By Dr. Megha Agrawal, Dr. Shyamasri Biswas, Dr.

Kim Van Vliet, Contirbuting Editors

Vacuum Technology Enabled

Prosthetics with Superior Functions

rosthetic implants are routinely employed to treat or replace diseased

human bones. The number of hip
replacements that take place each year
in the United States now ranges between
200,000 and 300,000. It is believed that
this number is expected to reach 600,000
per year by 2030. Further, the number of
knee replacements is expected to reach
3.48 million by 2030 [1]. The replacement of a diseased hip, knee or shoulder
can be full or partial. This procedure involves surgical removal of the damaged
or diseased parts of the patient's joint
and this is followed by replacement with
new artificial parts. Such an operation is
known as hip, knee or shoulder arthroplasty. The artificial material that replaces
the damaged joint is called a prosthesis.
Materials that are employed as prosthetic
implants are usually made of metal, ceramic, polymer, or various combinations
of these materials. In addition to the structural repair that is accomplished by joint
replacement, another major purpose of
hip and knee replacement surgeries is the
restoration of joint function and mobility
[2]. Figure 1 shows a recent design for a
hip prosthesis [2].
2

One of the main technological problems with prosthetic joints is that they
wear and corrode when they are employed for an extended period of time.
Wear results in the formation of debris
that in turn produces tissue inflammation
and osteolysis (active resorption of bone
matrix by osteoclasts) that eventually

results in loosening of the prosthetic implants. Loosening of the implants happens

when the surfaces of two materials slide
against each other. As a result, the softer
material is abraded and worn out. In addition, the material comes in contact with
human body fluids leading to corrosion of
the conjoining surfaces [2].

Figure 1. Hip prosthesis that includes acetabular cup, femoral head and femoral stem. [Source:
Materion, Technical Paper, Medical and Biomedical Thin Film Materials: Prosthetic Implants.]

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July 2015 Vacuum Technology & Coating

One viable solution to overcome this

problem is combining hard and inert coating material (on each surface) with prosthetic joints that can prevent wear, corrosion and debris formation. The coating
material should also have good adhesion
on the substrate especially in the presence
of human body fluid. Vacuum technology
plays an important role in enhancing the
wear, lubricity and corrosion resistance
properties of prosthetic implants. Vacuum
deposition processes that include magnetron sputtering, plasma assisted CVD
(PACVD), plasma enhanced CVD (PECVD), and conventional CVD are routinely
employed to deposit hard and low friction
and corrosion resistant thin film coatings
that are used in a number of prosthetic and
biomedical applications [2].
The most promising coating materials
for such wear resistance applications for
prosthetic implants with improved functionalities are diamond like carbon (DLC)
and tetrahedral carbon (ta-C) [3, 4], titanium nitride (TiN), titanium carbide (TiC),
titanium dioxide (TiO2) [4] and alpha
alumina (-Al2O3) [5]. Other materials

that are being evaluated are titanium niobium nitride (TiNbN), chromium nitride
(CrN), titanium carbon nitride (TiCN),
titanium aluminum nitride (TiAlN), silicon carbide (SiC) and zirconium nitride
(ZrN) [6]. DLC is generally deposited as
nanocrystalline diamond. Vacuum deposition processes such as plasma enhanced
chemical vapor deposition (PECVD),
plasma activated chemical vapor deposition (PACVD), microwave plasma chemical vapor deposition (MPCVD), ion beam
sputtering (IBS) and filtered cathodic arc
deposition (FACD) produce DLC, ta-C
and a-C:H films for the prosthetic implants. It is very important that the prosthetic implant surface prevent blood clot
(thrombus) formation. Increased platelet
adhesion, activation and aggregation on
implant surfaces exposed to blood result
in the formation of a thrombus. Hemocompatibility tests of DLC coating have
shown its ability to suppress thrombus
formation [2]. In addition, vacuum deposited DLC coated surfaces demonstrated favorable conditions for the growth
of cells like fibroblasts, osteoblasts, and

macrophages, without any inflammation

of tissues or cytotoxicity. Also, DLC coatings in hip and knee joint simulator minimized the wear and corrosion leading to
less debris formation [2].
Elevated vacuum prosthetic technology has been employed to develop superior prosthetic liners. In a new design of a
prosthetic liner, the nonstick outer surface
comprises a Parylene coating bonded to
the urethane produced by CVD process,
and this allows easier donning and doffing
[7]. The synthetic thermoplastic polymer
polyetheretherketone (PEEK) is becoming a popular component of clinical orthopedic and spinal applications. However,
its practical applications are limited due to
its bio-inertness. PEEK is a biocompatible
polymer that is chemically stable, radiolucent and has an elastic modulus similar
to that of normal human bone. Since it is
biologically inert, this prevents good compatibility with the adjacent bone tissues
upon implantation. Vacuum deposition
processes have been employed to improve
the bioactivity of PEEK [8] (Figure 2).

Figure 2. Vacuum technology based current strategies to improve the bioactivity of PEEK for the applications in prosthetic implants [Source: Ma,
R. and Tang, T. (2014).]
Vacuum Technology & Coating July 2015 www.vactechmag.com or www.vtcmag.com 

Figure 3. Schematic maps of typical IBSD and IBAD process (a) IBSD. (b) IBAD. [Source: Wang, G. and Zreiqat, H. (2010).]

Metallic biomaterials such as stainless

steel, Cobalt-based alloys, Titanium and
its alloys, are widely used in the production of artificial hip joints, bone plates
and dental implants due to their excellent
mechanical properties and endurance [9].
However, several properties of these biomaterials limit their application. These
include low wear resistance, corrosion in
biological environments resulting in the
release of ions and the formation of wear
debris, as well as poor implant fixation
resulting from a lack of osteoconductivity
and osteoinductivity. In addition to these
properties, implant-associated infections
due to bacterial adhesion and colonization
at the implantation site also make them
unsuitable for prosthetic implant applications [9]. Several surface treatments by
using vacuum deposition processes can
be applied to overcome such challenges.
Oxygen ion implantation has been used
to improve wear and corrosion resistance
as well as biocompatibility of the metallic materials. Ion implantation includes
conventional beam-line ion implantation
and plasma immersion ion implantation
(PIII). Other techniques such as magnetron sputtering and PACVD have been
successfully employed for coatings as
well. It has been shown that coatings can
successfully protect metal implants from
corrosion and wear [9].
4

Recently, by coating Titanium discs

with recombinant protein and inserting
these implants in a rat model, Decker et
al showed that they were able to stimulate
natural bone formation [10]. They coated
titanium porous oxide disks with recombinant human bone morphogenic protein-2
(rhBMP-2) and showed that after inserting this into the thoracic region in animal
studies that this resulted in accelerated local bone formation. In the initial studies,
the rhBMP-2 implants were produced using a wet soak-load method where the implants were immersed in rhBMP-2 solutions and air dried. However, this protocol
does not meet the needs for industrial
production of rhBMP-2-coated implants.
As a result, they developed an improved
production protocol where the implants
were partially coated with rhBMP-2 and
vacuum-dried using an industrial process.
The production protocol using vacuum
drying allows for better long-term stability of the recombinant protein coating and
provides the ability to manufacture large
series of implants and ensure a longer
product shelf life. This is just one example where vacuum techniques provide a
superior product.
Ion beam vacuum techniques, such as
ion beam sputtering deposition (IBSD),
and ion beam assisted deposition (IBAD),
have also been widely used to deposit cal-

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cium phosphate thin films on the metallic

substrates. These techniques can produce
a thin, homogeneous calcium phosphate
with high adhesive strength [9]. Magnetron sputtering deposition is another effective way to produce hydroxyapatite films
on biomedical implants [9] (Figure 3).
Parylene coating has been employed
and results in superior properties over
hydroxyapatite. The parylene coatings
are usually performed at ambient temperatures in the vacuum deposition environment. The parylene coatings are
applied as a thin film, which grows one
molecule at a time as the parylene polymer deposition takes place at the molecular level [11].
Titanium nitride (TIN) has been shown
to be promising for applications in implants due to its excellent hardness, high
scratch and wear resistant properties and
good wettability by synovial fluids along
with low carcinogenic and cytoxicity
[12]. Figure 4 shows examples of TIN
coated hip replacement. Such TIN coatings are usually done by PVD technique.
PVD TIN surface coating technology is
now well established within the orthopaedic industry.
Concluding Remarks
Vacuum deposition techniques have
been shown to be promising for producing
July 2015 Vacuum Technology & Coating

Figure 4. Examples of commercially available TIN coated replacements: TiNbN-coated CoCoMo alloy total hip replacement (a); TiN-coated Ti
alloy articulating unit of total hip replacement (b); TiN-coated total knee replacement (c); TiNbN-coated CoCoMo alloy hip resurfacing device (d)
[Source: Gotman, I., and Gutmanas E. Y. (2014).]

functional coating materials for prosthetic

implants with superior wear and corrosion
resistance properties. Existing vacuum
technology processes have been successfully employed for various biomaterial
coatings. However, more collaborative
efforts between materials scientists, vacuum technologists, biologists and medical
experts are needed to overcome challenges such as adhesion, and biocompatibility
issues of the coated prosthetic implants
for extending their safe long term use.
References for Further Reading
1. 
Martin, P.M., Chapters 1 & 4, Introduction
to Surface Engineering and Functionally
Engineered Materials, Wiley/Scrivener
(2011).
2. 
Materion technical paper, Medical and
Biomedical Thin Film Materials: Prosthetic Implants.

3. 
Zang S., Handbook of Nanostructured
Thin Films and Coatings, CRC Press
(2010).
4. Bunshah, R.F., Deposition technologies,
properties and applications, William Andrew Handbook of Hard Coatings (2001).
5. Cloud, A. N. et al., SVC 51st Annual Technical Conference Proceedings (2008) 153.
6. Fellenberg, R., Society of Vacuum Coaters 50th Annual Technical Conference Proceedings (2007) 107.
7. Fairley, M., Prosthetic Liners and Sleeves:
Reaching New Levels of Comfort, Control, and Suspension, The O&P EDGE
(2013).
8. Ma, R. and Tang, T., Current Strategies
to Improve the Bioactivity of PEEK, International Journal of Molecular Sciences
(2014).
9. 
Wang, G. and Zreiqat, H., Functional
Coatings or Films for Hard-Tissue Applications, Materials (2010) 3.

10. Decker, J.F., Lee, J., Cortella, C.A., Polimeni, G., Rohrer, M.D., Wozney, J.M.,
Hall, J., Susin, C., and Wikesjo, U.M.E.
Evaluation of Implants Coated with Recombinant Human Bone Morphogenetic
Protein-2 and Vacuum-Dried Using the
Critical-Size Supraalveolar Peri-Implant
Defect Model in Dogs. J. Periodontol.
(2010) 81(12).
11. 
Kuppusami, S. and Oskouei, R.H., Parylene Coatings in Medical Devices and
Implants: A Review, Universal Journal of
Biomedical Engineering (2015) 3.
12. Gotman, I., and Gutmanas E. Y., Titanium nitride-based coatings on implantable
medical devices. Advanced Biomaterials
in Medicine (2014) 1.

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