{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T02:03:07Z","timestamp":1788746587720,"version":"build-2803163510"},"reference-count":54,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T00:00:00Z","timestamp":1698278400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Slovenian Research Agency, ARRS","award":["L3-2621"],"award-info":[{"award-number":["L3-2621"]}]},{"name":"Slovenian Research Agency, ARRS","award":["P2-4447"],"award-info":[{"award-number":["P2-4447"]}]},{"name":"Slovenian Research Agency, ARRS","award":["J3-3066"],"award-info":[{"award-number":["J3-3066"]}]},{"name":"Slovenian Research Agency, ARRS","award":["P2-0132"],"award-info":[{"award-number":["P2-0132"]}]},{"name":"Slovenian Research Agency, ARRS","award":["P3-0388"],"award-info":[{"award-number":["P3-0388"]}]},{"name":"Slovenian Research Agency, ARRS","award":["L3-2621"],"award-info":[{"award-number":["L3-2621"]}]},{"name":"Slovenian Research Agency, ARRS","award":["P2-4447"],"award-info":[{"award-number":["P2-4447"]}]},{"name":"Slovenian Research Agency, ARRS","award":["J3-3066"],"award-info":[{"award-number":["J3-3066"]}]},{"name":"Slovenian Research Agency, ARRS","award":["P2-0132"],"award-info":[{"award-number":["P2-0132"]}]},{"name":"Slovenian Research Agency, ARRS","award":["P3-0388"],"award-info":[{"award-number":["P3-0388"]}]},{"name":"Slovenian Research Agency, ARRS","award":["L3-2621"],"award-info":[{"award-number":["L3-2621"]}]},{"name":"Slovenian Research Agency, ARRS","award":["P2-4447"],"award-info":[{"award-number":["P2-4447"]}]},{"name":"Slovenian Research Agency, ARRS","award":["J3-3066"],"award-info":[{"award-number":["J3-3066"]}]},{"name":"Slovenian Research Agency, ARRS","award":["P2-0132"],"award-info":[{"award-number":["P2-0132"]}]},{"name":"Slovenian Research Agency, ARRS","award":["P3-0388"],"award-info":[{"award-number":["P3-0388"]}]},{"name":"Slovenian Research Agency, ARRS","award":["L3-2621"],"award-info":[{"award-number":["L3-2621"]}]},{"name":"Slovenian Research Agency, ARRS","award":["P2-4447"],"award-info":[{"award-number":["P2-4447"]}]},{"name":"Slovenian Research Agency, ARRS","award":["J3-3066"],"award-info":[{"award-number":["J3-3066"]}]},{"name":"Slovenian Research Agency, ARRS","award":["P2-0132"],"award-info":[{"award-number":["P2-0132"]}]},{"name":"Slovenian Research Agency, ARRS","award":["P3-0388"],"award-info":[{"award-number":["P3-0388"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Materials"],"abstract":"<jats:p>For the improvement of surface roughness, titanium joint arthroplasty (TJA) components are grit-blasted with Al2O3 (corundum) particles during manufacturing. There is an acute concern, particularly with uncemented implants, about polymeric, metallic, and corundum debris generation and accumulation in TJA, and its association with osteolysis and implant loosening. The surface morphology, chemistry, phase analysis, and surface chemistry of retrieved and new Al2O3 grit-blasted titanium alloy were determined with scanning electron microscopy (SEM), X-ray energy-dispersive spectroscopy (EDS), transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS) and confocal laser fluorescence microscopy, respectively. Peri-prosthetic soft tissue was studied with histopathology. Blasted retrieved and new stems were exposed to human mesenchymal stromal stem cells (BMSCs) for 7 days to test biocompatibility and cytotoxicity. We found metallic particles in the peri-prosthetic soft tissue. Ti6Al7Nb with the residual Al2O3 particles exhibited a low cytotoxic effect while polished titanium and ceramic disks exhibited no cytotoxic effect. None of the tested materials caused cell death or even a zone of inhibition. Our results indicate a possible biological effect of the blasting debris; however, we found no significant toxicity with these materials. Further studies on the optimal size and properties of the blasting particles are indicated for minimizing their adverse biological effects.<\/jats:p>","DOI":"10.3390\/ma16216867","type":"journal-article","created":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T07:22:15Z","timestamp":1698304935000},"page":"6867","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The Impact of Al2O3 Particles from Grit-Blasted Ti6Al7Nb (Alloy) Implant Surfaces on Biocompatibility, Aseptic Loosening, and Infection"],"prefix":"10.3390","volume":"16","author":[{"given":"Bo\u0161tjan","family":"Kocjan\u010di\u010d","sequence":"first","affiliation":[{"name":"Department for Orthopaedic Surgery, UMC Ljubljana, Zalo\u0161ka 9, 1000 Ljubljana, Slovenia"},{"name":"Chair of Orthopedics, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klemen","family":"Avsec","sequence":"additional","affiliation":[{"name":"Department for Orthopaedic Surgery, UMC Ljubljana, Zalo\u0161ka 9, 1000 Ljubljana, Slovenia"},{"name":"Chair of Orthopedics, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1269-3364","authenticated-orcid":false,"given":"Barbara","family":"\u0160etina Bati\u010d","sequence":"additional","affiliation":[{"name":"Institute of Metals and Technology, Lepi pot 11, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0866-6424","authenticated-orcid":false,"given":"Darja","family":"Feizpour","sequence":"additional","affiliation":[{"name":"Institute of Metals and Technology, Lepi pot 11, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8452-9993","authenticated-orcid":false,"given":"Matja\u017e","family":"Godec","sequence":"additional","affiliation":[{"name":"Institute of Metals and Technology, Lepi pot 11, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronika","family":"Kralj-Igli\u010d","sequence":"additional","affiliation":[{"name":"University of Ljubljana, Faculty of Health Sciences, Laboratory of Clinical Biophysics, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rok","family":"Podlipec","sequence":"additional","affiliation":[{"name":"Laboratory for Biophysics, Jozef Stefan Institute, Jamova 39, 1000 Ljubljana, Slovenia"},{"name":"Ion Beam Center, Helmholtz-Zentrum Dresden-Rossendorf e.V., 01328 Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrej","family":"C\u00f6r","sequence":"additional","affiliation":[{"name":"Orthopaedic Hospital Valdoltra, Jadranska cesta 31, 6280 Ankaran, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mojca","family":"Debeljak","sequence":"additional","affiliation":[{"name":"University Rehabilitation Institute Republic of Slovenia So\u010da, Linhartova 51, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5243-4095","authenticated-orcid":false,"given":"John T.","family":"Grant","sequence":"additional","affiliation":[{"name":"Research Institute, University of Dayton, Dayton, OH 45469, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Jenko","sequence":"additional","affiliation":[{"name":"Institute of Metals and Technology, Lepi pot 11, 1000 Ljubljana, Slovenia"},{"name":"MD-RI Institute for Materials Research in Medicine, Bohori\u010deva 5a, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drago","family":"Dolinar","sequence":"additional","affiliation":[{"name":"Department for Orthopaedic Surgery, UMC Ljubljana, Zalo\u0161ka 9, 1000 Ljubljana, Slovenia"},{"name":"Chair of Orthopedics, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia"},{"name":"MD-RI Institute for Materials Research in Medicine, Bohori\u010deva 5a, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"780","DOI":"10.2106\/00004623-200704000-00012","article-title":"Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030","volume":"89","author":"Kurtz","year":"2007","journal-title":"J. Bone Joint Surg. Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1016\/j.apsusc.2017.08.007","article-title":"Surface chemistry and microstructure of metallic biomaterials for hip and knee endoprostheses","volume":"427","author":"Jenko","year":"2018","journal-title":"Appl. Surf. Sci."},{"key":"ref_3","unstructured":"Bobyn, J.D., Coiller, J.P., Mayor, M.B., McTighe, T., Tanzer, M., and Vaughn, B.K. (1993, January 5\u20137). Particulate debris in total hip arthroplasty: Problems and Solutions. Proceedings of the Scientific Exhibits at the 1993 AAOS Meeting, San Francisco, CA, USA."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Merola, M., and Affatato, S. (2019). Review Materials for Hip Prostheses: A Review of Wear and Loading Considerations. Materials, 12.","DOI":"10.3390\/ma12030495"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Delgado-Ruiz, R., and Georgios Romanos, G. (2018). Potential Causes of Titanium Particle, and Ion Release in Implant Dentistry: A Systematic Review. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19113585"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1007\/s00402-020-03517-0","article-title":"Surgeon-stratified cohort analysis of 1976 cementless Zweym\u00fcller total hip arthroplasties from a single hospital with 23,255 component years of follow-up","volume":"140","year":"2020","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Vance, A., Bari, K., and Arjunan, A. (2019). Investigation of Ti64 sheathed cellular anatomical structure as a tibia implant. Biomed. Phys. Eng. Express, 5.","DOI":"10.1088\/2057-1976\/ab0bd7"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.aej.2023.08.080","article-title":"Exploring the evolution of tissue engineering strategies over the past decade: From cell-based strategies to gene-activated matrix","volume":"81","author":"Esmaeili","year":"2023","journal-title":"Alex. Eng. J."},{"key":"ref_9","first-page":"61","article-title":"Biology of implant osseointegration","volume":"9","author":"Mavrogenis","year":"2009","journal-title":"J. Musculoskelet. Neuronal Interact."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1097\/01.blo.0000175889.82865.67","article-title":"Prevention of Staphylococcal Biofilm-associated Infections by the Quorum Sensing Inhibitor RIP","volume":"437","author":"Balaban","year":"2005","journal-title":"Clin. Orthop. Rel. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2014","DOI":"10.1177\/0300060517732697","article-title":"Current methods of preventing aseptic loosening and improving osseointegration of titanium implants in cementless total hip arthroplasty: A review. Special Issue: Surgical treatment of hip pathology: From childhood to adulthood","volume":"46","author":"Apostu","year":"2018","journal-title":"J. Int. Med. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.tibtech.2009.12.003","article-title":"Classification of osseointegrated implant surfaces: Materials, chemistry and topography","volume":"28","author":"Ehrenfest","year":"2010","journal-title":"Trends Biotechnol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"101745","DOI":"10.1016\/j.isci.2020.101745","article-title":"Titanium for Orthopedic Applications: An Overview of Surface Modification to Improve Biocompatibility and Prevent Bacterial Biofilm Formation","volume":"23","author":"Quin","year":"2020","journal-title":"iScience"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1016\/j.actbio.2011.11.026","article-title":"Effect of cleaning and sterilization on titanium implant surface properties and cellular response","volume":"8","author":"Park","year":"2012","journal-title":"Acta Biomater."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Podlipec, R., Punz\u00f3n-Quijorna, E., Pirker, L., Kelemen, M., Vavpetic, P., Kavalar, R., Hlawacek, G., \u0160trancar, J., Pelicon, P., and Fokter, S.K. (2021). Revealing Inflammatory Indications Induced by Titanium Alloy Wear Debris in Periprosthetic Tissue by Label-Free Correlative High-Resolution Ion, Electron and Optical Microspectroscopy. Materials, 14.","DOI":"10.3390\/ma14113048"},{"key":"ref_16","first-page":"59","article-title":"Effect of sterilization on the surface properties of Ti6Al7Nb alloy femoral stems","volume":"55","author":"Avsec","year":"2021","journal-title":"Mater. Technol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2852","DOI":"10.1016\/j.actbio.2010.01.009","article-title":"The removal of Al2O3 particles from grit-blasted titanium implant surfaces: Effects on biocompatibility, osseointegration and interface strength in vivo","volume":"6","author":"Gensior","year":"2010","journal-title":"Acta Biomater."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"172","DOI":"10.5312\/wjo.v6.i2.172","article-title":"Biological response to prosthetic debris","volume":"6","author":"Bitar","year":"2015","journal-title":"World J. Orthop."},{"key":"ref_19","first-page":"176","article-title":"An Overview of Surface Modifications of Titanium and its Alloys for Biomedical Applications","volume":"29","author":"Sharan","year":"2015","journal-title":"Trends Biomater. Artif. Organs"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Avsec, K., Jenko, M., Conradi, M., Kocijan, A., Vesel, A., Kova\u010d, J., Godec, M., Beli\u010d, I., \u0160etina Bati\u010d, B., and Donik, \u010c. (2019). Surface properties of retrieved cementless femoral hip endoprostheses produced from a Ti6Al7Nb alloy. Coatings, 9.","DOI":"10.3390\/coatings9120868"},{"key":"ref_21","first-page":"77","article-title":"Histological Picture of the Wear Particles, and the Biological Response in Periprosthetic Tissue","volume":"53","year":"2019","journal-title":"Mater. Technol."},{"key":"ref_22","unstructured":"Wagner, C., Moulder, J.F., and Sobol, P.E. (1995). Handbook of X-ray Photoelectron Spectroscopy, Physical Electronics."},{"key":"ref_23","first-page":"89","article-title":"Biomaterials in endoprosthetics","volume":"52","author":"Dolinar","year":"2018","journal-title":"Mater. Technol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1179\/cmq.1986.25.2.101","article-title":"Control of silica in the bayer process used for alumina production","volume":"25","author":"Ostap","year":"2013","journal-title":"Can. Metall. Q."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2354","DOI":"10.1016\/j.actbio.2014.02.003","article-title":"Contributions of human tissue analysis to understanding the mechanisms of loosening and osteolysis in total hip replacement","volume":"10","author":"Gallo","year":"2014","journal-title":"Acta Biomater."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Jan, Z., Ho\u010devar, M., Kononenko, V., Michelini, S., Repar, N., Caf, M., Kocjan\u010di\u010d, B., Dolinar, D., Kralj, S., and Makovec, D. (2023). Inflammatory, Oxidative Stress and Small Cellular Particle Response in HUVEC Induced by Debris from Endoprosthesis Processing. Materials, 16.","DOI":"10.3390\/ma16093287"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1007\/s11999-010-1649-1","article-title":"Perivascular and Diffuse Lymphocytic, Inflammation are not Specific for Failed Metal-on-metal Hip Implants","volume":"469","author":"Fujishiro","year":"2011","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"416","DOI":"10.5507\/bp.2020.019","article-title":"The number of lymphocytes increases in the periprosthetic tissues with increasing time of implant service in non-metal-on-metal total joint arthroplasties: A role of metallic particles","volume":"165","author":"Hobza","year":"2021","journal-title":"Biomed. Pap. Med. Fac. Palacky Univ. Olomouc"},{"key":"ref_29","first-page":"112","article-title":"Surface Roughness of Implants: A Review","volume":"25","author":"Alla","year":"2011","journal-title":"Trends Biomater. Artif. Organs"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.1126\/science.3629258","article-title":"Biomaterial-centered infection: Microbial adhesion versus tissue integration","volume":"237","author":"Gristina","year":"1987","journal-title":"Science"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1002\/jab.770030310","article-title":"Technical note: Embedded particulate contaminants in textured metal implant surfaces","volume":"3","author":"Ricci","year":"1992","journal-title":"J. Appl. Biomater."},{"key":"ref_32","unstructured":"Bobyn, J., Collier, J.P., Mayor, M.B., McTighe, T., Tanzer, M., and Vaughn, B.K. (1993, January 18\u201323). Particulate debris in Total Hip Arthroplasty: Problems and Solutions reported on particulate polymeric debris, metallic debris and third wear from debonded porous coatings in THA and solutions. Proceedings of the Conference: American Academy Orthopaedic Surgeons, Annual Meeting 1993, San Francisco, CA, USA."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/0300-5712(94)00003-X","article-title":"Contamination of titanium castings by aluminium oxide blasting","volume":"23","author":"Darvell","year":"1995","journal-title":"J. Dent."},{"key":"ref_34","first-page":"240","article-title":"Tissue response to the components of a hydroxyapatite-coated composite femoral implant","volume":"364","author":"Hucking","year":"1999","journal-title":"Clin. Orth. Rel. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1054\/arth.2001.17940","article-title":"Grit-Blasted Titanium Femoral Stem in Cementless Primary THA","volume":"161","author":"Delaunay","year":"2001","journal-title":"J. Arthroplast."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1302\/0301-620X.84B1.0840128","article-title":"Adverse tissue reactions to wear particles from Co-alloy articulations, increased by alumina-blasting particle contamination from cementless Ti-based total hip implants. A report of seven revisions with early failure","volume":"84","author":"Kanz","year":"2002","journal-title":"J. Bone Joint Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/S0736-0266(01)00077-8","article-title":"Differential apoptotic response of J774 macrophages to alumina and ultra-high-molecular-weight polyethylene particles","volume":"20","author":"Catelas","year":"2002","journal-title":"J. Orthop. Res."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Hatton, A., Nevelos, J., Matthews, J., Fisher, J., and Ingham, E. (2003). Effects of clinically relevant alumina ceramic wear particles on TNF-alpha production by human peripheral blood mononuclear phagocytes. Biomaterials, 24.","DOI":"10.1016\/S0142-9612(02)00510-0"},{"key":"ref_39","first-page":"9","article-title":"Surface Characterization of Corundum Blasted Implants in Hip Arthroplasty","volume":"18","author":"Uter","year":"2004","journal-title":"FE-SEM Biomed. Microsc. Anal."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1007\/s00402-005-0050-0","article-title":"Comparative surface contamination on corundum blasted titanium implants and explants in total hip arthroplasty","volume":"125","author":"Schuh","year":"2005","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1080\/17453670610045902","article-title":"Aseptic loosening, not only a question of wear, a review of different theories","volume":"77","author":"Sundfeldt","year":"2006","journal-title":"Acta Orthop."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/s00776-012-0343-4","article-title":"Contamination of surfaces for osseointegration of cementless total hip implants by small aluminum oxide particles; analysis of established implants by use of new technique","volume":"18","author":"Kolb","year":"2013","journal-title":"J. Orthop. Sci."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3995","DOI":"10.5504\/BBEQ.2013.0006","article-title":"Effects of surface modifications with oxalic acid Etching and sandblasting on surface topography and Biocompatibility of cpTi surfaces","volume":"27","author":"Yeniyol","year":"2013","journal-title":"Biotechnol. Biotechnol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1080\/17434440.2020.1702024","article-title":"Diagnosis, and management of implant debris-associated inflammation","volume":"17","author":"Goodman","year":"2020","journal-title":"Expert Rev. Med. Devices"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Hu, C., and Yoon, T. (2018). Recent updates for biomaterials used in total hip arthroplasty. Biomater. Res., 22.","DOI":"10.1186\/s40824-018-0144-8"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1016\/j.msec.2019.04.064","article-title":"Review on titanium and titanium-based alloys as biomaterials for orthopaedic applications","volume":"102","author":"Kaur","year":"2019","journal-title":"Mater. Sci. Eng. C"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1002\/jbm.a.36829","article-title":"Role of implants surface modification in osseointegration: A systematic review","volume":"108A","author":"Liu","year":"2020","journal-title":"J. Biomed. Mater. Res. A"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Affatato, S., Ruggerio, A., Jaber, S.A., Merola, M., and Bracco, P. (2018). Wear behaviors and oxidation effects on different UHMWPE acetabular cups using a hip joint simulator. Materials, 11.","DOI":"10.3390\/ma11030433"},{"key":"ref_49","first-page":"118","article-title":"Implant Debris: Clinical Data and Relevance","volume":"7","author":"Hallab","year":"2017","journal-title":"Compr. Biomater. II"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"111969","DOI":"10.1016\/j.msec.2021.111969","article-title":"Effects of titanium with different micro\/nanostructures on the ability of osteoblasts to resist oxidative stress","volume":"123","author":"Ma","year":"2021","journal-title":"Mater. Sci. Eng. C"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Gil, J., P\u00e9rez, R., Climent, M., Rizo-Gorrita, M., Torres-Lagares, D., and Gutierrez, J.L. (2022). Benefits of Residual Aluminum Oxide for Sand Blasting Titanium Dental Implants: Osseointegration and Bactericidal Effects. Materials, 15.","DOI":"10.3390\/ma15010178"},{"key":"ref_52","first-page":"2313","article-title":"Residual Contaminations of Silicon-Based Glass, Alumina and Aluminium Grits on a Titanium Surface After Sandblasting","volume":"11","author":"Matinlinna","year":"2015","journal-title":"Silicon"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.actbio.2018.10.036","article-title":"Review of titanium surface modification techniques and coatings for antibacterial applications","volume":"83","author":"Chouirfa","year":"2019","journal-title":"Acta Biomater."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/S0140-6736(18)31665-9","article-title":"How long does a hip replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up","volume":"393","author":"Evans","year":"2019","journal-title":"Lancet"}],"container-title":["Materials"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1996-1944\/16\/21\/6867\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:12:00Z","timestamp":1760130720000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1996-1944\/16\/21\/6867"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,26]]},"references-count":54,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["ma16216867"],"URL":"https:\/\/doi.org\/10.3390\/ma16216867","relation":{},"ISSN":["1996-1944"],"issn-type":[{"value":"1996-1944","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,26]]}}}