, vol. 19, no. 5, pp. 365–372, 2013. View at Publisher · View at Google Scholar · View at Scopus
  75. R. Dehoff, C. Duty, W. Peter et al., “Case study: additive manufacturing of aerospace brackets,” Advanced Materials and Processes, vol. 171, no. 3, pp. 19–22, 2013. View at Google Scholar · View at Scopus
  76. B. Vandenbroucke and J.-P. Kruth, “Selective laser melting of biocompatible metals for rapid manufacturing of medical parts,” Rapid Prototyping Journal, vol. 13, no. 4, pp. 196–203, 2007. View at Publisher · View at Google Scholar · View at Scopus
  77. L.-E. Rännar, A. Glad, and C.-G. Gustafson, “Efficient cooling with tool inserts manufactured by electron beam melting,” Rapid Prototyping Journal, vol. 13, no. 3, pp. 128–135, 2007. View at Publisher · View at Google Scholar · View at Scopus
  78. A. Palmquist, A. Snis, L. Emanuelsson, M. Browne, and P. Thomsen, “Long-term biocompatibility and osseointegration of electron beam melted, free-form-fabricated solid and porous titanium alloy: experimental studies in sheep,” Journal of Biomaterials Applications, vol. 27, no. 8, pp. 1003–1016, 2013. View at Publisher · View at Google Scholar · View at Scopus
  79. D. Cormier, O. Harrysson, and H. West, “Characterization of H13 steel produced via electron beam melting,” Rapid Prototyping Journal, vol. 10, no. 1, pp. 35–41, 2004. View at Publisher · View at Google Scholar · View at Scopus
  80. Arcam AB, “Arcam-Ti6Al4V-ELI-Titanium-Alloy,” 2014, http://www.arcam.com/wp-content/uploads/Arcam-Ti6Al4V-ELI-Titanium-Alloy.pdf.
  81. J.-P. Kruth, B. Vandenbroucke, J. Van Vaerenberg, and P. Mercelis, “Benchmarking of different SLS/SLM processes as rapid manufacturing techniques,” in Proceedings of the International Conference on Polymers & Moulds Innovations (PMI '2005), Gent, Belgium, April 2005, http://doc.utwente.nl/52902/1/Wa1021.pdf.
  82. A. B. Spierings, M. Schneider, and R. Eggenberger, “Comparison of density measurement techniques for additive manufactured metallic parts,” Rapid Prototyping Journal, vol. 17, no. 5, pp. 380–386, 2011. View at Publisher · View at Google Scholar · View at Scopus
  83. S. Leuders, M. Thöne, A. Riemer et al., “On the mechanical behaviour of titanium alloy TiAl6V4 manufactured by selective laser melting: Fatigue resistance and crack growth performance,” International Journal of Fatigue, vol. 48, pp. 300–307, 2013. View at Publisher · View at Google Scholar · View at Scopus
  84. J. Markwardt, J. Friedrichs, C. Werner et al., “Experimental study on the behavior of primary human osteoblasts on laser-cused pure titanium surfaces,” Journal of Biomedical Materials Research - Part A, vol. 102, no. 5, pp. 1422–1430, 2014. View at Publisher · View at Google Scholar · View at Scopus
  85. P. Thomsen, J. Malmström, L. Emanuelsson, M. René, and A. Snis, “Electron beam-melted, free-form-fabricated titanium alloy implants: material surface characterization and early bone response in rabbits,” Journal of Biomedical Materials Research—Part B: Applied Biomaterials, vol. 90, no. 1, pp. 35–44, 2009. View at Publisher · View at Google Scholar · View at Scopus
  86. S. Ponader, C. von Wilmowsky, M. Widenmayer et al., “In vivo performance of selective electron beam-melted Ti-6Al-4V structures,” Journal of Biomedical Materials Research Part A, vol. 92, no. 1, pp. 56–62, 2010. View at Publisher · View at Google Scholar · View at Scopus
  87. D. K. Pattanayak, A. Fukuda, T. Matsushita et al., “Bioactive Ti metal analogous to human cancellous bone: fabrication by selective laser melting and chemical treatments,” Acta Biomaterialia, vol. 7, no. 3, pp. 1398–1406, 2011. View at Publisher · View at Google Scholar · View at Scopus
  88. L. Facchini, E. Magalini, P. Robotti, A. Molinari, S. Höges, and K. Wissenbach, “Ductility of a Ti-6Al-4V alloy produced by selective laser melting of prealloyed powders,” Rapid Prototyping Journal, vol. 16, no. 6, pp. 450–459, 2010. View at Publisher · View at Google Scholar · View at Scopus
  89. International Organization for Standardization, “Implants for surgery—partial and total hip prostheses—part 6: determination of endurance properties of head and neck region of stemmed femoral components,” ISO 7206-6, International Organization for Standardization, London, UK, 1992. View at Google Scholar
  90. G. Branner and M. F. Zaeh, “Investigations on residual stresses and deformations in selective laser melting,” Production Engineering, vol. 4, no. 1, pp. 35–45, 2010. View at Publisher · View at Google Scholar · View at Scopus
  91. H. Gong, K. Rafi, H. Gu, G. J. Ram, T. Starr, and B. Stucker, “Influence of defects on mechanical properties of Ti-6Al-4V components produced by selective laser melting and electron beam melting,” Materials & Design, vol. 86, pp. 545–554, 2015. View at Publisher · View at Google Scholar
  92. S. E. Young, M. Zhang, J. T. Freeman, J. Mutu-Grigg, P. Pavlou, and G. A. Moore, “The mark coventry award: Higher tissue concentrations of vancomycin with low-dose intraosseous regional versus systemic prophylaxis in TKA: a randomized trial knee,” Clinical Orthopaedics and Related Research, vol. 472, no. 1, pp. 57–65, 2014. View at Publisher · View at Google Scholar · View at Scopus
  93. D. D. von Hoff, J. G. Kuhn, H. A. Burris III, and L. J. Miller, “Does intraosseous equal intravenous? A pharmacokinetic study,” The American Journal of Emergency Medicine, vol. 26, no. 1, pp. 31–38, 2008. View at Publisher · View at Google Scholar · View at Scopus
  94. F. Wang, B. Ni, Z. Zhu, F. Liu, Y.-Z. Zhu, and J. Liu, “Intra-discal vancomycin-loaded PLGA microsphere injection for MRSA discitis: an experimental study,” Archives of Orthopaedic and Trauma Surgery, vol. 131, no. 1, pp. 111–119, 2011. View at Publisher · View at Google Scholar · View at Scopus