Development of new metallic alloys for biomedical applications

Spinodal Zr-Nb alloys with ultrahigh elastic admissible strain and low magnetic susceptibility for orthopedic applications

Metallic biomaterials, such as stainless steels, cobalt-chromium-molybdenum (Co-Cr-Mo) alloys, and titanium (Ti) alloys, have long been used as load-bearing implant materials due to their metallic mechanical strength, corrosion resistance, and biocompatibility. However, their magnetic susceptibility and elastic modulus of more than 100 GPa significantly restrict their therapeutic applicability. In this study, spinodal Zr60Nb40, Zr50Nb50, and Zr40Nb60 (at.%) alloys were selected from the miscibility gap based on the Zr-Nb binary phase diagram and prepared by casting, cold rolling, and aging. Their microstructure, mechanical properties, corrosion resistance, magnetic susceptibility, and biocompatibility were systematically evaluated. Spinodal decomposition to alternating nanoscale Zr-rich β1 and Nb-rich β2 phases occurred in the cold-rolled Zr-Nb alloys during aging treatment at 650°C. In addition, a minor amount of α phase was precipitated in Zr60Nb40 due to the thermodynamic instability of the Zr-rich β1 phase. Spinodal decomposition significantly improved the mechanical strength of the alloys due to nanosized dual-cubic reinforcement. The Zr-Nb alloys showed an electrochemical corrosion rate of 94-262 nm per year in Hanks' solution because of formation of dense passive films composed of ZrO2 and Nb2O5 during the polarization process. The magnetic susceptibilities of the Zr-Nb alloys were significantly lower than those of commercial Co-Cr-Mo and Ti alloys. The cell viability of the Zr-Nb alloys was more than 98% toward MC3T3-E1 cells. Overall, the spinodal Zr-Nb alloys have enormous potential as bone-implant materials due to their outstanding overall mechanical properties, extraordinary corrosion resistance, low magnetic susceptibility, and sufficient bicompatibility. STATEMENT OF SIGNIFICANCE: This work reports on spinodal Zr-Nb alloys with heterostructure. Spinodal decomposition significantly improved their mechanical strength due to the nanosized dual-cubic reinforcement. The Zr-Nb alloys showed large corrosion resistance in Hanks' solution because of formation of dense passivation films composed of ZrO2 and Nb2O5 during the polarization process. The magnetic susceptibilities of the Zr-Nb alloys were significantly lower than those of commercial Co-Cr-Mo and Ti alloys. The cell viability of the Zr-Nb alloys was more than 98% toward MC3T3-E1 cells. The results demonstrate that spinodal Zr-Nb alloys have enormous potential as bone-implant materials due to their outstanding overall mechanical properties, high corrosion resistance, low magnetic susceptibility, and sufficient biocompatibility.

Effect of Cold-Rolling Deformation on the Microstructural and Mechanical Properties of a Biocompatible Ti-Nb-Zr-Ta-Sn-Fe Alloy

The primary focus of the current paper centers on the microstructures and mechanical properties exhibited by a Ti-30Nb-12Zr-5Ta-2Sn-1.25Fe (wt. %) (TNZTSF) alloy that has been produced through an intricate synthesis process comprising cold-crucible induction in levitation, carried out in an atmosphere controlled by argon, and cold-rolling deformation (CR), applying systematic adjustments in the total deformation degree (total applied thickness reduction), spanning from 10% to 60%. The microstructural characteristics of the processed specimens were investigated by SEM and XRD techniques, and the mechanical properties by tensile and microhardness testing. The collected data indicate that the TNZTSF alloy's microstructure, in the as-received condition, consists of a β-Ti phase, which shows polyhedral equiaxed grains with an average grain size close to 82.5 µm. During the cold-deformation processing, the microstructure accommodates the increased applied deformation degree by increasing crystal defects such as sub-grain boundaries, dislocation cells, dislocation lines, and other crystal defects, powerfully affecting the morphological characteristics. The as-received TNZTSF alloy showed both high strength (i.e., ultimate tensile strength close to σUTS = 705.6 MPa) and high ductility (i.e., elongation to fracture close to εf = 11.1%) properties, and the computed β-Ti phase had the lattice parameter a = 3.304(7) Å and the average lattice microstrain ε = 0.101(3)%, which are drastically influenced by the applied cold deformation, increasing the strength properties and decreasing the ductility properties due to the increased crystal defects density. Applying a deformation degree close to 60% leads to an ultimate tensile strength close to σUTS = 1192.1 MPa, an elongation to fracture close to εf = 7.9%, and an elastic modulus close to 54.9 GPa, while the computed β-Ti phase lattice parameter becomes a = 3.302(1) Å.

Influence of intermetallic phase (TiFe) on the microstructural evolution and mechanical properties of as-cast and quenched Ti-Mo-Fe alloys

This study presents the phase analysis, microstructural characteristics, and mechanical property evaluation of the as-cast and quenched Ti-15Mo-xFe alloys with high iron content ranging from 4 to 12 weight percent. All the four alloys were produced in a vacuum-arc melting furnace. Heat treatment in the form of solution treatment was performed in a muffle furnace at a temperature of 1100 °C, with 1-h holding time and the samples were rapidly quenched in ice-brine. X-ray diffractometer (XRD) was used to analyses the phases present in each alloy whereas the optical microscope (OM) was employed to track the microstructural evolution and percentage porosity. The mechanical properties of the alloys were evaluated using a tensile test and compression test method while the micro-Vickers hardness measurements were conducted to evaluate hardness of the alloys. The XRD patterns of as-cast showed peaks belonging to the β and α″ phases and intermetallic B2 TiFe phases. The as quenched XRD peaks illustrated β phase only and Fe·Ti·O2 phases. The as-cast OM micrographs revealed equiaxed β grains, substructures, dendritic structure, and pores forming around the grain boundaries. The quenched OM showed only β equiaxed grains with pores throughout the grain boundaries. The tensile properties such as ultimate tensile strength (UTS) and elastic modulus (E) of as-cast TMF0 were 264 MPa and 79 GPa respectively and these properties changed upon quenching to 411 MPa and 66 GPa respectively. The elastic modulus of TMF1 in as-cast condition was 74 GPa. The UTS and E of TMF1, TMF2, and TMF3 in as-cast and quenched conditions were not recorded due to the fragility of the samples that failed prior to yielding any useful data. The compressive strength in as-cast and in quenched condition decreased with an increase in Fe content. The micro-Vickers hardness in as-cast and quenched conditions showed a similar trend with hardness increasing slightly upon quenching for TMF0, TMF1, and TMF3 alloys but slightly decreased in the case of TMF2. The fracture surfaces of all the as-cast and quenched alloys were comprised of ductile and brittle fracture.

Corrosion and Biological Behaviors of Biomedical Ti-24Nb-4Zr-8Sn Alloy under an Oxidative Stress Microenvironment

Biomaterials can induce an inflammatory response in surrounding tissues after implantation, generating and releasing reactive oxygen species (ROS), such as hydrogen peroxide (H2O2). The excessive accumulation of ROS may create a microenvironment with high levels of oxidative stress (OS), which subsequently accelerates the degradation of the passive film on the surface of titanium (Ti) alloys and affects their biological activity. The immunomodulatory role of macrophages in biomaterial osteogenesis under OS is unknown. This study aimed to explore the corrosion behavior and bone formation of Ti implants under an OS microenvironment. In this study, the corrosion resistance and osteoinduction capabilities in normal and OS conditions of the Ti-24Nb-4Zr-8Sn (wt %, Ti2448) were assessed. Electrochemical impedance spectroscopy analysis indicated that the Ti2448 alloy exhibited superior corrosion resistance on exposure to excessive ROS compared to the Ti-6Al-4V (TC4) alloy. This can be attributed to the formation of the TiO2 and Nb2O5 passive films, which mitigated the adverse effects of OS. In vitro MC3T3-E1 cell experiments revealed that the Ti2448 alloy exhibited good biocompatibility in the OS microenvironment, whereas the osteogenic differentiation level was comparable to that of the TC4 alloy. The Ti2448 alloy significantly alleviates intercellular ROS levels, inducing a higher proportion of M2 phenotypes (52.7%) under OS. Ti2448 alloy significantly promoted the expression of the anti-inflammatory cytokine, interleukin 10 (IL-10), and osteoblast-related cytokines, bone morphogenetic protein 2 (BMP-2), which relatively increased by 26.9 and 31.4%, respectively, compared to TC4 alloy. The Ti2448 alloy provides a favorable osteoimmune environment and significantly promotes the proliferation and differentiation of osteoblasts in vitro compared to the TC4 alloy. Ultimately, the Ti2448 alloy demonstrated excellent corrosion resistance and immunomodulatory properties in an OS microenvironment, providing valuable insights into potential clinical applications as implants to repair bone tissue defects.

Bone Tissue Engineering and Nanotechnology: A Promising Combination for Bone Regeneration

Large bone defects are the leading contributor to disability worldwide, affecting approximately 1.71 billion people. Conventional bone graft treatments show several disadvantages that negatively impact their therapeutic outcomes and limit their clinical practice. Therefore, much effort has been made to devise new and more effective approaches. In this context, bone tissue engineering (BTE), involving the use of biomaterials which are able to mimic the natural architecture of bone, has emerged as a key strategy for the regeneration of large defects. However, although different types of biomaterials for bone regeneration have been developed and investigated, to date, none of them has been able to completely fulfill the requirements of an ideal implantable material. In this context, in recent years, the field of nanotechnology and the application of nanomaterials to regenerative medicine have gained significant attention from researchers. Nanotechnology has revolutionized the BTE field due to the possibility of generating nanoengineered particles that are able to overcome the current limitations in regenerative strategies, including reduced cell proliferation and differentiation, the inadequate mechanical strength of biomaterials, and poor production of extrinsic factors which are necessary for efficient osteogenesis. In this review, we report on the latest in vitro and in vivo studies on the impact of nanotechnology in the field of BTE, focusing on the effects of nanoparticles on the properties of cells and the use of biomaterials for bone regeneration.

Selective Laser Melting of the Porous Ta Scaffold with Mg-Doped Calcium Phosphate Coating for Orthopedic Applications

Addressing the repair of large-scale bone defects has become a hot research topic within the field of orthopedics. This study assessed the feasibility and effectiveness of using porous tantalum scaffolds to treat such defects. These scaffolds, manufactured using the selective laser melting (SLM) technology, possessed biomechanical properties compatible with natural bone tissue. To enhance the osteogenesis bioactivity of these porous Ta scaffolds, we applied calcium phosphate (CaP) and magnesium-doped calcium phosphate (Mg-CaP) coatings to the surface of SLM Ta scaffolds through a hydrothermal method. These degradable coatings released calcium and magnesium ions, demonstrating osteogenic bioactivity. Experimental results indicated that the Mg-CaP group exhibited biocompatibility comparable to that of the Ta group in vivo and in vitro. In terms of osteogenesis, both the CaP group and the Mg-CaP group showed improved outcomes compared to the control group, with the Mg-CaP group demonstrating superior performance. Therefore, both CaP and magnesium-CaP coatings can significantly enhance the osseointegration of three-dimensional-printed porous Ta, thereby increasing the surface bioactivity. Overall, the present study introduces an innovative approach for the biofunctionalization of SLM porous Ta, aiming to enhance its suitability as a bone implant material.

Black phosphorus-incorporated novel Ti-12Mo-10Zr implant for multimodal treatment of osteosarcoma

The repair and reconstruction of large bone defects after bone tumor resection is still a great clinical challenge. At present, orthopedic implant reconstruction is the mainstream treatment for repairing bone defects. However, according to clinical feedback, local tumor recurrence and nonunion of bone graft are common reasons leading to the failure of bone defect repair and reconstruction after bone tumor resection, which seriously threaten the physical and mental health of patients. On this basis, here the self-developed low modulus Ti-12Mo-10Zr alloy (TMZ) was chosen as substrate material. To improve its biological activity and osteointegration, calcium, oxygen, and phosphorus co-doped microporous coating was prepared on TMZ alloy by microarc oxidation (MAO). Then, black phosphorus (BP) nanosheets were incorporated onto MAO treated TMZ alloy to obtain multifunctional composites. The obtained BP-MAO-TMZ implant exhibited excellent photothermal effects and effective ablation of osteosarcoma cancer cells under the irradiation of 808 nm near infrared laser, while no photothermal or therapeutic effects were observed for TMZ alloy. Meanwhile, the structure/component bionic coating obtained after MAO treatment as well as the P-driven in situ biomineralization performance after incorporation of BP nanosheets endowed BP-MAO-TMZ implant with synergistic promoting effect on MC3T3-E1 osteoblasts' activity, proliferation and differentiation ability. This study is expected to provide effective clinical solutions for problems of difficult bone regeneration and tumor recurrence after tumor resection in patients with bone tumors and to solve a series of medical problems such as poor prognosis and poor postoperative quality of patients life with malignant bone tumors.

In vitroanalysis of insoluble salt formation mechanism associated with Mg corrosion-variations depending on the diffusion environment in model tissue

Magnesium (Mg) alloys have attracted attention as biodegradable metals, but the details of their corrosion behavior under biological environment have not been elucidated. Previous studies have suggested that diffusion through blood flow may influence Mg corrosion. Therefore, to understand the degradation behaviors of Mg, we analyzed insoluble salt precipitation associated with Mg corrosion in model tissue with different diffusion rates. A pure Mg specimen was immersed into a model tissue prepared with cell culture medium supplemented by a thickener at a different concentration (0.2%-0.5%) to form the gel. Micro-focus x-ray computed tomography of the gel was performed to observe gas cavity formation around the specimen. The insoluble salt layer formed on the specimen surface were analyzed by scanning electron microscopy with energy-dispersive x-ray spectroscopy, and Raman spectroscopy. As results, gas cavity formation was observed for all specimens. At day 7, the gas cavity volume was the highest at 0.5% thickener gel followed by 0.3% thickener gel. The insoluble salts were classified into three types based on their morphology; plate-like, granular-like, and crater-like salts. The crater-like salts were observed to cover 16.8 ± 3.9% of the specimen surface immersed in the 0.5% thickener gel, at the specimen area contacted to the gas cavity. The crater-like salts were composed by Mg hydroxide and carbonate from the deepest to the top layer. In plate-like or granular-like salts, Mg carbonate was formed in the deepest layer, but phosphates and carbonates, mainly containing calcium not Mg, were formed on the surface layer. In conclusion, the increase in the thickener concentration increased the gas cavity volume contacting to the specimen surface, resulting in the increase in precipitation of Mg hydroxide and carbonate, composing crater-like salts. Mg hydroxide and carbonate precipitation suggests the local increase in OH-concentration, which may be attributed to the decrease in diffusion rate.

Metallic Materials for Bone Repair

Repair of large bone defects caused by trauma or disease poses significant clinical challenges. Extensive research has focused on metallic materials for bone repair because of their favorable mechanical properties, biocompatibility, and manufacturing processes. Traditional metallic materials, such as stainless steel and titanium alloys, are widely used in clinics. Biodegradable metallic materials, such as iron, magnesium, and zinc alloys, are promising candidates for bone repair because of their ability to degrade over time. Emerging metallic materials, such as porous tantalum and bismuth alloys, have gained attention as bone implants owing to their bone affinity and multifunctionality. However, these metallic materials encounter many practical difficulties that require urgent improvement. This article systematically reviews and analyzes the metallic materials used for bone repair, providing a comprehensive overview of their morphology, mechanical properties, biocompatibility, and in vivo implantation. Furthermore, the strategies and efforts made to address the short-comings of metallic materials are summarized. Finally, the perspectives for the development of metallic materials to guide future research and advancements in clinical practice are identified.

Fibronectin Conformations after Electrodeposition onto 316L Stainless Steel Substrates Enhanced Early-Stage Osteoblasts' Adhesion but Affected Their Behavior

The implantation of metallic orthopedic prostheses is increasingly common due to an aging population and accidents. There is a real societal need to implement new metal implants that combine durability, good mechanical properties, excellent biocompatibility, as well as affordable costs. Since the functionalization of low-cost 316L stainless steel substrates through the successive electrodeposition of a polypyrrole film (PPy) and a calcium phosphate deposit doped with silicon was previously carried out by our labs, we have also developed a bio-functional coating by electrodepositing or oxidating of fibronectin (Fn) coating. Fn is an extracellular matrix glycoprotein involved in cell adhesion and differentiation. Impacts of either electrodeposition or oxidation on the structure and functionality of Fn were first studied. Thus, electrodeposition is the technique that permits the highest deposition of fibronectin, compared to adsorption or oxidation. Furthermore, electrodeposition seems to strongly modify Fn conformation by the formation of intermingled long fibers, resulting in changes to the accessibility of the molecular probes tested (antibodies directed against Fn whole molecule and Fn cell-binding domain). Then, the effects of either electrodeposited Fn or oxidized Fn were validated by the resulting pre-osteoblast behavior. Electrodeposition reduced pre-osteoblasts' ability to remodel Fn coating on supports because of a partial modification of Fn conformation, which reduced accessibility to the cell-binding domain. Electrodeposited Fn also diminished α5 integrin secretion and clustering along the plasma membrane. However, the N-terminal extremity of Fn was not modified by electrodeposition as demonstrated by Staphylococcus aureus attachment after 3 h of culture on a specific domain localized in this region. Moreover, the number of pre-osteoblasts remains stable after 3 h culture on either adsorbed, oxidized, or electrodeposited Fn deposits. In contrast, mitochondrial activity and cell proliferation were significantly higher on adsorbed Fn compared with electrodeposited Fn after 48 h culture. Hence, electro-deposited Fn seems more favorable to pre-osteoblast early-stage behavior than during a longer culture of 24 h and 48 h. The electrodeposition of matrix proteins could be improved to maintain their bio-activity and to develop this promising, fast technique to bio-functionalize metallic implants.

Prioritizing biomaterials for spinal disc implants by a fuzzy AHP and TOPSIS decision making method

Considerable research has been focused on identifying the optimum biomaterial for spine implants. New technologies and materials have allowed surgeons to better grasp the biomechanical principles underpinning implant stability and function. An optimal biomaterial for total disc replacement (TDR) should include essential characteristics such as biocompatibility, long-term durability, the capacity to withstand mechanical stresses, and economic viability. Our research has focused on six biomaterials for TDR, including Ti-6Al-4V, CoCr alloy, stainless steel 316L, zirconia toughened alumina (ZTA), polyether ether ketone (PEEK) and ultra-high-molecular weight polyethylene (UHMWPE). Ten common properties, i.e., the Young's modulus, density, tensile strength, the expense of the manufacturing process, the cost of raw material, wear rate, corrosion resistance, thermal conductivity, fracture toughness and compressive strength were utilized to assess these six different materials. The purpose of this study was to evaluate and rank the six alternative biomaterials proposed for use in the endplates and articulating surface of a spinal TDR. To accomplish this, a multi-criteria decision-making approach, namely the fuzzy analytic hierarchy process (fuzzy AHP) and the Technique of Order Preference by Similarity to Ideal Solution (TOPSIS) was adopted to solve the model. For validation and robustness of the proposed method, sensitivity analysis was performed, and comparison was performed with fuzzy-VIKOR and fuzzy-MOORA methods. In light of the study's results, ZTA and Ti-6Al-4V were identified as the best suited materials for the articulating surface and endplates, respectively, in a spinal disc implant.

Gallium-Containing Materials and Their Potential within New-Generation Titanium Alloys for Biomedical Applications

With the rising demand for implantable orthopaedic medical devices and the dominance of device-associated infections, extensive research into the development of novel materials has been prompted. Among these, new-generation titanium alloys with biocompatible elements and improved stiffness levels have received much attention. Furthermore, the development of titanium-based materials that can impart antibacterial function has demonstrated promising results, where gallium has exhibited superior antimicrobial action. This has been evidenced by the addition of gallium to various biomaterials including titanium alloys. Therefore, this paper aims to review the antibacterial activity of gallium when incorporated into biomedical materials, with a focus on titanium-based alloys. First, discussion into the development of new-generation Ti alloys that possess biocompatible elements and reduced Young's moduli is presented. This includes a brief review of the influence of alloying elements, processing techniques and the resulting biocompatibilities of the materials found in the literature. The antibacterial effect of gallium added to various materials, including bioglasses, liquid metals, and bioceramics, is then reviewed and discussed. Finally, a key focus is given to the incorporation of gallium into titanium systems for which the inherent mechanical, biocompatible, and antibacterial effects are reviewed and discussed in more detail, leading to suggestions and directions for further research in this area.

Electrospun PCL Wires Loaded with Vancomycin on Zirconium Substrate

The current study presents research about electrodeposition in relation to electrospinning PCL wires on a Zr substrate and loading the coating with vancomycin. The structural composition of the coatings was investigated via FT-IR analysis. The morphology evaluated using scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy, for the composition (SEM-EDS), evidenced the presence of the polymer wires, with and without drug vancomycin loading. The wettability of the coatings was evaluated from the hydrophobic-hydrophilic point of view, and the characterization was completed with mechanical and electrochemical tests. All the electrochemical tests performed in simulated body fluid highlighted that PCL represents a barrier against corrosion processes. The quantitative method to evaluate the loading efficiency shows that almost 80% of the total loaded vancomycin is released within 144 h; after the initial burst at 24 h, a steady release of vancomycin is observed over 7 days. A kinetic model of the drug release was also constructed.

Comprehensive Review on Biomaterials and Their Inherent Behaviors for Hip Repair Applications

Developing biomaterials for hip prostheses is challenging and requires dedicated attention from researchers. Hip replacement is an inevitable and remarkable orthopedic therapy for enhancing the quality of patient life for those who have arthritis as well as trauma. Generally, five types of hip replacement procedures are successfully performed in the current medical market: total hip replacements, hip resurfacing, hemiarthroplasty, bipolar, and dual mobility systems. The average life span of artificial hip joints is about 15 years, and several studies have been conducted over the last 60 years to improve the performance and thereby increase the lifespan of artificial hip joints. Present-day prosthetic hip joints are linked to the wide availability of biomaterials. Metals, ceramics, and polymers are some of the most promising types of biomaterials; nevertheless, each biomaterial has advantages and disadvantages. Metals and ceramics fail in most applications owing to stress shielding and the emission of wear debris; ongoing research is being carried out to find a remedy to these unfavorable responses. Recent research found that polymers and composites based on polymers are significant alternative materials for artificial joints. With growing research and several biomaterials, recent reviews lag in effectively addressing hip implant materials' individual mechanical, tribological, and physiological behaviors. This Review comprehensively investigates the historical evolution of artificial hip replacement procedures and related biomaterials' mechanical, tribological, and biological characteristics. In addition, the most recent advances are also discussed to stimulate and guide future researchers as they seek more effective methods and synthesis of innovative biomaterials for hip arthroplasty application.

Influence of the Phase Composition of Titanium Alloys on Cell Adhesion and Surface Colonization

The pivotal role of metal implants within the host's body following reconstructive surgery hinges primarily on the initial phase of the process: the adhesion of host cells to the implant's surface and the subsequent colonization by these cells. Notably, titanium alloys represent a significant class of materials used for crafting metal implants. This study, however, marks the first investigation into how the phase composition of titanium alloys, encompassing the volume fractions of the α, β, and ω phases, influences cell adhesion to the implant's surface. Moreover, the research delves into the examination of induced hemolysis and cytotoxicity. To manipulate the phase composition of titanium alloys, various parameters were altered, including the chemical composition of titanium alloys with iron and niobium, annealing temperature, and high-pressure torsion parameters. By systematically adjusting these experimental parameters, we were able to discern the distinct impact of phase composition. As a result, the study unveiled that the colonization of the surfaces of the examined Ti-Nb and Ti-Fe alloys by human multipotent mesenchymal stromal cells exhibits an upward trend with the increasing proportion of the ω phase, concurrently accompanied by a decrease in the α and β phases. These findings signify a new avenue for advancing Ti-based alloys for both permanent implants and temporary fixtures, capitalizing on the ability to regulate the volume fractions of the α, β, and ω phases. Furthermore, the promising characteristics of the ω phase suggest the potential emergence of a third generation of biocompatible Ti alloys, the ω-based materials, following the first-generation α-Ti alloys and second-generation β alloys.

A Review: Design from Beta Titanium Alloys to Medium-Entropy Alloys for Biomedical Applications

β-Ti alloys have long been investigated and applied in the biomedical field due to their exceptional mechanical properties, ductility, and corrosion resistance. Metastable β-Ti alloys have garnered interest in the realm of biomaterials owing to their notably low elastic modulus. Nevertheless, the inherent correlation between a low elastic modulus and relatively reduced strength persists, even in the case of metastable β-Ti alloys. Enhancing the strength of alloys contributes to improving their fatigue resistance, thereby preventing an implant material from failure in clinical usage. Recently, a series of biomedical high-entropy and medium-entropy alloys, composed of biocompatible elements such as Ti, Zr, Nb, Ta, and Mo, have been developed. Leveraging the contributions of the four core effects of high-entropy alloys, both biomedical high-entropy and medium-entropy alloys exhibit excellent mechanical strength, corrosion resistance, and biocompatibility, albeit accompanied by an elevated elastic modulus. To satisfy the demands of biomedical implants, researchers have sought to synthesize the strengths of high-entropy alloys and metastable β-Ti alloys, culminating in the development of metastable high-entropy/medium-entropy alloys that manifest both high strength and a low elastic modulus. Consequently, the design principles for new-generation biomedical medium-entropy alloys and conventional metastable β-Ti alloys can be converged. This review focuses on the design from β-Ti alloys to the novel metastable medium-entropy alloys for biomedical applications.

3D-printed LEGO®-inspired titanium scaffolds for patient-specific regenerative medicine

Despite the recent advances in 3D-printing, it is often difficult to fabricate implants that optimally fit a defect size or shape. There are some approaches to resolve this issue, such as patient-specific implant/scaffold designs based on CT images of the patients, however, this process is labor-intensive and costly. Especially in developing countries, affordable treatment options are required, while still not excluding these patient groups from potential material and manufacturing advances. Here, a selective laser melting (SLM) 3D-printing strategy was used to fabricate a hierarchical, LEGO®-inspired Assemblable Titanium Scaffold (ATS) system, which can be manually assembled in any shape or size with ease. A surgeon can quickly create a scaffold that would fit to the defect right before the implantation during the surgery. Additionally, the direct inclusion of micro- and macroporous structures via 3D-printing, as well as a double acid-etched surface treatment (ST) in the ATS, ensure biocompatibility, sufficient nutrient flow, cell migration and enhanced osteogenesis. Three different structures were designed (non-porous:NP, semi-porous:SP, ultra-porous:UP), 3D-printed with the SLM technique and then surface treated for the ST groups. After analyzing characteristics of the ATS such as printing quality, surface roughness and interconnected porosity, mechanical testing and finite element analysis (FEA) demonstrated that individual and stacked ATS have sufficient mechanical properties to withstand loading in a physiological system. All ATS showed high cell viability, and the SP and UP groups demonstrated enhanced cell proliferation rates compared to the NP group. Furthermore, we also verified that cells were well-attached and spread on the porous structures and successful cell migration between the ATS units was seen in the case of assemblies. The UP and SP groups exhibited higher calcium deposition and RT-qPCR proved higher osteogenic gene expression compared to NP group. Finally, we demonstrate a number of possible medical applications that reveal the potential of the ATS through assembly.

Process Development of a Generative Method for Partial and Controlled Integration of Active Substances into Open-Porous Matrix Structures

A special generative manufacturing (AM) process was developed for the partial integration of active ingredients into open-porous matrix structures. A mixture of a silver-containing solution as an antibacterial material with an alginate hydrogel as a carrier system was produced as the active ingredient. The AM process developed was used to introduce the active ingredient solution into an open-porous niobium containing a β-titanium matrix structure, thus creating a reproducible active ingredient delivery system. The matrix structure had already been produced in a separate AM process by means of selective laser melting (SLM). The main advantage of this process is the ability to control porosity with high precision. To determine optimal surface conditions for the integration of active ingredients into the matrix structure, different surface conditions of the titanium substrate were tested for their impact on wetting behaviour of a silver-containing hydrogel solution. The solution-substrate contact angle was measured and evaluated to determine the most favourable surface condition. To develop the generative manufacturing process, an FDM printer underwent modifications that permitted partial application of the drug solution to the structure in accordance with the bioprinting principle. The modified process enabled flexible control and programming of both the position and volume of the applied drug. Furthermore, the process was able to fill up to 95% of the titanium matrix body pore volume used. The customised application of drug carriers onto implants as a drug delivery system can be achieved via the developed process, providing an alternative to established methods like dip coating that lack this capability.

Synthesis of Titanium Oxide Nanotubes Loaded with Hydroxyapatite

A simple method of synthesis of TiO2 nanotubes (TiNT) loaded with hydroxyapatite (HAP) is described. Such nanotubes find wide applications in various fields, including biomedicine, solar cells, and drug delivery, due to their bioactivity and potential for osseointegration. The Cp-Ti substrate was anodized at a constant voltage of 40 V, with the subsequent heat treatment at 450 °C. The resulting TiNT had a diameter of 100.3 ± 2.8 nm and a length of 3.5 ± 0.04 μm. The best result of the growth rate of HAP in Hanks' balanced salt solution (Hanks' BSS) was obtained in calcium glycerophosphate (CG = 0.1 g/L) when precipitates formed on the bottom and walls of the nanotubes. Structural properties, surface wettability, corrosion resistance, and growth rate of HAP as an indicator of the bioactivity of the coating have been studied. X-ray diffraction (XRD), scanning electron microscope (SEM), energy dispersive spectroscopy (EDS), potentiodynamic polarization test (PPC), electrochemical impedance spectroscopy (EIS), and contact angle (CA) measurements were used to characterize HAP-loaded nanotubes (HAP-TiNT). The CA, also serving as an indirect indicator of bioactivity, was 30.4 ± 1.1° for the TiNT not containing HAP. The contact angle value for HAP-TiNT produced in 0.1 g/L CG was 18.2 ± 1.2°, and for HAP-TiNT exposed to Hanks' BSS for 7 days, the CA was 7.2 ± 0.5°. The corrosion studies and measurement of HAP growth rates after a 7-day exposure to Hanks' BSS confirmed the result that TiNT processed in 0.1 g/L of CG exhibited the most significant capacity for HAP formation compared to the other tested samples.

Multidimensional analysis for the correlation of physico-chemical attributes to osteoblastogenesis in TiNbZrSnTa alloys

Data-enabled approaches that complement experimental testing offer new capabilities to investigate the interplay between chemical, physical and mechanical attributes of alloys and elucidate their effect on biological behaviours. Reported here, instead of physical causation, statistical correlations were used to study the factors responsible for the adhesion, proliferation and maturation of pre-osteoblasts MC3T3-E1 cultured on Titanium alloys. Eight alloys with varying wt% of Niobium, Zirconium, Tin and Tantalum (Ti- (2-22 wt%)Nb- (5-20 wt%)Zr- (0-18 wt%)Sn- (0-14 wt%)Ta) were designed to achieve exemplars of allotropes (incl., metastable-β, β + α', α″). Following confirmation of their compositions (ICP, EDX) and their crystal structure (XRD, SEM), their compressive bulk properties were measured and their surface features characterised (XPS, SFE). Because these alloys are intended for the manufacture of implantable orthopaedic devices, the correlation focuses on the effect of surface properties on cellular behaviour. Physico-chemical attributes were paired to biological performance, and these highlight the positive interdependencies between oxide composition and proliferation (esp. Ti4+), and maturation (esp. Zr4+). The correlation reveals the negative effect of oxide thickness, esp. TiOx and TaOx on osteoblastogenesis. This study also shows that the characterisation of the chemical state and elemental electronic structure of the alloys' surface is more predictive than physical properties, namely SFE and roughness.

Experimental and Numerical Investigation of Shielding Gas Behaviors in Laser Welding of TC4 Alloy

Gas protection is a crucial part of quality control in laser welding, especially for titanium alloy, which oxidizes easily at high temperatures. Substantial experiments concerning shielding gas characteristics in the welding process have been implemented. However, the common analysis conducted is simplistic and lacks a theoretical basis. This paper presented an investigation of the shielding gas behaviors based on numerical simulation and a titanium alloy laser welding experiment. The numerical model was established and validated by experiment. Subsequently, the temperature field and gas flow fields were calculated. By combining the two fields, the threshold temperature of gas protection was determined, and the influence of shielding gas parameters on the protection effect was examined. The results revealed that the protection of the high-temperature zone was primarily influenced by the nozzle height, nozzle inner diameter, and nozzle angle, while the plasma suppression effect was mainly correlated with the nozzle inner diameter and gas flow rate. These initial findings provide scientific guidance for the better quality production of laser beam welded components made of not only titanium alloy but also other metallic materials.

Biological Performance of Duplex PEO + CNT/PCL Coating on AZ31B Mg Alloy for Orthopedic and Dental Applications

To regulate the degradation rate and improve the surface biocompatibility of the AZ31B magnesium alloy, three different coating systems were produced via plasma electrolytic oxidation (PEO): simple PEO, PEO incorporating multi-walled carbon nanotubes (PEO + CNT), and a duplex coating that included a polycaprolactone top layer (PEO + CNT/PCL). Surfaces were characterized by chemical content, roughness, topography, and wettability. Biological properties analysis included cell metabolism and adhesion. PEO ± CNT resulted in an augmented surface roughness compared with the base material (BM), while PCL deposition produced the smoothest surface. All surfaces had a contact angle below 90°. The exposure of gFib-TERT and bmMSC to culture media collected after 3 or 24 h did not affect their metabolism. A decrease in metabolic activity of 9% and 14% for bmMSC and of 14% and 29% for gFib-TERT was observed after 3 and 7 days, respectively. All cells died after 7 days of exposure to BM and after 15 days of exposure to coated surfaces. Saos-2 and gFib-TERT adhered poorly to BM, in contrast to bmMSC. All cells on PEO anchored into the pores with filopodia, exhibited tiny adhesion protrusions on PEO + CNT, and presented a web-like spreading with lamellipodia on PEO + CNT/PCL. The smooth and homogenous surface of the duplex PEO + CNT/PCL coating decreased magnesium corrosion and led to better biological functionality.

3D printing metal implants in orthopedic surgery: Methods, applications and future prospects

Background

Currently, metal implants are widely used in orthopedic surgeries, including fracture fixation, spinal fusion, joint replacement, and bone tumor defect repair. However, conventional implants are difficult to be customized according to the recipient's skeletal anatomy and defect characteristics, leading to difficulties in meeting the individual needs of patients. Additive manufacturing (AM) or three-dimensional (3D) printing technology, an advanced digital fabrication technique capable of producing components with complex and precise structures, offers opportunities for personalization.

Methods

We systematically reviewed the literature on 3D printing orthopedic metal implants over the past 10 years. Relevant animal, cellular, and clinical studies were searched in PubMed and Web of Science. In this paper, we introduce the 3D printing method and the characteristics of biometals and summarize the properties of 3D printing metal implants and their clinical applications in orthopedic surgery. On this basis, we discuss potential possibilities for further generalization and improvement.

Results

3D printing technology has facilitated the use of metal implants in different orthopedic procedures. By combining medical images from techniques such as CT and MRI, 3D printing technology allows the precise fabrication of complex metal implants based on the anatomy of the injured tissue. Such patient-specific implants not only reduce excessive mechanical strength and eliminate stress-shielding effects, but also improve biocompatibility and functionality, increase cell and nutrient permeability, and promote angiogenesis and bone growth. In addition, 3D printing technology has the advantages of low cost, fast manufacturing cycles, and high reproducibility, which can shorten patients' surgery and hospitalization time. Many clinical trials have been conducted using customized implants. However, the use of modeling software, the operation of printing equipment, the high demand for metal implant materials, and the lack of guidance from relevant laws and regulations have limited its further application.

Conclusions

There are advantages of 3D printing metal implants in orthopedic applications such as personalization, promotion of osseointegration, short production cycle, and high material utilization. With the continuous learning of modeling software by surgeons, the improvement of 3D printing technology, the development of metal materials that better meet clinical needs, and the improvement of laws and regulations, 3D printing metal implants can be applied to more orthopedic surgeries.

The translational potential of this paper

Precision, intelligence, and personalization are the future direction of orthopedics. It is reasonable to believe that 3D printing technology will be more deeply integrated with artificial intelligence, 4D printing, and big data to play a greater role in orthopedic metal implants and eventually become an important part of the digital economy. We aim to summarize the latest developments in 3D printing metal implants for engineers and surgeons to design implants that more closely mimic the morphology and function of native bone.

Recent advances in 3D printing of biodegradable metals for orthopaedic applications

The use of biodegradable polymers for treating bone-related diseases has become a focal point in the field of biomedicine. Recent advancements in material technology have expanded the range of materials suitable for orthopaedic implants. Three-dimensional (3D) printing technology has become prevalent in healthcare, and while organ printing is still in its early stages and faces ethical and technical hurdles, 3D printing is capable of creating 3D structures that are supportive and controllable. The technique has shown promise in fields such as tissue engineering and regenerative medicine, and new innovations in cell and bio-printing and printing materials have expanded its possibilities. In clinical settings, 3D printing of biodegradable metals is mainly used in orthopedics and stomatology. 3D-printed patient-specific osteotomy instruments, orthopedic implants, and dental implants have been approved by the US FDA for clinical use. Metals are often used to provide support for hard tissue and prevent complications. Currently, 70-80% of clinically used implants are made from niobium, tantalum, nitinol, titanium alloys, cobalt-chromium alloys, and stainless steels. However, there has been increasing interest in biodegradable metals such as magnesium, calcium, zinc, and iron, with numerous recent findings. The advantages of 3D printing, such as low manufacturing costs, complex geometry capabilities, and short fabrication periods, have led to widespread adoption in academia and industry. 3D printing of metals with controllable structures represents a cutting-edge technology for developing metallic implants for biomedical applications. This review explores existing biomaterials used in 3D printing-based orthopedics as well as biodegradable metals and their applications in developing metallic medical implants and devices. The challenges and future directions of this technology are also discussed.

Influence of β-Stabilizer Element on Microstructure and Mechanical Behavior of Porous Titanium Alloy Synthesized by Liquid Metal Dealloying

The metallic implant materials for load-bearing applications typically possess a significantly higher stiffness when compared with that of human bone. In some cases, this stiffness mismatch leads to a stress-shielding effect and eventual loosing of the implant. Porous metallic materials are suitable candidates to overcome this problem. In this study, we synthesized low modulus open porous TiFe alloy by liquid metal dealloying of the precursor Ti47.5Fe2.5Cu50 (at.%) material in liquid Mg. Upon liquid metal dealloying, Cu was selectively dissolved from the precursor, and the remaining Ti and Fe elements were reorganized into a bicontinous porous structure. The synthesized TiFe alloy is composed of α-titanium and β-titanium phases. The average measured ligament size is in the micrometer range. It was found that a higher dealloying temperature leads to a pronounced coarsening of the microstructure. The open porous TiFe alloy possesses a low elastic modulus of about 6.4-6.9 GPa. At the same time, its yield strength value reaches about 185 MPa due to the α + β microstructure. Its attractive mechanical properties for biomedical applications, together with its open porous structure, indicate the potential of porous TiFe alloys to be used as implants.

Molecular Mechanism Underlying the Action of a Celastrol-Loaded Layered Double Hydroxide-Coated Magnesium Alloy in Osteosarcoma Inhibition and Bone Regeneration

Osteosarcoma (OS) is a malignant bone tumor that threatens human health. Surgical removal of the tumor and followed by implantation with a graft is the golden standard for its clinical treatment. However, avoiding recurrence by enhancing the antitumor properties of the implants and improving osteogenesis around the implants remain a challenge. Here, we developed a layered double hydroxide (LDH)-coated magnesium (Mg) alloy and loaded it with celastrol. The celastrol-loaded Mg alloy exhibited enhanced corrosion resistance and sustained release of celastrol. In vitro cell culture suggested that the modified Mg alloy loaded with an appropriate amount of celastrol significantly inhibited the proliferation and migration of bone tumor cells while having little influence on normal cells. A mechanistic study revealed that the celastrol-loaded Mg alloy upregulated reactive oxygen species (ROS) generation in bone tumor cells, resulting in mitochondrial dysfunction due to reduced membrane potential, thereby inducing bone tumor cell apoptosis. Furthermore, it was found that celastrol-induced autophagy in tumor cells inhibited cell apoptosis in the initial 6 h. After ≥12 h of culture, inhibition of the PI3K-Akt-mTOR signaling pathway was noted, resulting in excessive autophagy in tumor cells, finally causing cell apoptosis. The celatsrol-loaded Mg alloy also exhibited effective antitumor properties in a subcutaneous tumor model. In vitro tartrate-resistant acid phosphatase (TRAP) staining and gene expression results revealed that the modified Mg alloy reduced the viability of osteoclasts, inducing a potential pathway for the increased bone regeneration around the modified Mg alloy seen in vivo. Together, the results of our study show that the celatsrol-loaded Mg alloy might be a promising implant for treating OS.

Mechanical influence of tissue scaffolding design with different geometries using finite element study

The mechanical properties of tissue scaffolds are essential in providing stability for tissue repair and growth. Thus, the ability of scaffolds to withstand specific loads is crucial for scaffold design. Most research on scaffold pores focuses on grids with pore size and gradient structure, and many research models are based on scaffolding with vertically arranged holes. However, little attention is paid to the influence of the distribution of holes on the mechanical properties of the scaffold. To address this gap, this research investigates the effect of pore distribution on the mechanical properties of tissue scaffolds. The study involves four types of scaffold designs with regular and staggered pore arrangements and porosity ranging from 30% to 80%. Finite element analysis (FEA) was used to compare the mechanical properties of different scaffold designs, with von-Mises stress distribution maps generated for each scaffold. The results show that scaffolds with regular vertical holes exhibit a more uniform stress distribution and better mechanical performance than those with irregular holes. In contrast, the scaffold with a staggered arrangement of holes had a higher probability of stress concentration. The study emphasized the importance of balancing porosity and strength in scaffold design.

Microstructural, Mechanical, and Electrochemical Characterization of CrMoNbTiZr High-Entropy Alloy for Biomedical Application

High-entropy alloys (HEA) with superior biocompatibility, high pitting resistance, minimal debris accumulation, and reduced release of metallic ions into surrounding tissues are potential replacements for traditional metallic bio-implants. A novel equiatomic HEA based on biocompatible metals, CrMoNbTiZr, was consolidated by spark plasma sintering (SPS). The relative sintered density of the alloy was about 97% of the theoretical density, indicating the suitability of the SPS technique to produce relatively dense material. The microstructure of the sintered HEA consisted of a BCC matrix and Laves phase, corresponding to the prediction of the thermodynamic CALPHAD simulation. The HEA exhibited a global Vickers microhardness of 531.5 ± 99.7 HV, while the individual BCC and Laves phases had hardness values of 364.6 ± 99.4 and 641.8 ± 63.0 HV, respectively. Its ultimate compressive and compressive yield strengths were 1235.7 ± 42.8 MPa and 1110.8 ± 78.6 MPa, respectively. The elasticity modulus of 34.9 ± 2.9 GPa of the HEA alloy was well within the range of cortical bone and significantly lower than the values reported for commonly used biomaterials made from Ti-based and Cr-Co-based alloys. In addition, the alloy exhibited good resistance to bio-corrosion in PBS and Hanks solutions. The CrMoNbTiZr HEA exhibited an average COF of 0.43 ± 0.06, characterized mainly by abrasive and adhesive wear mechanisms. The CrMoNbTiZr alloy's mechanical, bio-corrosion, and wear resistance properties developed in this study showed a good propensity for application as a biomaterial.

Surface characterization, electrochemical properties and in vitro biological properties of Zn-deposited TiO2 nanotube surfaces

In this work, to improve antibacterial, biocompatible and bioactive properties of commercial pure titanium (cp-Ti) for implant applications, the Zn-deposited nanotube surfaces were fabricated on cp-Ti by using combined anodic oxidation (AO) and physical vapor deposition (PVD-TE) methods. Homogenous elemental distributions were observed through all surfaces. Moreover, Zn-deposited surfaces exhibited hydrophobic character while bare Ti surfaces were hydrophilic. Due to the biodegradable behavior of Zn on the nanotube surface, Zn-deposited nanotube surfaces showed higher corrosion current density than bare cp-Ti surface in SBF conditions as expected. In vitro biological properties such as cell viability, ALP activity, protein adsorption, hemolytic activity and antibacterial activity for Gram-positive and Gram-negative bacteria of all surfaces were investigated in detail. Cell viability, ALP activity and antibacterial properties of Zn-deposited nanotube surfaces were significantly improved with respect to bare cp-Ti. Moreover, hemolytic activity and protein adsorption of Zn-deposited nanotube surfaces were decreased. According to these results; a bioactive, biocompatible and antibacterial Zn-deposited nanotube surfaces produced on cp-Ti by using combined AO and PVD techniques can have potential for orthopedic and dental implant applications.

Effect of Si Contents on the Properties of Ti15Mo7ZrxSi Alloys

The main purpose of this research is to evaluate the mechanical characteristics and biocompatibility of two novel titanium alloys, Ti15Mo7ZrxSi (x = 0, 0.5, 0.75, 1). These samples had already undergone grinding, polishing, cutting, and chipping. Electrochemical, metallographic, three-point bending, and microhardness studies were conducted on the studied materials to determine their corrosion behavior, microstructure, Young's modulus, and hardness. The first investigations revealed that both samples had biphasic and dendritic structures, elastic moduli that were between the highest and minimum values achieved by around 20 GPa, and favorable behavior when in contact with physiological fluids at ambient temperature. Ti15Mo7Zr0.5Si and Ti15Mo7Zr0.75Si, the research samples, had greater corrosion potentials, reduced corrosion rates, and therefore higher corrosion resistance, as well as modulus of elasticity values that were comparable to and closer to those of human bone. The results of this investigation indicate that both alloys exhibit favorable corrosion behavior, great biocompatibility, Young's modulus results lower than those of conventional alloys used in biomedical implants, and hardness values higher than commercially pure titanium.

Instrumented cervical fusion using patient specific end-plate conforming interbody devices with a micro-porous structure in nine dogs with disk-associated cervical spondylomyelopathy

Objective

To report the medium and long-term outcome of nine dogs with disk-associated cervical spondylomyelopathy (DA-CSM), treated by instrumented interbody fusion using patient specific end-plate conforming device that features a micro-porous structure to facilitate bone in-growth.

Study design

A retrospective clinical study.

Animals

Nine medium and large breed dogs.

Methods

Medical records at two institutions were reviewed between January 2020 and 2023. Following magnetic resonance imaging (MRI) diagnosis of DA-CSM, pre-operative computed tomography (CT) scans were exported to computer software for in-silico surgical planning. Interbody devices were 3D-manufactured by selecting laser melting in titanium alloy. These were surgically implanted at 13 segments alongside mono-or bi-cortical vertebral stabilization systems. Follow-up included neurologic scoring and CT scans post-operative, at medium-term follow up and at long-term follow-up where possible. Interbody fusion and implant subsidence were evaluated from follow-up CT scans.

Results

Nine dogs were diagnosed with DA-CSM between C5-C7 at a total of 13 operated segments. Medium-term follow up was obtained between 2 and 8 months post-operative (3.00 ± 1.82 months). Neurologic scoring improved (p = 0.009) in eight of nine dogs. Distraction was significant (p < 0.001) at all segments. Fusion was evident at 12/13 segments. Subsidence was evident at 3/13 operated segments but was only considered clinically relevant in one dog that did not improve; as clinical signs were mild, revision surgery was not recommended. Long-term follow up was obtained between 9 and 33 months (14.23 ± 8.24 months); improvement was sustained in 8 dogs. The dog that suffered worsened thoracic limb paresis at medium-term follow up was also diagnosed with immune-mediated polyarthropathy (IMPA) and was euthanased 9 months post-operative due to unacceptable side-effects of corticosteroid therapy.

Conclusion

End-plate conforming interbody devices with a micro-porous structure were designed, manufactured, and successfully implanted in dog with DA-CSM. This resulted in CT-determined fusion with minimal subsidence in the majority of operated segments.

Clinical significance

The technique described can be used to distract and fuse cervical vertebrae in dogs with DA-CSM, with favorable medium-and long-term outcomes.

Fabrication of CO-releasing surface to enhance the blood compatibility and endothelialization of TiO2 nanotubes on titanium surface

Although the construction of nanotube arrays with the micro-nano structures on the titanium surfaces has demonstrated a great promise in the field of blood-contacting materials and devices, the limited surface hemocompatibility and delayed endothelial healing should be further improved. Carbon monoxide (CO) gas signaling molecule within the physiological concentrations has excellent anticoagulation and the ability to promote endothelial growth, exhibiting the great potential for the blood-contact biomaterials, especially the cardiovascular devices. In this study, the regular titanium dioxide nanotube arrays were firstly prepared in situ on the titanium surface by anodic oxidation, followed by the immobilization of the complex of sodium alginate/carboxymethyl chitosan (SA/CS) on the self-assembled modified nanotube surface, the CO-releasing molecule (CORM-401) was finally grafted onto the surface to create a CO-releasing bioactive surface to enhance the biocompatibility. The results of scanning electron microscopy (SEM), X-ray energy dispersion spectroscopy (EDS), and X-ray photoelectron spectroscopy (XPS) revealed that the CO-releasing molecules were successfully immobilized on the surface. The modified nanotube arrays not only exhibited excellent hydrophilicity but also could slowly release CO gas molecules, and the amount of CO release increased when cysteine was added. Furthermore, the nanotube array can promote albumin adsorption while inhibit fibrinogen adsorption to some extent, demonstrating its selective albumin adsorption; although this effect was somewhat reduced by the introduction of CORM-401, it can be significantly enhanced by the catalytic release of CO. The results of hemocompatibility and endothelial cell growth behaviors showed that, as compared with the CORM-401 modified sample, although the SA/CS-modified sample had better biocompatibility, in the case of cysteine-catalyzed CO release, the released CO could not only reduce the platelet adhesion and activation as well as hemolysis rate, but also promote endothelial cell adhesion and proliferation as well as vascular endothelial growth factor (VEGF) and nitric oxide (NO) expression. As a result, the research of the present study demonstrated that the releasing CO from TiO₂ nanotubes can simultaneously enhance the surface hemocompatibility and endothelialization, which could open a new route to enhance the biocompatibility of the blood-contacting materials and devices, such as the artificial heart valve and cardiovascular stents.

Elastin-like recombinamer-mediated hierarchical mineralization coatings on Zr-16Nb-xTi (x = 4,16 wt%) alloy surfaces improve biocompatibility

The biocompatibility of biomedical materials is vital to their applicability and functionality. However, modifying surfaces for enhanced biocompatibility using traditional surface treatment techniques is challenging. We employed a mineralizing elastin-like recombinamer (ELR) self-assembling platform to mediate mineralization on Zr-16Nb-xTi (x = 4,16 wt%) alloy surfaces, resulting in the modification of surface morphology and bioactivity while improving the biocompatibility of the material. We modulated the level of nanocrystal organization by adjusting the cross-linker ratio. Nanoindentation tests revealed that the mineralized configuration had nonuniformity with respect to Young's modulus and hardness, with the center areas having higher values (5.626 ± 0.109 GPa and 0.264 ± 0.022 GPa) compared to the edges (4.282 ± 0.327 GPa and 0.143 ± 0.023 GPa). The Scratch test results indicated high bonding strength (2.668 ± 0.117 N) between the mineralized coating and the substrate. Mineralized Zr-16Nb-xTi (x = 4,16 wt%) alloys had higher viability compared to untreated alloys, which exhibited high cell viability (>100 %) after 5 days and high alkaline phosphatase activity after 7 days. Cell proliferation assays indicated that MG 63 cells grew faster on mineralized surfaces than on untreated surfaces. Scanning electron microscopy imaging confirmed that the cells adhered and spread well on mineralized surfaces. Furthermore, hemocompatibility test results revealed that all mineralized samples were non-hemolytic. Our results demonstrate the viability of employing the ELR mineralizing platform to improve alloy biocompatibility.

Surface Modification of Biomedical Ti-18Zr-15Nb Alloy by Atomic Layer Deposition and Ag Nanoparticles Decoration

Superelastic biocompatible alloys attract significant attention as novel materials for bone tissue replacement. These alloys are often composed of three or more components that lead to the formation of complex oxide films on their surfaces. For practical use, it is desirable to have a single-component oxide film with a controlled thickness on the surface of biocompatible material. Herein we investigate the applicability of the atomic layer deposition (ALD) technique for surface modification of Ti-18Zr-15Nb alloy with TiO₂ oxide. It was found that a 10-15 nm thick, low-crystalline TiO₂ oxide layer is formed by ALD method over the natural oxide film (~5 nm) of the Ti-18Zr-15Nb alloy. This surface consists of TiO₂ exclusively without any additions of Zr or Nb oxides/suboxides. Further, the obtained coating is modified by Ag nanoparticles (NPs) with a surface concentration up to 1.6% in order to increase the material's antibacterial activity. The resulting surface exhibits enhanced antibacterial activity with an inhibition rate of more than 75% against E. coli bacteria.

Microstructural Considerations of a Multi-Pass Rolled Ti-Nb-Ta-Zr Alloy

The microstructural characteristic evolution was investigated during thermomechanical processing of Ti-29Nb-9Ta-10Zr (wt %) alloy, which consisted of, in a first stage, in a Multi-Pass Rolling with increasing thickness reduction of 20%, 40%, 60%, 80%, and 90%; in step two, the multi-pass rolled sample with the highest thickness reduction (90%) was subjected to a series of three variants of static short recrystallization and then to a final similar aging. The objective was to evaluate the microstructural features evolution during thermomechanical processing (phase's nature, morphology, dimensions, and crystallographic characteristics) and to find the optimal heat treatment variant for refinement of the alloy granulation until ultrafine/nanometric level for a promising combination of mechanical properties. The microstructural features were investigated by X-ray diffraction and SEM techniques through which the presence of two phases was recorded: the β-Ti phase and the α″-Ti martensitic phase. The corresponding cell parameters, dimensions of the coherent crystallite and the micro-deformations at the crystalline network level for both recorded phases were determined. The majority β-Ti phase underwent a strong refinement during the Multi-Pass Rolling process until ultrafine/nano grain dimension (about 9.8 nm), with subsequent slow growing during recrystallization and aging treatments, hindered by the presence of sub-micron α″-Ti phase dispersed inside β-Ti grains. An analysis concerning the possible deformation mechanisms was performed.

A Novel Hydro-Thermal Synthesis of Nano-Structured Molybdenum-Iron Intermetallic Alloys at Relatively Low Temperatures

Nano-structured Mo/Fe intermetallics were synthesized from precursors that contained 72/28% and 30/70% molar ratios of Mo/Fe, which were given as precursors A and B, respectively. These precursors were prepared from the co-precipitation of aqueous hot solutions of ammonium heptamolybdate tetrahydrate (AHM) and ferrous oxalate. The dry precipitates were thermally treated using TG-DSC to follow up their behavior during roasting, in an Ar atmosphere of up to 700 °C (10° K/min). The TG profile showed that 32.5% and 55.5% weight losses were measured from the thermal treatment of precursors A and B, respectively. The DSC heat flow profile showed the presence of endothermic peaks at 196.9 and 392.5-400 °C during the thermal decomposition of the AHM and ferrous oxalate, respectively. The exothermic peak that was detected at 427.5 °C was due to the production of nano-sized iron molybdate [Fe₂(MoO₄)₃]. An XRD phase analysis indicated that iron molybdate was the only phase that was identified in precursor A, while iron molybdate and Fe₂O₃ were produced in precursor B. Compacts were made from the pressing of the nano-sized precursors, which were roasted at 500 °C for 3 h. The roasted compacts were isothermally reduced in H₂ at 600-850 °C using microbalance, and the O₂ weight loss that resulted from the reduction reactions was continuously recorded as a function of time. The influence of the reduction temperature and precursor composition on the reduction behavior of the precursors was studied and discussed. The partially and completely reduced compacts were examined with X-ray powder diffraction (XRD), a reflected light microscope (RLM), and a scanning electron microscope (SEM-EDS). Depending on the precursor composition, the reduction reactions of the [Fe₂(MoO₄)₃] and Fe₂O₃ proceeded through the formation of intermediate lower oxides, prior to the production of the MO/Fe intermetallic alloys. Based on the intermediate phases that were identified and characterized at the early, intermediate, and final reduction degrees, chemical reaction equations were given to follow up the formation of the MoFe and MoFe₃ intermetallic alloys. The mechanism of the reduction reactions was predicted from the apparent activation energy values (Ea) that were computed at the different reduction degrees. Moreover, mathematical formulations that were derived from the gas-solid reaction model were applied to confirm the reduction mechanisms, which were greatly dependent on the precursor composition and reduction temperature. However, it can be reported that nano-structured MoFe and MoFe₃ intermetallic alloys can be successfully fabricated via a gas-solid reaction technique at lower temperatures.

Design of Ti-Mo-W Alloys and Its Correlation with Corrosion Resistance in Simulated Body Fluid (SBF)

Titanium and its based alloys are frequently selected for designing biomedical implants and it is thus necessary to study as detailed as possible their corrosion behavior in biological solutions, such as those in the human body environment. In this paper, with the use of molecular orbital calculation, we designed and developed alloys in the Ti-19Mo-xW system (x = 7, 8, 9, and 10 wt%) and investigated the influence of different contents of tungsten on the behavior of Ti-19Mo-xW alloy samples following corrosion in simulated body fluid (SBF). The values of Bo¯ (bond order) and Md¯ (the metal-orbital energy level) were calculated for each alloy and correlations were established between Bo¯ and the content of tungsten. It was found that with the increase in tungsten content, the value of Bo¯ increases. Regarding the values of the corrosion resistance in SBF that resulted from the investigated alloys, the Ti19Mo7W alloy is distinguished by the lowest value of the corrosion current density and the lowest corrosion rate.

Fabrication of a New Hyaluronic Acid/Gelatin Nanocomposite Hydrogel Coating on Titanium-Based Implants for Treating Biofilm Infection and Excessive Inflammatory Response

Persistent inflammation caused by implant-associated biofilm infections has emerged as a significant clinical issue. While many methods have been developed to give implants great anti-biofilm benefits, the post-inflammatory microenvironment is frequently disregarded. Oxidative stress (OS) due to excessive reactive oxygen species (ROS) is considered to be one of the specific physiological signals of the inflammation microenvironment. Herein, ZIF-90-Bi-CeO₂ nanoparticles (NPs) were incorporated into a Schiff-base chemically crosslinked hydrogel composed of aldehyde-based hyaluronic acid and gelatin. Through chemical crosslinking between polydopamine and gelatin, the hydrogel coating adhered to the Ti substrate. The modified Ti substrate gained multimodal antibacterial and anti-biofilm functions, which were attributed to the photothermal effect of Bi NPs, and the release of Zn ions and CeO₂ NPs. Notably, CeO₂ NPs endowed the system with dual-enzyme (SOD- and CAT-like) catalytic activities. In a rat implant-associated infection (IAI) model, the dual-functional hydrogel had a biofilm-removal ability and regulated OS and inflammatory responses to facilitate osseointegration. The photothermal therapy combined with a host inflammation-microenvironment regulation strategy might provide a novel treatment for biofilm infection and the accompanying excessive inflammation.

In vitrocellular biocompatibility andin vivodegradation behavior of calcium phosphate-coated ZK60 magnesium alloy

Calcium phosphate (Ca-P) surface coating is a simple but effective way to enhance both corrosion resistance and biocompatibility of ZK60 magnesium alloy. However, cell compatibility on different Ca-P layers coated on ZK60 alloy has seldom been investigated. In this study, the effects of type, morphology and corrosion protection of several Ca-P coatings formed at pH 6.5, 7.8 and 10.2 on cell behavior were examined by using an osteoblastic cell line MC3T3-E1. Furthermore,in vivobehavior in rabbits of the alloy coated with the optimum Ca-P layer was also studied. It was found that the surface factors governed the cell morphology and density. The coating morphology plays a dominant role in these surface factors. The sample coated at pH 7.8 showed the best cellular biocompatibility, suggesting that the hydroxyapatite (HAp) layer formed at pH 7.8 was the optimum coating. In rabbits, this optimum coating enhanced remarkably the corrosion resistance of the alloy. During implantation, the outermost crystals of the HAp coating were shortened and thinned due to the dissolution of HAp caused by the body fluid of the rabbits. It is indicated that ZK60 alloy coated at pH 7.8 can be applied as a biodegradable implant.

Improving Biocompatibility for Next Generation of Metallic Implants

The increasing need for joint replacement surgeries, musculoskeletal repairs, and orthodontics worldwide prompts emerging technologies to evolve with healthcare's changing landscape. Metallic orthopaedic materials have a shared application history with the aerospace industry, making them only partly efficient in the biomedical domain. However, suitability of metallic materials in bone tissue replacements and regenerative therapies remains unchallenged due to their superior mechanical properties, eventhough they are not perfectly biocompatible. Therefore, exploring ways to improve biocompatibility is the most critical step toward designing the next generation of metallic biomaterials. This review discusses methods of improving biocompatibility of metals used in biomedical devices using surface modification, bulk modification, and incorporation of biologics. Our investigation spans multiple length scales, from bulk metals to the effect of microporosities, surface nanoarchitecture, and biomolecules such as DNA incorporation for enhanced biological response in metallic materials. We examine recent technologies such as 3D printing in alloy design and storing surface charge on nanoarchitecture surfaces, metal-on-metal, and ceramic-on-metal coatings to present a coherent and comprehensive understanding of the subject. Finally, we consider the advantages and challenges of metallic biomaterials and identify future directions.

An overview of translational research in bone graft biomaterials

Natural bone healing is often inadequate to treat fractures with critical size bone defects and massive bone loss. Immediate surgical interventions through bone grafts have been found to be essential on such occasions. Naturally harvested bone grafts, although are the preferred choice of the surgeons; they suffer from serious clinical limitations, including disease transmission, donor site morbidity, limited supply of graft etc. Synthetic bone grafts, on the other hand, offer a more clinically appealing approach to decode the pathways of bone repair through use of tissue engineered biomaterials. This article critically retrospects the translational research on various engineered biomaterials towards bringing transformative changes in orthopaedic healthcare. The first section of the article discusses about composition and ultrastructure of bone along with the global perspectives on statistical escalation of bone fracture surgeries requiring use of bone grafts. The next section reviews the types, benefits and challenges of various natural and synthetic bone grafts. An overview of clinically relevant biomaterials from traditionally used metallic, bioceramic, and biopolymeric biomaterials to new generation composites have been summarised. Finally, this narrative review concludes with the discussion on the emerging trends and future perspectives of the promising bone grafts.

Influence of Hafnium Addition on the Microstructure, Microhardness and Corrosion Resistance of Ti20Ta20Nb20(ZrMo)20-xHfx (where x = 0, 5, 10, 15 and 20 at.%) High Entropy Alloys

The presented work aimed to investigate the influence of the hafnium/(zirconium and molybdenum) ratio on the microstructure, microhardness and corrosion resistance of Ti₂₀Ta₂₀Nb₂₀(ZrMo)_20-xHf_x (where x = 0, 5, 10, 15 and 20 at.%) high entropy alloys in an as-cast state produced from elemental powder and obtained via the vacuum arc melting technique. All studied alloys contained only biocompatible elements and were chosen based on the thermodynamical calculations of phase formation predictions after solidification. Thermodynamical calculations predicted the presence of multi-phase, body-centered cubic phases, which were confirmed using X-ray diffraction and scanning electron microscopy. Segregation of alloying elements was recorded using elemental distribution maps. A decrease in microhardness with an increase in hafnium content in the studied alloys was revealed (512-482 HV1). The electrochemical measurements showed that the studied alloys exhibited a high corrosion resistance in a simulated body fluid environment (breakdown potential 4.60-5.50 V vs. SCE).

Mechanical Behavior of Austenitic Steel under Multi-Axial Cyclic Loading

Low-nickel austenitic steel is subjected to high-pressure torsion fatigue (HPTF) loading, where a constant axial compression is overlaid with a cyclic torsion. The focus of this work lies on investigating whether isotropic J2 plasticity or crystal plasticity can describe the mechanical behavior during HPTF loading, particularly focusing on the axial creep deformation seen in the experiment. The results indicate that a J2 plasticity model with an associated flow rule fails to describe the axial creep behavior. In contrast, a micromechanical model based on an empirical crystal plasticity law with kinematic hardening described by the Ohno-Wang rule can match the HPTF experiments quite accurately. Hence, our results confirm the versatility of crystal plasticity in combination with microstructural models to describe the mechanical behavior of materials under reversing multiaxial loading situations.

A novel biomimetic trabecular bone metal plate for bone repair and osseointegration

Fracture is one of the most common traumatic diseases in clinical practice, and metal plates have always been the first choice for fracture treatment because of their high strength. However, the bone plates have high elastic modulus and do not match the biomechanics of human bone, which adversely affects callus formation and fracture healing. Moreover, the complex microenvironment in the human body can induce corrosion of metallic materials and release toxic ions, which reduces the biocompatibility of the bone plate, and may necessitate surgical removal of the implant. In this study, tantalum (Ta) was deposited on porous silicon carbide (SiC) scaffolds by chemical vapor deposition technology to prepare a novel porous tantalum (pTa) trabecular bone metal plate. The function of the novel bone plate was evaluated by implantation in an animal fracture model. The results showed that the novel bone plate was effective in fracture fixation, without breakage. Both X-ray and microcomputed tomography analysis showed indirect healing by both pTa trabecular bone metal plates and titanium (Ti) plates; however, elastic fixation and obvious callus formation were observed after fixation with pTa trabecular bone metal plates, indicating better bone repair. Histology showed that pTa promoted the formation of new bone and integrated well with the host bone. Therefore, this novel pTa trabecular bone metal plate has good prospects for application in treating fractures.

Phase Transformations Caused by Heat Treatment and High-Pressure Torsion in TiZrHfMoCrCo Alloy

In this work the high-entropy alloy studied contained six components, Ti/Zr/Hf/Mo/Cr/Co, and three phases, namely one phase with body-centered cubic lattice (BCC) and two Laves phases C14 and C15. A series of annealings in the temperature range from 600 to 1000 °C demonstrated not only a change in the microstructure of the TiZrHfMoCrCo alloy, but also the modification of phase composition. After annealing at 1000 °C the BCC phase almost fully disappeared. The annealing at 600 and 800 °C leads to the formation of new Laves phases. After high-pressure torsion (HPT) of the as-cast TiZrHfMoCrCo alloy, the grains become very small, the BCC phase prevails, and C14 Laves phase completely disappears. This state is similar to the state after annealing at high effective temperature T_eff. The additional annealing at 1000 °C after HPT returns the phase composition back to the state similar to that of the as-cast alloy after annealing at 1000 °C. At 1000 °C the BCC phase completely wets the C15/C15 grain boundaries (GBs). At 600 and 800 °C the GB wetting is incomplete. The big spread of nanohardness and Young's modulus for the BCC phase and (C15 + C14) Laves phases is observed.

Hierarchy of hybrid materials. Part-II: The place of organics-on-inorganics in it, their composition and applications

Hybrid materials or hybrids incorporating organic and inorganic constituents are emerging as a very potent and promising class of materials due to the diverse but complementary nature of their properties. This complementarity leads to a perfect synergy of properties of the desired materials and products as well as to an extensive range of their application areas. Recently, we have overviewed and classified hybrid materials describing inorganics-in-organics in Part-I (Saveleva, et al., Front. Chem., 2019, 7, 179). Here, we extend that work in Part-II describing organics-on-inorganics, i.e., inorganic materials modified by organic moieties, their structure and functionalities. Inorganic constituents comprise of colloids/nanoparticles and flat surfaces/matrices comprise of metallic (noble metal, metal oxide, metal-organic framework, magnetic nanoparticles, alloy) and non-metallic (minerals, clays, carbons, and ceramics) materials; while organic additives can include molecules (polymers, fluorescence dyes, surfactants), biomolecules (proteins, carbohydtrates, antibodies and nucleic acids) and even higher-level organisms such as cells, bacteria, and microorganisms. Similarly to what was described in Part-I, we look at similar and dissimilar properties of organic-inorganic materials summarizing those bringing complementarity and composition. A broad range of applications of these hybrid materials is also presented whose development is spurred by engaging different scientific research communities.

An SMA Transducer for Sensing Tactile Sensation Focusing on Stroking Motion

The authors have developed a micro-vibration actuator using filiform SMA wire electrically driven by periodic electric current. While applying the SMA actuators to tactile displays, we discovered a phenomenon that the deformation caused by a given stress to an SMA wire generated a change in the electrical resistance. With this characteristic, the SMA wire works as a micro-force sensor with high sensitivity, while generating micro-vibration. In this paper, the micro-force sensing ability of an SMA transducer is described and discussed. Experiments are conducted by sliding the SMA sensor on the surface of different objects with different speeds, and the sensing ability is evaluated to be related with human tactile sensation.

Novel Method for the Production of Titanium Foams to Reduce Stress Shielding in Implants

Titanium foams have potential applications in orthopedic and dental implants because of their low elastic modulus and good bone in-growth properties. In the present study, a novel method for the preparation of three-dimensional interconnected microporous titanium foams has been developed. This method is based on the insertion of a filler metal into the titanium metal by arc melting, followed by its removal by an electrochemical dealloying process for the development of foams. Complete removal of the filler metal by the electrochemical dealloying process was confirmed by an X-ray diffractometry (XRD) analysis, whereas scanning electron microscopy (SEM) analysis of the developed foams showed the development of interconnected porosity. Ti foams with different levels of porosities were successfully developed by varying the amount of the filler metal. Mechanical and thermal characterizations of the developed foams were carried out using compression testing and laser flash apparatus, respectively. The yield strength and elastic modulus of the developed foams were found to decrease by increasing the volume fraction of pores. The elastic modulus of the developed titanium foams (15.5-36 GPa) was found to be closer to that of human bones, whereas their yield strength (147-170 MPa) remained higher than that of human bones. It is therefore believed that the developed Ti foams can help in reducing the problem of stress shielding observed in orthopedic implants. The thermal diffusivity of the developed foams (4.3-0.69 mm²/s) was found to be very close to that of human dentine.

Enhanced bone formation in locally-optimised, low-stiffness additive manufactured titanium implants: An in silico and in vivo tibial advancement study

A tibial tuberosity advancement (TTA), used to treat lameness in the canine stifle, provides a framework to investigate implant performance within an uneven loading environment due to the dominating patellar tendon. The purpose of this study was to reassess how we design orthopaedic implants in a load-bearing model to investigate potential for improved osseointegration capacity of fully-scaffolded mechanically-matched additive manufactured (AM) implants. While the mechanobiological nature of bone is well known, we have identified a lower limit in the literature where investigation into exceedingly soft scaffolds relative to trabecular bone ceases due to the trade-off in mechanical strength. We developed a finite element model of the sheep stifle to assess the stresses and strains of homogeneous and locally-optimised TTA implant designs. Using additive manufacturing, we printed three different low-stiffness Ti-6Al-4 V TTA implants: 0.8 GPa (Ti1), 0.6 GPa (Ti2) and an optimised design with a 0.3 GPa cortex and 0.1 GPa centre (Ti3), for implantation in a 12-week in vivo ovine pilot study. Static histomorphometry demonstrated uniform bone ingrowth in optimised low-modulus Ti3 samples compared to homogeneous designs (Ti1 and Ti2), and greater bone-implant contact. Mineralising surfaces were apparent in all implants, though mineral apposition rate was only consistent throughout Ti3. The greatest bone formation scores were seen in Ti3, followed by Ti2 and Ti1. Results from our study suggest lower stiffnesses and higher strain ranges improve early bone formation, and that by accounting for loading environments through rational design, implants can be optimised to improve uniform osseointegration. STATEMENT OF SIGNIFICANCE: The effect of different strain ranges on bone healing has been traditionally investigated and characterised through computational models, with much of the literature suggesting higher strain ranges being favourable. However, little has been done to incorporate strain-optimisation into porous orthopaedic implants due to the trade-off in mechanical strength required to induce these microenvironments. In this study, we used finite element analysis to optimise the design of additive manufactured (AM) titanium orthopaedic implants for different strain ranges, using a clinically-relevant surgical model. Our research suggests that there is potential for locally-optimised AM scaffolds in the use of orthopaedic devices to induce higher strains, which in turn encourages de novo bone formation and uniform osseointegration.

Titanium-protein nanocomposites as new biomaterials produced by high-pressure torsion

The development of new biomaterials with outstanding mechanical properties and high biocompatibility has been a significant challenge in the last decades. Nanocrystalline metals have provided new opportunities in producing high-strength biomaterials, but the biocompatibility of these nanometals needs to be improved. In this study, we introduce metal-protein nanocomposites as high-strength biomaterials with superior biocompatibility. Small proportions of bovine serum albumin (2 and 5 vol%), an abundant protein in the mammalian body, are added to titanium, and two nanocomposites are synthesized using a severe plastic deformation process of high-pressure torsion. These new biomaterials show not only a high hardness similar to nanocrystalline pure titanium but also exhibit better biocompatibility (including cellular metabolic activity, cell cycle parameters and DNA fragmentation profile) compared to nano-titanium. These results introduce a pathway to design new biocompatible composites by employing compounds from the human body.