Fabrication, microstructure, and properties of a biodegradable Mg-Zn-Ca clip

Magnesium for Implants: A Review on the Effect of Alloying Elements on Biocompatibility and Properties

An attempt is made to cover the whole of the topic of biodegradable magnesium (Mg) alloys with a focus on the biocompatibility of the individual alloying elements, as well as shed light on the degradation characteristics, microstructure, and mechanical properties of most binary alloys. Some of the various work processes carried out by researchers to achieve the alloys and their surface modifications have been highlighted. Additionally, a brief look into the literature on magnesium composites as also been included towards the end, to provide a more complete picture of the topic. In most cases, the chronological order of events has not been particularly followed, and instead, this work is concentrated on compiling and presenting an update of the work carried out on the topic of biodegradable magnesium alloys from the recent literature available to us.

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.

Corrosion Behavior in Magnesium-Based Alloys for Biomedical Applications

Magnesium alloys exhibit superior biocompatibility and biodegradability, which makes them an excellent candidate for artificial implants. However, these materials also suffer from lower corrosion resistance, which limits their clinical applicability. The corrosion mechanism of Mg alloys is complicated since the spontaneous occurrence is determined by means of loss of aspects, e.g., the basic feature of materials and various corrosive environments. As such, this study provides a review of the general degradation/precipitation process multifactorial corrosion behavior and proposes a reasonable method for modeling and preventing corrosion in metals. In addition, the composition design, the structural treatment, and the surface processing technique are involved as potential methods to control the degradation rate and improve the biological properties of Mg alloys. This systematic representation of corrosive mechanisms and the comprehensive discussion of various technologies for applications could lead to improved designs for Mg-based biomedical devices in the future.

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.

Mechanical properties and biodegradability of Mg-Zn-Ca alloys: homogenization heat treatment and hot rolling

In this study, Mg was alloyed with Zn and Ca to produce six different Mg-Zn-Ca alloys (designated as ZX alloys) by the gravity die casting method. Zn contents of the alloys were 1 wt., 3 wt., and 5 wt.% and Ca contents of the alloys were 0.2 wt. and 1.8 wt.%. Homogenization heat treatment was applied to all cast alloys. After that, a part of each homogenization heat-treated alloys was hot-rolled. Microstructure, mechanical properties, electrochemical and immersion corrosion behaviors at simulated physiological conditions of the heat-treated and hot-rolled alloys were compared. Increasing the amount of alloying elements (Zn and Ca) in Mg reduces grain size and improves the hardness. It was seen that the microstructure consisted of α-Mg as a matrix phase and intermetallic phases: Mg₂Ca phase for the alloy having Zn/Ca = 0.37 (ZX12) and Ca₂Mg₆Zn₃ phase for the other alloys. When the mechanical properties and corrosion rates of homogenized and hot-rolled alloys were compared, it was seen that hot-rolled ZX10-h (Mg-0.94Zn-0.16Ca) alloy can be considered as a fracture bone fixation plate material with its acceptable properties: 121 ± 2.1 MPa yield strength, 226 ± 3.7 MPa tensile strength, % 4.1 ± 0.2 elongation, and 0.062 mm/year immersion corrosion rate.

In vitro and in vivo studies on the degradation and biosafety of Mg-Zn-Ca-Y alloy hemostatic clip with the carotid artery of SD rat model

An Mg-Zn-Ca-Y alloy operative clip was developed to overcome the drawbacks of the Ti clips such as ion dissolution inflammation, interference imaging diagnosis, and the potential harm that permanent retention brings to the patient. The structure optimization design of the hemostatic clip was carried out by the finite element numerical simulation method to realize the matching between the structure design and the material properties. Hot extrusion and wire cutting process was used to prepare the Mg-Zn-Ca-Y alloy operative clip. Corrosion degradation behavior of Mg-Zn-Ca-Y alloy in vitro was investigated using electrochemical noise (EN) and immersion test in Simulated body fluid (SBF). The carotid artery of SD rats was clipped using the Mg-Zn-Ca-Y operative clip to evaluate occlusion safety and the complete corrosion degradation behavior and biocompatibility of Mg-Zn-Ca-Y alloy clip in vivo were investigated using micro-computed tomography, histological analysis, and blood biochemical indicators. It was found that the newly designed Mg-Zn-Ca-Y clip can successfully ligate the carotid artery, and no blood leakage occurred after surgery. After eight months, the Mg-Zn-Ca-Y clip degraded utterly. Histological analysis and various blood biochemical parameters in SD rat serum samples collected at different time periods showed no tissue inflammation around the clips.

Translational status of biomedical Mg devices in China

Magnesium (Mg) and its alloys as temporary medical implants with biodegradable and properly mechanical properties have been investigated for a long time. There are already three kinds of biodegradable Mg implants which are approved by Conformite Europeene (CE) or Korea Food and Drug Administration (KFDA), but not China Food and Drug Administration (CFDA, now it is National Medical Products Administration, NMPA). As we know, Chinese researchers, surgeons, and entrepreneurs have tried a lot to research and develop biodegradable Mg implants which might become other new approved implants for clinical applications. So in this review, we present the representative Mg implants of three categories, orthopedic implants, surgical implants, and intervention implants and provide an overview of current achievement in China from academic publications and Chinese patents. We would like to provide a systematic way to translate Mg and its alloy implants from experiment designs to clinical products.

Biodegradable Surgical Staple Composed of Magnesium Alloy

Currently, surgical staples are composed of non-biodegradable titanium (Ti) that can cause allergic reactions and interfere with imaging. This paper proposes a novel biodegradable magnesium (Mg) alloy staple and discusses analyses conducted to evaluate its safety and feasibility. Specifically, finite element analysis revealed that the proposed staple has a suitable stress distribution while stapling and maintaining closure. Further, an immersion test using artificial intestinal juice produced satisfactory biodegradable behavior, mechanical durability, and biocompatibility in vitro. Hydrogen resulting from rapid corrosion of Mg was observed in small quantities only in the first week of immersion, and most staples maintained their shapes until at least the fourth week. Further, the tensile force was maintained for more than a week and was reduced to approximately one-half by the fourth week. In addition, the Mg concentration of the intestinal artificial juice was at a low cytotoxic level. In porcine intestinal anastomoses, the Mg alloy staples caused neither technical failure nor such complications as anastomotic leakage, hematoma, or adhesion. No necrosis or serious inflammation reaction was histopathologically recognized. Thus, the proposed Mg alloy staple offers a promising alternative to Ti alloy staples.

In vitro and in vivo biocompatibility of Mg-Zn-Ca alloy operative clip

At present, titanium (Ti) and its alloys are most commonly use in hemostasis clip clinical applications. However, the Ti Clip cannot be absorbed in human body and produce artifacts on computed tomography (CT), and induce clinically relevant hypersensitivity in patients. In order to overcome the drawbacks of the non-degradable Ti clips, an Mg–Zn–Ca alloy operative clip was fabricated by combining hot extrusion and blanking processing. In vitro and in vivo biocompatibility of Mg–Zn–Ca alloy operative clip were evaluated by L-929 Cells and SD rat model respectively. It was found that Mg–Zn–Ca alloy exhibited non-cytotoxic to L929 cells. In vivo implantation showed that the newly designed Mg–Zn–Ca clip can successfully ligated carotid artery and no blood leakage occurred post-surgery. During the period of the clip degradation, a small amount of H₂ gas formation and no tissue inflammation around the clips were observed. The degradation rate of the clip near the heart ligated the arteries faster than that of clip far away the heart due do the effect of arterial blood. Histological analysis and various blood biochemical parameters in rat serum samples collected at different times after clip implantation showed no tissue inflammation around the clips.

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Mg–3Zn-0.2Ca alloy operative clip by combining hot extrusion and blanking processing.

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Mg–3Zn-0.2Ca alloy exhibited no cell toxicity to L929 cells in in vitro cell test.

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The newly designed Mg–Zn–Ca clip can successfully ligated carotid artery.

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Histological analysis and blood biochemistry parameters showed no tissue inflammation around the clips.