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Bulletin of the Transilvania University of Braşov • Vol. 8 (57) No.

2 - 2015
Series I: Engineering Sciences

TANTALUM BASED MATERIALS FOR


IMPLANTS AND PROSTHESES
APPLICATIONS

D. CRISTEA1 I. GHIUȚĂ1 D. MUNTEANU1

Abstract: The performance of biomaterials in biological systems is of


critical importance for the development of biomedical implants and tissue
engineering. Using a coating (thin film) as the interface between the bulk
material and the biologic environment is one of the solutions which can
potentially lead to better bioresponse, improved mechanical characteristics
and lower overall cost, compared to the same material as the coating, but
used in bulk form. In this paper, an overview on tantalum based biomaterials
will be presented, both in bulk and coating form, with emphasis on the
advantages or drawbacks reported for the particular type of material.

Key words: tantalum, biomaterials, bioresponse.

1. Introduction Certain features are desired from the


material, depending on the type of tissue
A biomaterial is a material used in medical (cells) with which there will be contact and
devices intended to interact with biological location of the implant. For example, if the
systems in order to evaluate, treat, augment biomedical device is intended to be a
or replace any tissue, organ or function of the blood-contacting device (catheter, graft
body [39], with as little as possible negative and stent), blood compatibility of the
effects to the tissue with which they come in biomaterials (haemocompatibility) is
contact. Currently there are numerous crucial. If the material will be used for
biomaterials that are successfully used in the orthopaedics applications, and depending
human body, ranging from metallic on the location (in direct contact with bone
materials, to ceramics, and synthetic and tissue), osseointegration is the key
natural polymers [23]. parameter. For both types of applications,
Metallic materials have been used in the host response and its severity are
medical applications, mainly in orthopaedics, strictly related to the surface properties of
cardiovascular applications or dentistry, the biomaterial [15].
for several decades. The key characteristics Generally speaking, the mechanical
that allow using metallic materials for properties of metals and their alloys
these types of applications are: their surpass those of other classes of
resistance to body fluid effects, great biomaterials. However, there are still some
tensile strength, flexibility and high drawbacks when using metallic materials
corrosion resistance, among others [15]. as implants. One of these disadvantages is

1
Materials Science Dept., Transilvania University of Braşov.
152 Bulletin of the Transilvania University of Braşov • Series I • Vol. 8 (57) No. 2 - 2015

the fact that they are usually inherently response, regardless of the implantation
bioinert. This phenomenon is, on one hand, positions, types of tissues and the forms
beneficial, because there will most likely (shapes) of implants [20], [21].
be no inflammatory response, and on the In this paper, some information
other hand, disadvantageous, because the regarding the manufacture technologies,
material surface tends to be overgrown by mechanical characteristics and bio-
fibrous tissue, especially for orthopaedics performance features regarding tantalum
implants. This leads to loosening of the based biomaterials will be presented.
implant, which may induce pain and
discomfort in the patient [29]. 2. Case Reports
One of the most successful metallic
materials, at least in terms of Orthopaedic implants are hard tissue
bioperformance, is tantalum. Tantalum substitutes for impaired human bones in
usage in the biomedical field dates back to case of trauma, diseases, and aging.
the 1940s, when Burke successfully Metallic materials are used due to their
performed several pure tantalum inertness and structural functions. They are
implantations, i.e., skin, subcutaneous and generally preferred over other types of
tendon sutures, as well as several plates materials (such as polymers or ceramics).
[45], [7]. Tantalum has the ability to If the implants are subjected to static,
spontaneously form a compact passive dynamic or cyclic loads that require a
oxide layer that strongly adheres to it. This combination of strength and ductility,
oxide layer has the capacity to facilitate metallic materials are generally required.
bone in-growth under in vivo conditions Orthopaedic implants are considered to be
via the development of bone-like apatite the largest use of metals in the body [10].
that promotes hard- and soft-tissue These types of implants can have the
adhesion [18]. Furthermore, Ta is a hard, following functions and/or geometries:
ductile, highly chemically resistant wires, screws, fracture-fixation plates, and
material with good apposition to human total joint prostheses (artificial joints) for
bone [12]. Depending on the required hips, knees, shoulders, elbows etc. The
application, tantalum based implants can latter variations consist of metallic parts
be available in bulk form (usually porous) and other types of materials, for example
and in coating form, generally as tantalum polymers (polyethylene - PE, ultra high
oxides. Porous metals have the ability to molecular weight polyethylene -
allow for bone ingrowth [35]. The UHMWPE etc.) The requirements for
relatively high cost of manufacturing and metals in orthopaedics application are their
the inability to produce modular implants ability to bear significant loads, withstand
have limited the acceptance of tantalum, in fatigue loading and undergo plastic
spite of its excellent in vitro and in vivo deformation prior to failure [30].
biocompatibility [3]. One of the main Metallic implants are also widely used in
reasons for the relative success of tantalum oral and maxillofacial surgery and
based implants is the fact that the cardiovascular surgery. As far as
biocompatibility of tantalum is higher in cardiovascular implants are concerned, the
bulk form and significantly higher in treatment of coronary and peripheral artery
powder form than titanium [19]. disease using metallic stents has been one
Furthermore, it has been reported that in of the most revolutionary and most rapidly
different animal models, tantalum adopted medical interventions of our time
demonstrates no remarkable inflammatory [25]. The purpose of a cardiovascular stent
Cristea, D., et al.: Tantalum Based Materials for Implants and Prostheses Applications 153

is to repair an obstruction which occurs widely spread use of this material, at least
inside a blood vessel, thus reinstating the in bulk for. Firstly, its large elastic
normal blood flow. The requirements for modulus of over 186 GPa and density of
this type of device are the following: the 16.6 g/cm3 make direct clinical application
plasticity of the material should be difficult [31]. These features, in particular
adequate in order for the stent to remain at the high elastic modulus, when applied to
the necessary size when deployed; if self- orthopaedics implants, are detrimental,
expanding stents are used, the material mainly due to the significant difference
should be sufficiently elastic so it can be when compared to those of natural cortical
compressed and then expanded and retain (12-18 GPa) and cancellous bone (0.1-0.5
sufficient radial hoop strength to prevent GPa) [20]. Secondly, the manufacture of
vessel recoil or closure once in place [32]. bulk tantalum implants is somewhat
The majority of current coronary and difficult, mainly due to the fact that this
peripheral stents are made from either metal is refractory, which means that it can
stainless steel, cobalt-chromium alloys, or be melted only at a very high temperature
from nickel-titanium materials (nitinol) (3017 °C) [3].
[26]. However, the major drawback for Consequently, for better osseointegration
these types of materials is observed when and adequate mechanical characteristics,
subjecting the patient to magnetic porous tantalum based implants have been
resonance imaging (MRI), because most of recently developed. One example of such
these materials are paramagnetic or porous structure is presented in Figure 1.
ferromagnetic. This means that several
effects can be observed: the most serious
of these include the risk of stent movement
and heating, due to the magnetic field
applied by the MRI equipment;
furthermore, the presence of artefacts on
the MRI image can limit the clinical
interpretation of the data.
Hereinafter, a few representative
examples for tantalum based orthopaedic
and cardiovascular implants will be
presented, with emphasis on the
manufacture techniques, and the
advantages or disadvantages compared to Fig. 1. Tantalum based porous implant
other materials for particular applications. used for total shoulder arthroplasty [6]

2.1. Tantalum Based Materials Used in In this particular case, the implant is one
Orthopaedic Applications of the components used for total shoulder
arthroplasty. One can notice the porous
Tantalum is a biocompatible metal with tantalum structure in the upper region of
excellent strength and anticorrosion the image, which due to its porosity, allows
properties even in an acidic medium. The for proper osseo-integration. In the lower
anticorrosion properties of tantalum are region of the image, one can observe the
due to the stable, native, Ta2O5 protective polyethylene PE friction cup. The implant
film formed on the surface [34]. However, presented in the image is the 46 mm PT-
certain negative characteristics limit the backed (PT - porous tantalum) glenoid
154 Bulletin of the Transilvania University of Braşov • Series I • Vol. 8 (57) No. 2 - 2015

prosthesis, produced by Zimmer Inc., All things considered, there have been also
Warsaw, IN, USA. Apart from the fact that reported a few disadvantages for these
the shape and size of the porous structure has types of structures: tantalum particulates
a significant role on the osseointegration, could be observed, originated from the
using a porous structure has also the effect surgical removal of the implant or from
of lowering the elastic modulus and weight implant wear, during implant revision
of the implant [5]. The manufacture of procedures. Furthermore there was noticed
these types of porous structures has been a difficulty to remove the implant during
done mainly using two techniques: revision, as they could remain skeletally
chemical vapour infiltration and deposition attached [28]. Tantalum implants may also
[13], and powder metallurgy [41]. In the reduce the effect of Doxorubicin (DOX) in
chemical vapour infiltration method, bone cancer treatment where both the Ta
tantalum is chemically vaporized, implant and DOX administration are
infiltrated, and deposited on the surface of required [9].
a low-density carbon skeleton. The powder One of the methods of modifying the
metallurgy technology consists in overall characteristics of implants is to use
submerging polyurethane sponges in different materials in tandem, each of their
tantalum slurry, followed with a thermal respective advantages improving the final
treatment at 1950 °C for 2 h. Tantalum product. Considering that the surface of the
foams have been also reported to be implant is the only region in direct contact
produced using sodium chloride as space- with the biological medium, one could
holders. Briefly, tantalum powder is mixed deposit a biocompatible coating on a
with sodium chloride particles, placed in a material that has adequate mechanical
furnace at 1800 °C, under protective characteristics, but lacks in bio-
atmosphere (to avoid oxidation), followed performance. Several reports can be found
by rinsing with water, to remove the salt in the literature, related to the effects of
particles [44]. Furthermore, the tantalum based coatings (mostly oxides),
manufacture of net-shape porous tantalum deposited on different kinds of substrates.
structures with varying porosity using The manufacture of these coatings can be
Laser Engineered Net Shaping (LENS) [3] achieved using: magnetron sputtering [8],
and Selective Laser Melting (SLM) was [27], [33], [42], pulse metal vacuum arc
also recently reported [35]. For these types source deposition [17], thermal treatment in
of porous tantalum structures, several molten salts [1], plasma immersion ion
beneficial characteristics have been implantation deposition [44], polymer-
reported: relatively high resistance to assisted deposition [40], and Laser
cyclic loading and substantial bone Engineered Net Shaping (LENS) [2]. Some
ingrowth after 12 weeks [35]; increased of the results concerning tantalum based
volume of tissue ingrowth due to high coatings that can be found in the literature
porosity (75%-85%), comparable elastic are: dense and adhesive tantalum coatings
modulus to trabecular bone (2.5-3.9 MPa) deposited on the NiTi alloy improve its
to reduce stress shielding, and favourable corrosion resistance [43]; the same
frictional characteristics to reduce improved corrosion resistance is noticed
micromotion [11]; radiographic signs of when deposited on Ti substrates, and
osseointegration and no migration or improved cellular responses (e.g., adhesion,
loosening of components [24]; propensity proliferation and differentiation), are also
for bony ingrowth [36]; decreasing noticed [40]; increase in hardness compared
osteolysis and mechanical loosening [37]. to the untreated (CoCrMo) alloys (used for
Cristea, D., et al.: Tantalum Based Materials for Implants and Prostheses Applications 155

total hip and knee replacement), followed strength) and its corrosion resistance [4].
by improved wear resistance [1]; good Apart from bulk tantalum stents, several
results have been obtained for tantalum other materials have been developed,
coated Co-Cr alloys, in terms of the which benefit from the desired
attachment, proliferation and differentiation characteristics of tantalum, while in the
of pre-osteoblasts (MC3T3-E1) [27]; good same time displaying overall better
antimicrobial performance against S. aureus properties. For example, a device
and A. actinomycetemcomitans for Ta2O5 comprised of a thin layer of tantalum
films [8]; enhanced cell attachment and sandwiched between two layers of 316L
proliferation on the Ta surface as a stainless steel exhibits sufficient strength
consequence of its high wettability and (due to the stainless steel layers) and radio-
surface energy [2]; antithrombotic opacity (due to the tantalum layer) to allow
performance [42]; and better adherence, significantly lower strut thicknesses.
growth, shape and proliferation of Thinner stent struts have been reported to
endothelial cells on tantalum and tantalum cause lower restenosis rates [25]. On one
oxide films when compared to 316L hand 316L stainless steel occasionally
stainless steel [17]. reveals biotoxicity [14]. On the other hand
bulk tantalum has good radio-opacity, but
2.2. Tantalum Based Materials Used in also has less radial force and is broken
Cardiovascular Applications more easily [16]. This means that this
combination of materials should benefit
As far as cardiovascular devices are from the advantages of both materials. One
concerned, tantalum was used since the of the earliest reports on bulk tantalum
early days of stent development in both stents showcased the advantage of being
coronary and peripheral stent applications. easily seen with fluoroscopic imaging in
These types of stents were helical wound contrast to the relatively poor visibility of
wire and knitted wire structures, stainless steel devices, while in the same
respectively. One of the factors which have time showing an ease of implantation and
led to its use as a stent material is its radio- no evidence of causing an excessive
opacity. Furthermore it was thought that proliferative healing response, which could
the inert nature of tantalum oxide surfaces lead to stenosis [38]. The good radio-
would lead to improved vascular opacity of tantalum has also been exploited
compatibility and in particular reduced when proposing new biomedical alloys,
thrombogenicity. Wire coiled and woven such as the one reported in Ref. [26]. In
structures were eventually replaced by this particular case, the surface of the Nb-
slotted tube/laser-cut designs [25]. 28Ta-3.5W-1.3Zr alloy is covered by
Corrosion properties are paramount, when niobium oxide, and to a smaller extent with
discussing of metallic stents. The some tantalum oxide, both appearing
formation of a surface metal oxide-film naturally. Furthermore, this alloy may be
retards corrosion. For some metals, similar to stainless steel for supporting cell
including tantalum, this passivation is growth, while the main advantage is its
highly effective [4]. Currently, metallic reduced magnetic susceptibility, making it
stents are manufactured from nickel - suitable for MRI imaging. Nickel -
titanium alloys and stainless steel with Titanium (NiTi) alloys are already used
relatively high contents of nickel and with significant success in both hard and
chromium. The latter element increases soft tissue biomedical applications that
both the mechanical properties (hardness, include orthodontic wire guides, braces,
156 Bulletin of the Transilvania University of Braşov • Series I • Vol. 8 (57) No. 2 - 2015

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