Quantitative analysis of the bone-hydroxyapatite coating interface

The bone implant interface in stainless steel pins coated with hydroxyapatite, used in a monoaxial fracture external fixation system was examined. The pins were transversally inserted into sheep tibial diaphyses where a defect was created, and they were loaded for 6 weeks. Uncoated pins were implanted as control. The microscopic relation between bone and implant was quantified through image analysis: the residual thickness of the hydroxyapatite coating, pin-bone contact surface and bone ingrowth value in between the threads were measured. The bone tissue at the interface appeared regularly mineralized and viable both in the implants of coated pins and in the control uncoated ones. The ceramic coating showed a slight and not statistically significant increase in thickness. The ceramic coated pins presented contact with bone higher than the uncoated pins (75.6±20.0 versus 47.5±19.4); they also induced a higher bone ingrowth (86.6±22.4 versus 78.7±13.5). Both differences are not statistically significant, but suggestive of a trend. The authors concluded that the hydroxyapatite coating of the pins might improve the performance of external fixators, by favouring bone apposition and reducing rate of loosening.