Ability of zirconia double coated with titanium and hydroxyapatite to bond to bone under load-bearing conditions

As a preclinical study, we evaluated the ability of hydroxyapatite and titanium on zirconia (HTOZ) to bond to bone under load-bearing conditions in animal experiments. HTOZ, HA, and Ti on Co–Cr alloy (HTOC) and Ti on Co–Cr alloy (TOC) were implanted into the weight-bearing portion of the femoral condyles of nine beagle dogs. Femurs were extracted 4, 12, and 52 weeks after implantation and examined mechanically by pullout testing, and histologically by toluidine blue staining, SEM, and calculation of the affinity index. The interfacial shear strengths (mean±SD) of the HTOZ, HTOC, and TOC groups were 4.42±0.453, 3.90±0.903, and 4.08±0.790 MPa at 4 weeks; 6.82±2.64, 6.00±1.88, and 6.63±1.63 MPa at 12 weeks; and 13.98±1.94, 11.95±1.51, and 10.78±0.83 MPa at 52 weeks. There were no significant differences in the interfacial shear strengths between the three groups at any time. Affinity indices (mean±SD) obtained from SEM images of the HTOZ, HTOC, and TOC groups were 49.6±6.52%, 43.3±10.43%, and 23.7±3.95% at 4 weeks; 55.0±6.72%, 51.5±3.07%, and 28.6±4.09% at 12 weeks; and 59.1±6.73%, 63.0±6.40%, and 34.3±6.72% at 52 weeks. HA-coated implants (HTOZ, HTOC) had significantly higher affinity indices than non-HA-coated implants (TOC) at all times. HTOZ has the ability to bond to bone equivalent to HTOC and TOC. HTOZ is an excellent material for components of cementless joint prostheses.