Contamination of titanium castings by aluminium oxide blasting

Objectives: It is desirable that the surfaces of surgical implants be uncontaminated by foreign materials to avoid untoward tissue reactions, and grit blasting is widely assumed to leave clean metal surfaces. SEM examination and X-ray microanalysis of a recovered ‘pure’ titanium implant casting that was associated with tissue breakdown revealed embedded particles of alumina. The casting had been cleaned of investment by blasting with alumina grit. Methods: A variety of treatments of cast titanium plates was used: (a) to establish that the observed aluminium was due to the blasting grit, and (b) to determine whether removal of investment could be achieved effectively by other means. SEM examination and X-ray microanalysis were used. Results: The detected aluminium was associated with embedded fragments identified as coming from the blasting grit. Acid-pickling and mechanical (rotary instrument) trimming produced minimally contaminated surfaces. Conclusions: Whilst unproven, the presence of the alumina is viewed with great concern as a possible causative agent in the observed tissue breakdown and procedures avoiding alumina blasting are recommended as a precautionary measure.