Surface modifications of magnesium alloys for biomedical applications

Metal-organic complex coating for enhanced corrosion control and biocompatibility on biodegradable magnesium alloy for orthopaedic implants

Magnesium alloy is currently regarded as the most favourable biodegradable metal; however, obstacles remain to be overcome in terms of managing its corrosion and ensuring its biocompatibility. In this study, a metal-organic complex comprising Ca ions incorporated in tannic acid (TA) was prepared and used to coat magnesium alloy by chemical conversion and dipping processes, followed by modification with stearic acid (SA). This metal-organic complex coating was demonstrated to be homogeneous and compact, and it significantly improved the electrochemical corrosion resistance and long-term degradation behaviour of the coated samples. Consequently, the well-controlled release of Mg and Ca ions, as well as the osteo-compatible TA and SA molecules, promoted the proliferation of osteoblast cells. This metal-organic complex coating offers a promising modifying strategy for magnesium-based orthopaedic implants.

Composite Nanocoatings of Biomedical Magnesium Alloy Implants: Advantages, Mechanisms, and Design Strategies

The rapid degradation of magnesium (Mg) alloy implants erodes mechanical performance and interfacial bioactivity, thereby limiting their clinical utility. Surface modification is among the solutions to improve corrosion resistance and bioefficacy of Mg alloys. Novel composite coatings that incorporate nanostructures create new opportunities for their expanded use. Particle size dominance and impermeability may increase corrosion resistance and thereby prolong implant service time. Nanoparticles with specific biological effects may be released into the peri-implant microenvironment during the degradation of coatings to promote healing. Composite nanocoatings provide nanoscale surfaces to promote cell adhesion and proliferation. Nanoparticles may activate cellular signaling pathways, while those with porous or core-shell structures may carry antibacterial or immunomodulatory drugs. Composite nanocoatings may promote vascular reendothelialization and osteogenesis, attenuate inflammation, and inhibit bacterial growth, thus increasing their applicability in complex clinical microenvironments such as those of atherosclerosis and open fractures. This review combines the physicochemical properties and biological efficiency of Mg-based alloy biomedical implants to summarize the advantages of composite nanocoatings, analyzes their mechanisms of action, and proposes design and construction strategies, with the purpose of providing a reference for promoting the clinical application of Mg alloy implants and to further the design of nanocoatings.

Polymer bilayer-Micro arc oxidation surface coating on pure magnesium for bone implantation

Background

Pure magnesium-based ortho-implants have a number of advantages. However, vital parameters like degradation rate and biocompatibility still call for significant improvement.

Methods

In this study, poly (1,3-trimethylene carbonate) (PTMC) and polydopamine (PDA) bilayer and micro arc oxidation composite coatings were prepared successively on magnesium surface by immersion method and microarc oxidation. Its corrosion resistance and biocompatibility were evaluated by in vitro corrosion tests, cellular compatibility experiments, and in vivo animal experiments.

Results

In vitro experiments demonstrated that the composite coating provides excellent corrosion protection and biocompatibility. Animal studies demonstrated that the composite coating slowed the degradation of the implant and was not toxic to animal viscera.

Conclusion

In conclusion, the inorganic-organic composite coating proposed in this study provided good corrosion resistance and enhanced biocompatibility for pure magnesium implants.

The translational potential of this article

The translational potential of this article is to develop an anti-corrosion composite coating on a pure magnesium surface and to verify the viability of its use in animal models. It is hoped to open up a new approach to the design of new degradable orthopedic magnesium-based implants.

Surface modification of biodegradable Mg alloy by adapting µEDM capabilities with cryogenically-treated tool electrodes

Biomaterials are engineered to develop an interaction with living cells for therapeutic and diagnostic purposes. The last decade reported a tremendously rising shift in the requirement for miniaturized biomedical implants exhibiting high precision and comprising various biomaterials such as non-biodegradable titanium (Ti) alloys and biodegradable magnesium (Mg) alloys. The excellent mechanical properties and lightweight characteristics of Mg AZ91D alloy make it an emerging material for biomedical applications. In this regard, micro-electric discharge machining (µEDM) is an excellent method that can be used to make micro-components with high dimensional accuracy. In the present research, attempts were made to improve the µEDM capabilities by using cryogenically-treated copper (CTCTE) and brass tool electrodes (CTBTE) amid machining of biodegradable Mg AZ91D alloy, followed by their comparison with a pair of untreated copper (UCTE) and brass tool electrodes (UBTE) in terms of minimum machining-time and dimensional-irregularity. To investigate the possible modification on the surfaces achieved with minimum machining-time and dimensional-irregularity, the morphology, chemistry, micro-hardness, corrosion resistance, topography, and wettability of these surfaces were further examined. The surface produced by CTCTE exhibited the minimum surface micro-cracks and craters, acceptable recast layer thickness (2.6 µm), 17.45% improved micro-hardness, satisfactory corrosion resistance, adequate surface roughness (Ra: 1.08 µm), and suitable hydrophobic behavior (contact angle: 119°), confirming improved biodegradation rate. Additionally, a comparative analysis among the tool electrodes revealed that cryogenically-treated tool electrodes outperformed the untreated ones. CTCTE-induced modification on the Mg AZ91D alloy surface suggests its suitability in biodegradable medical implant applications.

A "built-up" composite film with synergistic functionalities on Mg-2Zn-1Mn bioresorbable stents improves corrosion control effects and biocompatibility

Control of premature corrosion of magnesium (Mg) alloy bioresorbable stents (BRS) is frequently achieved by the addition of rare earth elements. However, limited long-term experience with these elements causes concerns for clinical application and alternative methods of corrosion control are sought after. Herein, we report a "built-up" composite film consisting of a bottom layer of MgF₂ conversion coating, a sandwich layer of a poly (1, 3-trimethylene carbonate) (PTMC) and 3-aminopropyl triethoxysilane (APTES) co-spray coating (PA) and on top a layer of poly (lactic-co-glycolic acid) (PLGA) ultrasonic spray coating to decorate the rare earth element-free Mg-2Zn-1Mn (ZM21) BRS for tailoring both corrosion resistance and biological functions. The developed "built-up" composite film shows synergistic functionalities, allowing the compression and expansion of the coated ZM21 BRS on an angioplasty balloon without cracking or peeling. Of special importance is that the synergistic corrosion control effects of the "built-up" composite film allow for maintaining the mechanical integrity of stents for up to 3 months, where complete biodegradation and no foreign matter residue were observed about half a year after implantation in rabbit iliac arteries. Moreover, the functionalized ZM21 BRS accomplished re-endothelialization within one month.

Biodegradable Zn-Dy binary alloys with high strength, ductility, cytocompatibility, and antibacterial ability for bone-implant applications

The unique combination of biodegradability, biocompatibility, and functionality of zinc (Zn)-based alloys makes them highly desirable for a wide range of medical applications. However, a long-standing problem associated with this family of biodegradable alloys in the as-cast state is their limited mechanical strength and slow degradation rate. Here we report the development of Zn-xDy (x = 1, 3, and 5 wt.%) alloys with high strength, ductility, cytocompatibility, antibacterial ability, and appropriate degradation rate for biodegradable bone-implant applications. Our results indicate that the mechanical properties of Zn-xDy alloys were effectively improved with increasing Dy addition and hot-rolling due to the second-phase strengthening. The hot-rolled (HR) Zn-3Dy alloy showed the best combined mechanical performance with an ultimate tensile strength of 270.5 MPa, a yield strength of 214.8 MPa, an elongation of 55.1%, and Brinell hardness of 75.9 HB. The corrosion and degradation rates of HR Zn-xDy alloys in Hanks' solution gradually increased with increasing Dy addition due to the intensification of galvanic corrosion. The HR Zn-3Dy alloy showed high antibacterial ability against S. aureus and cytocompatibility toward MC3T3-E1 cells among all the HR alloys. Overall, the HR Zn-3Dy alloy can be considered a promising biodegradable material for bone implants. STATEMENT OF SIGNIFICANCE: This work reports on Zn-xDy (x = 1, 3, and 5%) alloys fabricated by Dy alloying followed by hot-rolling for biodegradable bone-implant applications. Our findings demonstrate that the hot-rolled (HR) Zn-3Dy alloy showed the best combined mechanical performance with an ultimate tensile strength of 270.5 MPa, a yield strength of 214.8 MPa, an elongation of 55.1%, and Brinell hardness of 75.9 HB. The corrosion and degradation rates of HR Zn-xDy alloys in Hanks' solution gradually increased with increasing Dy addition due to the intensification of galvanic corrosion. Furthermore, the HR Zn-3Dy alloy showed greater antibacterial ability against S. aureus and the best cytocompatibility toward MC3T3-E1 cells among all the HR alloys.

Enhanced abrasive-mixed-µ-EDM performance towards improved surface characteristics of biodegradable Mg AZ31B alloy

The non-degradable metallic implants, such as bone screws, often act as the source of dysfunction and harmful corrosion products in the aqueous environment inside the human body. Many of these implants are fixed either temporarily or permanently into the human body, and therefore, both need to match tight tolerances with a remarkably finished surface to eradicate burrs or striations. In this regard, the new generation of degradable magnesium (Mg) alloy implants with excellent osseointegration and low elasticity (like that of human bone), minimizing stress shielding, have been identified as potential candidates to challenge surgical procedures reintervention. However, the biological response of an implant toward the cells in vivo can be predominantly regulated by modifying the surface chemistry, morphology, and corrosion characteristics. Powder or abrasive-mixed-micro-electric discharge machining (A-M-µ-EDM) is gaining attention for executing precision machining and achieving a simultaneous surface modification on micro-manufactured surfaces, suitable for clinical applications. Therefore, the present research aimed at improving the surface characteristics of Mg AZ31B alloy via an augmented performance of A-M-µ-EDM by adopting copper and brass-micro-electrodes (C-µ-E and B-µ-E) in association with distinct abrasive particle concentrations (APCs: 0, 1.5, 3, 4.5, and 6 g/l) of bioactive zinc abrasives. To enhance the A-M-µ-EDM capabilities, the experiments were designed with a one-variable-at-a-time (OVAT) strategy, and the trial runs were conducted using different combinations of µ-electrodes and APCs. The superior performance of A-M-µ-EDM was noticed with the fusion of C-µ-E and 3 g/l APC in terms of minimum machining time (MT) and dimensional deviation (DD). The additional outcomes of this work reported favorable improvements in surface morphology, chemistry, topography, wettability, microhardness, and corrosion resistance on the A-M-µ-EDMed sample of interest.

A comprehensive review of properties of the biocompatible thin films on biodegradable Mg alloys

Magnesium (Mg) and its alloys have attracted attention as biodegradable materials for biomedical applications owing to their mechanical properties being comparable to that of bone. Mg is a vital trace element in many enzymes and thus forms one of the essential factors for human metabolism. However, before being used in biomedical applications, the early stage or fast degradation of Mg and its alloys in the physiological environment should be controlled. The degradation of Mg alloys is a critical criterion that can be controlled by a surface modification which is an effective process for conserving their desired properties. Different coating methods have been employed to modify Mg surfaces to provide good corrosion resistance and biocompatibility. This review aims to provide information on different coatings and discuss their physical and biological properties. Finally, the current withstanding challenges have been highlighted and discussed, followed by shedding some light on future perspectives.

Advances in the development of biodegradable coronary stents: A translational perspective

Implantation of cardiovascular stents is an important therapeutic method to treat coronary artery diseases. Bare-metal and drug-eluting stents show promising clinical outcomes, however, their permanent presence may create complications. In recent years, numerous preclinical and clinical trials have evaluated the properties of bioresorbable stents, including polymer and magnesium-based stents. Three-dimensional (3D) printed-shape-memory polymeric materials enable the self-deployment of stents and provide a novel approach for individualized treatment. Novel bioresorbable metallic stents such as iron- and zinc-based stents have also been investigated and refined. However, the development of novel bioresorbable stents accompanied by clinical translation remains time-consuming and challenging. This review comprehensively summarizes the development of bioresorbable stents based on their preclinical/clinical trials and highlights translational research as well as novel technologies for stents (e.g., bioresorbable electronic stents integrated with biosensors). These findings are expected to inspire the design of novel stents and optimization approaches to improve the efficacy of treatments for cardiovascular diseases.

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Bioresorbable stents can overcome the limitations of non-degradable stents.

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3D printing of shape-memory polymeric stents can lead to better clinical outcomes.

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Advances in Mg-, Fe- and Zn-based stents from a translational perspective.

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Electronic stents integrated with biosensors can covey stent status in real time.

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Development in the assessment of stent performance in vivo.

Surface processing for iron-based degradable alloys: A preliminary study on the importance of acid pickling

The formation of a heterogeneous oxidized layer, also called scale, on metallic surfaces is widely recognized as a rapid manufacturing event for metals and their alloys. Partial or total removal of the scale represents a mandatory integrated step for the industrial fabrication processes of medical devices. For biodegradable metals, acid pickling has already been reported as a preliminary surface preparation given further processes, such as electropolishing. Unfortunately, biodegradable medical prototypes presented discrepancies concerning acid pickling studies based on samples with less complex geometry (e.g., non-uniform scale removal and rougher surface). Indeed, this translational knowledge lacks a detailed investigation on this process, deep characterization of treated surfaces properties, as well as a comprehensive discussion of the involved mechanisms. In this study, the effects of different acidic media (HCl, HNO3, H3PO4, CH3COOH, H2SO4 and HF), maintained at different temperatures (21 and 60 °C) for various exposition time (15-240 s), on the chemical composition and surface properties of a Fe-13Mn-1.2C biodegradable alloy were investigated. Changes in mass loss, morphology and wettability evidenced the combined effect of temperature and time for all conditions. Pickling in HCl and HF solutions favor mass loss (0.03-0.1 g/cm2) and effectively remove the initial scale.

Biodegradable magnesium-based biomaterials: An overview of challenges and opportunities

As promising biodegradable materials with nontoxic degradation products, magnesium (Mg) and its alloys have received more and more attention in the biomedical field very recently. Having excellent biocompatibility and unique mechanical properties, magnesium-based alloys currently cover a broad range of applications in the biomedical field. The use of Mg-based biomedical devices eliminates the need for biomaterial removal surgery after the healing process and reduces adverse effects induced by the implantation of permanent biomaterials. However, the high corrosion rate of Mg-based implants leads to unexpected degradation, structural failure, hydrogen evolution, alkalization, and cytotoxicity. To overcome these limitations, alloying Mg with suitable alloying elements and surface treatment come highly recommended. In this area, open questions remain on the behavior of Mg-based biomaterials in the human body and the effects of different factors that have resulted in these challenges. In addition to that, many techniques are yet to be verified to turn these challenges into opportunities. Accordingly, this article aims to review major challenges and opportunities for Mg-based biomaterials to minimize the challenges for the development of novel biomaterials made of Mg and its alloys.

Bioabsorbable Osteofixation Materials for Maxillofacial Bone Surgery: A Review on Polymers and Magnesium-Based Materials

Clinical application of osteofixation materials is essential in performing maxillofacial surgeries requiring rigid fixation of bone such as trauma surgery, orthognathic surgery, and skeletal reconstruction. In addition to the use of titanium plates and screws, clinical applications and attempts using bioabsorbable materials for osteofixation surgery are increasing with demands to avoid secondary surgery for the removal of plates and screws. Synthetic polymeric plates and screws were developed, reaching satisfactory physical properties comparable to those made with titanium. Although these polymeric materials are actively used in clinical practice, there remain some limitations to be improved. Due to questionable physical strength and cumbersome molding procedures, interests in resorbable metal materials for osteofixation emerged. Magnesium (Mg) gained attention again in the last decade as a new metallic alternative, and numerous animal studies to evaluate the possibility of clinical application of Mg-based materials are being conducted. Thanks to these researches and studies, vascular application of Mg-based biomaterials was successful; however, further studies are required for the clinical application of Mg-based biomaterials for osteofixation, especially in the facial skeleton. The review provides an overview of bioabsorbable osteofixation materials in maxillofacial bone surgery from polymer to Mg.

Electrodeposited Biocoatings, Their Properties and Fabrication Technologies: A Review

Coatings deposited under an electric field are applied for the surface modification of biomaterials. This review is aimed to characterize the state-of-art in this area with an emphasis on the advantages and disadvantages of used methods, process determinants, and properties of coatings. Over 170 articles, published mainly during the last ten years, were chosen, and reviewed as the most representative. The most recent developments of metallic, ceramic, polymer, and composite electrodeposited coatings are described focusing on their microstructure and properties. The direct cathodic electrodeposition, pulse cathodic deposition, electrophoretic deposition, plasma electrochemical oxidation in electrolytes rich in phosphates and calcium ions, electro-spark, and electro-discharge methods are characterized. The effects of electrolyte composition, potential and current, pH, and temperature are discussed. The review demonstrates that the most popular are direct and pulse cathodic electrodeposition and electrophoretic deposition. The research is mainly aimed to introduce new coatings rather than to investigate the effects of process parameters on the properties of deposits. So far tests aim to enhance bioactivity, mechanical strength and adhesion, antibacterial efficiency, and to a lesser extent the corrosion resistance.

Recent Advances in the Control of the Degradation Rate of PEO Treated Magnesium and Its Alloys for Biomedical Applications

Mg and Mg alloys have been studied for almost two centuries; nevertheless, commercial biomedical devices are still not available. The main issue that limits their use in the biomedical field is the rapid degradation rate combined with suitable surface properties. Novel approaches need to be designed for the development of biodegradable Mg-based devices, which could include the use of multifunctional coatings and/or new alloys designed “ad hoc”. The present article reviews on various properties, parameters and improvement methods concerning plasma electrolytic oxidation (PEO) coatings on Mg alloys substrates for biomedical applications. In this regard, (i) optimizing the PEO parameters, (ii) using additives and nanoparticles, (iii) creating combined layers of hard and/or soft particles, (iv) coating the PEO layer with a biodegradable polymer, could be the way to control their degradation rate. The review of recent scientific articles highlights that none of the techniques proposed may be preferred over the others and the need to deepen the studies for allowing the use of Mg-based devices in the biomedical field.

Plasma-Assisted Deposition of Magnesium-Containing Coatings on Porous Scaffolds for Bone Tissue Engineering

Magnesium plays a pivotal role in the formation, growth, and repair of bone tissue; therefore, magnesium-based materials can be considered promising candidates for bone tissue engineering. This study aims to functionalize the surfaces of three-dimensional (3D) porous poly-ε caprolactone (PCL) scaffolds with magnesium-containing coatings using cold plasma-assisted deposition processes. For this purpose, the radiofrequency (RF) sputtering of a magnesium oxide target was carried out in a low-pressure plasma reactor using argon, water vapor, hydrogen, or mixtures of argon with one of the latter two options as the feed. Plasma processes produced significant differences in the chemical composition and wettability of the treated PCL samples, which are tightly related to the gas feed composition, as shown by X-ray photoelectron spectroscopy (XPS) and water contact angle (WCA) analyses. Cytocompatibility assays performed with Saos-2 osteoblast cells showed that deposited magnesium-containing thin films favor cell proliferation and adhesion on 3D scaffold surfaces, as well as cell colonization inside them. These films appear to be very promising for bone tissue regeneration.

Olax scandens Mediated Biogenic Synthesis of Ag-Cu Nanocomposites: Potential Against Inhibition of Drug-Resistant Microbes

In the present study, we have synthesized silver-copper nanocomposites (Ag-Cu NCs) using an Olax scandens leaf extract (green synthesis method) and evaluated their antimicrobial potential against less susceptible pathogens. The kinetics of Ag-Cu NCs synthesis was followed by UV-VIS and fluorescence spectroscopy. The physicochemical characterization of as-synthesized Ag-Cu NCs was executed using electron microscopy, Energy Dispersive X-Ray, Fourier Transform Infrared Spectroscopy, and a Differential Light Scattering method. As-synthesized Ag-Cu NCs induced the formation of Reactive Oxygen Species (ROS), thereby causing alteration and decrementation of cellular proteins, DNA, lipids, etc., and eventually leading to cell death, as determined by a Live/Dead assay. Next, we assessed the anti-biofilm potential of as-synthesized Ag-Cu NCs against biofilm forming bacteria. The as-synthesized Ag-Cu NCs, when compared to monometallic silver nanoparticles, exhibited significantly higher anti-microbial activity against both sensitive as well as drug resistant microbial isolates.

Controlling the Degradation Rate of Biodegradable Mg-Zn-Mn Alloys for Orthopedic Applications by Electrophoretic Deposition of Hydroxyapatite Coating

Magnesium alloys as bioresorbable materials with good biocompatibility have raised a growing interest in the past years in temporary implant manufacturing, as they offer a steady resorption rate and optimal healing in the body. Magnesium exhibits tensile strength properties similar to those of natural bone, which determines its application in load-bearing mechanical medical devices. In this paper, we investigated the biodegradation rate of Mg-Zn-Mn biodegradable alloys (ZMX410 and ZM21) before and after coating them with hydroxyapatite (HAP) via the electrophoretic deposition method. The experimental samples were subjected to corrosion tests to observe the effect of HAP deposition on corrosion resistance and, implicitly, the rate of biodegradation of these in simulated environments. X-ray diffraction (XRD), scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS) provided detailed information on the quality, structure, and morphology of the HAP coating. The obtained results demonstrate that coating of Mg-Zn-Mn alloys by HAP led to the improvement of corrosion resistance in simulated environments, and that the HAP coating could be used in order to control the biodegradation rate.

Enhanced corrosion resistance and bioactivity of Mg alloy modified by Zn-doped nanowhisker hydroxyapatite coatings

In this work, Zn is doped into a hydroxyapatite coating on the surface of ZK60 magnesium alloys using a one-pot hydrothermal method to obtain a corrosion-resistant implant with abilities of osteogenic differentiation and bacterial inhibition. With the addition of Zn, the morphology changes with a nanowhisker structure appearing on the coating. Electrochemical measurements show that the nanowhisker hydroxyapatite coating provides a high corrosion resistance. Compared with hydroxyapatite coating, the nanowhisker coating not only effectively inhibits bacteria, but also promotes the adhesion and differentiation of rat bone marrow mesenchymal stem cells at appropriate Zn concentrations. In conclusion, a novel nanowhisker structure prepared by a single variable Zn doping can significantly improve the corrosion resistance and biological activity of hydroxyapatite coatings.

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.

Chaperone Like Attributes of Biogenic Fluorescent Gold Nanoparticles: Potential to Alleviate Toxicity Induced by Intermediate State Fibrils Against Neuroblastoma Cells

In general, neurodegenerative disorders have a great deal of correlation with the misfolded as well as aggregated forms of protein-based macromolecules. Among various species formed during the aggregation process, protein oligomers have been classified as most toxic entities against several types of living cells. A series of chemicals have been developed to inhibit protein aggregation as a measure to regulate neurodegenerative diseases. Recently, various classes of nanoparticles have also been reported to inhibit protein aggregation. In the present study, we synthesized fluorescent gold nanoparticles (B-AuNPs) employing Olax scandens leaf extract. Next, an in vitro study was performed to assess the effect of as-synthesized B-AuNPs on the aggregation behavior of the ovalbumin (OVA) and other related model proteins. We performed an extensive study to elucidate anti-amyloidogenic properties of nano-sized entities and established that small-sized B-AuNPs manifest chaperone potential against protein aggregation. Further, we exploited as-synthesized B-AuNPs as a mean to prevent protein aggregation mediated toxicity in neuroblastoma cells.

Methods Used for the Eradication of Staphylococcal Biofilms

Staphylococcus aureus is considered one of the leading pathogens responsible for community and healthcare-associated infections. Among them, infections caused by methicillin-resistant strains (MRSA) are connected with ineffective or prolonged treatment. The therapy of staphylococcal infections faces many difficulties, not only because of the bacteria's resistance to antibiotics and the multiplicity of virulence factors it produces, but also due to its ability to form a biofilm. The present review focuses on several approaches used for the assessment of staphylococcal biofilm eradication. The methods described here are successfully applied in research on the prevention of biofilm-associated infections, as well as in their management. They include not only the evaluation of the antimicrobial activity of novel compounds, but also the methods for biomaterial functionalization. Moreover, the advantages and limitations of different dyes and techniques used for biofilm characterization are discussed. Therefore, this review may be helpful for those scientists who work on the development of new antistaphylococcal compounds.

In Vivo Simulation of Magnesium Degradability Using a New Fluid Dynamic Bench Testing Approach

The degradation rate of magnesium (Mg) alloys is a key parameter to develop Mg-based biomaterials and ensure in vivo-mechanical stability as well as to minimize hydrogen gas production, which otherwise can lead to adverse effects in clinical applications. However, in vitro and in vivo results of the same material often differ largely. In the present study, a dynamic test bench with several single bioreactor cells was constructed to measure the volume of hydrogen gas which evolves during magnesium degradation to indicate the degradation rate in vivo. Degradation medium comparable with human blood plasma was used to simulate body fluids. The media was pumped through the different bioreactor cells under a constant flow rate and 37 °C to simulate physiological conditions. A total of three different Mg groups were successively tested: Mg WE43, and two different WE43 plasma electrolytically oxidized (PEO) variants. The results were compared with other methods to detect magnesium degradation (pH, potentiodynamic polarization (PDP), cytocompatibility, SEM (scanning electron microscopy)). The non-ceramized specimens showed the highest degradation rates and vast standard deviations. In contrast, the two PEO samples demonstrated reduced degradation rates with diminished standard deviation. The pH values showed above-average constant levels between 7.4–7.7, likely due to the constant exchange of the fluids. SEM revealed severe cracks on the surface of WE43 after degradation, whereas the ceramized surfaces showed significantly decreased signs of corrosion. PDP results confirmed the improved corrosion resistance of both PEO samples. While WE43 showed slight toxicity in vitro, satisfactory cytocompatibility was achieved for the PEO test samples. In summary, the dynamic test bench constructed in this study enables reliable and simple measurement of Mg degradation to simulate the in vivo environment. Furthermore, PEO treatment of magnesium is a promising method to adjust magnesium degradation.

Degradation and interaction with bone of magnesium alloy WE43 implants: A long-term follow-up in vivo rat tibia study

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.

Biodegradable magnesium alloys as temporary orthopaedic implants: a review

The study of innovative biodegradable implant materials is one of the most interesting research topics at the forefront in the area of biomaterials. Biodegradable implant materials in the human body can be gradually dissolved, absorbed, consumed or excreted, so there is no need for the secondary surgery to remove implants after the surgery regions have healed. However, most of the biodegradable materials, usually polymers, do not have good mechanical properties to be reliable for bearing the load of the body. Magnesium and its alloys due to the excellent biodegradability and biocompatibility as well as the suitable mechanical compatibility with human bone are very promising candidates for the development of temporary, degradable implants in load-bearing applications. However, Mg alloys are corrosion susceptible in a biological environment. Besides, the high corrosion rate and the low bioactivity of magnesium implants are the challenging problems, which need to be resolved before employing them in clinical applications. This paper provides a review of state-of-the-art of magnesium alloy implants for orthopedic and tissue engineering applications and describes recent progress in the design of novel structure design Mg alloys and potential approaches to improve their biodegradation performance.

Biomimetic porous Mg with tunable mechanical properties and biodegradation rates for bone regeneration

The medical applications of porous Mg scaffolds are limited owing to its rapid corrosion, which dramatically decreases the mechanical strength of the scaffold. Mimicking the bone structure and composition can improve the mechanical and biological properties of porous Mg scaffolds. The Mg structure can also be coated with HA by an aqueous precipitation coating method to enhance both the corrosion resistance and the biocompatibility. However, due to the brittleness of HA coating layer, cracks tend to form in the HA coating layer, which may influence the corrosion and biological functionality of the scaffold. Consequently, in this study, hybrid poly(ether imide) (PEI)-SiO₂ layers were applied to the HA-coated biomimetic porous Mg to impart the structure with the high corrosion resistance associated with PEI and excellent bioactivity with SiO₂. The porosity of the Mg was controlled by adjusting the concentration of the sodium chloride (NaCl) particles used in the fabrication via the space-holder method. The mechanical measurements showed that the compressive strength and stiffness of the biomimetic porous Mg increased as the portion of the dense region increased. In addition, following results show that HA/(PEI-SiO₂) hybrid-coated biomimetic Mg is a promising biodegradable scaffold for orthopedic applications. In-vitro testing revealed that the proposed hybrid coating reduced the degradation rate and facilitated osteoblast spreading compared to HA- and HA/PEI-coating scaffolds. Moreover, in-vivo testing with a rabbit femoropatellar groove model showed improved tissue formation, reduced corrosion and degradation, and improved bone formation on the scaffold. STATEMENT OF SIGNIFICANCE: Porous Mg is a promising biodegradable scaffold for orthopedic applications. However, there are limitations in applying porous Mg for an orthopedic biomaterial due to its poor mechanical properties and susceptibility to rapid corrosion. Here, we strategically designed the structure and coating layer of porous Mg to overcome these limitations. First, porous Mg was fabricated by mimicking the bone structure which has a combined structure of dense and porous regions, thus resulting in an enhancement of mechanical properties. Furthermore, the biomimetic porous Mg was coated with HA/(PEI-SiO₂) hybrid layer to improve both corrosion resistance and biocompatibility. As the final outcome, with tunable mechanical and biodegradable properties, HA/(PEI-SiO₂)-coated biomimetic porous Mg could be a promising candidate material for load-bearing orthopedic applications.

The Effect of Surface Treatments on the Degradation of Biomedical Mg Alloys-A Review Paper

This report reviews the effects of chemical, physical, and mechanical surface treatments on the degradation behavior of Mg alloys via their influence on the roughness and surface morphology. Many studies have been focused on technically-used AZ alloys and a few investigations regarding the surface treatment of biodegradable and Al-free Mg alloys, especially under physiological conditions. These treatments tailor the surface roughness, homogenize the morphology, and decrease the degradation rate of the alloys. Conversely, there have also been reports which showed that rough surfaces lead to less pitting and good cell adherence. Besides roughness, there are many other parameters which are much more important than roughness when regarding the degradation behavior of an alloy. These studies, which indicate the relationship between surface treatments, roughness and degradation, require further elaboration, particularly for biomedical Mg alloy applications.

Nanostructure coated AZ31 magnesium cylindrical mesh cage for potential long bone segmental defect repair applications

This current study is aimed towards the fabrication of AZ31 magnesium cylindrical mesh cage implant with circular holes for orthopedic applications. This mesh cage is coated with nanocomposite material containing polycaprolactone (PCL), pluronic F127 and nano hydroxyapatite (nHA) by electrospinning process. Morphology and composition were analyzed by various characterization techniques. Controlled degradation and weight loss of the nanocomposite coated samples in 28 days were observed when compared with uncoated samples in SBF (simulated body fluid). The nanocomposite coated material was not cytotoxic to MG63 osteosarcoma cells. The cell viability, morphology, ALP activity, calcium mineralization and collagen deposition were also better on this when compared to uncoated. Smooth and randomly deposited nanofibers on the mesh cage was observed and the contact angle indicated that the surface is hydrophilic with (initial contact angle of 55 ± 1° and after 10 s 0°) when compared to PCL (99°) coated surface. 2-5 fold higher mRNA expression levels of osteogenic genes namely ALP, BMP2, COL1 and RUNX2 was observed with nanocomposite coated scaffolds than uncoated and PCL coated samples in 14 days. These results indicate the potential use of the nanocomposite coated AZ31 cylindrical mesh cage for segmental bone defect repair and can be used as a degradable implant for orthopedic applications.

Plasma Electrolytic Oxidation of Titanium Implant Surfaces: Microgroove-Structures Improve Cellular Adhesion and Viability

BACKGROUND/AIM

Plasma electrolytic oxidation (PEO) is an established electrochemical treatment technique that can be used for surface modifications of metal implants. In this study we to treated titanium implants with PEO, to examine the resulting microstructure and to characterize adhesion and viability of cells on the treated surfaces. Our aim was to identify an optimal surface-modification for titanium implants in order to improve soft-tissue integration.

MATERIALS AND METHODS

Three surface-variants were generated on titanium alloy Ti6Al4V by PEO-treatment. The elemental composition and the microstructures of the surfaces were characterized using energy dispersive X-ray spectroscopy, scanning electron microscopy and profilometry. In vitro cytocompatibility of the surfaces was assessed by seeding L929 fibroblasts onto them and measuring the adhesion, viability and cytotoxicity of cells by means of live/dead staining, XTT assay and LDH assay.

RESULTS

Electron microscopy and profilometry revealed that the PEO-surface variants differed largely in microstructure/topography, porosity and roughness from the untreated control material as well as from one another. Roughness was generally increased after PEO-treatment. In vitro, PEO-treatment led to improved cellular adhesion and viability of cells accompanied by decreased cytotoxicity.

CONCLUSION

PEO-treatment provides a promising strategy to improve the integration of titanium implants with surrounding tissues.

Material Processing and Design of Biodegradable Metal Matrix Composites for Biomedical Applications

In recent years, biodegradable metallic materials have played an important role in biomedical applications. However, as typical for the metal materials, their structure, general properties, preparation technology and biocompatibility are hard to change. Furthermore, biodegradable metals are susceptible to excessive degradation and subsequent disruption of their mechanical integrity; this phenomenon limits the utility of these biomaterials. Therefore, the use of degradable metals, as the base material to prepare metal matrix composite materials, it is an excellent alternative to solve the problems above described. Biodegradable metals can thus be successfully combined with other materials to form biodegradable metallic matrix composites for biomedical applications and functions. The present article describes the processing methods currently available to design biodegradable metal matrix composites for biomedical applications and provides an overview of the current existing biodegradable metal systems. At the end, the manuscript presents and discusses the challenges and future research directions for development of biodegradable metallic matrix composites for biomedical purposes.

Biodegradable coronary scaffolds: their future and clinical and technological challenges

Angioplasty and stenting are standard treatment options for both stabile occlusive coronary artery disease and acute myocardial infarctions. Over the last years, several biodegradable stent systems have entered pre-clinical and clinical evaluation and into clinical practice. A strong supporting scaffold is necessary after angioplasty to prevent elastic recoil of the vessel but in the long term a permanent metallic stent will only impair normal physiology of the artery wall. Thus, the main advantage of a resorbable system is the potential for better vessel recovery and function in the long term. The new stent systems differ from traditional stents in size and biological responses and questions have risen regarding their mechanical strength and increased risk of stent thrombosis. Here, we present current treatment options with biodegradable scaffolds, discuss further key areas for improvements and review novel technological advances in the context of all up-to-date clinical trial information. New material choices are also covered as well as special considerations for pre-clinical testing.

Biodegradable Magnesium Alloys Developed as Bone Repair Materials: A Review

Bone repair materials are rapidly becoming a hot topic in the field of biomedical materials due to being an important means of repairing human bony deficiencies and replacing hard tissue. Magnesium (Mg) alloys are potentially biocompatible, osteoconductive, and biodegradable metallic materials that can be used in bone repair due to their in situ degradation in the body, mechanical properties similar to those of bones, and ability to positively stimulate the formation of new bones. However, rapid degradation of these materials in physiological environments may lead to gas cavities, hemolysis, and osteolysis and thus, hinder their clinical orthopedic applications. This paper reviews recent work on the use of Mg alloy implants in bone repair. Research to date on alloy design, surface modification, and biological performance of Mg alloys is comprehensively summarized. Future challenges for and developments in biomedical Mg alloys for use in bone repair are also discussed.

Biofunctionalisation of magnesium alloys by successive immobilisation of poly(ethylene glycol), fibronectin and heparin

In the present study, with the aim of improving their corrosion resistance, anticoagulation and cytocompatibility with endothelial cells, a magnesium alloy (AZ31B) was modified by the alkali heat treatment followed by the immobilisation of the dopamine layer. Subsequently, molecules of poly(ethylene glycol) (PEG) and fibronectin or fibronectin–heparin complexes were successively immobilised on the dopamine-modified surface. After the surface modification, the hydrophilicity of magnesium alloy was obviously improved. The corrosion resistance of the magnesium alloy was improved through alkali heat treatment, and the immobilisation of dopamine and PEG can further reduce the corrosion rate. However, the corrosion resistance of the magnesium alloy was slightly reduced by the grafting of fibronectin or fibronectin–heparin complex. Furthermore, the modified samples showed improved hemocompatibility and good cytocompatibility with the endothelial cells on the fibronectin or fibronectin–heparin-modified surfaces. Therefore, the corrosion resistance, anticoagulation and cytocompatibility of the magnesium alloy can be enhanced by alkali heat treatment and subsequent immobilisation of biomolecules. The method of this study can be used for surface modification of magnesium alloys to impart these with better corrosion resistance, blood compatibility and cytocompatibility with endothelial cells simultaneously.

Comparative study of different polymeric coatings for the next-generation magnesium-based biodegradable stents

Development of next-generation bioabsorbable stents based on magnesium alloys is gaining lots of attention. However, finding an appropriate coating in order to enhance its corrosion resistance along with preserving other requirements is still a challenge. In this study, three FDA-approved polymers, namely poly(lactic acid), polycaprolactone and poly(lactic-co-glycolic acid), have been investigated as potential coatings for magnesium-based stents to enhance their corrosion resistance, biocompatibility and haemocompatibility. Potentiodynamic and electrochemical impedance spectroscopy results demonstrated that PLA and PLGA coating performed better in improving corrosion resistance in comparison with uncoated and other coated samples. Although all coated and bare samples displayed desirable results of haemocompatibility assays, PLA-coated samples showed better outcome in terms of biocompatibility. The results revealed that PLA can be considered as a potential coating material to enhance the main characteristics of magnesium-based bioabsorbable stents.

Effects of degradable osteosynthesis plates of MgYREZr alloy on cell function of human osteoblasts, fibroblasts and osteosarcoma cells

The aim was to evaluate the biocompatibility of osteosynthesis plates of the MgYREZr/WE43 alloy by using human cells in vitro. Eluates of degradable magnesium osteosynthesis plates as well as halved plates were used for incubation with human osteoblasts, fibroblasts and osteosarcoma cells. The cell viability was evaluated by using FDA/PI-Staining and LDH analysis. Cell proliferation was assessed by MTT, WST-Test and BrdU-ELISA. Scanning electron microscope was used for investigation of the cell adhesion. The number of devitalized cells in all treatment groups did not significantly deviate from the control group. According to MTT results, the number of metabolically active cells was not significantly affected by the addition of the eluates. The number of metabolically active cells was reduced by 24 to 38% compared to the control on incubation in direct contact with the osteosynthesis plates. The proliferation of the cells was inhibited by the addition of the eluates. While the eluate of the half-hour elution has only a very small effect, the 24 h eluate significantly inhibits proliferation by 23-25% compared to the control. The roughened surface of the magnesium osteosynthesis plate after incubation showed adherent cells. However, some areas of the plates were also free of adherent cells. WE43 based magnesium alloys showed favorable biocompatibility considering the viability of the cells evaluated; however, proliferation rates were reduced in a time dependent manner, especially in fibroblast group. This might be a potential clinical benefit of magnesium osteosynthesis plates and their superiority to titanium, thus the fibroblastic ingrowth might negatively influence the bone-plate contact.

RGDC Peptide-Induced Biomimetic Calcium Phosphate Coating Formed on AZ31 Magnesium Alloy

Magnesium alloys as biodegradable metal implants have received a lot of interest in biomedical applications. However, magnesium alloys have extremely high corrosion rates a in physiological environment, which have limited their application in the orthopedic field. In this study, calcium phosphate compounds (Ca–P) coating was prepared by arginine–glycine–aspartic acid–cysteine (RGDC) peptide-induced mineralization in 1.5 simulated body fluid (SBF) to improve the corrosion resistance and biocompatibility of the AZ31 magnesium alloys. The adhesion of Ca–P coating to the AZ31 substrates was evaluated by a scratch test. Corrosion resistance and cytocompatibility of the Ca–P coating were investigated. The results showed that the RGDC could effectively promote the nucleation and crystallization of the Ca–P coating and the Ca–P coating had poor adhesion to the AZ31 substrates. The corrosion resistance and biocompatibility of the biomimetic Ca–P coating Mg alloys were greatly improved compared with that of the uncoated sample.

Improved corrosion resistance and biocompatibility of a calcium phosphate coating on a magnesium alloy for orthopedic applications

In this study a calcium phosphate (Ca–P) coating was fabricated on the surface of an AZ31 alloy by a chemical deposition process, and the in vitro and in vivo studies were carried out on a Ca–P-coated and uncoated AZ31 alloy to determine the effect of Ca–P coating on the corrosion behavior and biocompatibility of the AZ31 alloy. The morphology and composition of the Ca–P coating were characterized by scanning electron microscopy and energy dispersive spectroscopy. The corrosion behavior of the Ca-P coating was evaluated by a static immersion test and the effects of the Ca–P coating on biocompatibility were also investigated by in vitro cell experiments and in vivo animal experiments. The results indicated that the Ca–P coating reduced the in vitro and in vivo corrosion rates of the AZ31 alloy. Cell experiments showed significantly good adherence and high proliferation on the Ca–P-coated AZ31 alloy than those on the uncoated AZ31 alloy ( P < 0.05). The blood cell aggregation tests showed that the Ca–P-coated AZ31 alloy had decreased the blood cell aggregation compared to the uncoated AZ31 alloy. The animal experiments showed that the uncoated AZ31 alloy degraded more rapidly than the Ca–P-coated AZ31 alloy and the Ca–P coating provided significantly good biocompatibility, thus suggesting that the Ca–P coating not only slowed down the corrosion rate of the AZ31 alloy, but also improved its biocompatibility. Therefore, the Ca–P-coated AZ31 alloy can be considered as a promising biomaterial for orthopedic applications.

Corrosion resistance and biocompatibility of magnesium alloy modified by alkali heating treatment followed by the immobilization of poly (ethylene glycol), fibronectin and heparin

In recent years, magnesium alloys are attracting more and more attention as a kind of biodegradable metallic biomaterials, however, their uncontrollable biodegradation speed in vivo and the limited surface biocompatibility hinder their clinical applications. In the present study, with the aim of improving the corrosion resistance and biocompatibility, the magnesium alloy (AZ31B) surface was modified by alkali heating treatment followed by the self-assembly of 3-aminopropyltrimethoxysilane (APTMS). Subsequently, poly (ethylene glycol) (PEG) and fibronectin or fibronectin/heparin complex were sequentially immobilized on the modified surface. The results of attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR) and X-ray photoelectron spectroscopy (XPS) confirmed that the above molecules were successfully immobilized on the magnesium alloy surface. An excellent hydrophilic surface was obtained after the alkali heating treatment while the hydrophilicity decreased to some degree after the self-assembly of APTMS, the surface hydrophilicity was gradually improved again after the immobilization of PEG, fibronectin or fibronectin/heparin complex. The corrosion resistance of the control magnesium alloy was significantly improved by the alkali heating treatment. The self-assembly of APTMS and the following immobilization of PEG further enhanced the corrosion resistance of the substrates, however, the grafting of fibronectin or fibronectin/heparin complex slightly lowered the corrosion resistance. As compared to the pristine magnesium alloy, the samples modified by the immobilization of PEG and fibronectin/heparin complex presented better blood compatibility according to the results of hemolysis assay and platelet adhesion as well as the activated partial thromboplastin time (APTT). In addition, the modified substrates had better cytocompatibility to endothelial cells due to the improved anticorrosion and the introduction of fibronectin. The substrates modified by fibronectin or fibronectin/heparin complex can significantly promote endothelial cell adhesion and proliferation. Taking all these results into consideration, the method of the present study can be used for the surface modification of the magnesium alloy to simultaneously impart it better corrosion resistance, favorable blood compatibility and good cytocompatibility to endothelial cells.