The influence of alloying and fabrication techniques on the mechanical properties, biodegradability and biocompatibility of zinc: A comprehensive review

Microstructural and Mechanical Characterization of Newly Developed Zn-Mg-CaO Composite

In this study, the Zn-0.8Mg-0.28CaO wt.% composite was successfully prepared using different conditions of ball milling (rotations and time) followed by a direct extrusion process. These materials were characterized from the point of view of microstructure and compressive properties, and the correlation between those characteristics was found. Microstructures of individual materials possessed differences in grain size, where the grain size decreased with the intensified conditions (milling speed and time). However, the mutual relation between grain size and compressive strength was not linear. This was caused by the effect of other factors, such as texture, intermetallic phases, and pores. Material texture affects the mechanical properties by a different activity ratio between basal and pyramidal <c + a> slips. The properties of intermetallic particles and pores were determined in material volume using micro-computed tomography (µCT), enhancing the precision of our assumptions compared with commonly applied methods. Based on that, and the analysis after the compressive tests, we were able to determine the influence of aspect ratio, feret diameters, and volume content of intermetallic phases and pores on mechanical behavior. The influence of the aspects on mechanical behavior is described and discussed.

Comprehensive review of additively manufactured biodegradable magnesium implants for repairing bone defects from biomechanical and biodegradable perspectives

Bone defect repair is a complicated clinical problem, particularly when the defect is relatively large and the bone is unable to repair itself. Magnesium and its alloys have been introduced as versatile biomaterials to repair bone defects because of their excellent biocompatibility, osteoconductivity, bone-mimicking biomechanical features, and non-toxic and biodegradable properties. Therefore, magnesium alloys have become a popular research topic in the field of implants to treat critical bone defects. This review explores the popular Mg alloy research topics in the field of bone defects. Bibliometric analyses demonstrate that the degradation control and mechanical properties of Mg alloys are the main research focus for the treatment of bone defects. Furthermore, the additive manufacturing (AM) of Mg alloys is a promising approach for treating bone defects using implants with customized structures and functions. This work reviews the state of research on AM-Mg alloys and the current challenges in the field, mainly from the two aspects of controlling the degradation rate and the fabrication of excellent mechanical properties. First, the advantages, current progress, and challenges of the AM of Mg alloys for further application are discussed. The main mechanisms that lead to the rapid degradation of AM-Mg are then highlighted. Next, the typical methods and processing parameters of laser powder bed fusion fabrication on the degradation characteristics of Mg alloys are reviewed. The following section discusses how the above factors affect the mechanical properties of AM-Mg and the recent research progress. Finally, the current status of research on AM-Mg for bone defects is summarized, and some research directions for AM-Mg to drive the application of clinical orthopedic implants are suggested.

An Extracellular Matrix-like Surface for Zn Alloy to Enhance Bone Regeneration

Zn-based alloys are promising biodegradable implants for bone defect repair due to their good mechanical performance and degradability. However, local Zn²⁺ released from Zn-based implants can seriously affect adhering cell behaviors as well as new bone formation on implant surfaces. To address this issue, we have fabricated a bone-mimetic extracellular matrix (ECM)-like surface on Zn-1Ca implants using a hybrid process of anodization, hydrothermal treatment (HT), and fluorous-curing. The ECM-like surface consisted of Zn₂SiO₄ nanorods layered with collagen I (Col-I). The Zn₂SiO₄ nanorods were hemicrystallized and transformed by the reaction of Zn(OH)₂ and SiO₄^4- during the HT. The Zn₂SiO₄ nanorods effectively protected the substrate from corrosion; the Col-I layer decreased the degradation of Zn₂SiO₄ nanorods and further reduced Zn²⁺ release into the medium. This ECM-like surface generated a microenvironment with appropriate Zn²⁺ levels, nanorod-like topography, and Col-I. It significantly improved adhesion, proliferation, and differentiation of osteoblasts on implant surfaces and vascularization of endothelial cells in the extract medium. The in vivo results are in good agreement with in vitro tests, with the ECM-like surface significantly enhancing new bone formation and bone-implant contact compared to the bare implant surface. Overall, this bone-mimetic ECM-like material of Col-I layered Zn₂SiO₄ nanorods is a promising scaffold that promotes the bone regeneration of Zn-based implants.

Zinc-Based Biodegradable Materials for Orthopaedic Internal Fixation

Traditional inert materials used in internal fixation have caused many complications and generally require removal with secondary surgeries. Biodegradable materials, such as magnesium (Mg)-, iron (Fe)- and zinc (Zn)-based alloys, open up a new pathway to address those issues. During the last decades, Mg-based alloys have attracted much attention by researchers. However, the issues with an over-fast degradation rate and release of hydrogen still need to be overcome. Zn alloys have comparable mechanical properties with traditional metal materials, e.g., titanium (Ti), and have a moderate degradation rate, potentially serving as a good candidate for internal fixation materials, especially at load-bearing sites of the skeleton. Emerging Zn-based alloys and composites have been developed in recent years and in vitro and in vivo studies have been performed to explore their biodegradability, mechanical property, and biocompatibility in order to move towards the ultimate goal of clinical application in fracture fixation. This article seeks to offer a review of related research progress on Zn-based biodegradable materials, which may provide a useful reference for future studies on Zn-based biodegradable materials targeting applications in orthopedic internal fixation.

Corrosion fatigue behavior and anti-fatigue mechanisms of an additively manufactured biodegradable zinc-magnesium gyroid scaffold

Additively manufactured biodegradable zinc (Zn) alloy scaffolds constitute an important branch in orthopedic implants because of their moderate degradation behavior and bone-mimicking mechanical properties. This work investigated the corrosion fatigue response of a zinc-magnesium (Zn-Mg) alloy gyroid scaffold fabricated via laser-powder-bed-fusion additive manufacturing at the first time. The high-cycle compression-compression fatigue testing of the printed Zn-Mg scaffold was conducted in simulated body fluid, showing its favorable fatigue strength, structural reliability, and anti-fatigue capability. The printed Zn-Mg scaffold obtained a 227% higher fatigue strength than that of the printed Zn scaffold but 17% lower strain accumulation at 10⁶ cycles. The accumulative strain of the Zn-Mg scaffold at its fatigue strength was dominant by fatigue ratcheting, since the fatigue damage strain of the scaffold was approximately zero. The corrosion products (ZnO and Zn(OH)₂) were conducive to the inhibition of fatigue ratcheting and fatigue damage. Dislocation pile-up and solid solution phases at the grain boundaries of the Zn-Mg scaffold could retard the spreading of the crack tip and impede excessive grain coarsening, improving its fatigue endurance limit. Notably, the printed Zn-Mg scaffold could dissipate the fatigue energy through moderate grain boundary migration, thus reducing its plastic deformation. These findings illuminated the anti-fatigue mechanisms related to microstructural features and corrosive environments and highlighted the promising prospects of additively manufactured Zn-Mg scaffolds in orthopedic applications. STATEMENT OF SIGNIFICANCE: : Additive manufacturing (AM) of biodegradable metals shows unprecedented prospects for bone tissue regeneration medicine. The corrosion fatigue property is one of the key determinants in the performance of AM biodegradable scaffolds. In this study, a Zn-Mg gyroid scaffold was additively manufactured with admirable fatigue endurance limit and anti-fatigue capability. We reported that the corrosion fatigue performance was highly relevant to the microstructural features, validating that the grain boundary engineering strategy improved fatigue strength and inhibited crack penetration. Notably, moderate grain boundary migration could dissipate fatigue energy and reduce plastic deformation. Furthermore, corrosion products were conducive to impeding fatigue ratcheting and fatigue damage, indicating the promising potential of AM Zn-Mg scaffolds in treating load-bearing bone defects.

Compressive Properties and Degradable Behavior of Biodegradable Porous Zinc Fabricated with the Protein Foaming Method

A new protein foaming-consolidation method for preparing porous zinc was developed using three proteins (egg white protein (EWP), bovine bone collagen protein (BBCP), and fish bone collagen protein (FBCP)) as both consolidating and foaming agents. The preparation route utilized powder mixing and sintering processing, which could be divided into three steps: slurry preparation, low-temperature foaming, and high-temperature sintering. The morphological characteristics of the pore structures revealed that the porous zinc had an interconnected open-cell structure. Compared to the porous zinc prepared with EWP or BBCP, the porous zinc prepared with FBCP possessed the largest average pore size and the highest compressive properties. The porosity of the porous zinc increased with the stirring time, the content of protein and sucrose, and higher sintering temperatures. Moreover, a compression test and immersion test were performed to investigate the stress-strain behavior and corrosion properties of the resulting porous zinc. A fluctuated stress plateau could be found due to the brittle fracture of the porous cells. The porous zinc prepared with FBCP showed the highest compressive strength and elastic modulus. The corrosion rate of the porous zinc obtained through an immersion test in vitro using simulated bodily fluids on the thirty-second day was close to 0.02 mm/year. The corresponding corrosion mechanism of porous zinc was also discussed.

An overview and critical assessment of the mechanisms of microstructural refinement during ultrasonic solidification of metals

A refined, equiaxed grain structure and the formation of finer primary intermetallic phases are some of the notable benefits of ultrasonic processing of liquid/solidifying melts. Ultrasonic treatment (UST) has been widely explored in Al and Mg-based alloys due to its operational versatility and scalability. During UST, the refinement of grain and primary intermetallic phases occurs via cavitation-induced fragmentation mechanisms. In addition, UST improves the efficiency (activation of particles) of the conventional grain refinement process when potent particles are added through master alloys. Though the UST's ability to produce refined as-cast structures is well recognized, the understanding of the refinement mechanisms is still debated and unresolved. Significant efforts have been devoted to understanding these mechanisms through the use of sophisticated techniques such as in-situ/ real-time observation, lab-scale and commercial-scale casting processes. All these studies aim to demonstrate the significance of cavitation, fragmentation modes, and alloy chemistry in microstructure refinement. Although the physical effects of cavitation and acoustic streaming (fluid flow) are primary factors influencing the refinement, the dominant grain refinement mechanisms are affected by several solidification variables and casting conditions. Some of these include melt volume, solute, cooling rate, potent particles, grain growth (equiaxed, columnar or dendritic), and the cold zones of the casting where the onset of nucleation occurs. This review aims to provide a better insight into solidification variables emphasizing the importance of cold zones in generating fine structures for small- and large-volume (direct chill) castings. Another important highlight of this review is to present the relatively less explored mechanism of (acoustic) vibration-induced crystallization and discuss the role of cavitation in achieving a refined ingot structure.

In situ growth of Ca-Zn-P coatings on the Zn-pretreated WE43 Mg alloy to mitigate corrosion and enhance cytocompatibility

Magnesium (Mg) alloys are potential materials for orthopedic fixation devices but rapid degradation of the materials restricts wider clinical applications. Herein, zinc-incorporated calcium phosphate (Ca-Zn-P) coatings are prepared on the Zn-pretreated WE43 Mg alloy by a hydrothermal technique under relatively stable and favorable conditions. The hydrothermal coating consists of a compact bottom layer of CaZn₂(PO₄)₂∙2 H₂O and ZnO granular crystals and a jagged upper layer of CaHPO₄. The Zn coating reduces the corrosion current density of WE43 to (3.49 ± 1.60) × 10^-5 A cm^-2, whereas the Ca-Zn-P/Zn composite coating further reduces it by 3 orders of magnitude in the simulated body fluid (SBF). The charge transfer resistances of the Zn-coated and Ca-Zn-P/Zn-coated alloys increase by 49 and 7176 times to 835 and 1.22 × 10⁵ Ω cm², respectively. The 7-day immersion results reveal that the Zn coating cannot provide long-term protection to WE43 in SBF because of the formation of galvanic couples between the Zn coating and WE43. In contrast, Ca-Zn-P/Zn-coated WE43 remains intact after soaking for 7 days and furthermore, the Ca-Zn-P coating self-repairs and continues to grow despite dissolution. The compact and adherent Ca-Zn-P bottom layer plays a major role in mitigating corrosion of WE43 by hindering penetration of the aggressive medium and charge transfer of the corrosion reactions resulting in only slight corrosion of the Zn layer. Biologically, the Zn coating reduces attachment and proliferation of MC3T3-E1 pre-osteoblasts on WE43, but the composite coating fosters cell adhesion and proliferation which stems from the good biocompatibility of the hydrothermal layer and relatively stable surface conditions avoiding severe corrosion.

Recent advances on the mechanical behavior of zinc based biodegradable metals focusing on the strain softening phenomenon

Zinc based biodegradable metals (BMs) show great potential to be used in various biomedical applications, owing to their superior biodegradability and biocompatibility. Some high-strength (ultimate tensile strength > 600 MPa) Zn based BMs have already been developed through alloying and plastic working, making their use in load-bearing environments becomes a reality. However, different from Mg and Fe based BMs, Zn based BMs exhibit significant "strain-softening" effect that leads to limited uniform deformation. Non-uniform deformation is detrimental to Zn based devices or implants, which will possibly lead to unexpected failure. People might be misled by the considerable fracture elongation of Zn based BMs. Thus, it is important to specify uniform elongation as a term of mechanical requirements for Zn based BMs. In this review, recent advances on the mechanical properties of Zn based BMs have been comprehensively summarized, especially focusing on the strain softening phenomenon. At first, the origin and evaluation criteria of strain softening were introduced. Secondly, the effects of alloying elements (including element type, single or multiple addition, and alloying content) and microstructural characteristics (grain size, constituent phase, phase distribution, etc.) on mechanical properties (especially for uniform elongation) of Zn based BMs were summarized. Finally, how to get a good balance between strength and uniform elongation was generally discussed based on the service environment. In addition, possible ways to minimize or eliminate the strain softening effect were also proposed, such as controlling of twins, solute clusters, and grain boundary characteristics. All these items above would be helpful to understand the mechanical instability of Zn based BMs, and to make the full usage of them in the future medical device design. STATEMENT OF SIGNIFICANCE: Biodegradable metals (BMs) is a hotspot in the field of metallic biomaterials. Fracture elongation is normally adopted to quantify the deformability of Mg and Fe based BMs owing to their negligible necking strain, yet the strain softening would occur in Zn based BMs, which is extremely detrimental to performance of their medical device. In this review paper, a better understanding the mechanical performance of Zn-based BMs with the term "uniform elongation" instead of "fracture elongation" was depicted, and possible ways to minimize or eliminate the strain softening effect were also proposed, such as twins, solute clusters, self-stable dislocation network, and grain boundary characteristics. It would be helpful to understand the mechanical instability of Zn based BMs and making full usage of it in the future medical device design.

Advanced Zinc–Magnesium Alloys Prepared by Mechanical Alloying and Spark Plasma Sintering

Zinc and its alloys are considered as promising materials for the preparation of biodegradable medical devices (stents and bone fixation screws) due to their enhanced biocompatibility. These materials must achieve an ideal combination of mechanical and corrosion properties that can be influenced by alloying or thermomechanical processes. This paper presents the effects of different mechanical alloying (MA) parameters on the composition of Zn-1Mg powder. At the same time, this study describes the influence of preparation by MA on Zn-6Mg and Zn-16Mg alloys. The selected powders were compacted by the spark plasma sintering (SPS) method. Subsequently, their microstructures were studied and their mechanical properties were tested. The overall process led to a significant grain refinement (629 ± 274 nm for Zn-1Mg) and the formation of new intermetallic phases (Mg2Zn11, MgZn2). The compressive properties of the sintered samples were mainly related to the concentration of the alloying elements, where an increase in concentration led to an improvement in strength but a deterioration in ductility. According to the obtained results, the best properties were obtained for the Zn-1Mg alloy.

Degradable ZnS-Supported Bioorthogonal Nanozymes with Enhanced Catalytic Activity for Intracellular Activation of Therapeutics

Bioorthogonal catalysis using transition-metal catalysts (TMCs) provides a toolkit for the in situ generation of imaging and therapeutic agents in biological environments. Integrating TMCs with nanomaterials mimics key properties of natural enzymes, providing bioorthogonal "nanozymes". ZnS nanoparticles provide a platform for bioorthogonal nanozymes using ruthenium catalysts embedded in self-assembled monolayers on the particle surface. These nanozymes uncage allylated profluorophores and prodrugs. The ZnS core combines the non-toxicity and degradability with the enhancement of Ru catalysis through the release of thiolate surface ligands that accelerate the rate-determining step in the Ru-mediated deallylation catalytic cycle. The maximum rate of reaction (V_max) increases ∼2.5-fold as compared to the non-degradable gold nanoparticle analogue. The therapeutic potential of these bioorthogonal nanozymes is demonstrated by activating a chemotherapy drug from an inactive prodrug with efficient killing of cancer cells.

A biodegradable Fe/Zn-3Cu composite with requisite properties for orthopedic applications

Zinc (Zn)-based metals and alloys are emerging as promising biodegradable implant materials due to their inherent biodegradability and good biocompatibility. However, this class of materials exhibits low mechanical strength and a slow degradation rate, which hinders their clinical application. Here we report the development of a new biodegradable Fe/Zn-3Cu composite fabricated by infiltration casting of a Zn-3Cu alloy into an Fe foam followed by hot-rolling. Our results indicate that the hot-rolled (HR) Fe/Zn-3Cu composite exhibited an α-Zn matrix phase, a secondary CuZn₅ phase, and an α-Fe phase. The HR Fe/Zn-3Cu composite exhibited an ultimate tensile strength of 269 MPa, a tensile yield strength of 210 MPa, and an elongation of 27%. The HR Fe/Zn-3Cu composite showed a degradation rate of 228 µm/year after immersion in Hanks' solution for 30 d The diluted extract of the HR Fe/Zn-3Cu composite exhibited a higher cell viability than that of the HR Zn-3Cu alloy in relation to MC3T3-E1 and MG-63 cells. Furthermore, the HR Fe/Zn-3Cu composite showed significantly better antibacterial ability than that of the HR Zn-3Cu alloy in relation to S. aureus. Overall, the HR Fe/Zn-3Cu composite can be anticipated to be a promising biodegradable implant material for bone-fixation applications. STATEMENT OF SIGNIFICANCE: This work reports a new biodegradable Fe/Zn-3Cu composite fabricated by infiltration casting and followed by hot-rolling for biodegradable bone-fixation application. Our findings demonstrated that the hot-rolled (HR) Fe/Zn-3Cu composite exhibited an ultimate tensile strength of 269.1 MPa, a tensile yield strength of 210.3 MPa, and an elongation of 26.7%. HR Fe/Zn-3Cu composite showed a degradation rate of 227.6 µm/a, higher than HR Zn-3Cu alloy after immersion in Hanks' solution for 30 d The diluted extracts of the HR Fe/Zn-3Cu composite exhibited a higher cell viability than HR Zn-3Cu alloy toward MC3T3-E1 cells. Furthermore, the HR Fe/Zn-3Cu composite showed significantly better antibacterial ability than the HR Zn-3Cu alloy toward S. aureus.

Fabrication and characterization of biodegradable Zn scaffold by vacuum heating-press sintering for bone repair

Bone repair materials with excellent mechanical properties are highly desirable, especially in load-bearing sits. However, the currently used ceramic- and polymer-based ones mainly show poor mechanical properties. Recently, biodegradable metals have attracted extensive attention due to their reliable mechanical strength and degradability. As biodegradable metals, zinc-based materials are promising due to their suitable degradation rate and good biocompatibility. Here, we fabricated biodegradable porous Zn scaffolds with relatively high mechanical properties by vacuum heating-press sintering using NaCl particles as space holders. The microstructure, actual porosity, compressive mechanical properties, in vitro degradation behavior and the vitality of osteoblasts of porous Zn scaffolds were tested and investigated. The results show the porosities of the prepared porous Zn scaffolds are ranging from 11.3 % to 63.3 %, and the pore sizes are similar to the size range of the screened NaCl particles (200-500 μm). Compressive yield strength of 14.2-73.7 MPa and compressive elastic modulus of 1.9-6.7 GPa are shown on porous Zn scaffolds, some of which approach to that of cancellous bone (2-12 MPa and 0.1-5 GPa). Compared to bulk Zn, although the porous structures cause a partial loss of strength, the reliable mechanical properties are still retained. In addition, the porous structures not only greatly increase the degradation rate, but also promote the proliferation of osteoblasts. Based on these results, biodegradable porous Zn scaffolds (porosity in the 40 %-50 %) fabricated by vacuum heating-press sintering method show high application potential for clinical bone repair.

A biodegradable in situ Zn-Mg2Ge composite for bone-implant applications

Zinc (Zn)-based composites have received extensive attention as promising biodegradable materials due to their unique combination of moderate biodegradability, biocompatibility, and functionality. Nevertheless, the low mechanical strength of as-cast Zn-based composites impedes their practical clinical application. Here we reported the mechanical properties, corrosion behavior, wear properties, and cytotoxicity of in situ synthesized biodegradable Zn-xMg₂Ge (x = 1, 3, and 5 wt.%) composites for bone-implant applications. The mechanical properties of Zn-xMg₂Ge composites were effectively improved by alloying and hot-rolling due to particle reinforcement of the Mg₂Ge intermetallic phase and dynamic recrystallization. The hot-rolled (HR) Zn-3Mg₂Ge composite exhibited the best mechanical properties, including a yield strength of 162.3 MPa, an ultimate tensile strength of 264.3 MPa, an elongation of 10.9%, and a Brinell hardness of 83.9 HB. With an increase in Mg₂Ge content, the corrosion and degradation rates of the HR Zn-xMg₂Ge composites gradually increased, while their wear rate decreased and then increased in Hanks' solution. The diluted extract (12.5% concentration) of the HR Zn-3Mg₂Ge composite showed the highest cell viability compared to the other HR composites and their as-cast pure Zn counterparts. Overall, the HR Zn-3Mg₂Ge composite can be considered a promising biodegradable Zn-based composite for bone-implant applications. STATEMENT OF SIGNIFICANCE: This paper reports the mechanical properties, corrosion behavior, wear properties, and cytotoxicity of in situ synthesized biodegradable Zn-xMg₂Ge (x = 1, 3, and 5 wt.%) composites for bone-implant applications. Our findings demonstrated that the mechanical properties of Zn-xMg₂Ge composites were effectively improved by alloying and hot-rolling due to Mg₂Ge particle reinforcement and dynamic recrystallization. The hot-rolled Zn-3Mg₂Ge composite showed superior cytocompatibility, satisfying corrosion and degradation rates, and the best mechanical properties including a yield strength of 162.3 MPa, an ultimate tensile strength of 264.3 MPa, and an elongation of 10.9%.

Biomechanical evaluation on a novel design of biodegradable embossed locking compression plate for orthopaedic applications using finite element analysis

In orthopaedics, conventional implant plates such as locking compression plate (LCP) made from non-biodegradable materials play a vital role in the fixation to support bone fractures, but also create a complication such as stress shielding. These again require a painful surgery to remove/replace after they have healed as it does not degrade into the physiological environment (PE). Currently, there has already been enough discovery of biodegradable materials that, despite being mechanically inefficient compared to non-biodegradable materials, can completely be biodegraded in PE during and after healing to avoid such problems. While there has been insufficient research on the design of biodegradable implant plates, the implementation of which may help achieve the goal with an effort of high mechanical strength. A novel design of biodegradable embossed locking compression plate (BELCP) is designed for biodegradable materials to approach superior mechanical performance and complete degradation over time, considering all such parameters and factors. For biomechanical evaluation, four-point bending test (4PBT), axial compressive and tensile test (ACTT) and torsion test (TT) have been performed on LCP, BELCP and its continuously degraded forms made of biodegradable material (Mg-alloy) using finite element method. BELCP has found 50%, 100% and 100% higher mechanical performance and safer in 4PBT, ACTT and TT, respectively, than LCP. Moreover, BELCP has also observed safe during continuous degradation up to 6 months after implantation under these three tests, considering an approximate sustained degradation rate of about 4 mm/year. Even Mg-alloy made BELCP can be sufficient and safer to support fractured bone than SS-alloy made LCP, but not Ti-alloy made LCP. BELCP can be a successful biodegradable bone implant plate after human/animal trials in the future.

Biodegradable Zn-Cu-Fe Alloy as a Promising Material for Craniomaxillofacial Implants: An in vitro Investigation into Degradation Behavior, Cytotoxicity, and Hemocompatibility

Zinc-based nanoparticles, nanoscale metal frameworks and metals have been considered as biocompatible materials for bone tissue engineering. Among them, zinc-based metals are recognized as promising biodegradable materials thanks to their moderate degradation rate ranging between magnesium and iron. Nonetheless, materials’ biodegradability and the related biological response depend on the specific implant site. The present study evaluated the biodegradability, cytocompatibility, and hemocompatibility of a hot-extruded zinc-copper-iron (Zn-Cu-Fe) alloy as a potential biomaterial for craniomaxillofacial implants. Firstly, the effect of fetal bovine serum (FBS) on in vitro degradation behavior was evaluated. Furthermore, an extract test was used to evaluate the cytotoxicity of the alloy. Also, the hemocompatibility evaluation was carried out by a modified Chandler-Loop model. The results showed decreased degradation rates of the Zn-Cu-Fe alloy after incorporating FBS into the medium. Also, the alloy exhibited acceptable toxicity towards RAW264.7, HUVEC, and MC3T3-E1 cells. Regarding hemocompatibility, the alloy did not significantly alter erythrocyte, platelet, and leukocyte counts, while the coagulation and complement systems were activated. This study demonstrated the predictable in vitro degradation behavior, acceptable cytotoxicity, and appropriate hemocompatibility of Zn-Cu-Fe alloy; therefore, it might be a candidate biomaterial for craniomaxillofacial implants.

Additive manufacturing of Zn-Mg alloy porous scaffolds with enhanced osseointegration: In vitro and in vivo studies

Biodegradable metals (BM) and additive manufacturing (AM) are regarded revolutionary biomaterials and biofabrication technologies for bone repairing metal implants, the combination of both, namely AM of BM, is thus expected to solve the dual technical difficulties including "conventional medical metals are biologically inert and exist in the human body permanently" and "conventional manufacturing processes are inadequate to fabricate personalized implants of complicated structure". This work additively manufactured biodegradable Zn-Mg alloy porous scaffolds by laser powder bed fusion (L-PBF). By using the pre-alloyed Zn-xMg (x = 1, 2 and 5 wt.%) powder and the optimized processing conditions, high fusion quality with the relative density greater than 99.5% was confirmed for the L-PBF parts. The influence of Mg content on microstructure, mechanical properties, in vitro corrosion, cytocompatibility, in vivo degradation, biocompatibility and osteogenic effect was investigated. Fine α-Zn grains and precipitation phases including Mg₂Zn₁₁ and MgZn₂ were observed in the Zn-xMg L-PBF parts. The hardness increased, and the strength increases firstly and then decreased with increasing the Mg content. The compressive strength and elastic modulus of Zn-1Mg porous scaffolds reached the highest as 40.9 ± 0.4 MPa and 1.17 ± 0.11 GPa, respectively, equivalent to those of cancellous bone. The corrosion rate and cell viability slightly rose with increasing the Mg content. Histological analysis after 6-week and 12-week implantation in rabbit femurs showed enhanced bone formation around the Zn-1Mg porous scaffolds compared with pure Zn counterparts. In summary, Zn-1Mg porous scaffolds produced by L-PBF presented promising results to fulfill customized requirements of biodegradable bone implants. STATEMENT OF SIGNIFICANCE: Additive manufacturing of biodegradable metal porous scaffolds is expected to solve the dual challenges from customized structures and bioactive function required for bone implants. It was the first to present a systematic in vitro and in vivo investigation into the compositions, microstructure, mechanical properties, biodegradation, biocompatibility and osteogenic effect of additively manufactured Zn-Mg alloy porous scaffolds. Reliable formation quality and performance evaluation was achieved by using the pre-alloyed Zn-xMg (x = 1, 2 and 5 wt.%) powder and the optimized laser powder bed fusion process. Although the Zn-1Mg scaffolds exhibited promising mechanical strength, biocompatibility, and osteogenic effect, their degradation rate needs to be further accelerated compared with the term of bone reconstruction.

In vivo performance of a rare earth free Mg–Zn–Ca alloy manufactured using twin roll casting for potential applications in the cranial and maxillofacial fixation devices

A magnesium alloy containing essential, non-toxic, biodegradable elements such as Ca and Zn has been fabricated using a novel twin-roll casting process (TRC). Microstructure, mechanical properties, in vivo corrosion and biocompatibility have been assessed and compared to the properties of the rare earth (RE) element containing WE43 alloy. TRC Mg-0.5 wt% Zn- 0.5 wt% Ca exhibited fine grains with an average grain size ranging from 70 to 150 μm. Mechanical properties of a TRC Mg-0.5Zn-0.5Ca alloy showed an ultimate tensile strength of 220 MPa and ductility of 9.3%. The TRC Mg-0.5Zn-0.5Ca alloy showed a degradation rate of 0.51 ± 0.07 mm/y similar to that of the WE43 alloy (0.47 ± 0.09 mm/y) in the rat model after 1 week of implantation. By week 4 the biodegradation rates of both alloys studied were lowered and stabilized with fewer gas pockets around the implant. The histological analysis shows that both WE43 and TRC Mg-0.5Zn-0.5Ca alloy triggered comparable tissue healing responses at respective times of implantation. The presence of more organized scarring tissue around the TRC Mg-0.5Zn-0.5Ca alloys suggests that the biodegradation of the RE-free alloy may be more conducive to the tissue proliferation and remodelling process.

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Mg-0.5Zn-0.5Ca alloy plates were fabricated by a twin-roll casting (TRC) process.

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TRC alloy showed an ultimate strength and elongation of 221 ± 2 MPa and 9 ± 2%.

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Gas development during in vivo degradation was analysed using μ-CT techniques.

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Histological analysis revealed a good biocompatibility and promoted healing.

Intestinal stents: Structure, functionalization and advanced engineering innovation

Intestinal stents are a palliative treatment option that solves many shortcomings of traditional surgeries for cancer-induced intestinal obstructions. The present review provides an overview of the incidence, clinical manifestations and limitations in the treatment of intestinal cancers. The paper also discusses material property requirements, indications, complications and the future of stent-assisted therapy. The advantages and disadvantages of different materials and processing techniques for intestinal stents are reviewed along with new stent treatment combinations for colorectal cancer. Challenges that require further cooperative studies are also detailed. The future development of intestinal stents will depend on innovation in material designs as well as the utilization of multi-functional strategies and innovative engineering solutions.

Mg-, Zn-, and Fe-Based Alloys With Antibacterial Properties as Orthopedic Implant Materials

Implant-associated infection (IAI) is one of the major challenges in orthopedic surgery. The development of implants with inherent antibacterial properties is an effective strategy to resolve this issue. In recent years, biodegradable alloy materials have received considerable attention because of their superior comprehensive performance in the field of orthopedic implants. Studies on biodegradable alloy orthopedic implants with antibacterial properties have gradually increased. This review summarizes the recent advances in biodegradable magnesium- (Mg-), iron- (Fe-), and zinc- (Zn-) based alloys with antibacterial properties as orthopedic implant materials. The antibacterial mechanisms of these alloy materials are also outlined, thus providing more basis and insights on the design and application of biodegradable alloys with antibacterial properties as orthopedic implants.

Surface Modification of Pure Zinc by Acid Etching: Accelerating the Corrosion Rate and Enhancing Biocompatibility and Antibacterial Characteristics

Zinc (Zn) has recently been identified as an auspicious biodegradable metal for medical implants and devices due to its tunable mechanical properties and good biocompatibility. However, the slow corrosion rate of Zn in a physiological environment does not meet the requirements for biodegradable implants, hindering its clinical translation. The present study aimed to accelerate the corrosion rate of pure Zn by utilizing acid etching to roughen the surface and increase the substrate surface area. The effects of acid etching on surface morphology, surface roughness, tensile properties, hardness, electrochemical corrosion and degradation behavior, cytocompatibility, direct cell attachment, and biofilm formation were investigated. Interestingly, acid-treated Zn showed an exceptionally high rate of corrosion (∼226-125 μm/year) compared to untreated Zn (∼62 μm/year), attributed to the increased surface roughness (R_a ∼ 1.12 μm) of acid-etched samples. Immersion tests in Hank's solution revealed that acid etching accelerated the degradation rate of Zn samples. In vitro, MC3T3-E1 cell lines in 50 and 25% conditioned media extracts of treated samples showed good cytocompatibility. Reduced bacterial adhesion, biofilm formation, and dispersion were observed for Staphylococci aureus biofilms cultured on acid-etched pure Zn substrates. These results suggest that the surface modification of biodegradable pure Zn metals by acid etching markedly increases the translation potential of zinc for various biomedical applications.

Fixation Performance of Bioabsorbable Zn-6Ag Pins for Osteosynthesis

Bioabsorbable implants have become the focus of the latest research for new bone implant materials. With favorable characteristics such as compatible mechanical characteristics, no long-term side effects, and even osteogenesis enhancing properties they seem to be the future of osteosynthesis. Besides these characteristics, they must perform on the same level as traditional implant materials regarding their mechanical support for bone healing. A particular focus in the research for bioabsorbable implants has been on metal alloys, as these have particularly good mechanical properties such as excellent maximum force and high stability. This study focused on the shear strength of new bioabsorbable zinc and magnesium pins in comparison to traditional implants such as K-wires and cancellous bone screws in bone-implant connections. During quasi-static and fatigue loading experiments, magnesium pins (MAGNEZIX, Syntellix AG, Hannover, Germany) and new zinc silver pins (Zn-6Ag) by Limedion (Limedion GmbH., Mannheim, Germany) were compared with conventional osteosynthetic materials. The pins made of the new bioabsorbable alloys withstood the cyclic loads to the same extent as the conventional osteosynthesis materials. In the quasi-static loading, it was shown that the novel Zn-6Ag from Limedion has the same shear strength as the magnesium pin from Syntellix, which is already in clinical use. In addition, the zinc pin showed significantly better shear strength compared to osteosynthesis with K-wires (p < 0.05).

3D-Printed Double-Helical Biodegradable Iron Suture Anchor: A Rabbit Rotator Cuff Tear Model

Suture anchors are extensively used in rotator cuff tear surgery. With the advancement of three-dimensional printing technology, biodegradable metal has been developed for orthopedic applications. This study adopted three-dimensional-printed biodegradable Fe suture anchors with double-helical threads and commercialized non-vented screw-type Ti suture anchors with a tapered tip in the experimental and control groups, respectively. The in vitro study showed that the Fe and Ti suture anchors exhibited a similar ultimate failure load in 20-pound-per-cubic-foot polyurethane foam blocks and rabbit bone. In static immersion tests, the corrosion rate of Fe suture anchors was 0.049 ± 0.002 mm/year. The in vivo study was performed on New Zealand white rabbits and SAs were employed to reattach the ruptured supraspinatus tendon. The in vivo ultimate failure load of the Fe suture anchors was superior to that of the Ti suture anchors at 6 weeks. Micro-computed tomography showed that the bone volume fraction and bone surface density in the Fe suture anchors group 2 and 6 weeks after surgery were superior, and the histology confirmed that the increased bone volume around the anchor was attributable to mineralized osteocytes. The three-dimensional-printed Fe suture anchors outperformed the currently used Ti suture anchors.

Impact of gadolinium on mechanical properties, corrosion resistance, and biocompatibility of Zn-1Mg-xGd alloys for biodegradable bone-implant applications

Zinc (Zn) and its alloys are currently regarded as one of the promising families of biodegradable metals for implant applications owing to their suitable biodegradability and biofunctionality. However, the inadequate mechanical properties of as-cast (AC) pure Zn restricted the practical clinical bone-implant applications due to its coarse grain size and hexagon close-packed crystal structure. Here, the impact of gadolinium (Gd) on the mechanical properties, corrosion resistance, hemolysis percentage, anticoagulant activity, and cytotoxicity of AC and hot-rolled (HR) Zn-1Mg-xGd (x = 0.1, 0.2, and 0.3) (wt.%) alloys were investigated for biodegradable bone-implant applications. Tensile testing showed that the HR Zn-1Mg-0.3Gd alloy exhibited the highest tensile strength of 288.1 MPa, tensile yield strength of 250.9 MPa, and elongation of 13.2%. Electrochemical corrosion and immersion tests revealed that the corrosion rates of both AC and HR specimens increased with increasing Gd content in Hanks' solution, and the HR Zn-1Mg-xGd specimens exhibited higher corrosion rates compared to their AC counterparts. The HR Zn-1Mg-xGd specimens showed an increasing hemolysis percentages and decreasing activated partial thromboplastin time (APTT) values with increasing Gd addition. The alloy extracts of HR samples at ≤ 25% concentration exhibited no cytotoxicity toward MG-63 cells, and the HR Zn-1Mg-0.3Gd alloy displayed the highest cell viability among all three alloy extracts at 12.5% concentration. Overall, the HR Zn-1Mg-0.3Gd can be considered a promising biodegradable implant material for bone-implant materials owing to its high mechanical strength and ductility, suitable degradation rate, and satisfying biocompatibility. STATEMENT OF SIGNIFICANCE: In this work, Zn-1Mg-xGd (x = 0.1, 0.2, and 0.3 wt.%) alloys were developed by alloying with gadolinium (Gd) and hot-rolling, and their mechanical properties, corrosion behavior, hemolysis percentage, anticoagulant activity, and cytotoxicity were investigated for biodegradable implant application. Our findings demonstrated that the hot-rolled Zn-1Mg-0.3Gd alloy exhibit the highest ultimate tensile strength of 288.1 MPa, yield strength of 250.9 MPa, and elongation of 13.2%. Hot-rolled Zn-1Mg-xGd alloys show slowly increasing hemolysis percentages and decreasing activated partial thromboplastin time (APTT) values with increasing Gd addition. Extracts of hot-rolled Zn-1Mg-xGd alloys at a concentration of ≤ 25% show no cytotoxicity towards MG-63 cells, and Zn-1Mg-0.3Gd exhibit good cytocompatibility among all three alloys at a concentration of 12.5%.

Processing optimization, mechanical properties, corrosion behavior and cytocompatibility of additively manufactured Zn-0.7Li biodegradable metals

Biodegradable Zn-Li alloys exhibit superior mechanical performance and favorable osteogenic capability for load-bearing bone devices. Additive manufacturing (AM) endows freedom for the fabrication of bone implants of personalized structure to satisfy patient-specific needs. In this paper, AM of Zn-Li alloys was attempted for the first-time using laser powder bed fusion (LPBF), and the fabricated samples exhibited good fusion quality and high dimensional accuracy. The processing optimization, mechanical properties, in vitro corrosion behavior and cytocompatibility were investigated by using Zn-0.7Li bulk and porous samples. The ultimate tensile strength and elastic modulus of bulk samples respectively reached 416.5 MPa and 83.3 GPa, and both were the highest among various additively manufactured Zn alloys reported so far. Porous samples achieved compressive strength (18.2 MPa) and elastic modulus (298.0 MPa), which were comparable to those of cancellous bone. Porous samples exhibited a higher corrosion rate and alleviated the problem of slow degradation of Zn-Li alloys. Nevertheless, osteoblastic cells showed a more spreading and healthier morphology when adhering to the porous samples compared to the bulk samples, thus a better cytocompatibility was confirmed. This work shows tremendous potential to precisely design and modulate biodegradable Zn alloys to fulfill clinical needs by using AM technology. STATEMENT OF SIGNIFICANCE: This paper firstly studied processing optimization during laser powder bed fusion of Zn-Li alloy. Bulk and porous Zn-0.7Li samples in customized design were obtained with high formation quality. The tensile strength of bulk samples reached 416.5 MPa, while the compressive strength and modulus of porous samples reduced to 18.2 MPa and 298.0 MPa, comparable to those of bone. The weight loss of porous samples was roughly 5 times that of bulk samples; osteoblastic cells showed a more spreading and healthier morphology at porous samples, indicating improved biodegradation rate and cytocompatibility. This work shows tremendous potential to precisely design and modulate biodegradable Zn alloy porous scaffolds to fulfill clinical needs by using additive manufacturing technology.

A review of current challenges and prospects of magnesium and its alloy for bone implant applications

Medical application materials must meet multiple requirements, and the designed implant must mimic the bone structure in shape and support the formation of bone tissue (osteogenesis). Magnesium (Mg) alloys, as a "smart" biodegradable material and as "the green engineering material in the twenty-first century", have become an outstanding bone implant material due to their natural degradability, smart biocompatibility, and desirable mechanical properties. Magnesium is recognised as the next generation of orthopaedic appliances and bioresorbable scaffolds. At the same time, improving the mechanical properties and corrosion resistance of magnesium alloys is an urgent challenge to promote the application of magnesium alloys. Nevertheless, the excessively quick deterioration rate generally results in premature mechanical integrity disintegration and local hydrogen build-up, resulting in restricted clinical bone restoration applicability. The condition of Mg bone implants is thoroughly examined in this study. The relevant approaches to boost the corrosion resistance, including purification, alloying treatment, surface coating, and Mg-based metal matrix composite, are comprehensively revealed. These characteristics are reviewed to assess the progress of contemporary Mg-based biocomposites and alloys for biomedical applications. The fabricating techniques for Mg bone implants also are thoroughly investigated. Notably, laser-based additive manufacturing fabricates customised forms and complicated porous structures based on its distinctive additive manufacturing conception. Because of its high laser energy density and strong controllability, it is capable of fast heating and cooling, allowing it to modify the microstructure and performance. This review paper aims to provide more insight on the present challenges and continued research on Mg bone implants, highlighting some of the most important characteristics, challenges, and strategies for improving Mg bone implants.

Fabrication and Properties of Zn-3Mg-1Ti Alloy as a Potential Biodegradable Implant Material

A Zn-3Mg-1Ti alloy was fabricated by ultrasonic treatment of Zn-Mg alloy melt using a Ti ultrasonic radiation rod. The microstructure, phase structure, mechanical properties, degradation property, and in vitro cytotoxicity were investigated systematically. The obtained Zn-3Mg-1Ti alloy is composed of the Zn, Mg2Zn11, and TiZn16. Owing to the grain refinement and second phase reinforcement, the mechanical properties of Zn-3Mg-1Ti alloy is improved. In addition, the Zn-3Mg-1Ti alloy exhibits minimal cytotoxicity compared to pure Zn and Zn-1Ti alloy. Electrochemical tests show that the Zn-3Mg-1Ti alloy has an appropriate degradation rate in Hank's solution.

Feasibility evaluation of a Cu-38 Zn alloy for intrauterine devices: In vitro and in vivo studies

The existing adverse effects of copper in copper-containing intrauterine devices (Cu-IUDs) have raised concerns regarding their use. These adverse effects include burst release of cupric ions (Cu²⁺) at the initial stage and an increasingly rough surface of the Cu-IUDs. In this study, we investigated the use of two copper alloys, Cu-38 Zn and H62 as the new upgrading or alternative material for IUDs. Their corrosive properties were studied in simulated uterine fluid (SUF) by using electrochemical methods, with pure Cu as a control. We studied the in vitro long-term corrosion behaviors in SUF, cytotoxicity to uterine cells (human endometrial epithelial cells and human endometrial stromal cells), in vivo biocompatibility and contraceptive efficacy of pure Cu, H62, and Cu-38 Zn. In the first month, the burst release rate of Cu²⁺ in the Cu-38 Zn group was significantly lower than those in the pure Cu and H62 groups. The in vitro cytocompatibility Cu-38 Zn was better than that of pure Cu and H62. Moreover, Cu-38 Zn showed improved tissue biocompatibility in vivo experiments. Therefore, the contraceptive efficacy of the Cu-38 Zn is still maintained as high as the pure Cu while the adverse effects are significantly eased, suggesting that Cu-38 Zn can be a suitable potential candidate material for IUDs. STATEMENT OF SIGNIFICANCE: The existing adverse effects associated with the intrinsic properties of copper materials for copper-containing intrauterine devices (Cu-IUD) are of concern in their employment. Such as, burst release of cupric ions (Cu²⁺) at the initial stage and an increasingly rough surface of the Cu-IUD. In this work, Cu alloyed with a high amount of bioactive Zn was used for a Cu-IUD. The Cu-38 Zn alloy exhibited reduced burst release of Cu²⁺ within the first month compared with the pure Cu and H62. Furthermore, the Cu-38 Zn alloy displayed significantly improved biocompatibility and a much smoother surface. Therefore, high antifertility efficacy of the Cu-38 Zn alloy was well maintained, while the adverse effects are significantly eased, suggesting that the Cu-38 Zn alloy is promising for a Cu-IUD.

Biodegradable Zn-Cu-Mn alloy with suitable mechanical performance and in vitro degradation behavior as a promising candidate for vascular stents

Recently, zinc (Zn) alloy has been considered as a promising biodegradable material due to its excellent physiological degradable behavior and acceptable biocompatibility. However, poor mechanical performance limits its application as vascular stents. In this study, novel biodegradable Zn-2.2Cu-xMn (x = 0.4, 0.7, and 1.0 wt%) alloys with suitable mechanical performance were investigated. The effects of Mn addition on microstructure, mechanical properties, and in vitro degradation of Zn-2.2Cu-xMn alloys were systematically investigated. After adding Mn, dynamic recrystallization (DRX) during hot extrusion was promoted, resulting in slightly finer grain size, higher DRXed regions ratio, and weaker texture. And volume fraction and number density of second phase precipitates (micron, submicron, and nano-sized ε and MnZn₁₃ phase) and the concentration of (Cu, Mn) in the matrix were increased. Therefore, Zn-2.2Cu-xMn alloys exhibited suitable mechanical performances (strength >310 MPa, elongation >30%) mainly due to the combination effects of grain refinement, solid solution strengthening, second phase precipitation hardening, and texture weakening. Moreover, the alloys maintained good stability of mechanical properties within 18 months and good elongation over 15% even at a high strain rate of 0.1 s^-1. In addition, the alloys presented appropriate in vitro degradation rates in a basically uniform degradation mode and acceptable in vitro cytocompatibility. The above results indicated that the newly designed biodegradable Zn-2.2Cu-0.4Mn alloy with suitable comprehensive mechanical properties, appropriate degradation behavior, and acceptable cytocompatibility is a promising candidate for vascular stents.

Mechanical Analysis and Corrosion Analysis of Zinc Alloys for Bioabsorbable Implants for Osteosynthesis

Zinc alloys have recently been researched intensely for their great properties as bioabsorbable implants for osteosynthesis. Pure zinc (Zn) itself has relatively poor strength, which makes it insufficient for most clinical use. Research has already proven that the mechanical strength of zinc can be enhanced significantly by alloying it with silver. This study evaluated zinc silver alloys (ZnAg) as well as novel zinc silver titanium alloys (ZnAgTi) regarding their mechanical properties for the use as bioabsorbable implants. Compared to pure zinc the mechanical strength was enhanced significantly for all tested zinc alloys. The elastic properties were only enhanced significantly for the zinc silver alloys ZnAg6 and ZnAg9. Regarding target values for orthopedic implants proposed in literature, the best mechanical properties were measured for the ZnAg3Ti1 alloy with an ultimate tensile strength of 262 MPa and an elongation at fracture of 16%. Besides the mechanical properties, the corrosion rates are important for bioabsorbable implants. This study tested the corrosion rates of zinc alloys in PBS solution (phosphate buffered solution) with electrochemical corrosion measurement. Zinc and its alloys showed favorable corrosion rates, especially in comparison to magnesium, which has a much lower degradation rate and no buildup of hydrogen gas pockets during the process. Altogether, this makes zinc alloys highly favorable for use as material for bioabsorbable implants for osteosynthesis.

Modifications on porous absorbable Fe-based scaffolds for bone applications: A review from corrosion and biocompatibility viewpoints

Iron (Fe) and Fe-based scaffolds have become a research frontier in absorbable materials which is inherent to their promising mechanical properties including fatigue strength and ductility. Nevertheless, their slow corrosion rate and low biocompatibility have been their major obstacles to be applied in clinical applications. Over the last decade, various modifications on porous Fe-based scaffolds have been performed to ameliorate both properties encompassing surface coating, microstructural alteration via alloying, and advanced topologically order structural design produced by additive manufacturing (AM) techniques. The recent advent of AM produces topologically ordered porous Fe-based structures with an optimized architecture having controllable pore size and strut thickness, intricate internal design, and larger exposed surface area. This undoubtedly opens up new options for controlling Fe corrosion and its structural strengths. However, the in vitro biocompatibility of the AM porous Fe still needs to be addressed considering its higher corrosion rate due to the larger exposed surface area. This review summarizes the latest progress of the modifications on porous Fe-based scaffolds with a specific focus on their responses on the corrosion behavior and biocompatibility.

Design, mechanical and degradation requirements of biodegradable metal mesh for pelvic floor reconstruction

Pelvic organ prolapse (POP) is the herniation of surrounding tissue and organs into the vagina and or rectum, and is a result of weakening of pelvic floor muscles, connective tissue,...

A review on current research status of the surface modification of Zn-based biodegradable metals

Recently, zinc and its alloys have been proposed as promising candidates for biodegradable metals (BMs), owning to their preferable corrosion behavior and acceptable biocompatibility in cardiovascular, bone and gastrointestinal environments, together with Mg-based and Fe-based BMs. However, there is the desire for surface treatment for Zn-based BMs to better control their biodegradation behavior. Firstly, the implantation of some Zn-based BMs in cardiovascular environment exhibited intimal activation with mild inflammation. Secondly, for orthopedic applications, the biodegradation rates of Zn-based BMs are relatively slow, resulting in a long-term retention after fulfilling their mission. Meanwhile, excessive Zn2+ release during degradation will cause in vitro cytotoxicity and in vivo delayed osseointegration. In this review, we firstly summarized the current surface modification methods of Zn-based alloys for the industrial applications. Then we comprehensively summarized the recent progress of biomedical bulk Zn-based BMs as well as the corresponding surface modification strategies. Last but not least, the future perspectives towards the design of surface bio-functionalized coatings on Zn-based BMs for orthopedic and cardiovascular applications were also briefly proposed.

Zinc-nutrient element based alloys for absorbable wound closure devices fabrication: Current status, challenges, and future prospects

The need for the development of load-bearing, absorbable wound closure devices is driving the research for novel materials that possess both good biodegradability and superior mechanical characteristics. Biodegradable metals (BMs), namely: magnesium (Mg), zinc (Zn) and iron (Fe), which are currently being investigated for absorbable vascular stent and orthopaedic implant applications, are slowly gaining research interest for the fabrication of wound closure devices. The current review presents an overview of the traditional and novel BM-based intracutaneous and transcutaneous wound closure devices, and identifies Zn as a promising substitute for the traditional materials used in the fabrication of absorbable load-bearing sutures, internal staples, and subcuticular staples. In order to further strengthen Zn to be used in highly stressed situations, nutrient elements (NEs), including calcium (Ca), Mg, Fe, and copper (Cu), are identified as promising alloying elements for the strengthening of Zn-based wound closure device material that simultaneously provide potential therapeutic benefit to the wound healing process during implant biodegradation process. The influence of NEs on the fundamental characteristics of biodegradable Zn are reviewed and critically assessed with regard to the mechanical properties and biodegradability requirements of different wound closure devices. The opportunities and challenges in the development of Zn-based wound closure device materials are presented to inspire future research on this rapidly growing field.

Biocompatibility and Degradation Behavior of Molybdenum in an In Vivo Rat Model

The biocompatibility and degradation behavior of pure molybdenum (Mo) as a bioresorbable metallic material (BMM) for implant applications were investigated. In vitro degradation of a commercially available Mo wire (ø250 µm) was examined after immersion in modified Kokubo's SBF for 28 days at 37 °C and pH 7.4. For assessment of in vivo degradation, the Mo wire was implanted into the abdominal aorta of female Wistar rats for 3, 6 and 12 months. Microstructure and corrosion behavior were analyzed by means of SEM/EDX analysis. After explantation, Mo levels in serum, urine, aortic vessel wall and organs were investigated via ICP-OES analysis. Furthermore, histological analyses of the liver, kidneys, spleen, brain and lungs were performed, as well as blood count and differentiation by FACS analysis. Levels of the C-reactive protein were measured in blood plasma of all the animals. In vitro and in vivo degradation behavior was very similar, with formation of uniform, non-passivating and dissolving product layers without occurrence of a localized corrosion attack. The in vitro degradation rate was 101.6 µg/(cm2·d) which corresponds to 33.6 µm/y after 28 days. The in vivo degradation rates of 12, 33 and 36 µg/(cm2·d) were observed after 3, 6 and 12 months for the samples properly implanted in the aortic vessel wall. This corresponds with a degradation rate of 13.5 µm/y for the 12-month cohort. However, the magnitude of degradation strongly depended on the implant site, with the wires incorporated into the vessel wall showing the most severe degradation. Degradation of the implanted Mo wire neither induced an increase in serum or urine Mo levels nor were elevated Mo levels found in the liver and kidneys compared with the respective controls. Only in the direct vicinity of the implant in the aortic vessel wall, a significant amount of Mo was found, which, however, was far below the amounts to be expected from degrading wires. No abnormalities were detected for all timepoints in histological and blood analyses compared to the control group. The C-reactive protein levels were similar between all the groups, indicating no inflammation processes. These findings suggest that dissolved Mo from a degrading implant is physiologically transported and excreted. Furthermore, radiographic and µCT analyses revealed excellent radiopacity of Mo in tissues. These findings and the unique combination with its extraordinary mechanical properties make Mo an interesting alternative for established BMMs.

Advances on biodegradable zinc-silver-based alloys for biomedical applications

The biodegradable metals have great potential for the biomedical applications, which could be gradually degraded, absorbed, or excreted in the human body, avoiding the removal though secondary surgery. Zinc-based alloys are novel series of degradable metals for medical applications, and they are gaining lots of attention in the research field of absorbable metals. Zinc-silver (Zn-Ag) alloys show superior mechanical strength, good biodegradability, biocompatibility, and antibacterial properties, which render them to be potential candidates for biomedical applications. In this paper, we reviewed the development of Zn-Ag alloys in terms of mechanical properties, degradabilities, biocompatibilities, antibacterial properties, and potential applications in dentistry.

A Complex Evaluation of the In-Vivo Biocompatibility and Degradation of an Extruded ZnMgSr Absorbable Alloy Implanted into Rabbit Bones for 360 Days

The increasing incidence of trauma in medicine brings with it new demands on the materials used for the surgical treatment of bone fractures. Titanium, its alloys, and steel are used worldwide in the treatment of skeletal injuries. These metallic materials, although inert, are often removed after the injured bone has healed. The second-stage procedure—the removal of the plates and screws—can overwhelm patients and overload healthcare systems. The development of suitable absorbable metallic materials would help us to overcome these issues. In this experimental study, we analyzed an extruded Zn-0.8Mg-0.2Sr (wt.%) alloy on a rabbit model. From this alloy we developed screws which were implanted into the rabbit tibia. After 120, 240, and 360 days, we tested the toxicity at the site of implantation and also within the vital organs: the liver, kidneys, and brain. The results were compared with a control group, implanted with a Ti-based screw and sacrificed after 360 days. The samples were analyzed using X-ray, micro-CT, and a scanning electron microscope. Chemical analysis revealed only small concentrations of zinc, strontium, and magnesium in the liver, kidneys, and brain. Histologically, the alloy was verified to possess very good biocompatibility after 360 days, without any signs of toxicity at the site of implantation. We did not observe raised levels of Sr, Zn, or Mg in any of the vital organs when compared with the Ti group at 360 days. The material was found to slowly degrade in vivo, forming solid corrosion products on its surface.

Rivet-Inspired Modification of Carbon Nanotubes by In Situ-Reduced Ag Nanoparticles To Enhance the Strength and Ductility of Zn Implants

Zinc shows promise for bone repair applications, while its strength and ductility require to be improved. Carbon nanotubes (CNTs) are exceptional reinforcements due to their superior strength, ultrahigh Young's modulus, and large aspect ratio. However, their strong agglomeration and weak interfacial bonding with the matrix are key bottleneck problems restricting the reinforcing effect. In this study, Ag nanoparticles were in situ reduced on CNTs and then the CNT@Ag powders were used to prepare Zn-CNT@Ag implants by laser powder bed fusion. Results showed that Ag reacted with Zn to form a "knot"-like AgZn₃ phase. It had the same lattice structure (HCP) with Zn, which indicated a good lattice matching with the matrix, thus improving the dispersion of CNTs. More significantly, the knot played a "rivet" role and enhanced the load transfer capacity, which advantaged the CNT strengthening effects by assisting in transferring the load. Moreover, it enhanced the heterogeneous nucleation effects during solidification, which weakened the texture strength of the matrix and thus increased the ductility by improving the sliding capacity. The compressive yield strength, ultimate tensile strength, and elongation of the Zn-CNT@Ag implant were increased by 22, 26, and 17% in comparison to Zn-CNTs. Moreover, the Zn-CNT@Ag implant exhibited favorable antibacterial activity with a bacterial inhibition rate of 87.79%. Additionally, it also exhibited a suitable degradation rate and acceptable biocompatibility.

Improved mechanical, degradation, and biological performances of Zn–Fe alloys as bioresorbable implants

Zinc (Zn) is a promising bioresorbable implant material with more moderate degradation rate compared to magnesium (Mg) and iron (Fe). However, the low mechanical strength and localized degradation behavior of pure Zn limit its clinical applications. Alloying is one of the most effective ways to overcome these limitations. After screening the alloying element candidates regarding their potentials for improvement on the degradation and biocompatibility, we proposed Fe as the alloying element for Zn, and investigated the in vitro and in vivo performances of these alloys in both subcutaneous and femoral tissues. Results showed that the uniformly distributed secondary phase in Zn–Fe alloys significantly improved the mechanical property and facilitated uniform degradation, which thus enhanced their biocompatibility, especially the Zn-0.4Fe alloy. Moreover, these Zn–Fe alloys showed outstanding antibacterial property. Taken together, Zn–Fe alloys could be promising candidates as bioresorbable medical implants for various cardiovascular, wound closure, and orthopedic applications.

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Zn-0.4Fe alloy significantly improved the mechanical strength and ductility.

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Zn-0.4Fe alloy showed a uniform degradation behavior.

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Subcutaneous and femoral implantations to compare in vivo performances.

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Zn-0.4Fe alloy showed superior hemocompatibility and in vivo osteointegration.

Novel Biodegradable Zn Alloy with Exceptional Mechanical and In Vitro Corrosion Properties for Biomedical Applications

A series of quaternary Zn-Al-Cu-Li alloys with different weight fractions of Cu, Al, and Li were developed and investigated for potential application in high load bearing bioresorbable implants. The developed alloys provided various fractions of binary and ternary intermetallic structures, which resulted in formation of multiphase microstructures containing a zinc-rich η-phase and LiZn₄ and CuZn₄ phases. The intermetallic phases promoted grain refinement and a good combination of mechanical properties. The developed Zn-2Al-4Cu-0.6Li alloy showed strength and ductility close to commercially pure Ti alloys with a UTS value of ∼535 MPa and elongation of 37%. The examination of in vitro corrosion behavior of the developed alloys in the modified Hanks' solution revealed suitable corrosion rates (∼38.5 μm/year). The moderate corrosion rate was controlled by the formation of a homogeneous layer of stable corrosion products that protected the alloys from the corrosive environment, particularly in the late stages of immersion. The developed alloys with the most promising mechanical and corrosion properties appeared to be biocompatible to mouse fibroblast cells and human umbilical mesenchymal stem cells, making them suitable candidates for implant applications.

Impact of sterilization treatments on biodegradability and cytocompatibility of zinc-based implant materials

Biodegradable zinc (Zn) and Zn-based alloys have been recognized as promising biomaterials for biomedical implants. Sterilization is an essential step in handling Zn-based implants before their use in clinical practice and there are various sterilization methods are available. However, how these treatments influence the Zn-based biomaterials remains unknown and is of critical relevance. In this study, three commonly-applied standard sterilization methods, namely gamma irradiation, hydrogen peroxide gas plasma and steam autoclave, were used on pure Zn and Zn3Cu (wt%) alloy. The treated Zn and ZnCu alloy were investigated to compare the different influences of sterilizations on surface characteristics, transient and long-term degradation behavior and cytotoxicity of Zn and Zn alloy. Our results indicate that autoclaving brought about apparently a formation of inhomogeneous zinc oxide film whereas the other two methods produced no apparent alterations on the material surfaces. Consequently, the samples after autoclaving showed significantly faster degradation rates and more severe localized corrosion, especially for the ZnCu alloy, owing to the incomplete covering and unstable zinc oxide layer. Moreover, the autoclave-treated Zn and ZnCu alloy exhibited apparent cytotoxic effects towards fibroblasts, which may be due to the excessive Zn ion releasing and its local concentration exceeds the cellular tolerance capacity. In contrast, gamma irradiation and hydrogen peroxide gas plasma had no apparent adverse effects on the biodegradability and cytocompatibility of Zn and ZnCu alloy. Our findings may have significant implications regarding the selection of suitable sterilization methods for Zn-based implant materials among others.

Biodegradable shape memory alloys: Progress and prospects

Shape memory alloys (SMAs) have a wide range of potential novel medical applications due to their superelastic properties and ability to restore and retain a 'memorised' shape. However, most SMAs are permanent and do not degrade in the body when used in implantable devices. The use of non-degrading metals may lead to the requirement for secondary removal surgery and this in turn may introduce both short and long-term health risks, or additional waste disposal requirements. Biodegradable SMAs can effectively eliminate these issues by gradually degrading inside the human body while providing the necessary support for healing purposes, therefore significantly alleviating patient discomfort and improving healing efficiency. This paper reviews the current progress in biodegradable SMAs from the perspective of biodegradability, mechanical properties, and biocompatibility. By providing insights into the status of SMAs and biodegradation mechanisms, the prospects for Mg- and Fe-based biodegradable SMAs to advance biodegradable SMA-based medical devices are explored. Finally, the remaining challenges and potential solutions in the biodegradable SMAs area are discussed, providing suggestions and research frameworks for future studies on this topic.

Fabrication and characterization of biodegradable zinc matrix composites reinforced by uniformly dispersed beta-tricalcium phosphate via graphene oxide-assisted hetero-agglomeration

The development of biodegradable Zn matrix composites has been considered a promising approach to achieving enhanced mechanical properties, controllable degradation rate, good biocompatibility, and good osseointegration as orthopedic implants. However, scant literature regarding Zn matrix composites has been reported because of the great difficulty in dispersing the nano-sized bioactive reinforcements uniformly within the Zn matrix. In the present study, a novel and effective method were employed to obtain Zn matrix composites reinforced by uniformly dispersed beta-tricalcium phosphate (β-TCP) via graphene oxide (GO)-assisted hetero-agglomeration and subsequent spark plasma sintering process. A very low-content (0.04 vol%) few-layered GO was used as a coupling reagent to connect the Zn matrix and nano-sized TCP particles. In an appropriate polarity solvent, the negatively charged GO sheets could combine with both the positively charged Zn powder and TCP particles by electrostatic attraction and charge neutralization. Due to the nature of hetero-agglomeration, the flexible GO sheet could adhere to the large Zn powder and attracted a certain amount of TCP particles to form a Zn/GO/TCP sandwich structure by charge neutralization thereby forming a uniform dispersion of TCP particles within Zn matrix. After the spark plasma sintering (SPS) process, the TCP particles incorporated with very thin ZnO layers (thickness of a few dozen nanometers) formed a homogeneous and unique 3D network-like distribution in as-sintered TCP/Zn composites. A unique "snap pea"-like structure was confirmed at the grain boundary of α-Zn grains, which consisted of the TCP particles as "pea" and thin ZnO layer as "pod". Due to the uniform dispersion of bioactive TCP particles and unique structure of the TCP incorporating grain boundary, as-sintered 3TCP/Zn matrix composites possessed yield strength (YS) of 140.8 ± 7.7 MPa, failure strain of 36.0 ± 2.8%, the moderate degradation rate of 19.1 ± 3.3 μm·y^-1 and good cytocompatibility to MC3T3-E1 cells. Moreover, osteogenic differentiation activity evaluation revealed that the addition of TCP could significantly improve the expressions of the osteogenic differentiation-related gene (ALP) in MC3T3-E1 cells, thereby resulting in improved osteogenic capability. Therefore, biodegradable 3TCP/Zn matrix composites fabricated by GO-assisted hetero-agglomeration and subsequent SPS process could be a promising material as orthopedic implants.

Impact of scandium on mechanical properties, corrosion behavior, friction and wear performance, and cytotoxicity of a β-type Ti-24Nb-38Zr-2Mo alloy for orthopedic applications

β-type titanium (Ti) alloys have been extensively investigated as orthopedic implant materials due to their unique combination of low elastic modulus, high specific strength, corrosion resistance, and biocompatibility. In this study the mechanical properties, corrosion behavior, friction and wear performance, and cytotoxicity of β-type Ti-24Nb-38Zr-2Mo (TNZM) and Ti-24Nb-38Zr-2Mo-0.1Sc (TNZMS) have been comparatively investigated for orthopedic applications. Cold-rolling (CR) and cold-rolling plus solution-treatment (CR+ST) were performed on the as-cast (AC) alloys and their microstructures and material properties were characterized. The impact of Sc addition on the mechanical and corrosion properties, friction and wear behavior, and in vitro cytocompatibility of the TNZMS alloy was assessed. The CR+ST TNZMS alloy exhibited the best combination of properties among all the alloy samples, with a yield strength of 780 MPa, ultimate strength of 809 MPa, elongation of 19%, Young's modulus of 65.4 GPa, and hardness of 265 HV. Electrochemical testing in Hanks' Solution indicated that the CR+ST TNZMS sample also showed the highest corrosion resistance with a corrosion potential of -0.234 V, corrosion current density of 0.07 µA/cm², and corrosion rate of 1.2 µm/y. Friction and wear testing revealed that the TNZMS alloy showed higher wear resistance compared to the TNZM alloy and the wear resistance of the different samples was ranked CR > CR+ST > AC. Finally, both the CR+ST TNZM and TNZMS showed no-cytotoxicity towards MG-63 cells and the TNZMS exhibited slightly higher cytocompatibility than the TNZM alloy. STATEMENT OF SIGNIFICANCE: This work reports the β-type Ti-24Nb-38Zr-2Mo (TNZM) and Ti-24Nb-38Zr-2Mo-0.1Sc (TNZMS) alloys fabricated by as-cast (AC), cold-rolling (CR), and cold-rolling plus solution-treatment (CR+ST) for potential orthopedic applications. The experimental results showed that the TNZMS alloy exhibited significantly enhanced mechanical, wear, and corrosion properties than those of TNZM alloy; and the CR+ST TNZMS possess a unique combination of the best mechanical and corrosion properties including a yield strength of 780 MPa, ultimate strength of 809 MPa, elongation of 19%, Young's modulus of 65.4 GPa, and corrosion rate of 1.2 µm/y in Hanks' Solution. Both the CR+ST TNZM and TNZMS alloys exhibited non-cytotoxicity towards MG-63 cells and TNZMS showed a higher cytocompatibility than that of TNZM.

In vivo biocompatibility and degradability of a Zn-Mg-Fe alloy osteosynthesis system

Zinc is generally considered to be one of the most promising materials to be used in biodegradable implants, and many zinc alloys have been optimized to improve implant biocompatibility, degradation, and mechanical properties. However, long-term degradation leads to the prolonged presence of degradation products, which risks foreign body reactions. Herein, we investigated the in vivo biocompatibility and degradation of a biodegradable Zn–Mg–Fe alloy osteosynthesis system in the frontal bone, mandible, and femur in beagles for 1 year. Results of the routine blood, biochemical, trace element, and histological analyses of multiple organs, peripheral blood CD4/CD8a levels, and serum interleukin 2 and 4 levels showed good biocompatibility of the Zn–Mg–Fe alloy. Zinc content analysis revealed zinc accumulation in adjacent bone tissue, but not in the liver, kidney, and spleen, which was related to the degradation of the Zn–Mg–Fe alloy. The alloy demonstrated a uniform slowing degradation rate in vivo. No degradation differences in the frontal bone, mandible, and femur were observed. The degradation products included zinc oxide [ZnO], zinc hydroxide [Zn(OH)₂], hydrozincite [Zn₅(OH)₆(CO₃)₂], and hopeite [Zn₃(PO₄)₂·4H₂O]. The good biocompatibility and degradation properties of the Zn–Mg–Fe alloy render it a very attractive osteosynthesis system for clinical applications.

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Zn–Mg–Fe alloy possesses good biocompatibility.

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Zn–Mg–Fe alloy demonstrates a uniform slowing-down degradation rate in vivo.

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No degradation differences are observed in different sites, which supports the design of degradable osteosynthesis systems.

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The degradation products are zinc oxide, zinc hydroxide, hydrozincite, and hopeite.

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Zn–Mg–Fe alloy is a promising candidate for an osteosynthesis system.

A multi-dimensional non-uniform corrosion model for bioabsorbable metallic vascular stents

Bioabsorbable metallic vascular stents (BMVSs) are an innovative technological advancement in the medical engineering field of vascular implants. BMVSs have great potential to revolutionize vascular intervention, but the lack of understanding of the construction material's natural corrosion within the body inhibits the use in clinical medicine. In this study, a corrosion function concept for in vivo implants was created to develop a multi-dimensional, non-uniform corrosion model with a larger goal of simulating the mechanical integrity of BMVSs. This proposed corrosion model simulates the corrosion rate and its effects on magnesium (Mg) alloy AZ31 based on continuum damage mechanics. The model was calibrated using three degradation experiments on Mg alloy specimens. These experiments focused on multi-dimensional corrosion, mass loss rate, and mechanical integrity during the corrosion process. Lastly, to verify the applicability of the proposed model, the resulting corrosion behaviors and mechanical characteristics of the BMVSs were implemented into a finite element framework to produce an overarching simulation of the BMVS's degradation in vivo. The results of the experiments and simulations revealed a proportional link between the corrosion of BMVSs and the number of exposed surfaces. A non-linear decline in mechanical integrity with increasing mass loss was also discovered through experimentation and modeling. Furthermore, the model and simulation can provide some details about changes in morphology and mechanics during BMVS corrosion. This work gives new insights into accurately modeling for BMVS degradation and can be used to optimize product development of BMVSs. STATEMENT OF SIGNIFICANCE: Bioabsorbable metallic vascular stents (BMVSs) are an innovative technological advancement in the medical engineering field of vascular implants. Despite BMVSs have great potential to revolutionize vascular intervention, the lack of understanding of the construction material's natural corrosion within the body inhibits their use in clinical medicine. In this study, a novel multi-dimensional non-uniform corrosion model was proposed to unveil the mechanisms during the in vivo degradation of bioabsorbable metallic implants, which can accurately capture the overlooked changes in morphology and mechanics during BMVS corrosion. This work provides a technical solution to enhance the modeling accuracy in BMVS degradation and can be further used to optimize the design of BMVSs in the future.