The History, Technical Specifications and Efficacy of Plasma Spray Coatings Applied to Joint Replacement Prostheses

Thermal plasma sprayed coatings are designed to improve both the biocompatibility and durability of implantable medical devices, and include pure titanium, cobalt/chrome alloy and hydroxyapatite. Coated joint replacements have now been in continuous clinical use for thirty years and are applied to products manufactured or used in Europe, North America, South America, Africa, Asia and Australasia. Prostheses incorporating such coatings have been successfully implanted into several million of patients worldwide and to date there have been very few reports of any failure of an implant which could be attributed to problems with, or failure of, the coating. This paper summarises the early history of cementless prostheses and subsequent development, specification, validation, regulatory requirements and clinical performance of thermal plasma spray coatings provided by Accentus Medical.