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J Orthop Sci. 2020 Mar 3. pii: S0949-2658(20)30004-X. doi: 10.1016/j.jos.2019.12.013. [Epub ahead of print]

The feasibility of iodine-supported processing for titanium with different surfaces.

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Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan. Electronic address:



The reduction of microbial infections can substantially improve the success of implant surgery. The iodine-supported implants that were developed by us for infection prevention were featured at the recent International Consensus Meeting on Musculoskeletal Infection and were partly incorporated into the consensus guidelines. For future clinical application, we examined (1) whether iodine can be added to metals with different surface roughness, (2) differences in surface roughness before and after processing, and (3) the effect of sterilization on the iodine content.


Four Ti-6Al-4V metals were prepared with different surface roughness values by polishing, blasting and plasma spraying. Before and after processing, the surface structure of metals was observed using a scanning electron microscope and stylus instruments. Before and after sterilization, iodine contents were measured by X-ray fluorescence spectroscopy.


After processing, sufficient iodine contents with an antimicrobial effect were detected for each metal. These iodine contents decreased after sterilization but were higher than the lowest content of iodine observed to have an antimicrobial effect in a previous study, indicating that the antimicrobial effect persists even after sterilization. After processing, surface roughness was greater for polishing metal. With general surface processing, iodine processing was possible.


Our results indicated that surface roughness is affected by the processing method and that the iodine content should be set according to the sterilization method. Considering these factors, iodine processing can be used for clinical applications.


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