Plasma coating technologies have proven to be effective in improving the performance of artificial joints. Joint implant failure is common enough that attempts at improvement have been made. Plasma coating can enhance the fatigue strength, the corrosion and wear resistance as well as the load-bearing capacity.
Plasma coating technologies have proven to be effective in improving the performance of artificial joints. Joint implant failure is common enough that attempts at improvement have been made. Plasma coating can enhance the fatigue strength, the corrosion and wear resistance as well as the load-bearing capacity.
Plasma coating technologies have proven to be effective in improving the performance of artificial joints. Joint implant failure is common enough that attempts at improvement have been made. Plasma coating can enhance the fatigue strength, the corrosion and wear resistance as well as the load-bearing capacity.
Applications of plasma coatings in articial joints: an overview
Hong Liang a, *, Bing Shi a , Aaron Fairchild a , Timothy Cale b a Department of Mechanical Engineering, University of Alaska, Fairbanks, AK 99775-5905, USA b Rensselaer Polytechnic Institute, Troy, NY 12180-3590, USA Abstract Current surgical implants such as articial hip and knee joints undergo degradation after 1015 years of use. Joint implant failure is common enough that attempts at improvement have been made. Plasma coating technologies have proven to be effective in improving the performance of articial joints. Plasma coating can enhance the fatigue strength, the corrosion and wear resistance as well as the load-bearing capacity. In this work, we review the common failures in articial joints and the role of plasma coating in biomedical applications. r 2004 Elsevier Ltd. All rights reserved. Keywords: Articial joints; Plasma coatings; Biomaterials; Biotribology 1. Introduction As advances have been made in medical sciences, the aging population has grown signi- cantly. More organs, joints, and other critical body parts will wear out and must be replaced to maintain a good quality of life for elderly people. There are implants that play a major role in replacing or improving the function of every major body system (skeletal, circulatory, nervous, etc.). Materials we use in these replacements are by denition biomaterials. Some common implants include orthopedic devices such as total knee, hip, shoulder, and ankle joint replacements, spinal implants, and bone xators; cardiac implants such as articial heart valves and pacemakers; soft tissue implants such as breast implants and injectable collagen for soft tissue augmentation; and dental implants to replace teeth/root systems and bony tissue in the oral cavity. In this review, we will focus on joint replacements. Joint replacement surgery is most commonly performed for hips, knees, and shoulders as shown in Fig. 1, although toes, ngers, and elbows have been successfully replaced [1]. Most articial joint replacements are designed to remove diseased areas of the joint and replace them with implants designed specically to restore that joints function and stability. For biomedical applications, materi- als engineers must consider the physiologic loads to be placed on the implants. Material choices also must take into account immune system biocom- patability, the environment, corrosion issues, friction and wear of the articulating surfaces, and implant xation either through osseointegration (the degree to which bone will grow next to or integrate into the implant) or bone cement. One of the major problems plaguing these devices is purely materials-related: wear of the polymer cup in total joint replacements. A summary of ARTICLE IN PRESS *Corresponding author. Tel.: +1-907-474-6135; fax: +1- 907-474-6141. E-mail address: ffhl@uaf.edu (H. Liang). 0042-207X/$ - see front matter r 2004 Elsevier Ltd. All rights reserved. doi:10.1016/j.vacuum.2003.12.160 tribo-biomaterials is list in Table 1 [26]. These conventional materials t into the specic needs of bio-applications. 2. Problems in articial joints Despite the success of surgical implants such as articial hip and knee joints, materials used in these procedures still do not satisfy the demands of a durable functioning joint. Current synthetic materials, such as stainless steel, titanium alloy, polymers, and ceramic composites, undergo de- gradation after 1015 years of use [7]. There are several common failure types. Studies have sug- gested that the macrophage response to phagocy- tosis of particulate wear debris, occurring in interaction between the cement and bone, is an important causative factor in osteolysis, leading to eventual loosening of joint surfaces [8]. Due to ARTICLE IN PRESS Fig. 1. Joints of hips, knees, shoulders, and articial ankle and foot (left to right). Table 1 Summary of common biomaterials Materials Applications Major properties description Metals: brass, stainless steel, nickel plated, nickel plated steel, zinc plated steel Inserts Alloys: titanium alloys [6], titanium aluminum vanadium alloy [2], cobalt chromium alloy [3], cobalt chromium molybdenum alloy [4,5] Total joint replacement Wear and corrosion resistance Inorganic: diamond-like carbon Biocompatible coatings, Reduced friction and increased wear resistance Ceramics [6]: Al 2 O 3 , ZrO 2 , Si 3 N 4 , SiC, B 4 C, quartz, bioglass(Na 2 OCaOSiO 2 P 2 O 5 ), sintered hydroxyapatite (Ca 10 (PO 4 ) 6 (OH) 2 ) Bone joint coating Wear and corrosion resistance Polymers: Ultra-high molecular weight polyethylene (UHMWPE), Polytetraouroethylene (PTFE) Joint socket Wear, abrasion and corrosion resistance Interpositional implant temporomandibular joint(Jaw) Low coefcient of friction Polyglycolic acid Joint bone Elastic with less wear Leaet heart valve Highly biocompatible, high strength, and dynamic ranges of breathability Polyurethane Composites: Specialized silicone polymers Bone joint Wear, corrosion, and fatigue resistance H. Liang et al. / Vacuum 73 (2004) 317326 318 signicant localized contact stresses at the ball/ socket interface, small regions of implant materi- als, such as ultra-high molecular weight polyethy- lene (UHMWPE) tend to adhere to the metal or ceramic ball [9]. During the reciprocating motion of normal joint use, brils will be drawn from the adherent regions on the polymer surface, and these break off to form submicrometer-sized wear debris. This adhesive wear mechanism, coupled with fatigue-related delamination of the UHMWPE (most prevalent in knee joints), results in billions of tiny polymer particles being shed into the surrounding synovial uid and tissues. Biolo- gical interaction with these small particles in the body then becomes critical [10,11]. The bodys immune system attempts, unsuccessfully, to digest the wear particles (as it would a bacterium or virus). Enzymes are released that eventually result in the death of adjacent bone cells, or osteolysis. Over time, sufcient bone is resorbed around the implant to cause mechanical loosening which necessitates an implant replacement or revision, costly and painful options [12]. The parti- culate debris has emerged as a major factor in the long-term performance of joint replacement prostheses [13]. When present in sufcient amounts, particulates generated by wear, fretting, or fragmentation induce formation of an inam- matory, foreign-body granulation tissue that has the ability to invade the boneimplant inter- face [1422]. This may result in progressive periprosthetic loss of bone, a loss that threatens the xation of prostheses inserted with or with- out cement [15,23,24]. Since the loosening is not caused by an associated infection, it is termed aseptic. When present in sufcient amounts, particulates generated by wear, fretting, or fragmentation induce formation of inammatory, foreign-body granulation tissue that has the ability to invade the boneimplant interface. Corrosive attack is often found in the taper crevice of modular implants made of similar metals or mixed-metal combinations [2529]. The corrosive attack results in metal release and mechanical failure of the joint component [30]. Due to the cyclic loading, corrosive fatigue, wear, fretting, and fragmentation are all expected [3141]. The following is the summary of common failures: * Deciencies in design (size and shape) of the device for a particular patient (e.g., an under- sized noncemented stem) * Surgical problems (e.g., problematic orientation or problems in wound healing) * Host abnormalities or diseases (e.g., osteope- nia) * Infection * Material fracture, wear, and corrosion. 2.1. Fracture and wear Fractures occur often in both orthropedic implants and bone where load-bearing ability is important. Once fractured, however, biomaterials do not regenerate like bone. Fracture eventually leads to catastrophic failure of implants [42,43]. Bioenvironments are mostly wet. Wear is increased for wet sliding wear compared with dry sliding wear for unlled polymers [44]. The wear volume also increases in carbon ber and glass- reinforced composites compared with unlled polymers, thus enhancing the cutting/lowing/ cracking mechanism of abrasive particles against the polymer or polymer composite material [44]. In a physiological environment, metallic, ceramic, or polymeric wear particles may be trapped between two moving surfaces, causing three-body wear, which generally causes a signicantly higher wear rate than two-body wear. Other mechanisms for increased in vivo wear include environmental stress cracking, polymer degradation, microstruc- tural imperfections, and creep [45]. This wear may cause loosening of the prostheses by the resulting poor mechanical t between the ball and socket of the hip. Generation of wear debris is an important factor both because of the potential for wear debris to migrate to distant organs, particularly the lymph nodes where accumulation of particle- containing macrophages causes enlargement and chronic lymphadenitis [46] and because of local physiological responses such as inammatory, cytotoxic, and osteolytic reactions. A major cause of late failures of articial hips has been loosening between the hip stem and the ARTICLE IN PRESS H. Liang et al. / Vacuum 73 (2004) 317326 319 partially resorbed surrounding bone, causing pain and requiring hip replacement. Sometimes femoral bone weakened by osteolysis can fracture under high loading conditions and require replacement. It was thought that this condition was the result of osteolysis of the bone caused by bone cement particles released by wear and fatigue microfrac- tures [47], and it was occasionally called bone cement disease. Research has shown that polyethylene [48], titanium, and ceramic wear debris can cause the same osteolytic problem associated with bone cement debris. Both micro-sized particulates seen in earlier histological slides, as well as submicron particulates now found using digestion and scan- ning electron microscopic techniques, have been implicated in osteolytic destruction of the bone implant interface. Assuming a million steps per year and 0.03 to 0.08 mm per year wear into polyethylene acetabular cups, one recent calcula- tion estimates that on an average as many as 470,000 polyethylene particles of 0.5-mm size could be released to the surrounding tissues at each step [49]. Other examples of nonspecic osteolysis presumed to be caused by wear debris of devices include bone resorbtion around failed elastomeric nger, tow, and wrist prostheses and around failed poly(tetrauoroethylene)-carbon ber temporo- mandibular joint (jaw) prostheses. Therefore, an important in the selection of materials for use in medical implants is the quantity, size, shape, and composition of wear debris that may be released in vivo. The wear problem that occurs with an articial joint implant component (socket) constructed of UHMWPE is illustrated in Fig. 2 [50]. At left is unworn UHMWPE. The sample at right has undergone a friction and wear test versus cobalt chromium (articial joint ball material). The brillation and small particles are characteristic of an adhesive wear mechanism, which can result in surrounding bone loss and the need for implant replacement [50]. 2.2. Corrosion and corrosive fatigue The second type of wear is sub-surface fatigue. High contact stresses in the articial joints will cause a crack in the biological materials that will propagate beneath the surface. Fig. 3 shows a typical knee crack [51]. Corrosive attack in the taper crevice of modular implants made of similar metals or mixed-metals combinations [17,5254]. The corrosive attack results in metal release and mechanical failure of the component [55]. Corrosive fatigue is expected due to cyclic loading and the corrosive environment of ARTICLE IN PRESS Fig. 2. SEM micrographs of socket of UHMWPE [50]. Left: no wear. Right: with wear (20,000X). Fig. 3. A typical knee crack [51]. H. Liang et al. / Vacuum 73 (2004) 317326 320 the human body. The fractures occurred at grain boundaries of the microstructure and ap- peared to be the result of three factors: porosity at the grain boundaries; intergranular corrosive attack initiated both at the head-neck taper and at free surface; and cyclic fatigue-loading of stem [56]. 2.3. Plasma technology Plasma coatings have been used for surface hardening of materials in order to improve wear, corrosion, and fatigue performances in biomedical applications. This technique uses the plasma of a current intensive glow discharge to cause the mass transfer of doping element from generally a low- pressure atmosphere to the material undergoing treatment. Plasma coating can enhance the fatigue strength and wear resistance as well as the load- bearing capacity. In this work, we review the common failure in articial joints and the role of plasma coating in biomedical applications. Surface modication techniques can functiona- lize device surfaces through attachment of bioac- tive molecules, among other methods. This is seen in polymers and metals where surface modication enhances their biocompatability. Surface modi- cation has also been used widely to improve properties of the outmost layers of material surfaces. Surface modication can reduce the wear and improve frictional behavior of surface regions while maintaining desirable bulk properties of the underlying substrate. Surface modication can improve service life of components and devices signicantly. Common surface coating methods are: * Chemical reaction * Immobilization of biomolecules * Metalization * Micro-contact printing * Ozonolysis * Photoreaction * Plasma treatment and deposition * Ion etching * Ion implantation * Radiation grafting * Self assembly * Solvent case lms * Surface active modiers (low/high MW) Plasma coating technology has been used in manufacturing for more than two decades. It has been used to improve the performance of auto- mobiles and cutting tools [57]. Plasma coating technique introduces elements onto surface able to form structures that are favorable for mechanical, chemical, and biological performance. 2.3.1. High-performance plasma coatings High-performance plasma coatings aim at in- creasing wear and corrosion resistance of materi- als. Nitrogen implanted plasma coating has been widely used in manufacturing. This method can improve tribological behavior, i.e., good lubrica- tion and low wear, by obtaining improved composition and microstructure of materials surfaces [58,59]. High dose, high temperature nitrogen implantation of Ti6Al4V produced surfaces which exhibited lower friction and high wear resistance than untreated Ti alloy. The best performance for this specic implantation treat- ment is due to the deep nitrogen penetration depth, formation of TiN and Ti 2 N compounds, and incorporation of oxygen in the near-surface layer. It has also been reported that ion implanta- tion and plasma treatment is effective for alumi- num based alloys. The technique of ion nitriding and electron cyclotron resonance (ECR) plasma nitriding forms AlN and AlON layers [60]. These layers lead to high strength and high wear resistance. Plasma immersion ion implantation (PIII) was developed a decade ago. This technique increases the hardness, wear resistance, and corrosion resistance on metal alloys such as stainless steels, nickel, aluminium, and titanium alloys including those used in implants [6163]. The reason for improvement is an improved microstructure. In the case of steels, excellent tribological properties were achieved at a treatment temperature of over 500
C due to the formation of a CrN precipitation
and the expanded austenite transferring to mar- tensite. The good corrosion resistance was pre- served up to 400
C with only a small decrease due
ARTICLE IN PRESS H. Liang et al. / Vacuum 73 (2004) 317326 321 to nitrogen remaining in solid solution without CrN-precipitation [63]. Parameters for PIII are, such as implantation dose, ion density, pulse repetition rate, and sample temperature. Using an improved vacuum-arc plasma source can improve coating properties effectively. It was reported that when titanium and tantalum ions were implanted followed by nitrogen PIII, it yields a modied surface layer with superior wear resistance [64]. The wear resistance of the samples implanted with (Ti+N) and (Ta+N) was better than that of samples undergoing nitrogen PIII alone due to the presence of nitride phases in the implanted layer. For aluminum implanted Ti-6Al4V, surface harden- ing of the aluminum ion implantation resulted in improvement of wear resistance of Ti alloy by a factor of 2. It also appeared that surface precipita- tion hardening could improve the mechanical and surface properties without necessarily altering the wear mechanism of Ti alloy. Wear tests simulating joints showed the good wear resistance of UHMWPE against Ti6Al4V bearing surface ion implanted with oxygen and chromium or coated with ZrN by PVD [65]. In particular, ion implantation on Ti6Al4V reduced friction between the titanium alloy and the UHMWPE. This effect was not totally justied by the surface hardening caused by lattice disorder, interstitial elements or dispersed compounds. The chemical composition of the surface is probably responsible for the improvements of the wear resistance. 2.3.2. Plasma coating processessingle and duplex coatings Single plasma coating process is seen often in metals resulting improved wear resistance and surface hardness [66,67]. The duplex coating method can improve further of the tribological properties and load-bearing capacity of materials beyond metals. This method combines plasma coating with other coating technologies, such as PVD and CVD [68,69]. A duplex plasma surface-engineering pro- cess can be achieved by plasma nitriding the low alloy steel rst so as to produce a thick, strong substrate and then depositing a thin, hard and wear resistant TiN coating on the nitrided substrate by ion plating [70]. The TiN coating- nitrided steel composite has enhanced wear resistance, higher load-bearing capacity, intense shearprevented surface, and preventability of subsurface shear deformation during the wear process as well as the material loss from the coating caused by the micropolishing action of the slider (alumina ball, for example). Duplex treat- ment of plasma nitriding and PACVD allowed tailoring of the surface properties such as wear and corrosion resistance and is especially suitable for complex loading [70,71]. 2.3.3. Plasma-sprayed hydroxyapatite (HA) coatings In orthopaedic technology development, biome- dical coatings are often used on total joint replacement components. These coatings usually comprise a group of novel (glass) ceramics. The widely studied is a calcium-phosphate-based ma- terialHA [72]. HA is a bioactive material. Its formula is Ca 10 (PO 4 ) 6 (OH) 2 . HA is one of the most attractive materials for human hard tissue implants because of its close resemblance to chemical composition (Ca/P ratio) of teeth and bones [73,74]. A HA coating can accelerate the process of bony growth in the vicinity of the prosthesis [7580]. HA has been clinically applied as a dense, sintered material and as a coating on bioinert metallic implants [81]. HA has good biocompatibility and bioactivity for skeletal and dental Ti implants. This might due to the OH and O concentrations decrease with the distance from the surface of HA coatings, reaching the minimum at the interface between HA and Ti alloys [82]. Typically, the plasma sprayed HA/Ti 6Al4V composite material was a dense-layer [83], containing HA, nely divided Ti6Al4V, and amorphous calcium phosphate. A heat treatment process after spraying determines composition, structure, and properties of HA coatings [83]. Plasma-sprayed HA coatings on a Ti6Al4V substrate are found to increase both resistance to elastic and plastic deformation. However, such coatings have no effects on strain hardening behavior. The coating could reduce the resistance to coating/substrate separation [84]. The residual stress and bonding strength and fracture of ARTICLE IN PRESS H. Liang et al. / Vacuum 73 (2004) 317326 322 plasma-sprayed HA coatings are associated [85]. The fracture toughness of HA is about 1 MPam 1/2 . This material is low in fatigue resistance [86,87]. In order to achieve the mechanical characteristics needed for biomedical applications, blending with a tough phase is essential. Titanium metal, Ti 6Al4V alloy, ytrria-stabilized zirconia (YSZ), Ni 3 Al, and Al 2 O 3 ceramics have been considered good candidates as the reinforcing phases [8894]. HA coatings can be applied by a wide range of surface deposition techniques, such as plasma spraying, high-velocity oxy-fuel spraying (HVOF), pulsed laser ablation, ion-beam sputtering, elec- trophoretic deposition, radio frequency (RF) magnetron sputtering, sol-gel and conventional ceramic processes that involve pressing and sintering [95106]. Plasma spraying is an efcient method of depositing HA coating onto the surface of the implant. The temperature of the plasma ame is up to 10,000 K. Therefore, crystallization, phase transformation, and dehydroxylation are considered for optimizing coatings. Typical con- ditions are listed in Table 2. According to the table, pure crystalline HA powder used has a spherical shape with an average diameter. The plasma spray process is performed using a coating system with a certain type of arc gas, generally nitrogen. The arc current and voltage are typically 360400 A and 6070 V, respectively. The thick- ness of a HA coating can be controlled between 40 and 400 mm [106]. Thermally sprayed coatings are layers made of individual powder splats oriented parallel to the substrate surface. These splats produce high level of anisotropy for the coating [107]. There are many parameters chosen in control of the thermal spray technique, e.g. powder particle size and morphology, plasma gas mixture, working dis- tance, substrate cooling, etc. [108111]. Different phases in HA are known to have different solubilities and dissolution behaviors. Amorphous HA has been shown to be more soluble in aqueous solutions when compared to crystalline HA [112 115]. Fig. 4 is an example of HA coating layer [116]. Ceramic coatings are particularly weak in fatigue resistance. All joints in the human body are constantly subjected to fatigue loading during the simple actions of everyday living. There are increased surface microcracks and bulk porosity found in plasma sprayed HA coatings [117]. To eliminate the delamination problem of HA from their substrate [118,119], a bond coating, dical- cium silicate, is applied using the plasma coating technique. The plasma sprayed dicalcium silicate, Ca 2 SiO 4 , is a bond coat for improving the bonding of HA coatings on Ti alloys substrates [120]. Overall, HA coatings can improve the adhesion and xation of an implant device. A mechanical interlocking of implant with bone can eliminate problems associated with micromotion, i.e. loosen- ing. Consequently coated implants can be recom- mended for applications involving younger or more active patients. 2.3.4. Ammonia plasma treatment Polymeric materials have been used in joint implants since early 1060 s. Common ones are UHMWPE, PTFE, and urethane for knee, hip, jaw, or heart valves (refer to Table 1). Similar to issues involved to metal and ceramic implants, adhesion is one of the major focuses for develop- ment. The ammonia plasma treatment technique was developed from the plasma polymerization meth- od in early 1990s [121125]. Plasma polymeriza- tion modies the surface by polymerization of oxygen and nitrogen containing volatile chemicals such as methanol, amine, and amide compounds. Ammonia plasma modication generates surface chemistry on a treated surface incorporating amine and amide groups. These groups play an important role in endothelial cells adhesion and growth on a modied surface. In this technique, a RF plasma generator was capacitatively coupled to a plasma reactor. ARTICLE IN PRESS Table 2 Typical conditions for plasma-sprayed HA coatings Arc gas N 2 Ha powder Micron size Arc current 360400 A Arc voltage 6070 V Resulting thickness 40400 mm H. Liang et al. / Vacuum 73 (2004) 317326 323 Samples were placed in the plasma reactor 7.5 cm downstream from the ammonia gas inlet. The plasma reactor was evacuated using a rotary vacuum pump. Plasma treatment of substrates was carried out at 400 Millitorr since incorpora- tion of amino groups and amide groups to substrate materials was found to be optimal at this pressure [126]. This pressure was maintained by a constant in-ow of ammonia into the reactor. A pulsed RF power of 30 W was applied to the plasma reactor for 30 min. The substrates were evacuated for an additional 30 min to remove any unreacted species. Other plasma sprayed coatings are available such as wollastonite/TiO 2 composite coatings on titanium alloys [127]. Composite coatings exhibit lamellar structure with alternating wollastonite and TiO 2 coating. Dicalcium silicate (Ca 2 SiO 4 ) coatings on titanium alloys substrate were also reported [127]. This coating was reported as having excellent bioactivity. 3. Summary Plasma sprayed coatings can improve corrosion and wear resistance as well as load-bearing strength of articial joints. These coatings can also improve signicantly the adhesion between bones, tissues, and implants. The improvement of adhesion and xation of an implant device will enable the mechanical interlocking of implant with bone. This eliminates problems associated with micromotion, i.e. loosening. Consequently coated implants can be recommended for applications involving younger or more active patients. Acknowledgements This work was nancially sponsored by UAFs President Special Project Fund, and partially supported by grants of NSF CAREER - CMS 0239136 and NSF DMI 0300574. Assistance provided by Dr. G. Helen Xu during preparation of this manuscript was greatly appreciated. References [1] http://www.biomet.com/patients/bestimplant.html. [2] Gilbert JL, Jacobs JK. In: Marlowe DE, Parr JE, Mayor MB, editors. Modularity of orthopedic implants. Amer- ican Society for Testing and Materials, ASTM STP 1301; 1997. p. 4559. [3] Gilbert JL, Buckley CA. In: Galante JO, Rosenberg AG, Callaghan JJ, editors. Total hip revision surgery. New York: Raven Press Ltd.; 1995. [4] Goldberg JR, Gilbert JL. J Biomed Mater Res 1997;37:42131. [5] Long M, Rack HJ. Biomateriials 1998;19:162139. [6] Sarikaya, et al. Mater Sci Forum 1999;293:8398. [7] Spector M. Orthop Clin N Am 1992;23(2):2117. ARTICLE IN PRESS Fig. 4. HA coating layer [116]. H. Liang et al. / Vacuum 73 (2004) 317326 324 [8] Wang A, et al. New directions. In: Hutchings IM, editor. Tribology. London: World Tribology Congress; 1997. p. 44358. [9] Fujiu T, Ogion M. J Biomed Mater Res 1984;18(7): 84559. [10] Willert HG, Semlitsch M. J Biomed Mater Res 1977;11:15764. [11] Urban RM, Jacobs JJ, Gilbert JL, Galante JO. J Bone Jt Surg 1994;76-A(9):134559. [12] Daculsi G, et al. J Biomed Mater Res 1989;23:84983. [13] Tracy BM, Doremus RH. J Biomed Mater Res 1984;18:71926. [14] Hench LL. J Am Ceram Soc 1998;81:170528. [15] Wen J, et al. Biomaterials 2000;21:133943. [16] Dong ZL, et al. Biomaterials 2003;24:97105. [17] Buckley CA, et al. Trans Soc Biomater Implant Retrieval Symp 1992;15:58. [18] Collier J P, Surprenant VA, Jensen RE, Mayor MB. Clin Orthop 1991;271:30512. [19] Zhang C, Leng Y, Chen J. Biomaterials 2001;22:135763. [20] Yang YC, Chang E. Biomaterials 2001;22:182736. [21] Thomas MB, et al. J Mater Sci 1980;15:8914. [22] deWith G, et al. J Mater Sci 1981;16:15928. [23] Buser D, et al. J Biomed Mater Res 1991;25:889902. [24] Jansen JA, van de Waerden JPCM, Wolke JGC, de Groot K. J Biomed Mater Res 1991;25:97389. [25] Ensinger W. Surf and Coat Tech 1998;100101:34152. [26] Zeng AM, Zhang T, Tang BY. Surf and Coat Tech 1999;115:2348. [27] Brossa F, Cigada A, Fare S. J Mat Sci: Mat in Med 1996;7:4714. [28] Karamis MB. Wear 1991;147:38599. [29] Podgornik B, Vizintin J, Leskovsek V. Wear 1999;232: 23142. [30] Sun Y, Bell T. Mat Sci and Eng 1991;A140:41934. [31] Skoric B, Kakas D, Gredic T. Thin Solid Film 1998;317:4869. [32] Amstutz HC, Campbell P, Kossovsky N, Clark IC. Clin Orthop 1992;276:718. [33] Boss JH, Shajrawi I, Soundry M, Mendes DG. In: St. John KR, editor. Particulate debris from medical implants: mechanisms of formation and biological con- sequences, vol. 1144. Philadelphia: American Society of Testing and Materials, ASTM STP; 1992. p. 90-108. [34] Dicarlo EF, Bullough PG. Clin Mater 1992;9:23560. [35] Kossovsky N, Mirra JM. In: Amstutz HC, editor. Hip arthroplasty. New York: Churchill Livingstone; 1991. p. 571601. [36] Mirra JM, Amstutz HC, Matos M, Gold R. Clin Orthop 1976;117:22140. [37] Pizzoferrato A, Ciapetti G, Stea S, Toni A. Clin Mater 1991;7:5181. [38] Spanier S. In: Petty W, editor. Total joint replacemnt. Philadelphia: W.B. Saunders; 1991. p. 16585. [39] Willert HG, Bertram H, Buchhorn GH. Clin Orthop 1990;258:95107. [40] Nyquist RA, Kagel RO. Infrared spectra of inorganic compounds. New York: Academic Press; 1971. p. 171. [41] Willert HG. In: Older J, editor. Implant bone interface. New York: Springer; 1990. p. 6775. [42] Luo JB, et al. Int J Nonlinear Sci Numer Simul 2000;1:41923. [43] Luo JB, et al. STLE, Tribology Trans 1999;42(4):9126. [44] Lhymn C. ASLE Trans 1987;30(3):3247. [45] Dowling. Wear analysis of retrieved prostheses. In: Szycher M, editor. Biocompatible polymers, metals, and composites. Lancaster, PA: Technomic Publ.; 1983. p. 407. [46] Benz E, et al. Trans Soc Biomater 1990;XVII:83. [47] Willert HG, et al. Clin Orthop Relat Res 1990;258: 10821. [48] Willert HG, et al. Clin Orthop Relat Res 1990;258: 95107. [49] McKellp HA, et al. Trans Soc Biomater 1993;XVI:184. [50] Blanchard CR. Biomaterials: body parts of the future. Technology Today, Fall 1995 issue. Southwest Research Institute. [51] Wang A, et al. In: Hutchings IM, editor. New directions in tribology. London: World Tribology Congress; 1997. p. 44358. [52] Collier JP, et al. Clin Orthop 1991;271:30512. [53] Collier JP, et al. J Bone Jt Surg 1992;74B(4):5117. [54] Gilbert JL, et al. Transactions of the Fourth World Biomaterials Congress, Louisiana 1992. p. 267. [55] Urban RM, et al. Trans Orthop Res Soc 1993;18:81. [56] Gilbert JL, et al. J Bone Jt Surg 1994;76A(1):1105. [57] Tipnis VA. In: Peterson MB, Winer WO, editors. Wear control handbook. New York: ASME; 1998. [58] Straede CA, et al. Mater Sci Eng 1991;A139:1508. [59] Yan S, et al. Surf Coat Technol 1998;103104:34852. [60] Lin WL, Ding XJ, Zhang HZ, et al. Metal vapour vacuum arc source ion implantation as a surface treatment technique for industrial tool bits. Surf Coat Technol 1992;21:5349. [61] Ensinger W. Surf Coat Technol 1998;100101:34152. [62] Clawert, et al. Surf Coat Technol 1996;85:1527. [63] Samandi M, et al. Surf Coat Technol 1993;59:2616. [64] Zeng AM, et al. Surf and Coat Tech 1999;115:2348. [65] Brossa F. J Mater Sci: Mater Med 1996;7:4714. [66] Karamis MB. Wear 1991;147:38599. [67] Podgornik B. Wear 1999;232:23142. [68] Sun Y, Bell T. Mater Sci Eng 1991;A140:41934. [69] Skoric B. Thin Solid Film 1998;317:4869. [70] Kaufmann H. Surf Coat Technol 1995;7475:238. [71] Rie KT, Broszeit E. Surf Coat Technol 1995;7677: 42536. [72] Kokubo T, et al. J Mater Sci 1985;20:2001. [73] Holmes RE, et al. J Bone Jt Surg 1986;68(A):90411. [74] Bucholz RW, et al. Clin Orthop 1989;240:5362. [75] Osborne JF, Newesley H. Dental implants. Muchen, Heimke, editor. Carl Hansen Verlag; Munich 1980. [76] Orly I, et al. Calcif Tissue Int 1989;45:205. [77] Ducheyne P. J Biomed Mater Res 1987;21(A2):21936. ARTICLE IN PRESS H. Liang et al. / Vacuum 73 (2004) 317326 325 [78] Fujiu T, Ogion M. J Biomed Mater Res 1984;18(7): 84559. [79] Daculsi G, et al. J Biomed Mater Res 1989;23:84983. [80] Tracy BM, Doremus RH. J Biomed Mater Res 1984;18:71926. [81] Hench LL. J Am Cer Soc 1998;81:170528. [82] Wen J, et al. Biomaterials 2000;21:133943. [83] Dong ZL, et al. Biomaterials 2003;24:97105. [84] Zhang C, et al. Biomaterials 2001;22:135763. [85] Yang YC, Chang E. Biomaterials 2001;22:182736. [86] Thomas MB, et al. J Mater Sci 1980;15:8914. [87] de With G, et al. Mater Sci 1981;16:15928. [88] Buser D, et al. J Biomed Mater Res 1991;25:889902. [89] Jansen JA, et al. J Biomed Mater Res 1991;25:97389. [90] Soballe K, et al. Acta Orthop Scand 1990;61(4):299306. [91] Chang E, et al. J Mater Sci: Mater Med 1997;8:193200. [92] Bishop A, et al. J Mater Sci Lett 1993;12:15168. [93] Choi WJ, et al. J Am Ceram Soc 1998;81:17438. [94] Kong YM, et al. J Am Ceram Soc 1999;82:29638. [95] Lemons JE. Clin Orthop 1988;235:2203. [96] Haman JD, et al. J Thermal Spray Technol 1995;4: 17984. [97] Kyeck S, Remer P. Mater Sci Forum 1999;308311: 36873. [98] Singh RK, et al. Mater Manuf Process 1996;11:48190. [99] Ong JL, et al. J Am Cer Soc 1991;74:23014. [100] Dasarathy H, et al. J Biomed Mater Res 1996;31:819. [101] Wolke JGC, et al. J Biomed Mater Res 1994;28:147784. [102] Yamashita K, et al. J Am Ceram Soc 1996;79:33136. [103] Montenero A, et al. J Mater Res 2000;35:27917. [104] Haddow DB, et al. J SolGel Sci Technol 1998;13:2615. [105] Jillavenkatesa A, et al. J Mater Sci 1998;33:41119. [106] Hero H, et al. J Biomed Mater Res 1994;28:3438. [107] Gledhill HC, et al. Biomaterials 1999;20:31522. [108] Gustavson LJ. In: Hungerford DS, editor. Total hip arthroplastya new approach. Baltimore, MD: Univer- sity Park Press; 1984. [109] Bourne RB, et al. Clin Orthop Relat Res 1994;298:3746. [110] Ducheyne P, et al. Biomaterials 1990;11:24454. [111] Thorpe RJ, Thorpe ML. Proceedings of the 1993 National Thermal Spray Conference, Anaheim, CA, June, 1993. p. 199. [112] de Bruijn JD, et al. J Biomed Mater Res 1992;26:136582. [113] Bagambisa FB, et al. J Biomed Mater Res 1993;27(8):10457. [114] Hench LL, Paschall HA. J Biomed Mater Res Symp 1973;7(3):2542. [115] Ban S, et al. J Biomed Mater Res 1994;28:6571. [116] Grassmann O, Heimann RB. J Biomed Mater Res Appl Biomater 2000;53(6):68593. [117] Glendhill HC, et al. Biomaterials 2001;22:123340. [118] Hench LL. In: Shackelford JF, editor. Bioceramics. Switzerland, Germany, UK, USA: Trans. Tech. Publica- tions Ltd.; 1999. p. 3764. [119] Lamy D, et al. J Mater Res 1996;11:6806. [120] Liu X, Ding C. Biomatls 2002;23:406577. [121] Sipehia R. Int J Biomater Artif Cells Artif Organs 1990;18:43746. [122] Griesser HJ, et al. J Biomater Sci Polym Ed 1994;5(6): 53154. [123] Steele JG, et al. J Biomater Sci Polym Ed 1994;6(6): 51132. [124] Sipehia R. Int J Biomater Artif Cells Immob Biotechnol 1993;21:64758. [125] Sipehia R, et al. Int J Biomater Artif Cells Immob Biotechnol 1993;21:45568. [126] Lu A, Sipehia A. Biomaterials 2001;22:143946. [127] Liu X, et al. Biomaterials 2003;23:9638. ARTICLE IN PRESS H. Liang et al. / Vacuum 73 (2004) 317326 326