Osseointegration of cobalt-chrome alloy implants

Osseointegration or osteointegration refers to a direct bone-to-metal interface without interposition of non-bone tissue. The long-term clinical success of bone implants is critically related to wide bone-to-implant direct contact. However, only poor bone formation or even host bone resorption have been shown where bone is in tight contact with the implant surface. It has been suggested that an appropriate space between implant and host bone may be useful for early peri-implant bone formation. Additionally, osseointegration depends on the topographical and chemical characteristics of the implant surface. Cobalt-chrome (Co-Cr) is a metal alloy of cobalt and chromium. Because of its high strength, temperature endurance and wear resistance, it is commonly used in dental and orthopedic implants. In orthopedic implants it is usually composed of cobalt with chromium, molybdenum, and traces of other elements. Co-Cr alloys are especially useful where high stiffness or a highly polished and extremely wear-resistant material is required. This article reviews the Co-Cr alloy orthopedic implants in terms of their properties, porous coating, osseointegration, outcome, and failure.