Material fundamentals and clinical performance of plasma-sprayed hydroxyapatite coatings: A review

The clinical use of plasma-sprayed hydroxyapatite (HA) coatings on metal im plants has aroused as many controversies as interests over the last decade. Although faster and stronger fixation and more bone growth have been revea led, the performance of HA-coated implants has been doubted. This article w ill initially address the fundamentals of the material selection, design, a nd processing of the HA coating and show how the coating microstructure and properties can be a good predictor of the expected behavior in the body. F urther discussion will clarify the major concerns with the clinical use of HA coatings and introduce a comprehensive review concerning the outcomes ex perienced with respect to clinical practice over the past 5 years. A reflec tion on the results indicates that RA coatings can promote earlier and stro nger fixation but exhibit a durability that can be related to the coating q uality. Specific relationships between coating quality and clinical perform ance are being established as characterization methods disclose more inform ation about the coating. (C) 2001 John Wiley & Sons.