Element distribution in the corrosion layer and cytotoxicity of alloy Mg-10Dy during in vitro biodegradation

Semi-quantitative elemental imaging of corrosion products from bioabsorbable Mg vascular implants in vivo

While metal materials historically have served as permanent implants and were designed to avoid degradation, next generation bioabsorbable metals for medical devices such as vascular stents are under development, which would elute metal ions and corrosion byproducts into tissues. The fate of these eluted products and their local distribution in vascular tissue largely under studied. In this study, we employ a high spatial resolution spectrometric imaging modality, laser ablation inductively coupled plasma time-of-flight mass spectrometry (LA-ICP-TOF-MS) to map the metal distribution, (herein refered to as laser ablation mapping, or LAM) from Mg alloys within the mouse vascular system and approximate their local concentrations. We used a novel rare earth element bearing Mg alloy (WE22) wire implanted within the abdominal aorta of transgenic hypercholesterolemic mice (APOE-/-) to simulate a bioabsorbable vascular prosthesis for up to 30 days. We describe qualitatively and semi-quantitatively implant-derived corrosion product presence throughout the tissue cross sections, and their approximate concentrations within the various vessel structures. Additionally, we report the spatial changes of corrosion products, which we postulate are mediated by phagocytic inflammatory cells such as macrophages (MΦ's).

Effects of extract solution from magnesium alloys supplemented with different compositions of rare earth elements on in vitro epithelial and osteoblast progenitor cells

Background: Magnesium alloys (Mg-alloys) have gained significant attention in recent years as a potential bioactive material for clinical applications. The incorporation of rare earth elements (REEs) into Mg-alloys has been of particular interest due to their potential to improve both mechanical and biological properties. Although there are diverse results in terms of cytotoxicity and biological effects of REEs, investigating the physiological benefits of Mg-alloys supplemented with REEs will help in the transition from theoretical to practical applications. Methods: In this study, two culture systems were used to evaluate the effects of Mg-alloys containing gadolinium (Gd), dysprosium (Dy), and yttrium (Y): human umbilical vein endothelial cells (HUVEC) and mouse osteoblastic progenitor cells (MC3T3-E1). Different compositions of Mg-alloys were assessed, and the effects of the extract solution on cell proliferation, viability, and specific cell functions were analyzed. Results: Within the range of weight percentages tested, the Mg-REE alloys did not exhibit any significant negative impacts on either cell line. Interestingly, moderate compositions (Mg-1.5Gd-1.5Dy-0.825Y-0.5Zr and Mg-2Gd-2Dy-1.1Y-0.5Zr) demonstrated a tendency to enhance osteoblastic activity and promote the vascularization process in both HUVEC and MC3T3-E1 cell lines. Discussion: The results of this study provide valuable insights into the potential benefits of REE-supplemented Mg-alloys for clinical applications. The observed enhancement in osteoblastic activity and promotion of vascularization processes suggest that optimizing the compositions of REEs in Mg-alloys could lead to the development of novel, more effective bioactive materials. Further investigations are required to understand the underlying mechanisms and to refine the alloy compositions for improved biocompatibility and performance in clinical settings.

A review on properties of magnesium-based alloys for biomedical applications

With changing lifestyles, the demand for bone implantation has been increasing day by day. The deficiency of nutritious elements within the human body results in certain diseases like osteoporosis, rickets, and other skeletal disorders; lack of physical activities; and the increasing number of accidents are the primary reasons for bone damage/fracture. Metallic implants made up of chrome steel, cobalt-based alloys, and titanium-based alloys are being majorly used worldwide owing to their high strength and high corrosion resistance which makes them permanent orthopedic bioimplant materials, however, they display a stress-shielding effect and it also requires an implant removal surgery. Thus, these problems can be addressed through the employment of biodegradable materials. Among the available biodegradable metallic materials, Mg alloys have been identified as a prospective orthopedic implant material. These alloys are biodegradable as well as biocompatible, however, they experience a relatively higher rate of degradation limiting their usability as implant material. This study attempts to comprehensively assess the effects of various alloying elements such as Ca, Zn, Sn, Mn, Sr and Rare earth elements (REEs) on the mechanical and degradation behavior (bothin vivoandin vitro) of Mg alloys. Since the microstructure, mechanical properties and degradation response of the Mg alloys are dependent on the processing route, hence detailed processing- property database of different Mg alloys is provided in this paper.

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

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

Novel Mg-0.5Ca-xMn Biodegradable Alloys Intended for Orthopedic Application: An In Vitro and In Vivo Study

Mg-based biodegradable materials, used for medical applications, have been extensively studied in the past decades. The in vitro cytocompatibility study showed that the proliferation and viability (as assessed by quantitative MTT-assay-3-(4,5-dimethyltiazol-2-yl)-2,5-diphenyl tetrazolium bromide) were not negatively affected with time by the addition of Mn as an alloying element. In this sense, it should be put forward that the studied alloys don't have a cytotoxic effect according to the standard ISO 10993-5, i.e., the level of the cells' viability (cultured with the studied experimental alloys) attained both after 1 day and 5 days was over 82% (i.e., 82, 43-89, 65%). Furthermore, the fibroblastic cells showed variable morphology (evidenced by fluorescence microscopy) related to the alloy sample's proximity (i.e., related to the variation on the Ca, Mg, and Mn ionic concentration as a result of alloy degradation). It should be mentioned that the cells presented a polygonal morphology with large cytoplasmic processes in the vicinity of the alloy's samples, and a bipolar morphology in the remote region of the wells. Moreover, the in vitro results seem to indicate that only 0.5% Mn is sufficient to improve the chemical stability, and thus the cytocompatibility; from this point of view, it could provide some flexibility in choosing the right alloy for a specific medical application, depending on the specific parameters of each alloy, such as its mechanical properties and corrosion resistance. In order to assess the in vivo compatibility of each concentration of alloy, the pieces were implanted in four rats, in two distinct body regions, i.e., the lumbar and thigh. The body's reaction was followed over time, 60 days, both by general clinical examinations considering macroscopic changes, and by laboratory examinations, which revealed macroscopic and microscopic changes using X-rays, CT(Computed Tomography), histology exams and SEM (Scanning Electron Microscopy). In both anatomical regions, for each of the tested alloys, deformations were observed, i.e., a local reaction of different intensities, starting the day after surgery. The release of hydrogen gas that forms during Mg alloy degradation occurred immediately after implantation in all five of the groups examined, which did not affect the normal functionality of the tissues surrounding the implants. Imaging examinations (radiological and CT) revealed the presence of the alloy and the volume of hydrogen gas in the lumbar and femoral region in varying amounts. The biodegradable alloys in the Mg-Ca-Mn system have great potential to be used in orthopedic applications.

The role of rare earth elements in biodegradable metals: A review

Compared with non-degradable metals, biodegradable metals, as a new generation of medical metallic materials, do not require secondary, which reduces the pain and economic burden of patients. However, currently developed biodegradable metals, including iron-based alloys, magnesium-based alloys, and zinc-based alloys, have deficiencies in their corrosion rates and mechanical properties, which have severely restricted the clinical application of biodegradable metals. So there is an urgent need to improve their mechanical properties, degradation behaviors and biocompatibility. Alloying is an important way to modify biodegradable metal materials. Rare earth elements (REEs) as alloying elements in biodegradable metals have attracted a great deal of attention due to their unique atomic structure and properties. The present review summarizes the effects of rare earth elements on the mechanical properties, degradation behaviors, and biocompatibility of biodegradable metals. Moreover, future research directions of rare earth elements alloying biodegradable metals are also prospected. STATEMENT OF SIGNIFICANCE: As a new generation of biomedical metallic materials, biodegradable metals have become a hot research topic in recent years as they can degrade completely in human body and thus avoid further secondary surgery. However, these biodegradable metal systems have drawbacks in clinical applications. Alloying is an important method to improve the properties of biodegradable metals. Among the various alloying elements, Rare Earth alloying elements are usually considered due to their unique atomic structure and properties. The present review summarizes the recent research progress of Rare Earth alloying elements in biodegradable metals. The effects of the Rare Earth alloying elements on mechanical properties, biodegradation behavior and biocompatibility of biodegradable metals are presented and discussed in detail.

Microstructural, Electrochemical and In Vitro Analysis of Mg-0.5Ca-xGd Biodegradable Alloys

The subject of Mg-based biodegradable materials, used for medical applications, has been extensively studied throughout the years. It is a known fact that alloying Mg with biocompatible and non-toxic elements improves the biodegradability of the alloys that are being used in the field of surgical applications. The aim of this research is to investigate the aspects concerning the microstructure, electrochemical response (corrosion resistance) and in vitro cytocompatibility of a new experimental Mg-based biodegradable alloy—Mg–0.5%Ca with controlled addition of Gd as follows: 0.5, 1.0, 1.5, 2.0 and 3.0 wt.%—in order to establish improved biocompatibility with the human hard and soft tissues at a stable biodegradable rate. For this purpose, scanning electron microscopy (SEM), energy-dispersive spectroscopy (EDS), light microscopy (LM) and X-ray diffraction (XRD) were used for determining the microstructure and chemical composition of the studied alloy and the linear polarization resistance (LPR) method was used to calculate the corrosion rate for the biodegradability rate assessment. The cellular response was evaluated using the 3-(4,5-dimethyltiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) test followed by fluorescence microscopy observation. The research led to the discovery of a dendritic α-Mg solid solution, as well as a lamellar Mg2Ca and a Mg5Gd intermetallic compound. The in vivo tests revealed 73–80% viability of the cells registered at 3 days and between 77 and 100% for 5 days, a fact that leads us to believe that the experimental studied alloys do not have a cytotoxic character and are suitable for medical applications.

Electrochemical Analysis and In Vitro Assay of Mg-0.5Ca-xY Biodegradable Alloys

In recent years, biodegradable Mg-based materials have been increasingly studied to be used in the medical industry and beyond. A way to improve biodegradability rate in sync with the healing process of the natural human bone is to alloy Mg with other biocompatible elements. The aim of this research was to improve biodegradability rate and biocompatibility of Mg-0.5Ca alloy through addition of Y in 0.5/1.0/1.5/2.0/3.0wt.%. To characterize the chemical composition and microstructure of experimental Mg alloys, scanning electron microscopy (SEM), energy-dispersive spectroscopy (EDS), light microscopy (LM), and X-ray diffraction (XRD) were used. The linear polarization resistance (LPR) method was used to calculate corrosion rate as a measure of biodegradability rate. The cytocompatibility was evaluated by MTT assay (3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyltetrazolium bromide) and fluorescence microscopy. Depending on chemical composition, the dendritic α-Mg solid solution, as well as lamellar Mg₂Ca and Mg₂₄Y₅ intermetallic compounds were found. The lower biodegradability rates were found for Mg-0.5Ca-2.0Y and Mg-0.5Ca-3.0Y which have correlated with values of cell viability. The addition of 2-3 wt.%Y in the Mg-0.5Ca alloy improved both the biodegradability rate and cytocompatibility behavior.

Multi-material additive manufacturing technologies for Ti-, Mg-, and Fe-based biomaterials for bone substitution

The growing interest in multi-functional metallic biomaterials for bone substitutes challenges the current additive manufacturing (AM, =3D printing) technologies. It is foreseeable that advances in multi-material AM for metallic biomaterials will not only allow for complex geometrical designs, but also improve their multi-functionalities by tuning the types or compositions of the underlying base materials, thereby presenting unprecedented opportunities for advanced orthopedic treatments. AM technologies are yet to be extensively explored for the fabrication of multi-functional metallic biomaterials, especially for bone substitutes. The aim of this review is to present the viable options of the state-of-the-art multi-material AM for Ti-, Mg-, and Fe-based biomaterials to be used as bone substitutes. The review starts with a brief review of bone tissue engineering, the design requirements, and fabrication technologies for metallic biomaterials to highlight the advantages of using AM over conventional fabrication methods. Five AM technologies suitable for metal 3D printing are compared against the requirements for multi-material AM. Of these AM technologies, extrusion-based multi-material AM is shown to have the greatest potential to meet the requirements for the fabrication of multi-functional metallic biomaterials. Finally, recent progress in the fabrication of Ti-, Mg-, and Fe-based biomaterials including the utilization of multi-material AM technologies is reviewed so as to identify the knowledge gaps and propose the directions of further research for the development of multi-material AM technologies that are applicable for the fabrication of multi-functional metallic biomaterials. STATEMENT OF SIGNIFICANCE: Addressing a critical bone defect requires the assistance of multi-functional porous metallic bone substitutes. As one of the most advanced fabrication technology in bone tissue engineering, additive manufacturing is challenged for its viability in multi-material fabrication of metallic biomaterials. This article reviews how the current metal additive manufacturing technologies have been and can be used for multi-material fabrication of Ti-, Mg-, and Fe-based bone substitutes. Progress on the Ti-, Mg-, and Fe-based biomaterials, including the utilization of multi-material additive manufacturing, are discussed to direct future research for advancing the multi-functional additively manufactured metallic bone biomaterials.

Characterization of an Extruded Mg-Dy-Nd Alloy during Stress Corrosion with C-Ring Tests

This study focuses on the characterization of the failure behavior of an extruded Mg10Dy1Nd alloy during stress corrosion. The microstructure, hardness, strength and corrosion behavior of binary alloys Mg10Dy and Mg1Nd are compared to those of the ternary alloy system. The ternary alloy Mg-Dy-Nd that is not fully recrystallized has the highest hardness but lacks ductility. The investigated alloys twin during plastic deformation. Static C-ring tests in Ringer solution were used to evaluate the stress corrosion properties, and stress corrosion could not be found. None of the alloys failed by fracturing, but corrosion pits formed to various extents. These corrosion pits were elliptical in shape and located below the surface. Some of the pits reduced the remaining wall thickness significantly, but the stress increased by the notch effect did not lead to crack initiation. Furthermore, the C-ring specimen was subjected to compressive loading until fracture. Whereas the Mg1Nd alloy showed ductile behavior, the alloys containing Dy fractured on the tensile side. The crack initiation and growth were mainly influenced by the twin boundaries. The Mg10Dy1Nd alloy had an inhomogeneous microstructure and low ductility, which resulted in a lower fracture toughness than that of the Mg10Dy alloy. There were features that indicate hydrogen-assisted fracture. Although adding Nd decreased the fracture toughness, it reduced the grain size and had a positive influence on the corrosion rate during immersion testing.

The effect of nano-size second precipitates on the structure, apatite-inducing ability and in-vitro biocompatibility of Ti-29Nb-14Ta-4.5Zr alloy

The apatite formation and in-vitro biocompatibility of Ti-29Nb-14Ta-4.5Zr (TNTZ) alloy reinforced by various nano-sized phases of α″, α, and ω in the β matrix have been studied. The electrochemical performances of the elaborated microstructures have been assessed through potentiodynamic polarization in the simulated body fluid (SBF) and interestingly, the β + ω specimen exhibited an extraordinary corrosion resistance compared to the others. This was attributed to the uniform distribution, spherical morphology and coherent interface of the ω nano-precipitates. The polarization tests in simulated body fluid showed the high tendency of apatite formation on the surface of the β- matrix contained ω precipitates. The in-vitro cytotoxicity analysis employing MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay showed >85% cell viability of the TNTZ alloy reinforced by nano-ω precipitations. Since this specimen showed the highest cell adhesion as well, it introduces this structure as a promising high potential candidate for biomedical applications due to its high corrosion resistance, biocompatibility, ultra-low cytotoxicity, and good cell adhesion.

In vitro and in vivo studies of Mg-30Sc alloys with different phase structure for potential usage within bone

Proper alloying magnesium with element scandium (Sc) could transform its microstructure from α phase with hexagonal closed-packed (hcp) structure into β phase with body-cubic centered (bcc) structure. In the present work, the Mg-30 wt% Sc alloy with single α phase, dual phases (α + β) or β phase microstructure were developed by altering the heat-treatment routines and their suitability for usage within bone was comprehensively investigated. The β phased Mg-30 wt% Sc alloy showed the best mechanical performance with ultimate compressive strength of 603 ± 39 MPa and compressive strain of 31 ± 3%. In vitro degradation test showed that element scandium could effectively incorporate into the surface corrosion product layer, form a double-layered structure, and further protect the alloy matrix. No cytotoxic effect was observed for both single α phased and β phased Mg-30 wt% Sc alloys on MC3T3 cell line. Moreover, the β phased Mg-30 wt%Sc alloy displayed acceptable corrosion resistance in vivo (0.06 mm y^-1) and maintained mechanical integrity up to 24 weeks. The degradation process did not significantly influence the hematology indexes of inflammation, hepatic or renal functions. The bone-implant contact ratio of 75 ± 10% after 24 weeks implied satisfactory integration between β phased Mg-30 wt%Sc alloy and the surrounding bone. These findings indicate a potential usage of the bcc-structured Mg-Sc alloy within bone and might provide a new strategy for future biomedical magnesium alloy design. STATEMENT OF SIGNIFICANCE: Scandium is the only rare earth element that can transform the matrix of magnesium alloy into bcc structure, and Mg-30 wt%Sc alloy had been recently reported to exhibit shape memory effect. The aim of the present work is to study the feasibility of Mg-30 wt%Sc alloy with different constitutional phases (single α phase, single β phase or dual phases (α + β)) as biodegradable orthopedic implant by in vitro and in vivo testings. Our findings showed that β phased Mg-30 wt%Sc alloy which is of bcc structure exhibited improved strength and superior in vivo degradation performance (0.06 mm y^-1). No cytotoxicity and systematic toxicity were shown for β phased Mg-30 wt%Sc alloy on MC3T3 cell model and rat organisms. Moreover, good osseointegration, limited hydrogen gas release and maintained mechanical integrity were observed after 24 weeks' implantation into the rat femur bone.

Cytotoxicity of biodegradable magnesium alloy WE43 to tumor cells in vitro: Bioresorbable implants with antitumor activity?

In this study, a degradable magnesium alloy WE43 (Mg-3.56%Y-2.20%Nd-0.47%Zr) was used as a research object. To refine its microstructure from the initial homogenized one, the alloy was subjected to severe plastic deformation (SPD) by equal channel angular pressing (ECAP). The data presented show that coincubation of tumor LNCaP and MDA-MB-231 cells with the WE43 alloy in the homogenized and the ECAP-processed states led to a decrease in their viability and proliferation. An increase in the concentration of Annexin V(+) cells during coincubation with samples in both microstructural states investigated was also observed. This is associated with the induction of apoptosis in the cell culture through contact with the samples. Concurrently, a significant drop in the concentration of Bcl-2(+) cells occurred. It was established that ECAP led to an enhancement of the cytotoxic activity of the alloy against tumor cells. This study demonstrated that alloy WE43 can be considered as a promising candidate for application in orthopedic implants in clinical oncology, where it could play a double role of a mechanically stable, yet bioresorbable, scaffold with local antitumor activity. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 108B:167-173, 2020.

Acetic Acid Etching of Mg-xGd Alloys

Mg-xGd alloys show potential to be used for degradable implants. As rare earth containing alloys, they are also of special interest for wrought products. All applications from medical to engineering uses require a low and controlled degradation or corrosion rate without pitting. Impurities from fabrication or machining, like Fe inclusions, encourage pitting, which inhibits uniform material degradation. This work investigates a suitable etching method to remove surface contamination and to understand the influence of etching on surface morphology. Acetic acid (HAc) etching as chemical surface treatment has been used to remove contamination from the surface. Extruded Mg-xGd (x = 2, 5 and 10) discs were etched with 250 g/L HAc solution in a volume of 5 mL or 10 mL for different times. The microstructure in the near surface region was characterized. Surface characterization was done by SEM, EDS, interferometry, and ToF-SIMS (time-of-flight secondary ion mass spectrometry) analysis. Different etching kinetics were observed due to microstructure and the volume of etching solution. Gd rich particles and higher etching temperatures due to smaller etchant volumes promote the formation of pits. Removal of 2–9 µm of material from the surface was sufficient to remove surface Fe contamination and to result in a plain surface morphology.

The Effects of Static and Dynamic Loading on Biodegradable Magnesium Pins In Vitro and In Vivo

Here we systematically assess the degradation of biodegradable magnesium pins (as-drawn pure Mg, as-cast Mg-Zn-Mn, and extruded Mg-Zn-Mn) in a bioreactor applying cyclical loading and simulated body fluid (SBF) perfusion. Cyclical mechanical loading and interstitial flow accelerated the overall corrosion rate, leading to loss of mechanical strength. When compared to the in vivo degradation (degradation rate, product formation, uniform or localized pitting, and stress distribution) of the same materials in mouse subcutaneous and dog tibia implant models, we demonstrate that the in vitro model facilitates the analysis of the complex degradation behavior of Mg-based alloys in vivo. This study progresses the development of a suitable in vitro model to examine the effects of mechanical stress and interstitial flow on biodegradable implant materials.

Biodegradability and platelets adhesion assessment of magnesium-based alloys using a microfluidic system

Magnesium (Mg)-based stents are extensively explored to alleviate atherosclerosis due to their biodegradability and relative hemocompatibility. To ensure the quality, safety and cost-efficacy of bioresorbable scaffolds and full utilization of the material tunability afforded by alloying, it is critical to access degradability and thrombosis potential of Mg-based alloys using improved in vitro models that mimic as closely as possible the in vivo microenvironment. In this study, we investigated biodegradation and initial thrombogenic behavior of Mg-based alloys at the interface between Mg alloys' surface and simulated physiological environment using a microfluidic system. The degradation properties of Mg-based alloys WE43, AZ31, ZWEK-L, and ZWEK-C were evaluated in complete culture medium and their thrombosis potentials in platelet rich plasma, respectively. The results show that 1) physiological shear stress increased the corrosion rate and decreased platelets adhesion rate as compared to static immersion; 2) secondary phases and impurities in material composition induced galvanic corrosion, resulting in higher corrosion resistance and platelet adhesion rate; 3) Mg-based alloys with higher corrosion rate showed higher platelets adhesion rate. We conclude that a microfluidic-based in vitro system allows evaluation of biodegradation behaviors and platelets responses of Mg-based alloys under specific shear stress, and degradability is related to platelets adhesion.

Magnesium alloys: A stony pathway from intensive research to clinical reality. Different test methods and approval-related considerations

The first degradable implant made of a magnesium alloy, a compression screw, was launched to the clinical market in March 2013. Many different complex considerations are required for the marketing authorization of degradable implant materials. This review gives an overview of existing and proposed standards for implant testing for marketing approval. Furthermore, different common in vitro and in vivo testing methods are discussed. In some cases, animal tests are inevitable to investigate the biological safety of a novel medical material. The choice of an appropriate animal model is as important as subsequent histological examination. Furthermore, this review focuses on the results of various mechanical tests to investigate the stability of implants for temporary use. All the above aspects are examined in the context of development and testing of magnesium-based biomaterials and their progress them from bench to bedside. A brief history of the first market launch of a magnesium-based degradable implant is given. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 329-347, 2017.

Differential magnesium implant corrosion coat formation and contribution to bone bonding

Magnesium alloys are presently under investigation as promising biodegradable implant materials with osteoconductive properties. To study the molecular mechanisms involved, the potential contribution of soluble magnesium corrosion products to the stimulation of osteoblastic cell differentiation was examined. However, no evidence for the stimulation of osteoblast differentiation could be obtained when cultured mesenchymal precursor cells were differentiated in the presence of metallic magnesium or in cell culture medium containing elevated magnesium ion levels. Similarly, in soft tissue no bone induction by metallic magnesium or by the corrosion product magnesium hydroxide could be observed in a mouse model. Motivated by the comparatively rapid accumulation solid corrosion products physicochemical processes were examined as an alternative mechanism to explain the stimulation of bone growth by magnesium-based implants. During exposure to physiological solutions a structured corrosion coat formed on magnesium whereby the elements calcium and phosphate were enriched in the outermost layer which could play a role in the established biocompatible behavior of magnesium implants. When magnesium pins were inserted into avital bones, corrosion lead to increases in the pull out force, suggesting that the expanding corrosion layer was interlocking with the surrounding bone. Since mechanical stress is a well-established inducer of bone growth, volume increases caused by the rapid accumulation of corrosion products and the resulting force development could be a key mechanism and provide an explanation for the observed stimulatory effects of magnesium-based implants in hard tissue. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 697-709, 2017.

Corrosion-wear of β-Ti alloy TMZF (Ti-12Mo-6Zr-2Fe) in simulated body fluid

Titanium alloys are popular metallic implant materials for use in total hip replacements. Although, α+β titanium alloys such as Ti-6Al-4V have been the most commonly used alloys, the high Young's modulus (∼110GPa) leads to an undesirable stress shielding effect. An alternative is to use β titanium alloys that exhibit a significantly lower Young's modulus (∼70GPa). Femoral stems made of a β titanium alloy known as TMZF (Ti-12Mo-6Zr-2Fe (wt.%)) have been used as part of modular hip replacements since the early 2000's but these were recalled in 2011 by the US Food & Drug Administration (FDA) due to unacceptable levels of 'wear debris'. The wear was caused by small relative movement of the stem and neck at the junction where they fit together in the modular hip replacement design. In this study, the corrosion and wear properties of the TMZF alloy were investigated in simulated body fluid to identify the reason for the wear debris generation. Ti64 was used as a control for comparison. It is shown that the interaction between the surfaces of Ti64 and TMZF with simulated body fluid is very similar, both from the point of view of the products formed and the kinetics of the reaction. The dry wear behaviour of TMZF is also close to that of Ti64 and consistent with expectations based on Archard's law for abrasive wear. However, wear of Ti64 and TMZF in simulated body fluid show contrasting behaviours. A type of time-dependent wear test is used to examine the synergy between corrosion and wear of TMZF and Ti64. It is shown that the wear of TMZF accelerated rapidly in SBF whereas that of Ti64 is reduced. The critical role of the strain hardening capacity of the two materials and its role in helping the surface resist abrasion by hydroxyapatite particles formed as a result of the reaction with the SBF is discussed and recommendations are made for modifications that could be made to the TMZF alloy to improve the corrosion-wear response.

STATEMENT OF SIGNIFICANCE

TMZF is a low modulus β-Ti alloy that has been used as the femoral stem in the Stryker modular design total hip replacement. It went into service in the early 2000's but was recalled by the FDA in 2011 due to unacceptable levels of wear debris released in the body which led to adverse physiological reactions. A large number of these implants remain in patients today. In this contribution, we investigate the corrosion (interaction of the alloy with simulated body fluid (SBF)), dry wear and then corrosion-wear in SBF to identify the origin of the unacceptable levels of wear that led to the FDA recall of this material. We use Ti-6Al-4V as a control and demonstrate that the reaction between Ti64 and TMZF with SBF is very similar in terms of both products formed and kinetics. We also show that the dry wear behaviour of TMZF is very similar to that of Ti64 and exactly as should be expected for the hardness of this material. However, the wear behaviours of TMZF and Ti64 are completed different in SBF and wear of TMZF is significantly accelerated in SBF. A type of time-dependent wear test is used to demonstrate the synergy between corrosion and wear and the key role of the strain hardening capacity (or lack thereof in the case of β-Ti) is discussed.

Enhancing the performance of Mg-based implant materials by introducing basal plane stacking faults

One of the keys to allowing Mg alloys to serve as biodegradable materials is how to balance their degradation behaviours and mechanical properties in physiological environment. In this study, a novel Mg-6Ho-0.5Zn alloy (wt%) containing profuse basal plane stacking faults (SFs) is prepared. This newly-developed alloy with SFs exhibiting uniform corrosion behaviour, low corrosion rate and high mechanical properties, as compared to the classic Mg-Ho based alloys (Mg-6Ho and Mg-6Ho-1.5Zn). Furthermore, the Mg-6Ho-0.5Zn alloy shows no significant toxicity to Saos-2 cells. An original uniform corrosion mechanism is proposed by combining the special defect structure, orientation of SFs and promptly effective corrosion film. The development of the new microstructure for Mg-Ho based alloys with desirable corrosion performance has important implications in developing novel degradable Mg-based implant materials.

Corrosion behavior, biocompatibility and biomechanical stability of a prototype magnesium-based biodegradable intramedullary nailing system

Implants made of degradable magnesium alloys are a potential alternative to conventional orthopaedic implant materials, e.g. stainless steel or titanium. Intramedullary nails made of the magnesium alloy LAE442 were subjected to cyclic fatigue tests in both distilled water and Hank's Balanced Salt Solution (HBSS) at 37.5°C until implant failure or a limit of 500,000cycles was reached. In distilled water, four of the five nails were still intact after the end of the biomechanical test. In HBSS, a breakage within the first 70,000 bending cycles was observed. Additionally, the degradation rate of this alloy was determined in HBSS according to the weight loss method (0.24±0.12mmyear(-1)) and based on gas release (0.21±0.03mmyear(-1)) with a standard eudiometer. A cytotoxicity test with L929 cells was carried out in accordance with EN ISO 10993-5/12. This test demonstrated sufficient cell viability of the diluted extracts (50%, 25% and 12.5%). The relative metabolic activity of the 100% extract was reduced slightly below 70%, which is classified as a threshold value for cytotoxicity. In conclusion, this in vitro study indicates that intramedullary nails made of LAE442 may not have the required fatigue resistance for load-bearing applications and the development of a corrosion-protective coating may be necessary to prevent early failure of the implant.

New horizon for high performance Mg-based biomaterial with uniform degradation behavior: Formation of stacking faults

Designing the new microstructure is an effective way to accelerate the biomedical application of magnesium (Mg) alloys. In this study, a novel Mg-8Er-1Zn alloy with profuse nano-spaced basal plane stacking faults (SFs) was prepared by combined processes of direct-chill semi-continuous casting, heat-treatment and hot-extrusion. The formation of SFs made the alloy possess outstanding comprehensive performance as the biodegradable implant material. The ultimate tensile strength (UTS: 318 MPa), tensile yield strength (TYS: 207 MPa) and elongation (21%) of the alloy with SFs were superior to those of most reported degradable Mg-based alloys. This new alloy showed acceptable biotoxicity and degradation rate (0.34 mm/year), and the latter could be further slowed down through optimizing the microstructure. Most amazing of all, the uniquely uniform in vitro/vivo corrosion behavior was obtained due to the formation of SFs. Accordingly we proposed an original corrosion mechanism for the novel Mg alloy with SFs. The present study opens a new horizon for developing new Mg-based biomaterials with highly desirable performances.

Biocompatibility of magnesium implants in primary human reaming debris-derived cells stem cells in vitro

BACKGROUND

Use of magnesium for resorbable metal implants is a new concept in orthopaedic and dental medicine. The majority of studies on magnesium's biocompatibility in vitro have assessed the short-term effect of magnesium extract on cells. The aim of this study was to evaluate the influence of direct exposure to magnesium alloys on the bioactivity of primary human reaming debris-derived (HRD) cells.

MATERIALS AND METHODS

Pure Mg, Mg2Ag, WE43 and Mg10Gd were tested for biocompatibility. The study consisted of assessment of cell viability by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) test, evaluation of alkaline phosphatase (ALP) content, and study of cell morphology under light microscopy, scanning electron microscopy (SEM) and transmission electron microscopy (TEM), along with determination of calcification and pH changes induced by magnesium.

RESULTS

The number of viable cells in the presence of Mg2Ag was high over the entire observation period. Inhibition of ALP content in osteogenic differentiating HRD was caused by pure Mg at day 14 and 28. All other magnesium alloys did not affect the ALP content. Exposure of HRD to magnesium increased the amount of lysosomes and endocytotic vesicles. Cellular attachment was generally the best for those crystals that formed on the surface of all materials. A decrease was observed in Ca(2+) in the medium from day 1 to day 14.

CONCLUSIONS

In terms of cell morphology, cell viability and differentiation, cell density and the effect on the surrounding pH, Mg2Ag showed the most promising results. All magnesium materials induced calcification, which is beneficial for orthopaedic and dental applications.

The influence of biodegradable magnesium alloys on the osteogenic differentiation of human mesenchymal stem cells

The postdegradation effect of pure Mg, Mg-1Y, Mg-5Al, and Mg-2Ca alloys on the differentiation, proliferation and gene expression of human mesenchymal stem cells (hMSCs) was investigated. It was revealed that that Mg(2+) ions result in an increase in cell proliferation. However, we observed a maximum concentration (approximately 8.0 × 10(-4) M) that was favourable to ATP production, above which ATP production began to decrease. In contrast to proliferation, no maximum concentration for osteogenic differentiation was observed, with increasing concentration of Mg(2+) ions resulting in an increase in osteogenic differentiation across the entire tested range. Interestingly, the Mg-2Ca alloy had minimal effect on osteogenic differentiation, with Mg-1Y and pure Mg having a superior effect on the proliferation and differentiation of hMSCs. This was also observed from gene expression data, where these alloys upregulated TGFβ-1, SMAD4, FGF-2, FGF-10, and BMP-2, while SOX-2, SOX-9, and TNF-α were downregulated. Increased expression of TGFβ-1, SMAD4, BMPs, and COLIA1 protein provided further evidence to support osteogenic differentiation and that the influence of the alloying extracts on differentiation may be via the SMAD signaling pathway.

Microstructure, mechanical and corrosion properties of Mg-Dy-Gd-Zr alloys for medical applications

In previous investigations, a Mg-10Dy (wt.%) alloy with a good combination of corrosion resistance and cytocompatibility showed great potential for use as a biodegradable implant material. However, the mechanical properties of Mg-10Dy alloy are not satisfactory. In order to allow the tailoring of mechanical properties required for various medical applications, four Mg-10(Dy+Gd)-0.2Zr (wt.%) alloys were investigated with respect to microstructure, mechanical and corrosion properties. With the increase in Gd content, the number of second-phase particles increased in the as-cast alloys, and the age-hardening response increased at 200°C. The yield strength increased, while the ductility reduced, especially for peak-aged alloys with the addition of Gd. Additionally, with increasing Gd content, the corrosion rate increased in the as-cast condition owing to the galvanic effect, but all the alloys had a similar corrosion rate (~0.5 mm year(-1)) in solution-treated and aged condition.