Over the years, many
metal and
polymer implants have been developed for
internal fracture fixation. However, there are always some problems associated with their application, such as implant loosening or
infection. This study describes how the morphology and adhesion of both fibroblasts and osteoblasts to two manufactured commercially pure, medical implant-quality anodized
titanium surfaces (TS and TSS), and five modified
titanium surfaces (TLF, low friction gray anodized
titanium; TIG,
nitrogen ion implanted TSS; THY, TSS grafted with
sodium hyaluronate; TAST, TSS coated with hydrophilic
hydrogel; and TT, tiodized TS) were used to obtain an indication of their relative cytocompatibility and to assess which modified surface could potentially be used in vivo. Small variations were observed both qualitatively and quantitatively in the spreading and adhesion of fibroblasts and osteoblasts to the studied surfaces. Overall, fibroblast spreading and adhesion were greatest on the TIG and TLF surfaces. Osteoblast spreading and adhesion were greatest on TS, TIG, and TAST surfaces. No fibroblasts or osteoblasts were found attached to the THY-coated surfaces. Coating medical implant-quality anodized
titanium surfaces (TS and TSS) with a TLF, TAST, or more specifically TIG could probably improve soft
tissue adhesion and/or osseointegration of bone in vivo. However, it seemed that a
hyaluronic acid coating (THY) has potential as a coating in areas where cell adhesion is undesirable, such as
orbital fractures, where muscles should avoid adhesion to the implant, and
distal radius fractures, where tendons should freely glide over the implant.