Resumen

ZUJUR, D  y  ALVAREZ-BARRETO, J.F. PROSTHESES IN TOTAL HIP ARTHROPLASTY AND CHITOSAN BIOACTIVE COATINGS TO IMPROVE THEIR PERFORMANCE. Rev. ing. biomed. [online]. 2016, vol.10, n.19, pp.33-43. ISSN 1909-9762.

Total hip arthroplasty (THA) is a common procedure in traumatology. It consists in the substitution or replacement of the hip by a predominantly metallic system in the cases in which the main joint components have been irreversibly affected. Among the most widely used metals in THA prostheses, titanium and its alloys are found, especially Ti6Al4V due to its optimal mechanical properties and resistance to corrosion. These prostheses can be cemented or non-cemented, each one with advantages and disadvantages, but with common problems such as susceptibility to infection, poor osseointegration and high dependence on the surgical technique. In particular, the growth of bone into the implant surface has been promoted through either surface roughness or by creating coatings of calcium phosphates such as hydroxyapatite, thus achieving increases in the life of the prosthesis, but still not enough to avoid subsequent surgeries (revision arthroplasty) especially for young patients. In this sense, biopolymerbased bioactive coatings have been proposed. Chitosan, obtained from crustacean cytoskeleton, stands out among the polymers used for this purpose due its chemical structure that allows it to have appropriate biocompatibility, and versatility to be combined with other substances or molecules. Chitosan-based coatings have been developed through physical interactions by immersion, polyelectrolyte layers using anionic natural polymers, and the creation of covalent links via silanization, which activates the metal surface with silicon monomers containing at least one biomolecules highly reactive carbon-silico bond. These coatings have also been used to encapsulate growth and differentiation factors, conferring them not only bioactivity but also osseoinductivity at the metal-tissue interface allowing bone extracellular matrix deposition onto the implant surface. Due to the numerous studies carried out, it can be said that polymeric coatings have a promising future in orthopedic surgery. Specifically, this article describes the chitosan coatings as a feasible alternative to the current problem associated to the poor osseointegration of metallic components in the THA.

Palabras clave : Total hip arthroplasty; Prosthesis; Chitosan; Coating.

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