Comparative Evaluation of Coated and Uncoated 3D-Printed Porous Implants for Antibacterial and Biological Performance

Open Access

Abstract

Background: 3D-printed porous implants offer potential advantages in orthopaedic surgery, while surface coatings may improve antibacterial activity and biological integration. This study aimed to compare the antibacterial and biological performance of coated and uncoated 3D-printed porous implants. Methods & Materials: This prospective comparative study was conducted in the Department of Orthopaedic Surgery, 250 Bed General Hospital, Naogaon, Bangladesh, from January 2025 to June 2026. A total of 40 patients were enrolled and divided into coated (Group A, n=20) and uncoated (Group B, n=20) implant groups. Demographic, clinical, antibacterial and biological outcomes were assessed, including infection, bacterial isolates, radiographic union, implant stability and bone ingrowth. Results: The mean age was 44.2 ± 14.8 years and 67.5% of participants were male. Culture-positive infection occurred in 15.0% of the coated group compared with 45.0% of the uncoated group (p=0.082). Postoperative antibiotic requirements were significantly lower in the coated group (25.0% vs. 60.0%, p=0.027). Staphylococcus aureus was the predominant isolate (58.3%). Radiographic union was observed in 90.0% and 80.0% of the coated and uncoated groups, respectively. Mean bone ingrowth scores were 3.2 ± 0.8 and 2.7 ± 0.9, respectively (p=0.08). Conclusion: Coated implants demonstrated lower infection rates and generally more favorable biological outcomes. However, most differences were not statistically significant, warranting further investigation in larger studies.