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Infections associated with medical implants due to bacterial adhesion and biofilm formation are a serious problem, leading to acute health risks to patients by compromising their immune system. Therefore, suppressing biofilm formation on biomedical implants is a challenging task, especially for overcoming the drug resistance of bacterial biofilms. Herein, a synergistic efficient surface coating method was developed to inhibit biofilm formation on a model medical implant by combining the antimicrobial property of trimethyl chitosan (TMC) with either 2D material graphene oxide (GO) or black phosphorus (BP) sheets using layer-by-layer (LbL) self-assembly. The multilayer coatings of TMC/GO and TMC/BP were optimized on the glass surface (a model implant) and characterized by using spectroscopic and microscopy techniques. Next, we investigated the antibiofilm formation properties of the TMC/GO and TMC/BP coatings on glass surfaces against both Gram-negative, Escherichia coli ( E. coli ), and Gram-positive, Bacillus subtilis ( B. subtilis ), bacteria. The antibiofilm formation was studied using crystal violet (CV) and live/dead assays. Both the live/dead and the CV assays confirmed that the TMC/2D material (2DM)-coated surfaces prevented biofilm formation much more effectively compared to the uncoated surfaces. Scanning electron microscopy analyses revealed that the bacteria were affected physically by incubating with TMC/2DM-coated surfaces due to membrane perturbation, thereby preventing cell attachment and biofilm formation. Further, BP composite coatings (TMC/BP) showed a much better ability to thwart biofilm formation than GO composite coatings (TMC/GO). Also, multilayer coatings showed superior cytocompatibility with human foreskin fibroblast (HFF). Our results demonstrate that the developed coatings TMC/2DMs could be potential candidates for thwarting biofilm formation on medical implants.

Nanocomposite materials are emerging as key players in addressing critical challenges in healthcare, energy storage, and environmental remediation. These innovative systems hold great promise in engineering effective solutions for complex problems. Nanocomposites have demonstrated various advantages such as simplicity, versatility, lightweight, and potential cost-effectiveness. By reinforcing synthetic and natural polymers with nanomaterials, a range of nanocomposites have exhibited unique physicochemical properties, biocompatibility, and biodegradability. Current research on nanocomposites has demonstrated promising clinical and translational applications. Over the past decade, the production of nanocomposites has emerged as a critical nano-structuring methodology due to their adaptability and controllable surface structure. This comprehensive review article systematically addresses two principal domains. A comprehensive survey of metallic and nonmetallic nanomaterials (nanofillers), elucidating their efficacy as reinforcing agents in polymeric matrices. Emphasis is placed on the methodical design and engineering principles governing the development of functional nanocomposites. Additionally, the review provides an exhaustive examination of recent noteworthy advancements in industrial, environmental, biomedical, and clinical applications within the realms of nanocomposite materials. Finally, the review concludes by highlighting the ongoing challenges facing nanocomposites in a wide range of applications., (© 2024 Wiley Periodicals LLC.)

Plate-like structures had been thoroughly studied in literature over years to reduce the computational space from 3D to 2D. Many of these theories suffer either from satisfying the free traction condition or thickness extensibility in addition to the consistency of transverse shear strain energy. This work presents a higher order shear deformation thickness-extensible plate theory (eHSDT) for the analysis of plates. The proposed eHSDT satisfies the condition of free traction as other theories do but it also satisfies the condition of consistency of transverse shear strain energy which is neglected by many theories in the area of plates and shells. The implementation of the proposed theory in displacement-based finite element procedure requires continuity of derivatives across elements. This necessary condition was achieved using the penalty enforcement method for derivative-based nodal degrees of freedom across the standard 9-nodes Lagrange element. The theory was tested for elastic bending deformation of Polyether-ether-ketone (PEEK) which is one of the basic materials for medical implants. The theory showed good accuracy compared to experimental data of the three-points bending test. The present eHSDT was also tested for different conditions with a wide range of aspects ratios (thin to thick plates) and different boundary conditions. The accuracy of the proposed eHSDT was verified against exact solutions for these conditions which showed the advantage over other approaches and commercial finite element packages., (Creative Commons Attribution license.)

Titanium and titanium alloys remain the gold standard for dental and orthopedic implants. These materials are heavily used because of their bioinert nature, robust mechanical properties, and seamless integration with bone. However, implant-associated infections (IAIs) remain one of the leading causes of implant failure. Eradicating an IAI can be difficult since bacteria can form biofilms on the medical implant, protecting the bacterial cells against systemic antibiotics and the host's immune system. If the infection is not treated promptly and aggressively, device failure is inevitable, leading to costly multi-step revision surgeries. To circumvent this dire situation, scientists and engineers continue to develop novel strategies to protect the surface of medical implants from bacteria. In this review, details on emerging strategies to prevent infection in titanium implants are reported. These strategies include anti-adhesion properties provided by polymers, superhydrophobic, superhydrophilic, and liquid-infused surface coatings, as well as strategies and coatings employed to lyse the bacteria. Additionally, commercially available technologies and those under preclinical trials are examined while discussing current and future trends., (© 2024 The Author(s). Small published by Wiley‐VCH GmbH.)

Objective. A bone-inclusive ASTM phantom is proposed to improve the assessment of radiofrequency electromagnetic field (RF-EMF) power deposition near orthopedic device under 1.5 T and 3 T magnetic resonance imaging (MRI). Approach. A phantom is created by introducing a cylindrical bone structure inside the American Society for Testing and Materials (ASTM) phantom. Four orthopaedic implant families-rod, nailing system, plate system, and hip replacement-are used in the study. RF-EMF power deposition (in terms of peak averaged specific absorption rate over 1 gram) near these implants are evaluated by placing these implants inside the standard ASTM phantom, the developed bone-inclusive ASTM phantom, and two anatomically representative human body phantoms, known as Duke and Ella. Numerical simulations are performed to calculate the RF-EMF power deposition near various orthopaedic devices within these phantoms. Main Results. For devices implanted inside or near bone tissue, the evaluation of RF-EMF power deposition using the developed bone-inclusive ASTM phantom shows better correlations to the human body phantoms than the ASTM phantom. This improvement is attributed to the portion of the devices implanted within the bone tissue. Significance. The bone-inclusive ASTM phantom has the different tissue of interests surrounding the implants compared to the ASTM phantom. This variation can lead to the different resonance frequency under RF-EMF exposure. This leads to better correlation of RF-EMF power deposition near orthopaedic implants inside human body, making the bone-inclusive ASTM phantom more suitable for evaluating RF-EMF power deposition than ASTM phantom in MRI scans., (© 2024 Institute of Physics and Engineering in Medicine.)

Purpose: The aim of this study was to outline a fully automatic tool capable of reliably predicting the most suitable total knee replacement implant sizes for patients, using bi-planar X-ray images. By eliminating the need for manual templating or guiding software tools via the adoption of convolutional neural networks, time and resource requirements for pre-operative assessment and surgery could be reduced, the risk of human error minimized, and patients could see improved outcomes.Methods: The tool utilizes a machine learning-based 2D—3D pipeline to generate accurate predictions of subjects’ distal femur and proximal tibia bones from X-ray images. It then virtually fits different implant models and sizes to the 3D predictions, calculates the implant to bone root-mean-squared error and maximum over/under hang for each, and advises the best option for the patient. The tool was tested on 78, predominantly White subjects (45 female/33 male), using generic femur component and tibia plate designs scaled to sizes obtained for five commercially available products. The predictions were then compared to the ground truth best options, determined using subjects’ MRI data.Results: The tool achieved average femur component size prediction accuracies across the five implant models of 77.95% in terms of global fit (root-mean-squared error), and 71.79% for minimizing over/underhang. These increased to 99.74% and 99.49% with ±1 size permitted. For tibia plates, the average prediction accuracies were 80.51% and 72.82% respectively. These increased to 99.74% and 98.98% for ±1 size. Better prediction accuracies were obtained for implant models with fewer size options, however such models more frequently resulted in a poor fit.Conclusion: A fully automatic tool was developed and found to enable higher prediction accuracies than generally reported for manual templating techniques, as well as similar computational methods.

Medical implants are essential tools for treating chronic illnesses, restoring physical function, and improving the quality of life for millions of patients worldwide. However, implant failures due to infection, mechanical wear, corrosion, and tissue rejection continue to be a major challenge. Nanocomposites, composed of nanoparticles or nanofillers dispersed in a matrix material, have shown promising results in enhancing implant performance. This paper provides an overview of the current state of research on the use of nanocomposites for medical implants. We discuss the types of nanocomposites being developed, including polymer-, metal-, and ceramic-based materials, and their advantages/disadvantages for medical implant applications. Strategies for improving implant performance using nanocomposites, such as improving biocompatibility and mechanical properties and reducing wear and corrosion, are also examined. Challenges to the widespread use of nanocomposites in medical implants are discussed, such as biocompatibility, toxicity, long-term stability, standardisation, and quality control. Finally, we discuss future directions for research, including the use of advanced fabrication techniques and the development of novel nanocomposite materials. The use of nanocomposites in medical implants has the potential to improve patient outcomes and advance healthcare, but continued research and development will be required to overcome the challenges associated with their use.

Single point incremental forming (SPIF) of sheet metal is a process that is widely used for rapid prototyping and small series production. The process is known for its flexibility, performance, and ease of use in forming custom parts with complex geometries. However, SPIF seems to present many challenges, especially its use in the biomedical sector, where control of operating parameters and compliance with component dimensions are production qualification requirements. This includes springback, which particularly affects the dimensional and geometric compliance of the formed part to the programmed one. This paper describes the results obtained from a design of experiment (DOE) related to the forming process of perforated plates produced by the SPIF process applied to AZ31B Magnesium alloy. The comparative analysis between the responses of obtained parts without holes and obtained ones from perforated plates showed discrepancies between the collected responses. [ABSTRACT FROM AUTHOR]

The effects of micro texturing on several surface characteristics, i.e. biofouling, wetting, lubrication, cell adhesion, have been widely investigated. In the healthcare sector, and specifically medical devices, micro-structured surfaces are exploited to improve tribological properties or foster the osseointegration of surgical implants. Polymeric components in joint implants substitute cartilages of natural joints guaranteeing biocompatibility, low friction and wear, high load bearing capacity, impact strength and stiffness. Among these, tribological properties are very important for their direct impact on the implant lifespan. Micro-structuring of on-contact sliding surfaces can drastically reduce the friction and wear by promoting hydrostatic friction due to synovial fluid at the components interface. In these applications, Ultra-High Molecular Weight Polyethylene (UHMWPE) is a successful material but its current manufacturing process hinders surface micro-texturing. In this scenario, a production process chain, combining micro-injection molding of UHMWPE with molds made by Stereolithography (SLA) can be a successful option for investigating several micro-structuring designs reducing time and cost for the analysis. In this work, the micro-texturing surface manufacturing capability of an SLA technology is investigated through four micro-textures, two mold materials, three orientations in 3Dprinting and two micro-features heights. Micro-texturing patterns are realized and characterized on the molds. The same molds are then used for injection molding of parts, studying the process parameters and the replication capability on molded samples. The results show that dimension of the micro-textures brings the SLA to its limit, with good agreement on pin height and an error on the pin diameter between 24 and 108µm. The 3Dprinting orientation can improve both pin shape and surface roughness. The injection molding experimentation allows to obtain a good replication capability. [ABSTRACT FROM AUTHOR]

The interactions of medical implants in the human body with electromagnetic fields from newly introduced high-field technologies such as near-field wireless power transfer (WPT) are of great concern. In this study, the effects of implants on the specific absorption rate (SAR) in a head model were computationally evaluated in the immediate vicinity of a WPT system operating at 6.78 MHz with a transferred power of 50 W. The SAR in the head model located 30 mm above the WPT system was evaluated with a skull plate, bone plates (different shapes), miniplate, fixtures, and a deep brain stimulator. The results indicated that even small implants had notable effects on the SAR distribution and corresponding local peak and mass-averaged SAR values. Apart from the size and shape of the implant, the crucial factor influencing the SAR was the implant’s position with respect to the WPT system. Therefore, various position configurations were simulated for the WPT system to determine the worst case scenario for each specific implant. Although the local peak SAR value was increased by a factor of 600 in the worst-case scenario (for the skull plate), the SAR $_{\text{1}g}$ and SAR $_{\text{10}g}$ were only increased by factors of seven and four, respectively. Compliance with international safety limits was studied, followed by computing the maximum allowable transmit power (MATP). It was found that, without the implant, the MATP satisfying SAR $_{\text{1}g}$ was 43 W for the designed WPT system, and was reduced to 6.9 W in the presence of the skull plate. [ABSTRACT FROM AUTHOR]

The advent of additive technologies has provided a significant breakthrough in the production of medical implants. It has reduced costs, increased productivity and accuracy of the implant manufacturing process. However, there are problems associated with assessing defects in the microstructure, mechanical and technological properties of alloys, both during their production by powder metallurgy and in the process of 3D printing. Thus traditional research methods of alloys properties demand considerable human, material, and time resources. At the same time, artificial intelligence tools create opportunities for intelligent evaluation of the conformity for the microstructure, phase composition, and properties of titanium powder’s alloys. It provides new possibilities for the efficient production of biocompatible implants for various functional purposes. However, the accuracy of the methods and models used should be as high as possible. In this paper we designed a hybrid PNN-SVM (Probabilistic Neural Network-Support Vector Machine) high-precision approach for the intelligent evaluation of alloy properties for additive manufacturing of biomedical implants. We have proposed a new approach for extending the dimensionality of input data space by the outputs of the summation layer of the modified PNN topology. Subsequent classification based on the expanded dataset is performed using SVM. We conducted experimental modeling of the proposed approach using a data set on the properties of titanium alloys Ti-6Al-4V and Ti-Al-V-Zr. We have demonstrated a significant increase in the accuracy of the PNN-SVM scheme compared to the single classifiers that form it and other machine learning methods. [ABSTRACT FROM AUTHOR]

Providing sustainable electrical power to medical electronic implants is key to enabling the diverse functions of implants and to avoiding repetitive replacement surgeries of depleted batteries. Subcutaneous photovoltaic energy harvesting with an external light source patch can be a reliable approach that provides sufficient power using light. However, from a practical perspective, aligning the external light source patch over opaque skin by patients may affect the amount of delivered electrical power. The amount of delivered power may also be affected by the deformation of the light source and receiver patches in accordance with thin skin layers. In this paper, an experimental and analytical study on the performance of a power implant under an animal skin depending on the implantation depth, lateral misalignment with the external light patch, and bending radius and direction is presented. The experimental results indicate that the transferred power by the patches in misalignment (about 20% of the transmitter length) or in bending (≈30 mm radius) is maintained at least 90% power of the aligned and flat ones. The results provide important characteristic data that are required in designing reliable wireless power transfer systems for various types of implantable medical devices. [ABSTRACT FROM AUTHOR]

The production of biocompatible medical implants is accompanied by technological and time costs. As a result, to be used in the human body, such a product must be of the highest quality. Assessing the quality of biomedical implants made of titanium alloys is relevant given their impact on the health and life of their wearer. In the case of the production of such implants by additive technologies, an important task is to evaluate the properties of the alloys from which it is made. The modern development of Artificial Intelligence allows replacing traditional assessment methods with machine learning methods for such assessment. Existing machine learning methods demonstrate very low classification accuracy, and existing hybrid systems, although increasing classification accuracy, are not sufficient to apply such schemes in practice. The authors improved the hybrid PNN-SVM system to solve this problem in this paper. It is based on the combining use of PNN, Ito Decomposition, and SVM. The PNN's summation layer outputs were used as additional attributes to an initial dataset. Ito decomposition was used to nonlinearly model relationships between features of an extended dataset. Further classification is carried out using SVM with a linear kernel. The proposed approach's modeling is performed based on a real-world dataset using the smart web service designed by the authors. Experimentally found an increase in the classification accuracy by 6% of the proposed system compared to existing ones. It makes it possible to use it in practice. Designed smart web service, in which the authors implemented both improved and existing hybrid classification schemes allows to quickly, easily, and without high qualification of the user to implement and explore in more detail chosen classification scheme when classification tasks in various fields of industry. [ABSTRACT FROM AUTHOR]

Nanomedicine is a speedily growing area of medical research that is focused on developing nanomaterials for the prevention, diagnosis, and treatment of diseases. Nanomaterials with unique physicochemical properties have recently attracted a lot of attention since they offer a lot of potential in biomedical research. Novel generations of engineered nanostructures, also known as designed and functionalized nanomaterials, have opened up new possibilities in the applications of biomedical approaches such as biological imaging, biomolecular sensing, medical devices, drug delivery, and therapy. Polymers, natural biomolecules, or synthetic ligands can interact physically or chemically with nanomaterials to functionalize them for targeted uses. This paper reviews current research in nanotechnology, with a focus on nanomaterial functionalization for medical applications. Firstly, a brief overview of the different types of nanomaterials and the strategies for their surface functionalization is offered. Secondly, different types of functionalized nanomaterials are reviewed. Then, their potential cytotoxicity and cost-effectiveness are discussed. Finally, their use in diverse fields is examined in detail, including cancer treatment, tissue engineering, drug/gene delivery, and medical implants. [ABSTRACT FROM AUTHOR]

The bioactive glass S520 was applied to an ultrafine-grained Ti-6Al-7Nb titanium alloy by a laser-directed energy deposition (LDED) process, in order to create a biocompatible material without potentially toxic vanadium for use in load bearing biomedical implants. The laser cladding process influenced the substrate's structure by melting the metallic material at the surface and infusing it with bioactive glass. Subsequently, the melted titanium alloy crystallised, resulting in the formation of relatively large grains. Deeper into the material, laser-induced heat triggered martensitic transformation, leading to the formation of α′ acicular martensite. In the lower regions of the HAZ, a distinctive band with refined grains was identified. Detection of certain amounts of Al directly in the bioactive glass raises concerns about potential toxicity as the glass dissolves in the human body. The nearly complete reduction in P concentration after 14 days highlights the high bioactivity of the material produced. • The bioactive glass S520 was applied to an ultrafine-grained Ti-6Al-7Nb alloy. • Vanadium-free biomaterial suitable for implants was produced. • Identification of aluminium in the bioactive glass raises concerns regarding toxicity. • High bioactivity of the produced material was observed. [ABSTRACT FROM AUTHOR]

In recent times, wireless power transfer systems have been identified as a reliable option to supply power to medical implants. Up to now, Wireless Power Transfer Systems (WPTS) have only been used to charge batteries of low-power medical implants. However, for medical implants requiring a relatively higher power, such as a ventricular assist device, which is an implanted blood pump in the patient’s abdominal cavity, an external power supply has been used. When WPTS is used for medical implants, it increases the number of required power converter stages and hardware complexity along with the volume, which tends to reduce the overall efficiency. In addition, the existence of uncertainties in WPTS-based medical implants, such as load and mutual inductance variations, can lead to system instability or poor performance. The focus of this paper is to design a WPTS to supply power to the pump motor directly through its inverter based on the requirements of the motor drive system (MDS) without resorting to an additional DC-to-DC converter stage. To this end, the constraints that the drive system imposes upon WPTS have been identified. In addition, to make a reliable closed-loop operation, a µ-synthesis robust controller is designed to make sure the system maintains its stability and performance with respect to the system’s existing uncertainties. A number of experimental results are provided to verify the effectiveness of the adopted WPTS design approach and the corresponding closed-loop controller for WPTS. Furthermore, the experimental findings for the maximum efficiency tracking (MET) approach (to minimize WPTS coil losses) and constant DC link voltage control approach are shown and compared. According to experimental results and system efficiency analysis, the former appears to perform better. The system dynamic performance analysis, on the other hand, demonstrates the latter’s advantage.

In a typical wireless power transfer (WPT) system, the load, the mutual inductance, and the required tuning frequency can vary in a particular range. Variation of each parameter can substantially impact the dynamic characteristics of the system. Thus, they can be considered as sources of uncertainty in the system. To address this, robust control methods such as μ-synthesis are developed to deal with possible system uncertainties. This article first undertakes the generic dynamic analysis of the series–series WPT compensation network for two modes of operation, i.e., constant output voltage (COV) mode and constant output current (COC) mode, in the presence of three aforementioned uncertainty sources. Subsequently, the frequency detuning as a function of the compensation capacitor variation is explored and broadened as a technique to obtain the optimized compensation capacitor value that can lead to a plant with minimized dynamic deviations from its nominal system in the operating range between COC and COV modes. As such, this approach offers a design procedure for a least conservative robust controller, which can significantly improve the system performance. The optimized structure and the corresponding designed μ-synthesis controller are comprehensively elaborated. The theoretical achievements and experimental results show superior dynamic performance of the optimized structure and the corresponding designed controller in the presence of three uncertainty sources compared to the COC and COV modes of operation. [ABSTRACT FROM AUTHOR]

Cobalt–chromium–molybdenum (CCM) alloys possess high corrosion‐resistant properties as well as good mechanical properties. Hence, the alloys are employed in medical implants such as artificial knee and hip joints, coronary stents, and removable partial dentures. To improve the biocompatibility of CCM alloys, we reported that CCM‐binding peptide (CBP) linked to cell‐adhesive motif Arg–Gly–Asp (RGD) improved the attachment of endothelial cells on CCM alloys. However, the stability of CBP adsorption on the alloy and its effect on osteoblast compatibility are still unclear. In this study, we evaluated the stabilization of the adsorption layer of CBP–RGD on CCM alloy surface and investigated the effect of CBP–RGD peptide on the proliferation and differentiation of the osteoblasts. CBP–RGD layer exhibited higher stabilization than the RGD adsorption layer for 7 days. In addition, the proliferation of osteoblast on CBP–RGD adsorbed alloy higher than that on RGD adsorbed alloy. Moreover, the calcification of cells cultured on the CBP–RGD adsorbed alloy was significantly higher than that of the cells on RGD adsorbed alloy. These findings indicate that the CBP binding was stable during the culture of osteoblasts on the CCM alloy. [ABSTRACT FROM AUTHOR]

Excluding persons from magnetic resonance imaging (MRI) research studies based on their medical history or because they have tattoos, can create bias and compromise the validity and generalizability of study results. In the population-based Rhineland Study, we limited exclusion criteria for MRI and allowed participants with passive medical implants, tattoos or permanent make-up to undergo MRI. Thereby, we could include 16.6% more people than would have been possible based on common recommendations. We observed no adverse events or artifacts. This supports that most passive medical implants, tattoos and permanent make-up are MRI suitable and can be scanned in research settings. [ABSTRACT FROM AUTHOR]

With the massive use of medical implants (e.g., metals, polymers and ceramics) in orthopedic and cardiovascular surgery, surface biomodification of these exogenous biomaterials has caused growing concern, for the purpose of improving their functions and avoiding surgical failure. Mussel-inspired chemistry (i.e., dopamine self-polymerization) based on covalent and noncovalent catechol-mediated molecular adhesion exhibits versatility in surface biomodification. However, the inevitable consumption of amino and thiol groups in the bioactive molecules still makes this robust surface chemistry in a dilemma. Taking this biomimetic strategy one step further, synthetic peptides with multiple DOPA (3,4-Dihydroxy-L-phenylalanine) units were recently extensively studied. Since the catecholic DOPA unit is abundant in the main component of mussel foot protein, these peptides are able to adhere onto various substrates. In addition, these mussel-inspired peptides could be flexibly linked with bioactive or attachable molecules, which can bypass the consumption of active groups in the second-step biomodification of poly(dopamine) method. Owing to these superiorities, mussel adhesive peptides mimics with diversified bioactivity are widely used for surface modification of medical implants to regulate different cell responses. The purpose of this review is to provide a brief overview of the latest developments in the surface bioengineering of medical implants using these mussel adhesive peptides mimics as a medium. We anticipate that the stepwise discussions from peptide mimicking and synthesis to surface bioactivity adaptation in different implants may also encourage researchers to innovate current mussel-inspired peptides at molecular level and expand their applications in the field of biomaterial engineering.

Purpose: Bearing partially or fully metallic passive implants represents an exclusion criterion for patients undergoing a magnetic hyperthermia procedure, but there are no specific studies backing this restrictive decision. This work assesses how the secondary magnetic field generated at the surface of two common types of prostheses affects the safety and efficiency of magnetic hyperthermia treatments of localized tumors. The paper also proposes the combination of a multi-criteria decision analysis and a graphical representation of calculated data as an initial screening during the preclinical risk assessment for each patient. Materials and methods: Heating of a hip joint and a dental implant during the treatment of prostate, colorectal and head and neck tumors have been assessed considering different external field conditions and exposure times. The Maxwell equations including the secondary field produced by metallic prostheses have been solved numerically in a discretized computable human model. The heat exchange problem has been solved through a modified version of the Pennes' bioheat equation assuming a temperature dependency of blood perfusion and metabolic heat, i.e. thermorregulation. The degree of risk has been assessed using a risk index with parameters coming from custom graphs plotting the specific absorption rate (SAR) vs temperature increase, and coefficients derived from a multi-criteria decision analysis performed following the MACBETH approach. Results: The comparison of two common biomaterials for passive implants - Ti6Al4V and CoCrMo - shows that both specific absorption rate (SAR) and local temperature increase are found to be higher for the hip prosthesis made by Ti6Al4V despite its lower electrical and thermal conductivity. By tracking the time evolution of temperature upon field application, it has been established that there is a 30 s delay between the time point for which the thermal equilibrium is reached at prostheses and tissues. Likewise, damage may appear in those tissues adjacent to the prostheses at initial stages of treatment, since recommended thermal thresholds are soon surpassed for higher field intensities. However, it has also been found that under some operational conditions the typical safety rule of staying below or attain a maximum temperature increase or SAR value is met. Conclusion: The current exclusion criterion for implant-bearing patients in magnetic hyperthermia should be revised, since it may be too restrictive for a range of the typical field conditions used. Systematic in silico treatment planning using the proposed methodology after a well-focused diagnostic procedure can aid the clinical staff to find the appropriate limits for a safe treatment window.

In the past few decades, additive manufacturing (AM) has been developed and applied as a cost-effective and versatile technique for the fabrication of geometrically complex objects in the medical industry. In this review, we discuss current advances of AM in medical applications for the generation of pharmaceuticals, medical implants, and medical devices. Oral and transdermal drugs can be fabricated by a variety of AM technologies. Different types of hard and soft clinical implants have also been realized by AM, with the goal of producing tissue-engineered constructs. In addition, medical devices used for diagnostics and treatment of various pathological conditions have been developed. The growing body of research on AM reveals its great potential in medical applications. The goal of this review is to highlight the usefulness and elucidate the current limitations of AM applications in the medical field.

Excluding persons from magnetic resonance imaging (MRI) research studies based on their medical history or because they have tattoos, can create bias and compromise the validity and generalizability of study results. In the population-based Rhineland Study, we limited exclusion criteria for MRI and allowed participants with passive medical implants, tattoos or permanent make-up to undergo MRI. Thereby, we could include 16.6% more people than would have been possible based on common recommendations. We observed no adverse events or artifacts. This supports that most passive medical implants, tattoos and permanent make-up are MRI suitable and can be scanned in research settings.

A method to noninvasively measure the concentration of radiolabeled pharmaceuticals on modified drug‐eluting biomedical implant surfaces is described. The implants are coated with microphosphors and radiolabeled pharmaceuticals in a polyurethane film. The drug molecules emit radiation which excites radioluminescence in nearby phosphors; for drug released from the film the radiation is absorbed by the surrounding media and generates no light. The technique is applied to measure beta‐emitting tritium‐labeled vancomycin (3H‐vancomycin) concentration on the surface of an orthopedic plate. Bacteria can coat orthopedic implant surfaces and form biofilms which are resistant to antibiotics and the host's immune system. Antibiotic eluting implant coatings are thus promising candidates for infection prevention and treatment. Radioluminescence imaging permits surface‐specific, noninvasive measurement of drug concentration on implant surfaces, which is an important metric for developing effective drug eluting coatings. The radioluminescence signal increases linearly with 3H‐vancomycin concentration, with a limit of detection (LOD) of 9.6 nCi (3.5 pmol) without tissue. Biomedically relevant drug release concentrations are monitored through 5 mm of porcine tissue slices (38.7 nmol LOD). Despite light scattering, and an eightfold signal decrease through 5 mm of tissue, drug release and reference regions are resolvable for non‐invasive quantification. [ABSTRACT FROM AUTHOR]

Pulsed laser-based micro-texturing induces topographical and chemical modifications on surfaces that yield beneficial properties such as anti-microbial effect, micro-hydrodynamic bearing, and surface hardening. These properties find a multitude of applications in surface treatment and tribology. However, laser texturing of free form surfaces is a cost and effort-intensive process, specifically medical implants or ergonomically designed tools/devices. Such components often require numerically controlled 3 or 5 axes machines and sophisticated computer-aided manufacturing (CAM) software for precise tool movement. In this manuscript, the authors have designed, fabricated, and validated a jerk-free, cost-effective Stewart platform that works in tandem with an existing laser machining setup. A microcontroller and stepper motor based linear actuators were used to orient and translate the six degrees-of-freedom (DoF) platform. A customized computer program helped maneuver the workpieces (medical implants) for the micro texturing of the 3D surface profiles. As laser irradiation demands a time-invariant focal length for effective ablation, the platform maintains the focal length from the galvo-scanner of the laser machine to the workpiece while maneuvering the workpiece throughout the texture trajectory. To estimate the smoothness of the platform during motion, vibrational parameters were also measured and analyzed. Such cost-effective platforms may find applications in free form texturing in non-contact mode of machining as well as in metrology. Texturing was performed successfully on implants freeform surface with an average diameter of ~35–40 μm and depth of ~15–20 μm. [Display omitted] • A cost-effective Stewart platform was designed for freeform texturing of implant. • Jerk-free 3D maneuvering with ±25 μm tolerance was achieved by customized program. • The platform works in tandem with an existing laser machining setup. • 6 degrees-of-freedom was achieved using a microcontroller and linear actuators. • Electrochemical studies showed improved corrosion resistance post texturing. [ABSTRACT FROM AUTHOR]

Goal: This work introduces an integrated system incorporated seamlessly with a commercial Foley urinary catheter for bacterial growth sensing and biofilm treatment. Methods: The system is comprised of flexible, interdigitated electrodes incorporated with a urinary catheter via a 3D-printed insert for impedance sensing and bioelectric effect-based treatment. Each of the functions were wirelessly controlled using a custom application that provides a user-friendly interface for communicating with a custom PCB via Bluetooth to facilitate implementation in practice. Results: The integrated catheter system maintains the primary functions of indwelling catheters - urine drainage, balloon inflation - while being capable of detecting the growth of Escherichia coli, with an average decrease in impedance of 13.0% after 24 hours, tested in a newly-developed simulated bladder environment. Furthermore, the system enables bioelectric effect-based biofilm reduction, which is performed by applying a low-intensity electric field that increases the susceptibility of biofilm bacteria to antimicrobials, ultimately reducing the required antibiotic dosage. Conclusion: Overall, this modified catheter system represents a significant step forward for catheter-associated urinary tract infection (CAUTI) management using device-based approaches, integrating flexible electrodes with an actual Foley catheter along with the control electronics and mobile application. Significance: CAUTIs, exacerbated by the emergence of antibiotic-resistant pathogens, represent a significant challenge as one of the most prevalent healthcare-acquired infections. These infections are driven by the colonization of indwelling catheters by bacterial biofilms. [ABSTRACT FROM AUTHOR]

SUMMARYImplant-associated infections (IAIs) pose serious threats to patients and can be associated with significant morbidity and mortality. These infections may be difficult to diagnose due, in part, to biofilm formation on device surfaces, and because even when microbes are found, their clinical significance may be unclear. Despite recent advances in laboratory testing, IAIs remain a diagnostic challenge. From a therapeutic standpoint, many IAIs currently require device removal and prolonged courses of antimicrobial therapy to effect a cure. Therefore, making an accurate diagnosis, defining both the presence of infection and the involved microorganisms, is paramount. The sensitivity of standard microbial culture for IAI diagnosis varies depending on the type of IAI, the specimen analyzed, and the culture technique(s) used. Although IAI-specific culture-based diagnostics have been described, the challenge of culture-negative IAIs remains. Given this, molecular assays, including both nucleic acid amplification tests and next-generation sequencing-based assays, have been used. In this review, an overview of these challenging infections is presented, as well as an approach to their diagnosis from a microbiologic perspective., Competing Interests: M.A.A. is a consultant for Cytophage Technologies Ltd., as well as BioFire USA and bioMérieux Canada. R.P. reports grants from MicuRx Pharmaceuticals and BioFire USA. R.P. is a consultant to PhAST, Day Zero Diagnostics, Abbott Laboratories, Sysmex, DEEPULL DIAGNOSTICS, S.L., Netflix and CARB-X. In addition, R.P. has a patent on Bordetella pertussis/parapertussis PCR issued, a patent on a device/method for sonication with royalties paid by Samsung to Mayo Clinic, and a patent on an anti-biofilm substance issued. R.P. receives honoraria from Up-to-Date and the Infectious Diseases Board Review Course.

In the present work, we explored Lewis acid catalysis, via FeCl 3 , for the heterogeneous surface functionalization of cellulose nanofibrils (CNFs). This approach, characterized by its simplicity and efficiency, facilitates the amidation of nonactivated carboxylic acids in carboxymethylated cellulose nanofibrils (c-CNF). Following the optimization of reaction conditions, we successfully introduced amine-containing polymers, such as polyethylenimine and Jeffamine, onto nanofibers. This introduction significantly enhanced the physicochemical properties of the CNF-based materials, resulting in improved characteristics such as adhesiveness and thermal stability. Reaction mechanistic investigations suggested that endocyclic oxygen of cellulose finely stabilizes the transition state required for further functionalization. Notably, a nanocomposite, containing CNF and a branched low molecular weight polyethylenimine (CNF-PEI 800), was synthesized using the catalytic reaction. The composite CNF-PEI 800 was thoroughly characterized having in mind its potential application as coating biomaterial for medical implants. The resulting CNF-PEI 800 hydrogel exhibits adhesive properties, which complement the established antibacterial qualities of polyethylenimine. Furthermore, CNF-PEI 800 demonstrates its ability to support the proliferation and differentiation of primary human osteoblasts over a period of 7 days.

The widespread occurrence of bacterial infections and their increased resistance to antibiotics has led to the development of antimicrobial coatings for multiple medical implants. Owing to their desirable properties, gold nanoparticles (AuNPs) have been developed as antibacterial agents. This systematic investigation sought to analyze the antibacterial effects of implant material surfaces modified with AuNPs. The data from 27 relevant studies were summed up. The included articles were collected from September 2011 to September 2021. According to the retrieved literature, we found that medical implants modified by AuNPs have good antibacterial effects against gram-positive and gram-negative bacteria, and the antibacterial effects would be improved by near-infrared (NIR) radiation.

Biofilms are an intricate community of microbes that colonize solid surfaces, communicating via a quorum-sensing mechanism. These microbial aggregates secrete exopolysaccharides facilitating adhesion and conferring resistance to drugs and antimicrobial agents. The escalating global concern over biofilm-related infections on medical devices underscores the severe threat to human health. Carbon dots (CDs) have emerged as a promising substrate to combat microbes and disrupt biofilm matrices. Their numerous advantages such as facile surface functionalization and specific antimicrobial properties, position them as innovative anti-biofilm agents. Due to their minuscule size, CDs can penetrate microbial cells, inhibiting growth via cytoplasmic leakage, reactive oxygen species (ROS) generation, and genetic material fragmentation. Research has demonstrated the efficacy of CDs in inhibiting biofilms formed by key pathogenic bacteria such as Escherichia coli , Staphylococcus aureus , and Pseudomonas aeruginosa. Consequently, the development of CD-based coatings and hydrogels holds promise for eradicating biofilm formation, thereby enhancing treatment efficacy, reducing clinical expenses, and minimizing the need for implant revision surgeries. This review provides insights into the mechanisms of biofilm formation on implants, surveys major biofilm-forming pathogens and associated infections, and specifically highlights the anti-biofilm properties of CDs emphasizing their potential as coatings on medical implants.

The great majority of medical devices elicit foreign body response (FBR) postimplantation. FBR is a major hurdle to develop a successful device for impaired organs, leading to failure of devices/treatments. In recent times, several advantageous technologies have been developed based on either surface modifications or localized drug delivery systems (DDSs) in order to overcome the FBR limitation, which enhanced the success of implantable medical devices. The recent advances for improving the functionality, biocompatibility, and longevity of implantable medical devices and deliverable DDSs are discussed here. It is believed that these advances will further guarantee the improvement of existing implants and deliverable entities while enabling the development of new therapy technologies. Such technologies are anticipated to be long‐term patient‐friendly and thus lead to a higher quality of life. [ABSTRACT FROM AUTHOR]

Purpose: Patients with active implants such as deep brain stimulation (DBS) devices are often denied access to MRI due to safety concerns associated with the radiofrequency (RF) heating of their electrodes. The majority of studies on RF heating of conductive implants have been performed in horizontal close‐bore MRI scanners. Vertical MRI scanners which have a 90° rotated transmit coil generate fundamentally different electric and magnetic field distributions, yet very little is known about RF heating of implants in this class of scanners. We performed numerical simulations as well as phantom experiments to compare RF heating of DBS implants in a 1.2T vertical scanner (OASIS, Hitachi) compared to a 1.5T horizontal scanner (Aera, Siemens). Methods: Simulations were performed on 90 lead models created from post‐operative CT images of patients with DBS implants. Experiments were performed with wires and commercial DBS devices implanted in an anthropomorphic phantom. Results: We found significant reduction of 0.1 g‐averaged specific absorption rate (30‐fold, P < 1 × 10−5) and RF heating (9‐fold, P <.026) in the 1.2T vertical scanner compared to the 1.5T conventional scanner. Conclusion: Vertical MRI scanners appear to generate lower RF heating around DBS leads, providing potentially heightened safety or the flexibility to use sequences with higher power levels than on conventional systems. [ABSTRACT FROM AUTHOR]

The study is aimed to virtually miniaturize medical implants produced of the biocompatible Ti with improved mechanical performance. The results on the simulation-driven design of medical implants fabricated of nanostructured commercially pure Ti with significantly enhanced mechanical properties are presented. The microstructure of initially coarse-grained Ti has been refined to ultrafine grain size by severe plastic deformation. The ultrafine-grained (UFG) Ti exhibits remarkably high static and cyclic strength, allowing to design new dental and surgical implants with miniaturized geometry. The possibilities to reduce the implant dimensions via virtual fatigue tests for the digital twins of two particular medical devices (a dental implant and a maxillofacial surgery plate) are explored with the help of finite element modeling. Additionally, the effect of variation in loading direction and the fixation methods for the tested implants are studied in order to investigate the sensitivity of the fatigue test results to the testing conditions. It is shown that the UFG materials are promising for the design of a new generation of medical products.

Modern healthcare is transforming from hospital-centric to individual-centric systems. Emerging implantable and wearable medical (IWM) devices are integral parts of enabling affordable and accessible healthcare. Early disease diagnosis and preventive measures are possible by continuously monitoring clinically significant physiological parameters. However, most IWM devices are battery-operated, requiring replacement, which interrupts the proper functioning of these devices. For the continuous operation of medical devices for an extended period of time, supplying uninterrupted energy is crucial. A sustainable and health-compatible energy supply will ensure the high-performance real-time functioning of IWM devices and prolong their lifetime. Therefore, harvesting energy from the human body and ambient environment is necessary for enduring precision healthcare and maximizing user comfort. Energy harvesters convert energy from various sources into an equivalent electrical form. This paper presents a state-of-the-art comprehensive review of energy harvesting techniques focusing on medical applications. Various energy harvesting approaches, working principles, and the current state are discussed. In addition, the advantages and limitations of different methods are analyzed and existing challenges and prospects for improvement are outlined. This paper will help with understanding the energy harvesting technologies for the development of high-efficiency, reliable, robust, and battery-free portable medical devices.

This article presents the development of a power loss emulation (PLE) system device to study and find ways of mitigating skin tissue heating effects in transcutaneous energy transmission systems (TETS) for existing and next generation left ventricular assist devices (LVADs). Skin thermal profile measurements were made using the PLE system prototype and also separately with a TETS in a porcine model. Subsequent data analysis and separate computer modelling studies permit understanding of the contribution of tissue blood perfusion towards cooling of the subcutaneous tissue around the electromagnetic coupling area. A 2-channel PLE system prototype and a 2-channel TETS prototype were implemented for this study. The heating effects resulting from power transmission inefficiency were investigated under varying conditions of power delivery levels for an implanted device. In the part of the study using the PLE setup, the implanted heating element was placed subcutaneously 6–8 mm below the body surface of in vivo porcine model skin. Two operating modes of transmission coupling power losses were emulated: (a) conventional continuous transmission, and (b) using our proposed pulsed transmission waveform protocols. Experimental skin tissue thermal profiles were studied for various levels of LVAD power. The heating coefficient was estimated from the porcine model measurements (an in vivo living model and a euthanised cadaver model without blood circulation at the end of the experiment). An in silico model to support data interpretation provided reliable experimental and numerical methods for effective wireless transdermal LVAD energization advanced solutions. In the separate second part of the study conducted with a separate set of pigs, a two-channel inductively coupled RF driving system implemented wireless power transfer (WPT) to a resistive LVAD model (50 Ω) to explore continuous versus pulsed RF transmission modes. The RF-transmission pulse duration ranged from 30 ms to 480 ms, and the idle time (no-transmission) from 5 s to 120 s. The results revealed that blood perfusion plays an important cooling role in reducing thermal tissue damage from TETS applications. In addition, the results analysis of the in vivo, cadaver (R1Sp2) model, and in silico studies confirmed that the tissue heating effect was significantly lower in the living model versus the cadaver model due to the presence of blood perfusion cooling effects.

Biofilms, when formed on medical devices, can cause malfunctions and reduce the efficiency of these devices, thus complicating treatments and serving as a source of infection. The autolysin protein of Staphylococcus epidermidis contributes to its biofilm forming ability, especially on polystyrene surfaces. R2ab and amidase are autolysin protein domains thought to have high affinity to polystyrene surfaces, and they are involved in initial bacterial attachment in S. epidermidis biofilm formation. However, the structural details of R2ab and amidase binding to surfaces are poorly understood. In this study, we have investigated how R2ab and amidase influence biofilm formation on polystyrene surfaces. We have also studied how these proteins interact with polystyrene nanoparticles (PSNPs) using biophysical techniques. Pretreating polystyrene plates with R2ab and amidase domains inhibits biofilm growth relative to a control protein, indicating that these domains bind tightly to polystyrene surfaces and can block bacterial attachment. Correspondingly, we find that both domains interact strongly with anionic, carboxylate-functionalized as well as neutral, non-functionalized PSNPs, suggesting a similar binding interaction for nanoparticles and macroscopic surfaces. Both anionic and neutral PSNPs induce changes to the secondary structure of both R2ab and amidase as monitored by circular dichroism (CD) spectroscopy. These changes are very similar, though not identical, for both types of PSNPs, suggesting that carboxylate functionalization is only a small perturbation for R2ab and amidase binding. This structural change is also seen in limited proteolysis experiments, which exhibit substantial differences for both proteins when in the presence of carboxylate PSNPs. Overall, our results demonstrate that the R2ab and amidase domains strongly favor adsorption to polystyrene surfaces, and that surface adsorption destabilizes the secondary structure of these domains. Bacterial attachment to polystyrene surfaces during the initial phases of biofilm formation, therefore, may be mediated by aromatic residues, since these residues are known to drive adsorption to PSNPs. Together, these experiments can be used to develop new strategies for biofilm eradication, ensuring the proper long-lived functioning of medical devices.

The problem of producing medical and biological products in the case when such a product must be biocompatible is a complex and resource-intensive task. The conventional apparatus for studying alloys, from which such a product will be created, involves lengthy and expensive tests. Today, some traditional methods can be replaced by artificial intelligence tools. This paper solves the problem of predicting the properties of alloys for the manufacture of biocompatible products using machine learning. The authors developed a hybrid approach that involves a combination of PNN, Ito decomposition, and Logistic regression classifier. The first step of our approach is reducing the dimension of the input data space by replacing the initial inputs with a set of probabilities obtained by using PNN. The next step is the use of Ito decomposition and the application of the classifier using the final dataset. The proposed approach is tested using a real task. It has been experimentally established that the replacement of the initial inputs with the outputs of PNN provides a significant increase in the generalization properties of the Logistic regression classifier. Additional application of the Ito decomposition provides an increase in the classification accuracy. Comparison with other methods showed that our approach provides the highest classification accuracy based on different indicators. [ABSTRACT FROM AUTHOR]

This article proposes an efficient and complete wireless power transfer (WPT) system (WPTS) for multipurpose biomedical implants. The WPTS is composed of a self-diplexing implantable antenna, efficient rectifier, and WPT transmitter (WPT Tx). The proposed system is capable of simultaneously transmitting recorded data and recharging the batteries of the devices (so as to elongate the implant life). The WPT Tx occupies dimensions of $50 \times 50 \times 1.6$ mm3 and is optimized to effectively transfer power at 1470 MHz to a 55-mm deep implantable device. An efficient and compact ($3.4 \times 6.7$ mm2) rectifier is used at 1470 MHz to convert the harvested RF power into a useful direct current (dc) power. The proposed rectifier circuit exhibits a high conversion efficiency of 50% even at an input power of −14 dBm and maximum efficiency of 76.1% at 2 dBm. The proposed self-diplexing implantable antenna occupies small dimensions (9.4 mm3) and operates at 915 and 1470 MHz by exciting ports 1 and 2, respectively. The biotelemetry operation is performed using a 915 MHz band (port 1), and the rectifier circuit is connected to port 2 (1470 MHz) to perform wireless powering. The simulated results are validated by examining the individual elements (WPT Tx, rectifier, and self-diplexing antenna) and overall WPTS in a saline solution and minced pork. The results prove that the proposed scheme is suitable for biotelemetry and wireless powering of biomedical implants. [ABSTRACT FROM AUTHOR]

Biofilms, when formed on medical devices, can cause malfunctions and reduce the efficiency of these devices, thus complicating treatments and serving as a source of infection. The autolysin protein of Staphylococcus epidermidis contributes to its biofilm forming ability, especially on polystyrene surfaces. R2ab and amidase are autolysin protein domains thought to have high affinity to polystyrene surfaces, and they are involved in initial bacterial attachment in S. epidermidis biofilm formation. However, the structural details of R2ab and amidase binding to surfaces are poorly understood. In this study, we have investigated how R2ab and amidase influence biofilm formation on polystyrene surfaces. We have also studied how these proteins interact with polystyrene nanoparticles (PSNPs) using biophysical techniques. Pretreating polystyrene plates with R2ab and amidase domains inhibits biofilm growth relative to a control protein, indicating that these domains bind tightly to polystyrene surfaces and can block bacterial attachment. Correspondingly, we find that both domains interact strongly with anionic, carboxylate-functionalized as well as neutral, non-functionalized PSNPs, suggesting a similar binding interaction for nanoparticles and macroscopic surfaces. Both anionic and neutral PSNPs induce changes to the secondary structure of both R2ab and amidase as monitored by circular dichroism (CD) spectroscopy. These changes are very similar, though not identical, for both types of PSNPs, suggesting that carboxylate functionalization is only a small perturbation for R2ab and amidase binding. This structural change is also seen in limited proteolysis experiments, which exhibit substantial differences for both proteins when in the presence of carboxylate PSNPs. Overall, our results demonstrate that the R2ab and amidase domains strongly favor adsorption to polystyrene surfaces, and that surface adsorption destabilizes the secondary structure of these domains. Bacterial attachment to polystyrene surfaces during the initial phases of biofilm formation, therefore, may be mediated by aromatic residues, since these residues are known to drive adsorption to PSNPs. Together, these experiments can be used to develop new strategies for biofilm eradication, ensuring the proper long-lived functioning of medical devices. [ABSTRACT FROM AUTHOR]

Powder bed fusion of metals by laser beam enables the production of porous lattice structures that facilitate bone ingrowth and the vascularization of medical implants. Comprehensive implementation is currently limited by the medium reproducibility of porous structures with insufficient dimensional accuracy. Therefore strategies for minimizing geometrical mismatch and roughness are investigated by way of experiment. A parametric compensation scheme that takes into account the melt pool depth of the struts' downskins in reducing the geometric mismatch between as-designed and as-built lattice structures is proposed. Build angles of 10° with respect to the platform were created without support structures. [ABSTRACT FROM AUTHOR]

In this research, we focused on the investigation of the structural, surface, and corrosion behavior properties of copper-loaded TiO 2 nanotubular array surfaces that were further deposited with a chitosan biopolymer. This composite material was fabricated on Ti6Al4V alloy substrates using a combination of anodic oxidation (AO), electro-cathodic deposition (ECD), and electrophoretic deposition (EPD) techniques, primarily to apply it in medical implant contexts. Initially, the TiO 2 nanotubes were prepared via anodization (AO). Subsequently, copper was introduced into the TiO 2 nanotubes through electro-cathodic deposition (ECD), followed by the coating of chitosan over the copper-loaded TiO 2 nanotubes using electrophoretic deposition (EPD). To comprehensively assess the characteristics of these surfaces, a series of analytical techniques were employed, including SEM, EDX mapping, XRD, and wettability measurements. Furthermore, the electrochemical properties of these surfaces, namely the OCP, PDP, and EIS, were extensively scrutinized. The outcomes of this investigation directed a notable development in the electrochemical corrosion resistance of the chitosan-deposited copper-loaded TiO 2 nanotubular array surfaces in comparison to uncoated Ti6Al4V alloy, particularly under conditions simulating a physiological environment (simulated body fluid, SBF). Corrosion rates, assessed through PDP (Potentiodynamic Polarization) curves, were determined to be 0.3023 mm/y for polished Ti6Al4V, 0.1476 mm/y for TiO 2 30 V 4 h, 0.1235 mm/y for TNT-Cu 2/30 /Ch, 0.0733 mm/y for TNT-Cu 2/60 /Ch, and 0.0611 mm/y for TNT-Cu 2/90 /Ch. Additionally, corrosion protection efficiencies were calculated as 51.16 % for TiO 2 30 V 4 h, 59.15 % for TNT-Cu 2/30 /Ch, 75.76 % for TNT-Cu 2/60 /Ch, and 79.81 % for TNT-Cu 2/90 /Ch. Notably, the TNT-Cu 2/90 /Ch sample demonstrated a significantly low corrosion rate of 0.0611 mm/year and a high corrosion protection efficiency of 79.81 %. This enhancement can happen due to the chitosan coating, which acts as a protective layer, hindering the ingress of the physical solution into the original metal surfaces. Notably, TNT-Cu 2/90 /Ch coated sample exhibited a corrosion rate (i corr) approximately 5 times lower than that of the uncoated alloy. In conclusion, this study presents a novel chitosan-coated composite material consisting of copper-loaded TiO 2 nanotubular surfaces that effectively enhances corrosion resistance compared to polished Ti6Al4V substrates. [Display omitted] • Copper loaded TiO 2 nanotubes coated with chitosan on Ti6Al4V. • Enhanced hydrophilicity in modified surfaces • TNT-Cu 2/90 /Ch resulted 0.0611 mm/y corrosion rate and 79.81 % efficiency. • Corrosion products: Al 2 O 3 , TiO 2 , Cu 2 O, V 2 O 5 [ABSTRACT FROM AUTHOR]