**Progress in Bioactive Metal and, Ceramic Implants for Load-Bearing Application**

Mohammed Elbadawi, James Meredith, Lynne Hopkins and Ian Reaney

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/62598

#### **Abstract**

[129] Leonardi CL, Kimball AB, Papp KA, Yeilding N, Guzzo C, Wang Y, Li S, Dooley LT, Gordon KB, investigators Ps. Efficacy and safety of ustekinumab, a human interleu‐ kin-12/23 monoclonal antibody, in patients with psoriasis: 76-week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 1). Lancet 2008;371:

[130] Papp KA, Langley RG, Lebwohl M, Krueger GG, Szapary P, Yeilding N, Guzzo C, Hsu MC, Wang Y, Li S, Dooley LT, Reich K, investigators Ps. Efficacy and safety of usteki‐ numab, a human interleukin-12/23 monoclonal antibody, in patients with psoriasis: 52 week results from a randomised, double-blind, placebo-controlled trial (PHOENIX 2).

[131] Pearl JI, Ma T, Irani AR, Huang Z, Robinson WH, Smith RL, Goodman SB. Role of the Toll-like receptor pathway in the recognition of orthopedic implant wear-debris

[132] Zhang Q, Raoof M, Chen Y, Sumi Y, Sursal T, Junger W, Brohi K, Itagaki K, Hauser CJ. Circulating mitochondrial DAMPs cause inflammatory responses to injury. Nature

[133] Li H, Hong S, Qian J, Zheng Y, Yang J, Yi Q. Cross talk between the bone and immune systems: osteoclasts function as antigen-presenting cells and activate CD4+ and CD8+

1665–74.

194 Advanced Techniques in Bone Regeneration

Lancet 2008;371: 1675–84.

T cells. Blood 2010;116: 210–7.

2010;464: 104–7.

particles. Biomaterials 2011;32: 5535–42.

The field of biomaterials is an exuberant and enticing field, attracting interest across a number of scientific disciplines. Synthetic materials such as metals and ceramics have helped civilisation accomplish many feats, and this can also be said for the achieve‐ ments in orthopaedic applications. Metals and ceramics have achieved success in nonload-bearing applications and attempts are made to translate the accomplishments into weight-bearing applications. For this, a material needs to be porous but with sufficient strength to withstand daily loading; however, both properties are mutually exclusive. The implant must also avoid causing adverse reactions and toxicity and, preferably, bond to the surrounding tissues. Metals such as stainless steels and chromium-cobalt alloys have been used due to their excellent mechanical properties that can withstand daily activities, but retrospective studies have alluded to the possibilities of significant adverse reaction when implanted within the human body, caused by the elution of metal ions. Lessons from metals have also demonstrated that materials with significantly higher mechanical properties will not necessarily enhance the longevity of the implant—such is the complexity of the human body. Ceramics, on the other hand, exhibit excellent biocompatibility, but their mechanical properties are a significant hindrance for loadbearing use. Thus, the chapter herein provides a select overview of contemporary research undertaken to address the aforementioned drawbacks for both metals and ceramics. Furthermore, the chapter includes a section of how metals and ceramics can be com‐ bined in a multi-material approach to bring together their respective properties to achieve a desirable characteristics.

**Keywords:** Bioactive Metals, Osseointegration, High Strength, Fabrication, Ceramics

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
