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Hassan N, Krieg T, Kopp A, Bach AD, Kröger N. Challenges and Pitfalls of Research Designs Involving Magnesium-Based Biomaterials: An Overview. Int J Mol Sci 2024; 25:6242. [PMID: 38892430 PMCID: PMC11172609 DOI: 10.3390/ijms25116242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/31/2024] [Accepted: 06/01/2024] [Indexed: 06/21/2024] Open
Abstract
Magnesium-based biomaterials hold remarkable promise for various clinical applications, offering advantages such as reduced stress-shielding and enhanced bone strengthening and vascular remodeling compared to traditional materials. However, ensuring the quality of preclinical research is crucial for the development of these implants. To achieve implant success, an understanding of the cellular responses post-implantation, proper model selection, and good study design are crucial. There are several challenges to reaching a safe and effective translation of laboratory findings into clinical practice. The utilization of Mg-based biomedical devices eliminates the need for biomaterial removal surgery post-healing and mitigates adverse effects associated with permanent biomaterial implantation. However, the high corrosion rate of Mg-based implants poses challenges such as unexpected degradation, structural failure, hydrogen evolution, alkalization, and cytotoxicity. The biocompatibility and degradability of materials based on magnesium have been studied by many researchers in vitro; however, evaluations addressing the impact of the material in vivo still need to be improved. Several animal models, including rats, rabbits, dogs, and pigs, have been explored to assess the potential of magnesium-based materials. Moreover, strategies such as alloying and coating have been identified to enhance the degradation rate of magnesium-based materials in vivo to transform these challenges into opportunities. This review aims to explore the utilization of Mg implants across various biomedical applications within cellular (in vitro) and animal (in vivo) models.
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Affiliation(s)
- Nourhan Hassan
- Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital Cologne, 50937 Cologne, Germany
- Institute for Laboratory Animal Science and Experimental Surgery, University of Aachen Medical Center, Faculty of Medicine, RWTH-Aachen University, 52074 Aachen, Germany
- Biotechnology Department, Faculty of Science, Cairo University, Giza 12613, Egypt
| | - Thomas Krieg
- Translational Matrix Biology, Medical Faculty, University of Cologne, 50937 Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50937 Cologne, Germany
- Center for Molecular Medicine (CMMC), University of Cologne, 50937 Cologne, Germany
| | | | - Alexander D. Bach
- Department of Plastic, Aesthetic and Hand Surgery, St. Antonius Hospital Eschweiler, 52249 Eschweiler, Germany
| | - Nadja Kröger
- Institute for Laboratory Animal Science and Experimental Surgery, University of Aachen Medical Center, Faculty of Medicine, RWTH-Aachen University, 52074 Aachen, Germany
- Department of Plastic, Aesthetic and Hand Surgery, St. Antonius Hospital Eschweiler, 52249 Eschweiler, Germany
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Jana A, Das M, Balla VK. In vitro and in vivo degradation assessment and preventive measures of biodegradable Mg alloys for biomedical applications. J Biomed Mater Res A 2021; 110:462-487. [PMID: 34418295 DOI: 10.1002/jbm.a.37297] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/31/2021] [Accepted: 08/04/2021] [Indexed: 12/21/2022]
Abstract
Magnesium (Mg) and its alloys have been widely explored as a potential biodegradable implant material. However, the fast degradation of Mg-based alloys under physiological environment has hindered their widespread use for implant applications till date. The present review focuses on in vitro and in vivo degradation of biodegradable Mg alloys, and preventive measures for biomedical applications. Initially, the corrosion assessment approaches to predict the degradation behavior of Mg alloys are discussed along with the measures to control rapid corrosion. Furthermore, this review attempts to explore the correlation between in vitro and in vivo corrosion behavior of different Mg alloys. It was found that the corrosion depends on experimental conditions, materials and the results of different assessment procedures hardly matches with each other. It has been demonstrated the corrosion rate of magnesium can be tailored by alloying elements, surface treatments and heat treatments. Various researches also studied different biocompatible coatings such as dicalcium phosphate dihydrate (DCPD), β-tricalcium phosphate (β-TCP), hydroxyapatite (HA), polycaprolactone (PCL), polylactic acid (PLA), and so on, on Mg alloys to suppress rapid degradation and examine their influence on new bone regeneration as well. This review shows the need for a standard method of corrosion assessment to predict the in vivo corrosion rate based on in vitro data, and thus reducing the in vivo experimentation.
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Affiliation(s)
- Anuradha Jana
- Bioceramics & Coating Division, CSIR-Central Glass and Ceramic Research Institute, Kolkata, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Mitun Das
- Bioceramics & Coating Division, CSIR-Central Glass and Ceramic Research Institute, Kolkata, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Vamsi Krishna Balla
- Bioceramics & Coating Division, CSIR-Central Glass and Ceramic Research Institute, Kolkata, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
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3
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In vivo Evaluation of PEEK Copolymer Composites for Prosthetic Spine. Macromol Res 2021. [DOI: 10.1007/s13233-021-9027-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lee JH, Baek SM, Lee G, Kim SJ, Kim HS, Hahn SK. Biocompatible Magnesium Implant Double-Coated with Dexamethasone-Loaded Black Phosphorus and Poly(lactide- co-glycolide). ACS APPLIED BIO MATERIALS 2020; 3:8879-8889. [PMID: 35019564 DOI: 10.1021/acsabm.0c01179] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Magnesium (Mg) and its alloys have presented a paradigm for biodegradability in the field of biomedical devices. However, biodegradation of Mg and its alloys cause the formation of hydrogen gas and basic molecules in the body. Here we developed a surface modification method for Mg implants by double-coating with osteogenic dexamethasone (Dex)-loaded black phosphorus (BP) and poly(lactide-co-glycolide) (PLGA). According to electrochemical and biodegradation tests, the prepared Mg-Dex/BP/PLGA showed remarkably enhanced resistance against corrosion possibly by the neutralization of basic molecules from Mg implants with acidic molecules from BP and PLGA with increasing biodegradation. Scanning electron microscopy, cell proliferation tests, Alizarin Red staining, and alkaline phosphatase activity tests confirmed that MC3T3-E1 cells significantly proliferated and were differentiated on the Mg-Dex/BP/PLGA surface. Taken together, the facile surface modification of Mg implants could be effectively harnessed for protecting the Mg surface from corrosion and inducing the osseointegration of preosteoblasts onto the Mg implant.
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Affiliation(s)
- Jung Ho Lee
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Kyungbuk 790-784, Korea
| | - Seung Mi Baek
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Kyungbuk 790-784, Korea
| | - Gibum Lee
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Kyungbuk 790-784, Korea
| | - Seong-Jong Kim
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Kyungbuk 790-784, Korea
| | - Hyoung Seop Kim
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Kyungbuk 790-784, Korea
| | - Sei Kwang Hahn
- Department of Materials Science and Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Kyungbuk 790-784, Korea
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5
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Torroni A, Witek L, Fahliogullari HP, Bortoli JP, Ibrahim A, Hacquebord J, Gupta N, Coelho P. WE43 and WE43-T5 Mg alloys screws tested in-vitro cellular adhesion and differentiation assay and in-vivo histomorphologic analysis in an ovine model. J Biomater Appl 2020; 35:901-911. [PMID: 32903065 DOI: 10.1177/0885328220956788] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
WE43 Mg alloy proved to be an ideal candidate for production of resorbable implants in both clinical and trial settings. In previous studies we tested biocompatibility and degradation properties of WE43 (as-cast) and artificially aged (WE43-T5) Mg alloys in a sheep model. Both alloys showed excellent biocompatibility with the as-cast, WE43, form showing increased degradability compared to the artificially aged, WE43-T5. In the present study, our group assessed the biological behavior and degradation pattern of the same alloys when implanted as endosteal implants in a sheep model. Twelve screws (3x15 mm) were evaluated, one screw per each composition was placed bi-cortically in the mandible of each animal with a titanium (2x12 mm) screw serving as an internal positive control. At 6 and 24 weeks histomorphological analysis was performed, at 6 weeks as cast, WE43, yielded a higher degradation rate, increased bone remodeling and osteolysis compared to the WE43-T5 alloy; however, at 24 weeks WE43-T5 showed higher degradation rate and increased bone remodeling than as-cast. In vitro assay of cell growth, adhesion and differentiation was also conducted to investigate possible mechanisms underlying the behavior expressed from the alloys in vivo. In conclusion WE43-T5 indicated bone/implant interaction properties that makes it more suitable for fabrication of endosteal bone screws.
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Affiliation(s)
| | - Lukasz Witek
- New York University College of Dentistry, New York, NY, USA
| | | | | | | | | | - Nikhil Gupta
- New York University Tandon School of Engineering, Brooklyn, NY, USA
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6
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Sukotjo C, Lima-Neto TJ, Santiago Júnior JF, Faverani LP, Miloro M. Is There a Role for Absorbable Metals in Surgery? A Systematic Review and Meta-Analysis of Mg/Mg Alloy Based Implants. MATERIALS 2020; 13:ma13183914. [PMID: 32899725 PMCID: PMC7558106 DOI: 10.3390/ma13183914] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 12/19/2022]
Abstract
Magnesium (Mg) alloys have received attention in the literature as potential biomaterials for use as absorbable implants in oral and maxillofacial and orthopedic surgery applications. This study aimed to evaluate the available clinical studies related to patients who underwent bone fixation (patients), and received conventional fixation (intervention), in comparison to absorbable metals (comparison), in terms of follow-up and complications (outcomes). A systematic review and meta-analysis were performed in accordance with the PRISMA statement and PROSPERO (CRD42020188654), PICO question, ROBINS-I, and ROB scales. The relative risk (RR) of complications and failures were calculated considering a confidence interval (CI) of 95%. Eight studies (three randomized clinical trial (RCT), one retrospective studies, two case-control studies, and two prospective studies) involving 468 patients, including 230 Mg screws and 213 Titanium (Ti) screws, were analyzed. The meta-analysis did not show any significant differences when comparing the use of Mg and Ti screws for complications (p = 0.868). The estimated complication rate was 13.3% (95% CI: 8.3% to 20.6%) for the comparison group who received an absorbable Mg screw. The use of absorbable metals is feasible for clinical applications in bone surgery with equivalent outcomes to standard metal fixation devices.
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Affiliation(s)
- Cortino Sukotjo
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612, USA
- Correspondence: ; Tel.: +1-617-272-5512
| | - Tiburtino J. Lima-Neto
- Oral and Maxillofacial Surgery, Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, School of Dentistry, São Paulo State University—Unesp, Araçatuba, São Paulo 16015-050, Brazil;
| | - Joel Fereira Santiago Júnior
- Department of Health Sciences, Centro Universitário Sagrado Coração-UNISAGRADO, Bauru, São Paulo 16011-160, Brazil;
| | - Leonardo P. Faverani
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery and Implantology, School of Dentistry, São Paulo State University—Unesp, Araçatuba, São Paulo 16015-050, Brazil;
| | - Michael Miloro
- Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612, USA;
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7
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Cytotoxicity and In Vivo Biosafety Studies of the Poly(alkylphenol) Derivatives as Vulcanizing Agents. Macromol Res 2019. [DOI: 10.1007/s13233-019-7150-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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8
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Sato T, Shimizu Y, Odashima K, Sano Y, Yamamoto A, Mukai T, Ikeo N, Takahashi T, Kumamoto H. In vitro and in vivo analysis of the biodegradable behavior of a magnesium alloy for biomedical applications. Dent Mater J 2019; 38:11-21. [PMID: 30158349 DOI: 10.4012/dmj.2017-324] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The present study was designed to investigate the biodegradation behavior of Mg alloy plates in the maxillofacial region. For in vitro analysis, the plates were immersed in saline solution and simulated body fluid. For in vivo, the plates were implanted into the tibia, head, back, abdominal cavity, and femur and assessed at 1, 2, and 4 weeks after implantation. After implantation, the plate volumes and the formed insoluble salt were measured via micro-computed tomography. SEM/EDX analysis of the insoluble salt and histological analysis of the surrounding tissues were performed. The volume loss of plates in the in vitro groups was higher than that in the in vivo groups. The volume loss was fastest in the abdomen, followed by the head, back, tibia, and femur. There were no statistically significant differences in the insoluble salt volume of the all implanted sites. The corrosion of the Mg alloy will be affected to the surrounding tissue responses. The material for the plate should be selected based on the characteristic that Mg alloys are decomposed relatively easily in the maxillofacial region.
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Affiliation(s)
- Takumi Sato
- Division of Oral and Maxillofacial Surgery, Department of Oral and Medicine and Surgery, Graduate School of Dentistry, Tohoku University
| | - Yoshinaka Shimizu
- Division of Oral Pathology, Department of Oral Medicine and Surgery, Graduate School of Dentistry, Tohoku University
| | - Kenji Odashima
- Division of Oral and Maxillofacial Surgery, Department of Oral and Medicine and Surgery, Graduate School of Dentistry, Tohoku University
| | - Yuya Sano
- Division of Oral Pathology, Department of Oral Medicine and Surgery, Graduate School of Dentistry, Tohoku University
| | - Akiko Yamamoto
- Biometals Group, Biomaterials Unit, Nano-life Field, International Center for Materials Nanoarchitectonics, National Institute for Materials Science
| | - Toshiji Mukai
- Department of Mechanical Engineering, Kobe University
| | - Naoko Ikeo
- Department of Mechanical Engineering, Kobe University
| | - Tetsu Takahashi
- Division of Oral and Maxillofacial Surgery, Department of Oral and Medicine and Surgery, Graduate School of Dentistry, Tohoku University
| | - Hiroyuki Kumamoto
- Division of Oral Pathology, Department of Oral Medicine and Surgery, Graduate School of Dentistry, Tohoku University
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9
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Oshibe N, Marukawa E, Yoda T, Harada H. Degradation and interaction with bone of magnesium alloy WE43 implants: A long-term follow-up in vivo rat tibia study. J Biomater Appl 2019; 33:1157-1167. [DOI: 10.1177/0885328218822050] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The aim of this in vivo study was to examine the degradation and biocompatibility of the WE43 magnesium alloy containing magnesium yttrium, rare earth elements, and zirconium over a one-year long-term follow-up period. Additionally, we compared anodized WE43 implants with monolithic ones and clarified the effect of the anodization. WE43 cylindrical implants with and without anodization (length, 10 mm; diameter, 0.3 mm) were transplanted into the rat tibia. In both groups, the development of corrosion and the change in implant volume were evaluated by in vivo micro-computed tomography until 12 months, and the bone tissue reaction was observed histologically. In the monolithic WE43 implants, hydrogen gas was evident until 14 days and the volume loss was 36.3% after 12 months. In the anodized WE43 implants, the development of hydrogen gas was inhibited and the volume loss was 27.7% after 12 months. The anodized WE43 implants showed a significantly slower corrosion process in the early phase. Therefore, these implants may require a prolonged period to degrade completely and may even resist complete degradation. At one year post surgery, bone maturation progressed and lamellar bone structure developed around the implant in both groups. In conclusion, the WE43 implants showed good long-term stability and biocompatibility in bone tissue.
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Affiliation(s)
- Narumi Oshibe
- Maxillofacial surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Eriko Marukawa
- Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuya Yoda
- Maxillofacial surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroyuki Harada
- Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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10
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Initial Stages of AZ31B Magnesium Alloy Degradation in Ringer′s Solution: Interpretation of EIS, Mass Loss, Hydrogen Evolution Data and Scanning Electron Microscopy Observations. METALS 2018. [DOI: 10.3390/met8110933] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The initial stages of corrosion of AZ31B magnesium alloy, immersed in Ringer′s solution at 37 °C body temperature for four days, have been evaluated by independent gravimetric and chemical methods and through electrochemical impedance spectroscopy (EIS) measurements. The corrosion current densities estimated by hydrogen evolution are in good agreement with the time-integrated reciprocal charge transfer resistance values estimated by EIS. The change in the inductive behavior has been correlated with difference in the chemical composition of corrosion layers. At the shorter immersion of 2 days, EDS analysis of cross section of the uniform corrosion layer detected Cl and Al elements, perhaps as formed aluminum oxychlorides salts.
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Torroni A, Xiang C, Witek L, Rodriguez ED, Flores RL, Gupta N, Coelho PG. Histo-morphologic characteristics of intra-osseous implants of WE43 Mg alloys with and without heat treatment in an in vivo cranial bone sheep model. J Craniomaxillofac Surg 2018; 46:473-478. [DOI: 10.1016/j.jcms.2017.12.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 12/22/2017] [Accepted: 12/27/2017] [Indexed: 11/30/2022] Open
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12
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A Case of Implant Failure in Partial Wrist Fusion Applying Magnesium-Based Headless Bone Screws. Case Rep Orthop 2016; 2016:7049130. [PMID: 27800201 PMCID: PMC5069367 DOI: 10.1155/2016/7049130] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 09/14/2016] [Indexed: 11/18/2022] Open
Abstract
This article presents a case of implant failure resulting in mechanical instability of a scaphotrapezotrapezoideal arthrodesis using magnesium-based headless bone screws. During revision surgery osteolysis surrounding the screws was observed as well as degraded screw threads already in existence at 6 weeks after implantation. The supposed osseous integration attributed to magnesium-based screws could not be reproduced in this particular case. Thus, it can be reasoned that the use of magnesium-based screws for partial wrist arthrodesis cannot be encouraged, at least not in dual use.
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Gomes PS, Zomorodian A, Kwiatkowski L, Lutze R, Balkowiec A, Colaço B, Pinheiro V, Fernandes JCS, Montemor MF, Fernandes MH. In vivo assessment of a new multifunctional coating architecture for improved Mg alloy biocompatibility. ACTA ACUST UNITED AC 2016; 11:045007. [PMID: 27508333 DOI: 10.1088/1748-6041/11/4/045007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Magnesium alloys are regarded as potential biodegradable load-bearing biomaterials for orthopedic applications due to their physico-chemical and biomechanical properties. However, their clinical applicability is restricted by their high degradation rate, which limits the physiological reconstruction of the neighbouring tissues. In this work, a multifunctional coating architecture was developed on an AZ31 alloy by conjoining an anodization process with the deposition of a polymeric-based layer consisting of polyether imine reinforced with hydroxyapatite nanoparticles, aiming at improved control of the corrosion activity and biological performance of the Mg substrate. Anodization and coating protocols were evaluated either independently or combined for corrosion resistance and biological behaviour, i.e. the irritation potential and angiogenic capability within a chicken chorioallantoic membrane assay, and bone tissue response following tibia implantation within a rabbit model. Electrochemical impedance spectroscopy (EIS) analysis showed that coated Mg constructs, particularly anodized plus coated with AZ31, exhibited excellent stability compared to the anodized alloy and, particularly, to the bare AZ31. Microtomographic evaluation of the implanted samples correlated with these degradation results. Mg constructs displayed a non-irritating behaviour, and were associated with high levels of vascular ingrowth. Bone ingrowth neighbouring the implanted constructs was observed for all samples, with coated and anodized plus coated samples presenting the highest bone formation. Gene expression analysis suggested that the enhanced bone tissue formation was associated with the boost in osteogenic activity through Runx2 upregulation, following the activation of PGC-1α/ERRα signaling. Overall, the developed multifunctional coatings appear to be a promising strategy to obtain safe and bioactive biodegradable Mg-based implants with potential applications within bone tissue.
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Affiliation(s)
- Pedro S Gomes
- Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, U. Porto, R. Dr Manuel Pereira da Silva, 4200-393 Porto, Portugal
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14
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Lim HK, Byun SH, Lee JY, Lee JW, Kim SM, Lee SM, Kim HE, Lee JH. Radiological, histological, and hematological evaluation of hydroxyapatite-coated resorbable magnesium alloy screws placed in rabbit tibia. J Biomed Mater Res B Appl Biomater 2016; 105:1636-1644. [PMID: 27174442 DOI: 10.1002/jbm.b.33703] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 03/15/2016] [Accepted: 04/21/2016] [Indexed: 11/11/2022]
Abstract
Titanium (Ti) screw has excellent mechanical property, and osseointegration capacity. However, they require surgery for removal. In contrast, polymer screws are resorbable, but they have poor mechanical properties. In this research, magnesium alloy screws (WE43: Mg-Y-Nd-Zr) that have advantages of titanium and polymer were manufactured. In addition, to increase biocompatibility and control degradation rate, the Mg alloy was coated with hydroxyapatite (HA). Torsion test and corrosion test were performed in vitro. For clinical, radiological and histological evaluation, on the eight rabbits, two HA-coated screws were installed in left tibia, and two noncoated screws were installed in right tibia. Each four rabbits were sacrificed 6 and 12 weeks postoperatively. For hematological evaluation, the same type of screws were installed on both legs. Complete blood count (CBC), Mg2+ concentrate were sampled from the ear central artery on the operation day for a control point, and at 1, 2, 4, 6, 8, and 12 weeks. Mg alloy screws have no differences of biocompatibility according to the HA coating. However, resorption of screw was slower in case of the HA coating. The hematological problem related releasing of Mg was not found. The results suggest that Mg alloy screws have feasibility for clinical application. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1636-1644, 2017.
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Affiliation(s)
- Ho-Kyung Lim
- Department of Oral and Maxillofacial Surgery, Clinical Trial Center, Seoul National University Dental Hospital, Seoul, Korea.,Department of Oral and Maxillofacial Surgery, Korea University Medical Center, Guro Hospital, Seoul, Korea
| | - Soo-Hwan Byun
- Department of Oral and Maxillofacial Surgery, Dongtan Sacred Heart Hospital, Hallym University Medical Center, Kyonggi-do, Korea
| | - Jin-Yong Lee
- Department of Oral and Maxillofacial Surgery, Korea University Medical Center, Guro Hospital, Seoul, Korea
| | - Jung-Woo Lee
- Department of Oral and Maxillofacial Surgery, Kyunghee University Dental Hospital, Seoul, Korea
| | - Sae-Mi Kim
- Department of Material Science and Engineering, Seoul National University, Seoul, Korea
| | - Sung-Mi Lee
- Department of Material Science and Engineering, Seoul National University, Seoul, Korea
| | - Hyoun-Ee Kim
- Department of Material Science and Engineering, Seoul National University, Seoul, Korea
| | - Jong-Ho Lee
- Department of Oral and Maxillofacial Surgery, Clinical Trial Center, Seoul National University Dental Hospital, Seoul, Korea
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15
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Schaller B, Saulacic N, Imwinkelried T, Beck S, Liu EWY, Gralla J, Nakahara K, Hofstetter W, Iizuka T. In vivo degradation of magnesium plate/screw osteosynthesis implant systems: Soft and hard tissue response in a calvarial model in miniature pigs. J Craniomaxillofac Surg 2016; 44:309-17. [DOI: 10.1016/j.jcms.2015.12.009] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 11/19/2015] [Accepted: 12/21/2015] [Indexed: 10/22/2022] Open
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16
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Grillo CA, Alvarez F, Fernández Lorenzo de Mele MA. Degradation of bioabsorbable Mg-based alloys: Assessment of the effects of insoluble corrosion products and joint effects of alloying components on mammalian cells. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 58:372-80. [DOI: 10.1016/j.msec.2015.08.043] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 07/16/2015] [Accepted: 08/22/2015] [Indexed: 02/06/2023]
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17
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Marukawa E, Tamai M, Takahashi Y, Hatakeyama I, Sato M, Higuchi Y, Kakidachi H, Taniguchi H, Sakamoto T, Honda J, Omura K, Harada H. Comparison of magnesium alloys and poly-l-lactide screws as degradable implants in a canine fracture model. J Biomed Mater Res B Appl Biomater 2015; 104:1282-9. [DOI: 10.1002/jbm.b.33470] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 03/27/2015] [Accepted: 05/22/2015] [Indexed: 01/02/2023]
Affiliation(s)
- Eriko Marukawa
- Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University; 1-5-45 Yushima Bunkyo-ku Tokyo 113-8549 Japan
| | - Masato Tamai
- Medical Technology Research Department Medical Technology R&D Division; Olympus Corporation; 2-3 Kuboyama-cho Hachioji Tokyo 192-8512 Japan
| | - Yukinobu Takahashi
- Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University; 1-5-45 Yushima Bunkyo-ku Tokyo 113-8549 Japan
| | - Ichiro Hatakeyama
- Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University; 1-5-45 Yushima Bunkyo-ku Tokyo 113-8549 Japan
| | - Masaru Sato
- Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University; 1-5-45 Yushima Bunkyo-ku Tokyo 113-8549 Japan
| | - Yusuke Higuchi
- Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University; 1-5-45 Yushima Bunkyo-ku Tokyo 113-8549 Japan
| | - Hiroshi Kakidachi
- Medical Technology Research Department Medical Technology R&D Division; Olympus Corporation; 2-3 Kuboyama-cho Hachioji Tokyo 192-8512 Japan
| | - Hirofumi Taniguchi
- Medical Technology Research Department Medical Technology R&D Division; Olympus Corporation; 2-3 Kuboyama-cho Hachioji Tokyo 192-8512 Japan
| | - Takamitsu Sakamoto
- Medical Technology Research Department Medical Technology R&D Division; Olympus Corporation; 2-3 Kuboyama-cho Hachioji Tokyo 192-8512 Japan
| | - Jun Honda
- Medical Technology Research Department Medical Technology R&D Division; Olympus Corporation; 2-3 Kuboyama-cho Hachioji Tokyo 192-8512 Japan
| | - Ken Omura
- Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University; 1-5-45 Yushima Bunkyo-ku Tokyo 113-8549 Japan
| | - Hiroyuki Harada
- Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University; 1-5-45 Yushima Bunkyo-ku Tokyo 113-8549 Japan
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Liu C, He P, Wan P, Li M, Wang K, Tan L, Zhang Y, Yang K. Thein vitrobiocompatibility and macrophage phagocytosis of Mg17Al12phase in Mg-Al-Zn alloys. J Biomed Mater Res A 2014; 103:2405-15. [PMID: 25424541 DOI: 10.1002/jbm.a.35374] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 10/30/2014] [Accepted: 11/20/2014] [Indexed: 11/07/2022]
Affiliation(s)
- Chen Liu
- Department of Materials Science and Engineering; Nanjing University of Science and Technology; Nanjing 210094 China
- Institute of Metal Research; Chinese Academy of Science; Shenyang 110016 China
| | - Peng He
- Southern Medical University; Guangzhou 510515 China
- Hospital of Orthopedics; Guangzhou General Hospital of Guangzhou Military Command; Guangzhou 510010 China
| | - Peng Wan
- Institute of Metal Research; Chinese Academy of Science; Shenyang 110016 China
| | - Mei Li
- Hospital of Orthopedics; Guangzhou General Hospital of Guangzhou Military Command; Guangzhou 510010 China
| | - Kehong Wang
- Department of Materials Science and Engineering; Nanjing University of Science and Technology; Nanjing 210094 China
| | - Lili Tan
- Institute of Metal Research; Chinese Academy of Science; Shenyang 110016 China
| | - Yu Zhang
- Hospital of Orthopedics; Guangzhou General Hospital of Guangzhou Military Command; Guangzhou 510010 China
| | - Ke Yang
- Institute of Metal Research; Chinese Academy of Science; Shenyang 110016 China
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Systematic understanding of corrosion behavior of plasma electrolytic oxidation treated AZ31 magnesium alloy using a mouse model of subcutaneous implant. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2014; 45:45-55. [DOI: 10.1016/j.msec.2014.08.052] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 08/05/2014] [Accepted: 08/29/2014] [Indexed: 11/21/2022]
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Tian P, Liu X. Surface modification of biodegradable magnesium and its alloys for biomedical applications. Regen Biomater 2014; 2:135-51. [PMID: 26816637 PMCID: PMC4669019 DOI: 10.1093/rb/rbu013] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 09/01/2014] [Accepted: 09/02/2014] [Indexed: 12/22/2022] Open
Abstract
Magnesium and its alloys are being paid much attention recently as temporary implants, such as orthopedic implants and cardiovascular stents. However, the rapid degradation of them in physiological environment is a major obstacle preventing their wide applications to date, which will result in rapid mechanical integrity loss or even collapse of magnesium-based implants before injured tissues heal. Moreover, rapid degradation of the magnesium-based implants will also cause some adverse effects to their surrounding environment, such as local gas cavity around the implant, local alkalization and magnesium ion enrichment, which will reduce the integration between implant and tissue. So, in order to obtain better performance of magnesium-based implants in clinical trials, special alloy designs and surface modifications are prerequisite. Actually, when a magnesium-based implant is inserted in vivo, corrosion firstly happens at the implant-tissue interface and the biological response to implant is also determined by the interaction at this interface. So the surface properties, such as corrosion resistance, hemocompatibility and cytocompatibility of the implant, are critical for their in vivo performance. Compared with alloy designs, surface modification is less costly, flexible to construct multi-functional surface and can prevent addition of toxic alloying elements. In this review, we would like to summarize the current investigations of surface modifications of magnesium and its alloys for biomedical application. The advantages/disadvantages of different surface modification methods are also discussed as a suggestion for their utilization.
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Affiliation(s)
- Peng Tian
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, PR China
| | - Xuanyong Liu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai 200050, PR China
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Cellular response to rare earth mixtures (La and Gd) as components of degradable Mg alloys for medical applications. Colloids Surf B Biointerfaces 2014; 117:312-21. [DOI: 10.1016/j.colsurfb.2014.02.030] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 02/18/2014] [Accepted: 02/19/2014] [Indexed: 01/18/2023]
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Ezechieli M, Diekmann J, Weizbauer A, Becher C, Willbold E, Helmecke P, Lucas A, Schavan R, Windhagen H. Biodegradation of a magnesium alloy implant in the intercondylar femoral notch showed an appropriate response to the synovial membrane in a rabbit model in vivo. J Biomater Appl 2014; 29:291-302. [DOI: 10.1177/0885328214523322] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Degradable magnesium alloys are promising biomaterials for orthopedic applications. The aim of this study was to evaluate the potential effects on both the synovial membrane (synovialis) and the synovial fluid (synovia) of the degradation products of a MgYREZr-pin implanted in the intercondylar femoral notch in a rabbit model. Thirty-six animals were randomized into two groups (MgYREZr or Ti6Al4V alloy) of 18 animals each. Each group was then divided into three subgroups with implantation periods of 1, 4, and 12 weeks, with six animals in each subgroup. The initial inflammatory reaction caused by the surgical trauma declined after 12 weeks of implantation, and elucidated a progressive recovery of the synovial membrane. Compared with control Ti6Al4V pins, there were no significant differences between the groups. However, after 12 weeks, recovery of the synovial membrane was more advanced in the titanium group, in which 92% showed no signs of synovitis, than in the magnesium group. A cytotoxicity test with L929 cells and human osteoblasts (HOB) was also conducted, according to EN ISO 10993-5/12, and no toxic leachable products were observed after 24 h of incubation. In conclusion, the MgYREZr alloy seems to be a suitable material for intra-articular degradable implants.
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Affiliation(s)
- Marco Ezechieli
- Department of Orthopedic Surgery, Hannover Medical School, Hannover, Germany
| | - Julia Diekmann
- Department of Orthopedic Surgery, Hannover Medical School, Hannover, Germany
- CrossBIT, Center for Biocompatibility and Implant-Immunology, Department of Orthopedic Surgery, Hannover Medical School, Hannover, Germany
| | - Andreas Weizbauer
- Department of Orthopedic Surgery, Hannover Medical School, Hannover, Germany
- CrossBIT, Center for Biocompatibility and Implant-Immunology, Department of Orthopedic Surgery, Hannover Medical School, Hannover, Germany
| | - Christoph Becher
- Department of Orthopedic Surgery, Hannover Medical School, Hannover, Germany
| | - Elmar Willbold
- Department of Orthopedic Surgery, Hannover Medical School, Hannover, Germany
| | - Patrick Helmecke
- Institute of Production Engineering and Machine Tools (IFW), Leibniz Universität Hannover, Garbsen, Germany
| | - Arne Lucas
- Syntellix AG, Schiffgraben 11, Hannover, Germany
| | | | - Henning Windhagen
- Department of Orthopedic Surgery, Hannover Medical School, Hannover, Germany
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Lindtner RA, Castellani C, Tangl S, Zanoni G, Hausbrandt P, Tschegg EK, Stanzl-Tschegg SE, Weinberg AM. Comparative biomechanical and radiological characterization of osseointegration of a biodegradable magnesium alloy pin and a copolymeric control for osteosynthesis. J Mech Behav Biomed Mater 2013; 28:232-43. [DOI: 10.1016/j.jmbbm.2013.08.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 07/20/2013] [Accepted: 08/04/2013] [Indexed: 01/08/2023]
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Zhou WR, Zheng YF, Leeflang MA, Zhou J. Mechanical property, biocorrosion and in vitro biocompatibility evaluations of Mg-Li-(Al)-(RE) alloys for future cardiovascular stent application. Acta Biomater 2013; 9:8488-98. [PMID: 23385218 DOI: 10.1016/j.actbio.2013.01.032] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 01/18/2013] [Accepted: 01/28/2013] [Indexed: 11/21/2022]
Abstract
Mg-Li-based alloys were investigated for future cardiovascular stent application as they possess excellent ductility. However, Mg-Li binary alloys exhibited reduced mechanical strengths due to the presence of lithium. To improve the mechanical strengths of Mg-Li binary alloys, aluminum and rare earth (RE) elements were added to form Mg-Li-Al ternary and Mg-Li-Al-RE quarternary alloys. In the present study, six Mg-Li-(Al)-(RE) alloys were fabricated. Their microstructures, mechanical properties and biocorrosion behavior were evaluated by using optical microscopy, X-ray diffraction, scanning electronic microscopy, tensile tests, immersion tests and electrochemical measurements. Microstructure characterization indicated that grain sizes were moderately refined by the addition of rare earth elements. Tensile testing showed that enhanced mechanical strengths were obtained, while electrochemical and immersion tests showed reduced corrosion resistance caused by intermetallic compounds distributed throughout the magnesium matrix in the rare-earth-containing Mg-Li alloys. Cytotoxicity assays, hemolysis tests as well as platelet adhesion tests were performed to evaluate in vitro biocompatibilities of the Mg-Li-based alloys. The results of cytotoxicity assays clearly showed that the Mg-3.5Li-2Al-2RE, Mg-3.5Li-4Al-2RE and Mg-8.5Li-2Al-2RE alloys suppressed vascular smooth muscle cell proliferation after 5day incubation, while the Mg-3.5Li, Mg-8.5Li and Mg-8.5Li-1Al alloys were proven to be tolerated. In the case of human umbilical vein endothelial cells, the Mg-Li-based alloys showed no significantly reduced cell viabilities except for the Mg-8.5Li-2Al-2RE alloy, with no obvious differences in cell viability between different culture periods. With the exception of Mg-8.5Li-2Al-2RE, all of the other Mg-Li-(Al)-(RE) alloys exhibited acceptable hemolysis ratios, and no sign of thrombogenicity was found. These in vitro experimental results indicate the potential of Mg-Li-(Al)-(RE) alloys as biomaterials for future cardiovascular stent application and the worthiness of investigating their biodegradation behaviors in vivo.
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Affiliation(s)
- W R Zhou
- Center for Biomedical Materials and Tissue Engineering, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
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Windhagen H, Radtke K, Weizbauer A, Diekmann J, Noll Y, Kreimeyer U, Schavan R, Stukenborg-Colsman C, Waizy H. Biodegradable magnesium-based screw clinically equivalent to titanium screw in hallux valgus surgery: short term results of the first prospective, randomized, controlled clinical pilot study. Biomed Eng Online 2013; 12:62. [PMID: 23819489 PMCID: PMC3702514 DOI: 10.1186/1475-925x-12-62] [Citation(s) in RCA: 247] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 06/25/2013] [Indexed: 02/06/2023] Open
Abstract
Purpose Nondegradable steel-and titanium-based implants are commonly used in orthopedic surgery. Although they provide maximal stability, they are also associated with interference on imaging modalities, may induce stress shielding, and additional explantation procedures may be necessary. Alternatively, degradable polymer implants are mechanically weaker and induce foreign body reactions. Degradable magnesium-based stents are currently being investigated in clinical trials for use in cardiovascular medicine. The magnesium alloy MgYREZr demonstrates good biocompatibility and osteoconductive properties. The aim of this prospective, randomized, clinical pilot trial was to determine if magnesium-based MgYREZr screws are equivalent to standard titanium screws for fixation during chevron osteotomy in patients with a mild hallux valgus. Methods Patients (n=26) were randomly assigned to undergo osteosynthesis using either titanium or degradable magnesium-based implants of the same design. The 6 month follow-up period included clinical, laboratory, and radiographic assessments. Results No significant differences were found in terms of the American Orthopaedic Foot and Ankle Society (AOFAS) score for hallux, visual analog scale for pain assessment, or range of motion (ROM) of the first metatarsophalangeal joint (MTPJ). No foreign body reactions, osteolysis, or systemic inflammatory reactions were detected. The groups were not significantly different in terms of radiographic or laboratory results. Conclusion The radiographic and clinical results of this prospective controlled study demonstrate that degradable magnesium-based screws are equivalent to titanium screws for the treatment of mild hallux valgus deformities.
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Affiliation(s)
- Henning Windhagen
- Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Str,1-7, 30625 Hannover, Germany
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Lensing R, Behrens P, Müller PP, Lenarz T, Stieve M. In vivo testing of a bioabsorbable magnesium alloy serving as total ossicular replacement prostheses. J Biomater Appl 2013; 28:688-96. [DOI: 10.1177/0885328212472246] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Magnesium alloys have been investigated in different fields of medicine and represent a promising biomaterial for implants due to characteristics like bioabsorbability and osteoinduction. The objective of this study was to evaluate the usability of magnesium as implant material in middle ear surgery. Magnesium implants were placed into the right middle ear of eighteen New Zealand White rabbits. Nine animals were euthanized after four weeks and nine animals after three month. The petrous bones were removed and embedded in epoxy resin. The specimens were then polished, stained and evaluated with the aid of a light microscope. The histological examination revealed a good biocompatibility. After four weeks, a beginning corrosion of the implant’s surface and low amount of trabecular bone formation in the area of the stapes base plate was observed. A considerable degradation of implants and obvious bone formation was found three month after implantation. The magnesium alloy used in the present study partly corroded too fast, so that a complete bone reconstruction could not be established in time. The increased osteoinduction on the stapes base plate resulted in a tight bone-implant bonding. Thus, a promising application of magnesium could be a coating of biomaterials in order to improve the bony integration of implants.
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Affiliation(s)
- Rebecca Lensing
- Department of Otolaryngology, Hannover Medical School, Hannover, Germany
| | - Peter Behrens
- Institute for Inorganic Chemistry, Leibniz University of Hannover, Hannover, Germany
| | | | - Thomas Lenarz
- Department of Otolaryngology, Hannover Medical School, Hannover, Germany
| | - Martin Stieve
- Department of Otolaryngology, Hannover Medical School, Hannover, Germany
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Huehnerschulte TA, Reifenrath J, von Rechenberg B, Dziuba D, Seitz JM, Bormann D, Windhagen H, Meyer-Lindenberg A. In vivo assessment of the host reactions to the biodegradation of the two novel magnesium alloys ZEK100 and AX30 in an animal model. Biomed Eng Online 2012; 11:14. [PMID: 22429539 PMCID: PMC3352308 DOI: 10.1186/1475-925x-11-14] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Accepted: 03/20/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Most studies on biodegradable magnesium implants published recently use magnesium-calcium-alloys or magnesium-aluminum-rare earth-alloys.However, since rare earths are a mixture of elements and their toxicity is unclear, a reduced content of rare earths is favorable. The present study assesses the in vivo biocompatibility of two new magnesium alloys which have a reduced content (ZEK100) or contain no rare earths at all (AX30). METHODS 24 rabbits were randomized into 4 groups (AX30 or ZEK100, 3 or 6 months, respectively) and cylindrical pins were inserted in their tibiae. To assess the biodegradation μCT scans and histological examinations were performed. RESULTS The μCT scans showed that until month three ZEK100 degrades faster than AX30, but this difference is leveled out after 6 months. Histology revealed that both materials induce adverse host reactions and high numbers of osteoclasts in the recipient bone. The mineral apposition rates of both materials groups were high. CONCLUSIONS Both alloys display favorable degradation characteristics, but they induce adverse host reactions, namely an osteoclast-driven resorption of bone and a subsequent periosteal formation of new bone. Therefore, the biocompatibility of ZEK100 and AX30 is questionable and further studies, which should focus on the interactions on cellular level, are needed.
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Affiliation(s)
- Tim Andreas Huehnerschulte
- School of Veterinary Medicine Hanover, Small Animals Clinic, CRC 599, Bünteweg 9, 30559 Hanover, Germany
| | - Janin Reifenrath
- School of Veterinary Medicine Hanover, Small Animals Clinic, CRC 599, Bünteweg 9, 30559 Hanover, Germany
| | - Brigitte von Rechenberg
- University of Zurich, Muscoskeletal Research Unit, Winterthurerstrasse 260, 8057 Zurich, Switzerland
| | - Dina Dziuba
- School of Veterinary Medicine Hanover, Small Animals Clinic, CRC 599, Bünteweg 9, 30559 Hanover, Germany
| | - Jan Marten Seitz
- Leibniz University of Hanover, Institute of Materials Science, An der Universität 2, 30823 Garbsen, Germany
| | - Dirk Bormann
- Leibniz University of Hanover, Institute of Materials Science, An der Universität 2, 30823 Garbsen, Germany
| | - Henning Windhagen
- Medical School Hanover, Annastift, Anna-von-Borries-Straße 1-7 30625 Hanover-Kleefeld, Germany
| | - Andrea Meyer-Lindenberg
- Faculty of Veterinary Medicine, Ludwig-Maximilians-Universitaet Muenchen, Veterinärstraße 13, 80539 Munich, Germany
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Waizy H, Weizbauer A, Modrejewski C, Witte F, Windhagen H, Lucas A, Kieke M, Denkena B, Behrens P, Meyer-Lindenberg A, Bach FW, Thorey F. In vitro corrosion of ZEK100 plates in Hank's Balanced Salt Solution. Biomed Eng Online 2012; 11:12. [PMID: 22413949 PMCID: PMC3395858 DOI: 10.1186/1475-925x-11-12] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Accepted: 03/13/2012] [Indexed: 12/20/2022] Open
Abstract
Background In recent years magnesium alloys have been intensively investigated as potential resorbable materials with appropriate mechanical and corrosion properties. Particularly in orthopedic research magnesium is interesting because of its mechanical properties close to those of natural bone, the prevention of both stress shielding and removal of the implant after surgery. Methods ZEK100 plates were examined in this in vitro study with Hank's Balanced Salt Solution under physiological conditions with a constant laminar flow rate. After 14, 28 and 42 days of immersion the ZEK100 plates were mechanically tested via four point bending test. The surfaces of the immersed specimens were characterized by SEM, EDX and XRD. Results The four point bending test displayed an increased bending strength after 6 weeks immersion compared to the 2 week group and 4 week group. The characterization of the surface revealed the presence of high amounts of O, P and Ca on the surface and small Mg content. This indicates the precipitation of calcium phosphates with low solubility on the surface of the ZEK100 plates. Conclusions The results of the present in vitro study indicate that ZEK100 is a potential candidate for degradable orthopedic implants. Further investigations are needed to examine the degradation behavior.
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Affiliation(s)
- Hazibullah Waizy
- Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Str,1-7, 30625 Hannover, Germany.
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Chai H, Guo L, Wang X, Gao X, Liu K, Fu Y, Guan J, Tan L, Yang K. In vitro and in vivo evaluations on osteogenesis and biodegradability of a β-tricalcium phosphate coated magnesium alloy. J Biomed Mater Res A 2011; 100:293-304. [DOI: 10.1002/jbm.a.33267] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Revised: 08/24/2011] [Accepted: 09/08/2011] [Indexed: 11/05/2022]
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Bondarenko A, Hewicker-Trautwein M, Erdmann N, Angrisani N, Reifenrath J, Meyer-Lindenberg A. Comparison of morphological changes in efferent lymph nodes after implantation of resorbable and non-resorbable implants in rabbits. Biomed Eng Online 2011; 10:32. [PMID: 21521497 PMCID: PMC3111424 DOI: 10.1186/1475-925x-10-32] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Accepted: 04/26/2011] [Indexed: 11/10/2022] Open
Abstract
Background Magnesium alloys as biodegradable implant materials received much interest in recent years. It is known that products of implant degradation can induce several types of immune response. Hence, the aim of this study was to examine the morphological changes of efferent lymph nodes after implantation of different resorbable magnesium alloys (MgCa0.8, LAE442) in comparison to commercially available resorbable (PLA) and non-resorbable (titanium) implant materials as well as control groups without implant material. Methods The different implant materials were inserted intramedullary into the rabbit tibia. After postoperative observation periods of three and six months, popliteal lymph nodes were examined histologically and immunhistologically and compared to lymph nodes of sham operated animals and animals without surgery. Haematoxylin and eosin staining was performed for cell differentiation. Mouse anti-CD79α and rat anti-CD3 monoclonal primary antibodies were used for B- and T-lymphocyte detection, mouse anti-CD68 primary antibodies for macrophage detection. Evaluation of all sections was performed applying a semi quantitative score. Results The histological evaluation demonstrated low and moderate levels of morphological changes for both magnesium alloys (LAE442 and MgCa0.8). Higher than moderate values were reached for titanium in sinus histiocytosis and histiocytic apoptosis (3 months) and for PLA in histiocytic apoptosis (3 and 6 months). The immune response to all investigated implants had a non-specific character and predominantly was a foreign-body reaction. LAE442 provoked the lowest changes which might be due to a lower degradation rate in comparison to MgCa0.8. Therewith it is a promising candidate for implants with low immunogenic potential. Conclusion Both examined magnesium alloys did not cause significantly increased morphological changes in efferent lymph nodes in comparison to the widely used implant materials titanium and PLA. LAE442 induced even lower immunological reactions. Therewith MgCa0.8 and especially LAE442 are appropriate candidates for biomedical use.
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Affiliation(s)
- Alexandr Bondarenko
- Department of Pathology, Dnipropetrovs’k State Medical Academy, str. Zhovtneva ploshcha 14, 49005 Dnipropetrovs’k, Ukraine
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Castellani C, Lindtner RA, Hausbrandt P, Tschegg E, Stanzl-Tschegg SE, Zanoni G, Beck S, Weinberg AM. Bone-implant interface strength and osseointegration: Biodegradable magnesium alloy versus standard titanium control. Acta Biomater 2011; 7:432-40. [PMID: 20804867 DOI: 10.1016/j.actbio.2010.08.020] [Citation(s) in RCA: 207] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2010] [Revised: 08/16/2010] [Accepted: 08/20/2010] [Indexed: 10/19/2022]
Abstract
Previous research on the feasibility of using biodegradable magnesium alloys for bone implant applications mainly focused on biocompatibility and corrosion resistance. However, successful clinical employment of endosseous implants is largely dependent on biological fixation and anchorage in host bone to withstand functional loading. In the present study, we therefore aimed to investigate whether bone-implant interface strength and osseointegration of a novel biodegradable magnesium alloy (Mg-Y-Nd-HRE, based on WE43) is comparable to that of a titanium control (Ti-6Al-7Nb) currently in clinical use. Biomechanical push-out testing, microfocus computed tomography and scanning electron microscopy were performed in 72 Sprague-Dawley rats 4, 12 and 24 weeks after implantation to address this question. Additionally, blood smears were obtained from each rat at sacrifice to detect potential systemic inflammatory reactions. Push-out testing revealed highly significantly greater maximum push-out force, ultimate shear strength and energy absorption to failure in magnesium alloy rods than in titanium controls after each implantation period. Microfocus computed tomography showed significantly higher bone-implant contact and bone volume per tissue volume in magnesium alloy implants as well. Direct bone-implant contact was verified by histological examination. In addition, no systemic inflammatory reactions were observed in any of the animals. We conclude that the tested biodegradable implant is superior to the titanium control with respect to both bone-implant interface strength and osseointegration. These results suggest that the investigated biodegradable magnesium alloy not only achieves enhanced bone response but also excellent interfacial strength and thus fulfils two critical requirements for bone implant applications.
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Feser K, Kietzmann M, Bäumer W, Krause C, Bach F. Effects of Degradable Mg-Ca Alloys on Dendritic Cell Function. J Biomater Appl 2010; 25:685-97. [DOI: 10.1177/0885328209360424] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Degradable magnesium alloys are new materials for implants used in orthopedic and trauma surgery. The aim of this study was to investigate the influence of degradable magnesium alloys on the function of dendritic cells (DC) as these cells represent the major antigen presenting cells of the body. MgP (pure magnesium), MgCa 0.6 (0.6% calcium), MgCa 0.8 (0.8% calcium), MgCa 1.0 (1% calcium), and MgCa 1.2 (1.2% calcium) alloys were degraded in cell culture medium. In parallel, murine bone marrow-derived DC were incubated with increasing concentrations (0.1—10 mmol/L) of magnesium chloride and calcium chloride, respectively. Incubation of DC with degradation media over 6 days had no influence on cell viability and only marginal influence on DC migration. Also, the production of TNFα and expression of CD86 was not enhanced by incubation with degraded magnesium alloys. The mixed leukocyte reaction revealed that there was also no increase of the T-cell proliferation in comparison to untreated controls. However, there was a trend toward macrophage development at the expense of DC expansion and an enhanced DC migration was induced by incubation with higher magnesium concentrations. Particularly the latter should be verified in in vivo experiments.
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Affiliation(s)
- K. Feser
- Department of Pharmacology, Toxicology and Pharmacy University of Veterinary Medicine Hannover, Germany
| | - M. Kietzmann
- Department of Pharmacology, Toxicology and Pharmacy University of Veterinary Medicine Hannover, Germany
| | - W. Bäumer
- Department of Pharmacology, Toxicology and Pharmacy University of Veterinary Medicine Hannover, Germany,
| | - C. Krause
- Institute of Materials Science, Leibniz University of Hannover, Germany
| | - F.W. Bach
- Institute of Materials Science, Leibniz University of Hannover, Germany
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Witte F, Calliess T, Windhagen H. [Biodegradable synthetic implant materials : clinical applications and immunological aspects]. DER ORTHOPADE 2009; 37:125-30. [PMID: 18214423 DOI: 10.1007/s00132-008-1193-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In the last decade biodegradable synthetic implant materials have been established for various clinical applications. Ceramic materials such as calcium phosphate, bioglass and polymers are now routinely used as degradable implants in the clinical practice. Additionally these materials are now also used as coating materials or as microspheres for controlled drug release and belong to a series of examples for applications as scaffolds for tissue engineering. Because immense local concentrations of degradation products are produced during biodegradation, this review deals with the question whether allergic immune reactions, which have been reported for classical metallic and organic implant materials, also play a role in the clinical routine for synthetic biodegradable materials. Furthermore, possible explanatory theories will be developed to clarify the lack of clinical reports on allergy or sensitization to biodegradable synthetic materials.
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Affiliation(s)
- F Witte
- Labor für Biomechanik und Biomaterialien, Orthopädische Klinik der Medizinischen Hochschule Hannover, Anna-von-Borries-Str. 1-7, 30625, Hannover, Deutschland.
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