Double-edged sword of biofouling potentials associated with haemocompatibility behaviour: titania nanotube arrays for medical implant surface technology

Abstract

Background: Medical implant failures are frequently associated with limitations of the surface technology that lead to biofouling and haemocompatibility issues. Titania nanotube array technology could provide a solution for this existing limitation. The present study describes the biofouling potential using the simulated body fluid model according to ISO 23317-2007 and haemocompatibility profiles according to ISO 10993-4 guidelines. Further haemocompatibility profiles were also assessed by evaluating full blood count, coagulation assays, haemolytic rate, whole blood clotting factor, platelet profiles, and FESEM characterization. Result: Titania nanotube array nanosurface was found to present with better apatite biofouling and hydrophilic potential compared to bare titanium foil. Furthermore, good compatibility behaviour was observed based on the haemocompatibility profiles where no signs of thrombogenesis and haemolysis risks were observed. Titania nanotube array reduced fibrinogen adsorption, red blood cell and platelet adhesion and activation, which could be associated with detrimental biofouling properties. Conclusion: Titania nanotube array could possess a double-edged sword of biofouling potentials that resist detrimental biofouling properties associated with thrombogenesis and haemolysis risk. It also provides better apatite biofouling potential for improved tissue and osseointegration activities. Knowledge from this study provides a better understanding of medical implant surface technology. Graphical Abstract: [Figure not available: see fulltext.]