Long-term in vivo evolution of high-purity Mg screw degradation - Local and systemic effects of Mg degradation products

Multifaceted Materials for Enhanced Osteogenesis and Antimicrobial Properties on Bioplastic Polyetheretherketone Surfaces: A Review

Implant-associated infections and the increasing number of bone implants loosening and falling off after implantation have become urgent global challenges, hence the need for intelligent alternative solutions to combat implant loosening and falling off. The application of polyetheretherketone (PEEK) in biomedical and medical therapy has aroused great interest, especially because its elastic modulus close to bone provides an effective alternative to titanium implants, thereby preventing the possibility of bone implants loosening and falling off due to the mismatch of elastic modulus. In this Review, we provide a comprehensive overview of recent advances in surface modifications to prevent bone binding deficiency and bacterial infection after implantation of bone implants, starting with inorganics for surface modification, followed by organics that can effectively promote bone integration and antimicrobial action. In addition, surface modifications derived from cells and related products of biological activity have been proposed, and there is increasing evidence of clinical potential. Finally, the advantages and future challenges of surface strategies against medical associated poor osseointegration and infection are discussed, with promising prospects for developing novel osseointegration and antimicrobial PEEK materials.

Preparation of a novel antibacterial magnesium carbonate coating on a titanium surface and its in vitro biocompatibility

Magnesium-based coatings have attracted great attention in surface modification of titanium implants due to their superior angiogenic and osteogenic properties. However, their biological effects as a carbonate-based constituent remain unrevealed. In this study, magnesium carbonate coatings were prepared on titanium surfaces under hydrothermal conditions and subsequently treated with hydrogen peroxide. Also, their antibacterial activity and in vitro cell biocompatibility were evaluated. The obtained coatings consisted of nanoparticles without cracks and exhibited excellent adhesion to the substrate. X-ray diffraction (XRD) results indicated pure magnesium carbonate coatings formed on the Ti surface after hydrothermal treatment. After hydrogen peroxide treatment, the phase composition of the coatings had no obvious change. Compared to the untreated coatings, the hydrogen peroxide-treated coatings showed increased surface roughness and hydrophilicity. Co-culture with Staphylococcus aureus (S. aureus) demonstrated that the obtained coatings had good antibacterial activity. In vitro cell culture results showed that the hydrogen peroxide-treated coatings enhanced the viability, proliferation, and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). These findings suggest that this MgCO3-based coating exhibits excellent antibacterial performance and osteogenic potential. Based on the above, this study provides a simple method for preparing titanium implants with dual antibacterial and osteogenic capabilities, holding great promise in clinical applications.

Ion-bombardment-driven surface modification of porous magnesium scaffolds: Enhancing biocompatibility and osteoimmunomodulation

Porous Mg scaffolds are promising for bone repair but are limited by high corrosion rates and challenges in preserving coating integrity. We used Directed Plasma Nanosynthesis (DPNS) at 400 eV and a fluence of 1 × 1018 cm-2 to augment the bioactivity and corrosion resistance of porous Mg scaffolds, maintaining their overall material integrity. DPNS creates nanostructures that increase surface area, promote apatite nucleation, and enhance osseointegration, improving the bioactivity and corrosion resistance of porous Mg scaffolds without compromising their structure. Our findings indicate a decrease in surface roughness, with pre-irradiated samples having Rq = 60.4 ± 5.3 nm andRa = 48.2 ± 3.1 nm, and post-DPNS samples showing Rq = 36.9 ± 0.3 nm andRa = 28.6 ± 0.8 nm. This suggests changes in topography and wettability, corroborated by the increased water contact angles (CA) of 129.2 ± 3.2 degrees. The complexity of the solution influences the CA: DMEM results in a CA of 120.4 ± 0.1 degrees, while DMEM + SBF decreases it to 103.6 ± 0.5 degrees, in contrast to the complete spreading observed in non-irradiated samples. DPNS-treated scaffolds exhibit significantly reduced corrosion rates at 5.7 × 10-3 ± 3.8 × 10-4 mg/cm²/day, compared to the control's 2.3 × 10-2 ± 3.2 × 10-4 mg/cm²/day over 14 days (P < 0.01). The treatment encourages the formation of a Ca-phosphate-rich phase, which facilitates cell spreading and the development of focal adhesion points in hBM-MSCs on the scaffolds. Additionally, J774A.1 murine macrophages show an enhanced immune response with diminished TNF-α cytokine expression. These results offer insights into nanoscale modifications of Mg-based biomaterials and their promise for bone substitutes or tissue engineering scaffolds.

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.

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.

Optimization of Machining Parameters to Minimize Cutting Forces and Surface Roughness in Micro-Milling of Mg13Sn Alloy

This comprehensive study investigates the micro-milling of a Mg13Sn alloy, a material of considerable interest in various high-precision applications, such as biomedical implants. The main objective of the study was to explore the optimizations of variable feed per tooth (fz), cutting speed (Vc), and depth of cut (ap) parameters on the key outcomes of the micro-milling process. A unique experimental setup was employed, employing a spindle capable of achieving up to 60,000 revolutions per minute. Additionally, the study leveraged linear slides backed by micro-step motors to facilitate precise axis movements, thereby maintaining a resolution accuracy of 0.1 μm. Cutting forces were accurately captured by a mini dynamometer and subsequently evaluated based on the peak to valley values for Fx (tangential force) and Fy (feed force). The study results revealed a clear and complex interplay between the varied cutting parameters and their subsequent impacts on the cutting forces and surface roughness. An increase in feed rate and depth of cut significantly increased the cutting forces. However, the cutting forces were found to decrease noticeably with the elevation of cutting speed. Intriguingly, the tangential force (Fx) was consistently higher than the feed force (Fy). Simultaneously, the study determined that the surface roughness, denoted by Sa values, increased in direct proportion to the feed rate. It was also found that the Sa surface roughness values decreased with the increase in cutting speed. This study recommends a parameter combination of fz = 5 µm/tooth feed rate, Vc = 62.8 m/min cutting speed, and ap = 400 µm depth of cut to maintain a Sa surface roughness value of less than 1 µm while ensuring an optimal material removal rate and machining time. The results derived from this study offer vital insights into the micro-milling of Mg13Sn alloys and contribute to the current body of knowledge on the topic.

Newly Developed Resorbable Magnesium Biomaterials for Orbital Floor Reconstruction in Caprine and Ovine Animal Models-A Prototype Design and Proof-of-Principle Study

BACKGROUND

orbital floor fractures have not been reconstructed using magnesium biomaterials.

METHODS

To test technical feasibility, ex vivo caprine and ovine heads (n = 5) were used. Head tissues were harvested from pubescent animals (n = 5; mean age: 3.2 years; mean mass: 26.3 kg) and stored below 11 degrees for 7-10 days. All procedures were performed in a university animal resource facility. Two experienced maxillofacial surgeons performed orbital floor procedures in both orbits of all animals in a step-by-step preplanned dissection. A transconjunctival approach was chosen to repair the orbital floor with three different implants (i.e., magnesium implants; titanium mesh; and polydioxanone or PDO sheets). The position of each implant was evaluated by Cone-beam computed tomography (CBCT).

RESULTS

Axial, coronal, and sagittal plane images showed good positioning of the magnesium plates. The magnesium plates had a radiographic visibility similar to that of the PDO sheets but lower than that of the titanium mesh.

CONCLUSIONS

The prototype design study showed a novel indication for magnesium biomaterials. Further testing of this new biomaterial may lead to the first resorbable biomaterial with good mechanical properties for extensive orbital wall defects.

Long-term in vivo degradation of Mg-Zn-Ca elastic stable intramedullary nails and their influence on the physis of juvenile sheep

The use of bioresorbable magnesium (Mg)-based elastic stable intramedullary nails (ESIN) is highly promising for the treatment of pediatric long-bone fractures. Being fully resorbable, a removal surgery is not required, preventing repeated physical and psychological stress for the child. Further, the osteoconductive properties of the material support fracture healing. Nowadays, ESIN are exclusively implanted in a non-transphyseal manner to prevent growth discrepancies, although transphyseal implantation would often be required to guarantee optimized fracture stabilization. Here, we investigated the influence of trans-epiphyseally implanted Mg-Zinc (Zn)-Calcium (Ca) ESIN on the proximal tibial physis of juvenile sheep over a period of three years, until skeletal maturity was reached. We used the two alloying systems ZX10 (Mg-1Zn-0.3Ca, in wt%) and ZX00 (Mg-0.3Zn-0.4Ca, in wt%) for this study. To elaborate potential growth disturbances such as leg-length differences and axis deviations we used a combination of in vivo clinical computed tomography (cCT) and ex vivo micro CT (μCT), and also performed histology studies on the extracted bones to obtain information on the related tissue. Because there is a lack of long-term data regarding the degradation performance of magnesium-based implants, we used cCT and μCT data to evaluate the implant volume, gas volume and degradation rate of both alloying systems over a period of 148 weeks. We show that transepiphyseal implantation of Mg-Zn-Ca ESIN has no negative influence on the longitudinal bone growth in juvenile sheep, and that there is no axis deviation observed in all cases. We also illustrate that 95 % of the ESIN degraded over nearly three years, converging the time point of full resorption. We thus conclude that both, ZX10 and ZX00, constitute promising implant materials for the ESIN technique.

The combined effect of zinc and calcium on the biodegradation of ultrahigh-purity magnesium implants

Magnesium (Mg)-based implants are promising candidates for orthopedic interventions, because of their biocompatibility, good mechanical features, and ability to degrade completely in the body, eliminating the need for an additional removal surgery. In the present study, we synthesized and investigated two Mg-based materials, ultrahigh-purity ZX00 (Mg-Zn-Ca; <0.5 wt% Zn and <0.5 wt% Ca, in wt%; Fe-content <1 ppm) and ultrahigh-purity Mg (XHP-Mg, >99.999 wt% Mg; Fe-content <1 ppm), in vitro and in vivo in juvenile healthy rats to clarify the effect of the alloying elements Zn and Ca on mechanical properties, microstructure, cytocompatibility and degradation rate. Potential differences in bone formation and bone in-growth were also assessed and compared with state-of-the-art non-degradable titanium (Ti)-implanted, sham-operated, and control (non-intervention) groups, using micro-computed tomography, histology and scanning electron microscopy. At 6 and 24 weeks after implantation, serum alkaline phosphatase (ALP), calcium (Ca), and Mg level were measured and bone marrow stromal cells (BMSCs) were isolated for real-time PCR analysis. Results show that ZX00 implants have smaller grain size and superior mechanical properties than XHP-Mg, and that both reveal good biocompatibility in cytocompatibilty tests. ZX00 homogenously degraded with an increased gas accumulation 12 and 24 weeks after implantation, whereas XHP-Mg exhibited higher gas accumulation already at 2 weeks. Serum ALP, Ca, and Mg levels were comparable among all groups and both Mg-based implants led to similar relative expression levels of Alp, Runx2, and Bmp-2 genes at weeks 6 and 24. Histologically, Mg-based implants are superior for new bone tissue formation and bone in-growth compared to Ti implants. Furthermore, by tracking the sequence of multicolor fluorochrome labels, we observed higher mineral apposition rate at week 2 in both Mg-based implants compared to the control groups. Our findings suggest that (i) ZX00 and XHP-Mg support bone formation and remodeling, (ii) both Mg-based implants are superior to Ti implants in terms of new bone tissue formation and osseointegration, and (iii) ZX00 is more favorable due to its lower degradation rate and moderate gas accumulation.

Comprehensive review of additively manufactured biodegradable magnesium implants for repairing bone defects from biomechanical and biodegradable perspectives

Bone defect repair is a complicated clinical problem, particularly when the defect is relatively large and the bone is unable to repair itself. Magnesium and its alloys have been introduced as versatile biomaterials to repair bone defects because of their excellent biocompatibility, osteoconductivity, bone-mimicking biomechanical features, and non-toxic and biodegradable properties. Therefore, magnesium alloys have become a popular research topic in the field of implants to treat critical bone defects. This review explores the popular Mg alloy research topics in the field of bone defects. Bibliometric analyses demonstrate that the degradation control and mechanical properties of Mg alloys are the main research focus for the treatment of bone defects. Furthermore, the additive manufacturing (AM) of Mg alloys is a promising approach for treating bone defects using implants with customized structures and functions. This work reviews the state of research on AM-Mg alloys and the current challenges in the field, mainly from the two aspects of controlling the degradation rate and the fabrication of excellent mechanical properties. First, the advantages, current progress, and challenges of the AM of Mg alloys for further application are discussed. The main mechanisms that lead to the rapid degradation of AM-Mg are then highlighted. Next, the typical methods and processing parameters of laser powder bed fusion fabrication on the degradation characteristics of Mg alloys are reviewed. The following section discusses how the above factors affect the mechanical properties of AM-Mg and the recent research progress. Finally, the current status of research on AM-Mg for bone defects is summarized, and some research directions for AM-Mg to drive the application of clinical orthopedic implants are suggested.

Microstructure, Mechanical, In Vitro Biodegradation, and Antimicrobial Behavior of a Mg-Zn-Ca-Sr/ZrO2 Composite Prepared Using Powder Metallurgy

Biodegradable materials, especially Mg alloys, have an exceptional advantage over nonbiodegradable materials in orthopedic applications, such as avoiding second surgery for removal/replacement, stress shielding, but not enough mechanical strength, and so forth. By further improving the Mg alloy to get all the remaining required properties, it can be used for better biodegradable implants, which depend adequately on material optimization, processing, and so forth. A Mg-Zn-Ca-Sr/ZrO₂ composite has been prepared using powder metallurgy by adding 0, 1, 2, and 3 wt % of ZrO₂, which also contains Zn, Ca, and Sr as nutrient elements. Microstructure characterization, as well as mechanical and in vitro biodegradation, have been investigated by hardness, compression, and immersion tests. The highest compressive strength, contraction, and hardness of about 185.6 MPa, 9.5%, and 65.2 HRB are observed in the 2% ZrO₂-containing composite, respectively, whereas a minimum biodegradation rate of 2.76 mm/year is observed on the same. The antibiotic sensitivity observations against Staphylococcus aureus suggest that the alloy C3 has superior biological activity against the pathogen which ranks this alloy on top in merit. Overall, Mg-Zn-Ca-Sr/ZrO₂ exhibits impressive potential for use as a biodegradable and antibiotic material for orthopedic applications.

Characterization of a Magnesium Fluoride Conversion Coating on Mg-2Y-1Mn-1Zn Screws for Biomedical Applications

MgF₂-coated screws made of a Mg-2Y-1Mn-1Zn alloy, called NOVAMag^® fixation screws (biotrics bioimplants AG), were tested in vitro for potential applications as biodegradable implants, and showed a controlled corrosion rate compared to non-coated screws. While previous studies regarding coated Mg-alloys have been carried out on flat sample surfaces, the present work focused on functional materials and final biomedical products. The substrates under study had a complex 3D geometry and a nearly cylindrical-shaped shaft. The corrosion rate of the samples was investigated using an electrochemical setup, especially adjusted to evaluate these types of samples, and thus, helped to improve an already patented coating process. A MgF₂/MgO coating in the µm-range was characterized for the first time using complementary techniques. The coated screws revealed a smoother surface than the non-coated ones. Although the cross-section analysis revealed some fissures in the coating structure, the electrochemical studies using Hanks' salt solution demonstrated the effective role of MgF₂ in retarding the alloy degradation during the initial stages of corrosion up to 24 h. The values of polarization resistance (Rp) of the coated samples extrapolated from the Nyquist plots were significantly higher than those of the non-coated samples, and impedance increased significantly over time. After 1200 s exposure, the Rp values were 1323 ± 144 Ω.cm² for the coated samples and 1036 ± 198 Ω.cm² for the non-coated samples, thus confirming a significant decrease in the degradation rate due to the MgF₂ layer. The corrosion rates varied from 0.49 mm/y, at the beginning of the experiment, to 0.26 mm/y after 1200 s, and decreased further to 0.01 mm/y after 24 h. These results demonstrated the effectiveness of the applied MgF₂ film in slowing down the corrosion of the bulk material, allowing the magnesium-alloy screws to be competitive as dental and orthopedic solutions for the biodegradable implants market.

Plain metallic biomaterials: opportunities and challenges

The 'plainification of materials' has been conceptualized to promote the sustainable development of materials. This perspective, for the first time in the field of biomaterials, proposes and defines 'plain metallic biomaterials (PMBs)' with demonstrated research and application case studies of pure titanium with high strength and toughness, and biodegradable, fine-grained and high-purity magnesium. Then, after discussing the features, benefits and opportunities of PMBs, the challenges are analyzed from both technical and regulatory aspects. Regulatory perspectives on PMB-based medical devices are also provided for the benefit of future research, development and commercialization.

Tribo-corrosive behavior of additive manufactured parts for orthopaedic applications

Background

Additive manufacturing (AM) being an integral component of the production offers a wide variety of applications in the production of different components. The medical industry after the introduction of Additive Manufacturing has resulted in several advancements. The production of intricate patient-specific implants is one of such advancements which greatly assist a surgeon during a surgery. Orthopedic implants apart from possessing good mechanical strength are also expected to exhibit good tribological and corrosion behavior. As a result, the development of various orthopaedic implants and tools has become simple with the use of additive manufacturing.

Objectives and Rationale

In the current paper an effort has been made to discuss actual scientific knowledge on the tribo-corrosive behavior of additive manufactured parts for orthopedic applications. Different studies dealing with the mechanisms of lubrication and friction in synovial joints have also been considered. A special focus has also been laid down to study the corrosive effect of implants on the human body. A section dedicated to texturing of orthopedic implants has also been provided. The paper further elaborates the different research challenges and issues related to the use of additive manufacturing for the production of optimized orthopedic implants.

Conclusion

The study revealed that additive manufacturing has greatly aided in the manufacture of different orthopaedic implants with enhanced properties. However, a detailed study of the effect of processes like friction, wear, lubrication and corrosion in these implants needs to be done. The performance of these implants in the presence of various synovial fluids also needs to be addressed. However, the lack of more biocompatible materials, scalability and cost issues hinder the widespread use of AM in the different orthopaedic applications.

Oxyhydroxide-Coated PEO–Treated Mg Alloy for Enhanced Corrosion Resistance and Bone Regeneration

Plasma electrolytic oxidation (PEO) is widely used as a surface modification method to enhance the corrosion resistance of Mg alloy, the most likely applied biodegradable material used in orthopedic implants. However, the pores and cracks easily formed on the PEO surface are unfavorable for long-term corrosion resistance. In this study, to solve this problem, we used simple immersion processes to construct Mn and Fe oxyhydroxide duplex layers on the PEO-treated AZ31 (PEO–Mn/Fe). As control groups, single Mn and Fe oxyhydroxide layers were also fabricated on PEO (denoted as PEO–Mn and PEO–Fe, respectively). PEO–Mn showed a similar porous morphology to the PEO sample. However, the PEO–Fe and PEO–Mn/Fe films completely sealed the pores on the PEO surfaces, and no cracks were observed even after the samples were immersed in water for 7 days. Compared with PEO, PEO–Mn, and PEO–Fe, PEO–Mn/Fe exhibited a significantly lower self-corrosion current, suggesting better corrosion resistance. In vitro C3H10T1/2 cell culture showed that PEO–Fe/Mn promoted the best cell growth, alkaline phosphatase activity, and bone-related gene expression. Furthermore, the rat femur implantation experiment showed that PEO–Fe/Mn–coated Mg showed the best bone regeneration and osteointegration abilities. Owing to enhanced corrosion resistance and osteogenesis, the PEO–Fe/Mn film on Mg alloy is promising for orthopedic applications.

Degradation Behavior and Mechanical Integrity of a Mg-0.7Zn-0.6Ca (wt.%) Alloy: Effect of Grain Sizes and Crystallographic Texture

The microstructural characteristics of biodegradable Mg alloys determine their performance and appropriateness for orthopedic fixation applications. In this work, the effect of the annealing treatment of a Mg-0.7Zn-0.6Ca (ZX11) alloy on the mechanical integrity, corrosive behavior, and biocompatibility-osteoinduction was studied considering two annealing temperatures, 350 and 450 °C. The microstructure showed a recrystallized structure, with a lower number of precipitates, grain size, and stronger basal texture for the ZX11-350 condition than the ZX11-450. The characteristics mentioned above induce a higher long-term degradation rate for the ZX11-450 than the ZX11-350 on days 7th and 15th of immersion. In consequence, the mechanical integrity changes within this period. The increased degradation rate of the ZX11-450 condition reduces 40% the elongation at failure, in contrast with the 16% reduction for the ZX11-350 condition. After that period, the mechanical integrity remained unchanged. No cytotoxic effects were observed for both treatments and significant differentiation of mesenchymal stem cells into the osteoblast phenotype was observed.

Feasibility and Efficacy of a Degradable Magnesium-Alloy GBR Membrane for Bone Augmentation in a Distal Bone-Defect Model in Beagle Dogs

We explored the feasibility and efficacy of a degradable magnesium (Mg) alloy guided bone regeneration (GBR) in the treatment of bone defects after tooth extraction. A GBR membrane (MAR-Gide (MG)) was used to treat a mandibular second molar (M2M)-distal bone defect (DBD). In eight beagle dogs, bilateral mandibular second and fourth premolars were hemi-sected. The distal roots were removed to create a two-wall bony defect of dimension 5 mm × 5 mm × 5 mm to simulate M2M-DBD. Thirty-two bone defects were assigned randomly into four groups according to GBR membranes (MG and Bio-Gide (BG)) applied and the time of killing (3 months and 6 months after surgery). The osteogenesis of bone defects and MG degradation were analyzed using micro-CT, histology (staining, tartrate-resistant acid phosphatase), and inductively coupled plasma mass spectrometry. MG did not increase the prevalence of infection, wound dehiscence, or subcutaneous emphysema compared with those using BG. Trabecular volume/total volume at 3 months (63.71 ± 10.4% vs. 59.97 ± 8.94%) was significantly higher in the group MG than that in the group BG. Implanted MG was degraded completely within 3 months, and "island-shaped" new bone was found near MG degradation products. A significant difference was not found in vertical bone height or percent of new bone formation (45.44 ± 12.28% vs. 43.49 ± 7.12%) between the groups. The concentration of rare-earth elements in mandibular lymph nodes of the group MG was significantly higher than that of the group BG (P ≤ 0.017) but did not lead to histopathological changes. In summary, MG exhibited good biocompatibility and clinical applicability compared with BG in vivo. The osteogenic effect of MG could be enhanced by regulating the degradation rate of Mg-alloy.

A review of current challenges and prospects of magnesium and its alloy for bone implant applications

Medical application materials must meet multiple requirements, and the designed implant must mimic the bone structure in shape and support the formation of bone tissue (osteogenesis). Magnesium (Mg) alloys, as a "smart" biodegradable material and as "the green engineering material in the twenty-first century", have become an outstanding bone implant material due to their natural degradability, smart biocompatibility, and desirable mechanical properties. Magnesium is recognised as the next generation of orthopaedic appliances and bioresorbable scaffolds. At the same time, improving the mechanical properties and corrosion resistance of magnesium alloys is an urgent challenge to promote the application of magnesium alloys. Nevertheless, the excessively quick deterioration rate generally results in premature mechanical integrity disintegration and local hydrogen build-up, resulting in restricted clinical bone restoration applicability. The condition of Mg bone implants is thoroughly examined in this study. The relevant approaches to boost the corrosion resistance, including purification, alloying treatment, surface coating, and Mg-based metal matrix composite, are comprehensively revealed. These characteristics are reviewed to assess the progress of contemporary Mg-based biocomposites and alloys for biomedical applications. The fabricating techniques for Mg bone implants also are thoroughly investigated. Notably, laser-based additive manufacturing fabricates customised forms and complicated porous structures based on its distinctive additive manufacturing conception. Because of its high laser energy density and strong controllability, it is capable of fast heating and cooling, allowing it to modify the microstructure and performance. This review paper aims to provide more insight on the present challenges and continued research on Mg bone implants, highlighting some of the most important characteristics, challenges, and strategies for improving Mg bone implants.

Bone Scaffolds: An Incorporation of Biomaterials, Cells, and Biofactors

Large injuries to bones are still one of the most challenging musculoskeletal problems. Tissue engineering can combine stem cells, scaffold biomaterials, and biofactors to aid in resolving this complication. Therefore, this review aims to provide information on the recent advances made to utilize the potential of biomaterials for making bone scaffolds and the assisted stem cell therapy and use of biofactors for bone tissue engineering. The requirements and different types of biomaterials used for making scaffolds are reviewed. Furthermore, the importance of stem cells and biofactors (growth factors and extracellular vesicles) in bone regeneration and their use in bone scaffolds and the key findings are discussed. Lastly, some of the main obstacles in bone tissue engineering and future trends are highlighted.

Laser-Sintered Mg-Zn Supersaturated Solid Solution with High Corrosion Resistance

Solid solutions of Zn as an alloy element in Mg matrixes are expected to show improved corrosion resistance due to the electrode potential being positively shifted. In this study, a supersaturated solid solution of Mg-Zn alloy was achieved using mechanical alloying (MA) combined with laser sintering. In detail, supersaturated solid solution Mg-Zn powders were firstly prepared using MA, as it was able to break through the limit of phase diagram under the action of forced mechanical impact. Then, the alloyed Mg-Zn powders were shaped into parts using laser sintering, during which the limited liquid phase and short cooling time maintained the supersaturated solid solution. The Mg-Zn alloy derived from the as-milled powders for 30 h presented enhanced corrosion potential and consequently a reduced corrosion rate of 0.54 mm/year. Cell toxicity tests confirmed that the Mg-Zn solid solution possessed good cytocompatibility for potential clinical applications. This study offers a new strategy for fabricating Mg-Zn solid solutions using laser sintering with MA.

Resorbable Mg2+-Containing Phosphates for Bone Tissue Repair

Materials based on Mg2+-containing phosphates are gaining great relevance in the field of bone tissue repair via regenerative medicine methods. Magnesium ions, together with condensed phosphate ions, play substantial roles in the process of bone remodeling, affecting the early stage of bone regeneration through active participation in the process of osteosynthesis. In this paper we provide a comprehensive overview of the usage of biomaterials based on magnesium phosphate and magnesium calcium phosphate in bone reconstruction. We consider the role of magnesium ions in angiogenesis, which is an important process associated with osteogenesis. Finally, we summarize the biological properties of calcium magnesium phosphates for regeneration of bone.

Degradable magnesium implants inhibit gallbladder cancer

Gallbladder cancer can be difficult to detect in its early stages and is prone to metastasize, causing bile duct obstruction, which is usually treated by stent implantation in clinic. However, the commonly used biliary stents are non-degradable, which not only prone to secondary blockage, but also need to be removed by secondary surgery. Biodegradable magnesium (Mg) is expected to one of the promising candidates for degradable biliary stents due to its excellent physicochemical property and biocompatibility. In this work, we studied the influence of high-purity Mg wires on gallbladder cancer through in vitro and in vivo experiments and revealed that the degradation products of Mg could significantly inhibit the growth of gallbladder cancer cells and promote their apoptosis. Our findings indicate that Mg biliary stent possesses the function of draining bile and treating gallbladder cancer, suggesting that Mg has good application prospects in biliary surgery. STATEMENT OF SIGNIFICANCE: Current research and development of biomedical magnesium are mainly concentrated in the cardiovascular and orthopedics field. Degradable magnesium bile duct stents have great application prospects in the treatment of bile duct blockage caused by bile duct-related cancers. At present, the effect of magnesium implants on gallbladder cancer is not clear. Our work verified the effectiveness of magnesium wire implants in inhibiting gallbladder cancer through in vivo and in vitro experiments, and studied the effect of magnesium degradation products on gallbladder cancer cells from the perspective of cell proliferation, apoptosis and cycle. This study provided new understanding for the application of magnesium in biliary surgery.

Design approaches and challenges for biodegradable bone implants: a review

Introduction: Biodegradable materials have been at the forefront of cutting-edge research and offer a truly viable option in the designing and manufacturing of bone implants in biomedical engineering. Most research regarding these materials has focused on their biological characteristics and mechanical behavior vis-à-vis nonbiodegradable (NB) materials; but the design aspects and parametric configurations of biodegradable bone implant have somehow not received as much attention as they deserved.Area covered: This review aims to develop insight into the parametrically conceptualized design of biodegradable bone implant and takes into due consideration the characteristics of bone-biodegradable implant interface (BBII), design techniques employed for conventionally used bone implants to optimize parameters using standard test methods, traditional design, and finite element analysis approaches for implant and healing behavior, manufacturing techniques, real-time surgical simulations, and so on.Expert opinion: Some successful and conventionally used NB bone implants do not dissolve or degrade with time and require removal through a complicated surgery after fulfilling the intended objectives. These bone implants should be reconceptualized and designed with an appropriate biodegradable material while paying due attention to all factors/parameters involved and striking a balance between these factors with the ultimate objective of fulfilling all desired orthopedic requirements.

Matched retrospective analysis of three different fixation devices for chevron osteotomy

Chevron osteotomy with consecutive fixation is a commonly performed operative treatment option for hallux valgus deformities. The present retrospective study aims to compare the clinical and radiological outcome of novel bioabsorbable magnesium screw fixation with metal screw and Kirschner wire fixation. Eighteen matched triplets were assembled according to the following criteria: female gender, age difference less than 5 years, date of operation within 4 months, difference in preoperative intermetatarsal angle less than 5°, and equal experience of the first and second surgeon. These patients, between 18 and 85 years of age and with a minimum follow-up period of 12 months, were invited to a follow-up examination, of which only 16 matched triplets of patients entirely kept the appointment. Thus, 48 feet of 44 patients were clinically evaluated using the American Orthopaedic Foot & Ankle Society scale, Foot Function Index, University of California and Los Angeles Activity Score, as well as a visual analogue scale for pain, satisfaction, cosmetic results, and functional impairment. Radiographical assessment included measuring intermetatarsal angle and first metatarsophalangeal angles. All occurring complications and revision surgeries were noted. Significant differences were observed for postoperative intermetatarsal angle between magnesium screw and pin fixation (p = 0.009). Moreover, patients receiving magnesium screw were significantly more prone to undergo the same procedure again (p = 0.03). In conclusion, if the advantages of bioabsorbable magnesium screws outweigh the drawbacks of increased costs and a higher surgical demand, this implant might serve as possible chevron osteotomy fixation method. Compression screws and Kirschner wires also show comparable satisfactory outcomes. LEVEL OF EVIDENCE: III retrospective comparative study.

High-purity magnesium pin enhances bone consolidation in distraction osteogenesis via regulating Ptch protein activating Hedgehog-alternative Wnt signaling

Magnesium alloys are promising biomaterials for orthopedic implants because of their degradability, osteogenic effects, and biocompatibility. Magnesium has been proven to promote distraction osteogenesis. However, its mechanism of promoting distraction osteogenesis is not thoroughly studied. In this work, a high-purity magnesium pin developed and applied in rat femur distraction osteogenesis. Mechanical test, radiological and histological analysis suggested that high-purity magnesium pin can promote distraction osteogenesis and shorten the consolidation time. Further RNA sequencing investigation found that alternative Wnt signaling was activated. In further bioinformatics analysis, it was found that the Hedgehog pathway is the upstream signaling pathway of the alternative Wnt pathway. We found that Ptch protein is a potential target of magnesium and verified by molecular dynamics that magnesium ions can bind to Ptch protein. In conclusion, HP Mg implants have the potential to enhance bone consolidation in the DO application, and this process might be via regulating Ptch protein activating Hedgehog-alternative Wnt signaling.

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

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

Corrosion Behavior and Biocompatibility of Diamond-like Carbon-Coated Zinc: An In Vitro Study

Owing to the desirable degradation rate and good biocompatibility, zinc (Zn) and Zn alloys are promising biodegradable implant metals in orthopedic and cardiovascular applications. Surface modification, such as deposition of coatings, is frequently implemented to further enhance their biological properties. In this study, diamond-like carbon (DLC) films are deposited on Zn by magnetron sputtering. The DLC films do not change the surface morphology of Zn but alter the hydrophobic properties with a contact angle of approximately 90°. Electrochemical and in vitro immersion tests reveal that the corrosion resistances of the DLC-coated Zn decrease unexpectedly, which is possibly due to galvanic corrosion between the DLC film and Zn substrate. Furthermore, the uncoated and coated Zn samples show hemolysis ratios less than 1%. The cells cultured in the Zn extract exhibit higher viability than those cultured in the extract of the DLC-coated Zn, suggesting that the DLC films decrease the cytocompatibility of Zn. The lower corrosion resistance has little influence on the hemolysis ratio, suggesting that hemolysis is not an obstacle for the design of Zn-based biomaterials. Our results show that the traditional concept of protection with DLC films may not be applicable universally and decreased corrosion resistance and cytocompatibility are actually observed in DLC-coated Zn.

Osteogenesis, angiogenesis and immune response of Mg-Al layered double hydroxide coating on pure Mg

Layered double hydroxides (LDHs) are widely studied to enhance corrosion resistance and biocompatibility of Mg alloys, which are promising bone implants. However, the influence of LDH coating on the osteointegration of Mg implants lacks of a systematic study. In this work, Mg-Al LDH coating was prepared on pure Mg via hydrothermal treatment. The as-prepared Mg-Al LDH coated Mg exhibited better in vitro and in vivo corrosion resistance than bare Mg and Mg(OH)2 coated Mg. In vitro culture of mouse osteoblast cell line (MC3T3-E1) suggested that Mg-Al LDH coated Mg was more favorable for its osteogenic differentiation. In vitro culture of HUVECs revealed that cells cultured in the extract of Mg-Al LDH coated Mg showed superior angiogenic behaviors. More importantly, the immune response of Mg-Al LDH coated Mg was studied by in vitro culturing murine-derived macrophage cell line (RAW264.7). The results verified that Mg-Al LDH coated Mg could induce macrophage polarize to M2 phenotype (anti-inflammatory). Furthermore, the secreted factor in the macrophage-conditioned culture medium of Mg-Al LDH group was more suitable for the bone differentiation of rat bone marrow stem cells (rBMSCs) and the angiogenic behavior of human umbilical vein endothelial cells (HUVECs). Finally, the result of femoral implantation suggested that Mg-Al LDH coated Mg exhibited better osteointegration than bare Mg and Mg(OH)2 coated Mg. With favorable in vitro and in vivo performances, Mg-Al LDH is promising as protective coating on Mg for orthopedic applications.

Biodegradation ZK50 magnesium alloy compression screws: Mechanical properties, biodegradable characteristics and implant test

BACKGROUND

Magnesium alloy implants have lower stress load and can be absorbed gradually, but their degradation rates are too fast generally. A magnesium alloy contained 5% Zn and 0.5% Zr (ZK50) which have lower degradation rate are designed to be applied to cannulated bone screw.

METHODS

An oxidation heat treatment of 380 °C for 2 h proceeds to modify the ZK50 Mg alloy (ZK50-H). The microstructure observation, degradation tests and Biocompatibility analysis are proceeded between ZK50 and ZK50-H. Finally, a mini-pig implantation test is proceeded to provide a reference of implant application for future pre-clinical evaluation.

RESULTS

The heat treatment can improve the mechanical properties. A passive ceramic layer formed after simulated body fluid (SBF) solution immersion can restrict the degradation effectively. The cytotoxicity test shows the initial biosafety of ZK50 Mg alloy. A mini-pig implantation test of bone screw has proceeded to confirm the advanced biocompatibility. The ZK50-H screws can maintain enough support at least 8 weeks which the fracture of bone can get curing. The excellent osteoinduction of ZK50-H has a positive effect to growth of new bones and help the mini-pig regain heal faster in 12 weeks.

CONCLUSION

This study shows ZK50-H Mg alloy screw is a feasible degradation implant and can be carried out the next-step clinical experiments.

Osteogenic effects of bioabsorbable magnesium implant in rat mandibles and in vitro

BACKGROUND

Bone augmentation or grafting is often required for placement of dental implants or surgical reconstruction of bony defects. Bioabsorbable magnesium implant was shown to promote osteogenesis in long bones. The objectives of this study were to determine osteogenic effects of pure magnesium (Mg) in rat mandible and underlying mechanisms.

METHODS

Pure Mg was implanted in sockets after rat mandibular incisors were extracted. Titanium (Ti) was used as control. Systemic effects were determined by serum Mg level and histologic analyses of liver and kidney. Local Mg concentration was measured by microscopy-energy-dispersive spectroscopy (SEM-EDS). Alveolar bone was analyzed by micro-computed tomography (micro-CT) and histology. Osteogenic effects of 0.8 to 20 mM magnesium chloride (MgCl₂ ) on periosteum-derived cells (PDCs) were evaluated by proliferation, alizarin red staining and quantitative RT-PCR assays.

RESULTS

Systemic effects were similar in Mg and Ti groups. Higher local Mg concentration was detected in Mg group (P < 0.05). Micro-CT showed higher alveolar bone volume (2- and 6-weeks post-operation) and denser cancellous bone (2 weeks post-operation) in Mg group, with significant amount of new subperiosteal bone formation on lateral alveolar bone surfaces by H&E staining. In PDC culture, proliferation rates, osteogenic gene expression for runt related transcription factor 2 (Runx2), bone sialoprotein (Bsp) and osteocalcin (Ocn), as well as calcium nodule formation rose significantly in 5, 10, and 20 mM MgCl₂ groups.

CONCLUSIONS

Rapid osteogenesis (especially subperiosteal) is induced by pure Mg in rat mandibular alveolar bone. Osteogenic capacity of PDCs is enhanced by higher Mg ion concentrations in vitro.

Bioabsorbable high-purity magnesium interbody cage: degradation, interbody fusion, and biocompatibility from a goat cervical spine model

Background

Bioabsorbable Mg-based implants have been a focus of orthopedic researches due to their intrinsic advantages in orthopedics surgeries. This study aimed to investigate the performance of bioabsorbable high-purity magnesium (HP Mg, 99.98 wt.%) interbody cages in anterior cervical discectomy and fusion (ACDF) and to evaluate the degradation of HP Mg cages under an interbody microenvironment.

Methods

ACDF was performed at C2–3 and C4–5, and a HP Mg cage or autologous iliac bone was randomly implanted. At 3, 6, 12 and 24 weeks after surgery, the cervical specimens were harvested to evaluate the fusion status, degradation and biocompatibility by CT, micro-CT, histological examinations and blood tests.

Results

There was no significant difference in the CT fusion score between cage group and autogenous ilium group at 3 and 6 weeks. At 12 and 24 weeks, the mean CT fusion score in the cage group was markedly lower than in the autogenous ilium group. CT and histological examinations showed bony junctions formed through the middle hole of the cage between upper and lower vertebral bodies in the cage group, but the total fusion area was less than 30%. The degradation rate of cages was relatively rapid within the first 3 weeks and thereafter became stable and slow gradually. The HP Mg cage had good biosecurity and biomechanical characteristics.

Conclusions

Implantation of Mg-based interbody cage achieves successful histological fusion, while the total fusion area needs to be improved. More studies are needed to improve the bone-cage interface.

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

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

An in vitro and in vivo comparison of Mg(OH)2-, MgF2- and HA-coated Mg in degradation and osteointegration

Magnesium hydroxide (Mg(OH)₂), magnesium fluoride (MgF₂), and hydroxyapatite (HA) films on Mg are widely studied owing to their easy preparation and favorable corrosion protection. Nevertheless, the most suitable film with the best performance for biomedical applications between the three films remains unknown. Therefore, the performance of the three coatings from in vitro to in vivo must be systematically investigated. In this study, Mg(OH)₂, MgF₂, and HA films were fabricated on pure Mg. Electrochemical analysis and the hydrogen evolution test suggested that the HA film showed the best in vitro corrosion resistance, followed by MgF₂ and Mg(OH)₂ films. In vitro cell culture indicated that the extract of the MgF₂-coated sample was most beneficial for the osteogenic differentiation of MC3T3-E1 cells and the vascularization of human umbilical vein endothelial cells (HUVECs), which might be ascribed to the existence of the F element in the film. The result of this subcutaneous implantation showed that the HA film exhibited the best in vivo corrosion resistance and induced the lightest inflammatory response. Femoral implantation data revealed that the HA film exhibited the best osseointegration. Furthermore, the major organs and blood indicators of all of the tested rats were normal in 8 weeks. In summary, though the in vitro biological performance of the MgF₂ film was the best among the three films, the HA film showed the best in vivo performance, suggesting that it is a more promising modification method for orthopedic applications.

Microstructure controls the corrosion behavior of a lean biodegradable Mg-2Zn alloy

Microstructural design was a long-term sustainable development method to improve the biodegradability and mechanical properties of low alloyed biomedical Mg alloys. In this study, the microstructural features (including grain size, deformation twin, deformed grains, sub-grains, and recrystallized grains) of the MZ2 ((Mg-2Zn (wt%)) alloy were controlled by different single-passed rolling reductions at high temperature. Besides the effect of grain size, we found that deformation twins and deformed grains influenced corrosion performance. Grain refinement with uniform distribution, meanwhile reducing the content of deformation twins, deformed grains, and sub-grains, was a practical method to improve both corrosion resistance and mechanical properties of MZ2 alloy. This finding proposed a better understanding of the development of lean biomedical Mg alloys with superior mechanical properties and favorable corrosion resistance. STATEMENT OF SIGNIFICANCE: Current research and development of biomedical Mg focused on alloying methods. The lean biodegradable Mg, which reduced the materials' compositional complexity, was the benefit of development for long-term sustainability. Here, our work revealed the relationship between microstructural features and corrosion resistance of a lean Mg-2Zn alloy during the different single-passed rolling processes. We found that recrystallized fine grains with partially ultra-fine grains could improve both strength and corrosion resistance. This study could give a new understanding of the development of lean biodegradable Mg alloys by using microstructural design to improve the overall performance of biomedical applications.

A pure zinc membrane with degradability and osteogenesis promotion for guided bone regeneration: In vitro and in vivo studies

Selection of an appropriate membrane material for guided bone regeneration (GBR) is still ongoing among resorbable and nonresorbable membranes with different characteristics. The major problem with nonresorbable membranes is the inevitable secondary surgery, while resorbable polymer membranes have limitations in providing sufficient mechanical support during the bone repair period due to premature loss of mechanical strength. Pure magnesium foil has been evaluated to explore its feasibility as a resorbable GBR membrane. It exhibited better mechanical properties, whereas poor formability and fast degradation rate were noted. In light of this, pure zinc membrane was developed as a pilot research in this paper. We designed three types of pure zinc membranes: pure Zn without pores, pure Zn with 300 µm diameter and 1000 µm diameter pores, and pure titanium without pores as a control. The mechanical property, in vitro immersion tests, and MC3T3-E1 cell viability assays were tested. Moreover, in vivo behaviors of three type zinc membranes were evaluated by using a rat calvarial critical-sized bone defect model. The experimental results indicated that pure Zn membrane with 300 µm pores showed the most favorable osteogenic capability, comparable to that of titanium membrane without pores. Therefore, considering appropriate degradation rate, adequate mechanical maintenance, and profitable osteogenic capacity, metallic pure zinc is believed to be a promising candidate for barrier membranes in GBR therapy for bone regeneration, and its mechanical property can be enhanced with further alloying. STATEMENT OF SIGNIFICANCE: Metallic element zinc plays a pivotal role in the growth and mineralization of bone tissues. As a pilot research, three type of guided bone regeneration (GBR) membranes were developed in the present work: pure Zn without pores, pure Zn with 300 µm-diameter and 1000 µm-diameter pores respectively. The mechanical property, in vitro immersion tests and MC3T3-E1 cell viability assays were tested, with pure titanium without pores as a control, thereafter the in vivo performance were evaluated by using a rat calvarial critical-sized bone defect model. It indicated that pure Zn membrane with 300 µm pores showed the most favorable osteogenic capability, comparable to that of titanium membrane control, and is believed to be a promising material candidate as barrier membrane in GBR therapy for bone regeneration.

Local intragranular misorientation accelerates corrosion in biodegradable Mg

Mg-based implants are used in biomedical applications predominantly because of their degradable property. In this paper, the effect of local misorientations (intragranular misorientation) on the corrosion behavior of high-purity Mg (HPM) was systematically investigated according to microstructure characterization and corrosion measurements. The results showed that local misorientation introduced into grains by deformation could result in corrosion around the grain boundary (GB), which ultimately reduces the corrosion resistance of HPM. After removing the local misorientation by annealing, the corrosion around GB could be eliminated. This work is expected to inspire better control over the degradation behaviors of biomedical Mg through microstructure design to be used for various biomedical applications. STATEMENT OF SIGNIFICANCE: 1. Fine grains, fine grains with large local misorientation, and coarse grains could be obtained, respectively, in high-purity Mg by sequential hot rolling, compression deformation, and annealing treatments. 2. Large local misorientation introduced into grains could lead to corrosion around the grain boundary and ultimately reduce corrosion resistance. 3. In the absence of local misorientation, refining grain size could improve the corrosion resistance of Mg.

In vivo study of the efficacy, biosafety, and degradation of a zinc alloy osteosynthesis system

In this study, a comprehensive analysis of a novel zinc alloy osteosynthesis system in a canine mandibular fracture model is presented. The efficacy of the system was compared for PLLA (poly-l-lactic acid) and titanium materials using X-ray radiography, micro-CT tomography, undecalcified bone histomorphometry, and a three-point bending test. Histology, blood normal, blood biochemical, and serum zinc concentration tests were also performed to assess the biosafety of the zinc alloy osteosynthesis system. The degradability of the zinc alloy was evaluated using a micro-CT and scanning electron microscope during the 24-week post operation period. The results showed that zinc alloy possesses good mechanical properties that support fracture healing. Its uniform and slow corrosion leads to adequate degradation behavior in 24 weeks. Additionally, the zinc alloy proved to be biocompatible, indicating that this novel osteosynthesis system is safe for use in the body. The results of the study demonstrate that this zinc alloy-based osteosynthesis system is a promising candidate for a new generation of osteosynthesis systems, with further improvements required in the future.

Influence of surface modifications on the degradation of standard-sized magnesium plates and healing of mandibular osteotomies in miniature pigs

Biodegradable magnesium alloys are suitable osteosynthesis materials. Despite the alloy composition, surface modifications appear to have an influence on the degradation process and biocompatibility. The aim of this study was to investigate the impact of hydrogenation and fluoridation of the surface in a mandibular osteotomy model. Standard-sized plates and screws were implanted in an osteotomy at the mandibular angle in nine miniature pigs. The plates and screws were harvested together with the adjacent tissues at 8 weeks after surgery and were investigated by micro-computed tomography and histological analysis. The bone healing of the osteotomy was undisturbed, independent of the surface properties. The adjacent bone tissue showed new bone formation at the implant surface; however, formation of some lacunae could be observed. The corrosion was between 9.8% and 11.6% (fluoridated<hydrogenated<non-modified) in histological specimens, while radiologically neither the volume nor the density of the osteosynthesis material was reduced in any treatment group. The soft tissues exhibited full biocompatibility with every surface property. In summary, surface modification by hydrogenation and fluoridation did not significantly influence bone healing, biocompatibility, or corrosion kinetics of the magnesium osteosynthesis at the mandibular angle.

Effect of magnesium particle fraction on osteoinduction of hydroxyapatite sphere-based scaffolds

HAs-30Mg (incorporation of 30% Mg into HA sphere-based scaffolds) induced the optimum new bone formation.

Degradation and In Vivo Response of Hydroxyapatite-Coated Mg Alloy

Nowadays there is a need for new generation of biodegradable implants, which should be able to stimulate the healing responses of injured tissues at the molecular level. Magnesium alloys attract great attention as perspective bone implants due to their biocompatibility, physical properties and ability to degrade completely under physiological conditions. The main purpose of this research was assessment of in vitro corrosion and surface morphology after short term in vivo implantation of Mg based implant covered by hydroxyapatite (HA). Mg alloys with the addition of Zr (0.65%), Al (1.85%) and Nd (1.25%) were used. In our work, we propose dipping method for hydroxyapatite coatings formation which has been shown to reduce the corrosion rate of magnesium implants in vivo. Simulated body fluid (SBF; pH 7.4) with ion concentrations approximately equal to those of human blood plasma resembling physiological conditions and citrate buffer with pH 5—simulating inflammation were selected as modelling environments for in vitro degradation test. The rod samples were implanted into the tibia bone of rats and after 1 day and 5 days of implantation were taken out to observe cells adhesion on surface samples. SEM was used to assess surface morphology after in vitro and in vivo tests. SBF solution causes some cracks on the surface of HA coatings, while citrate solution at pH 2 caused complete dissolving of the coating. The HA coating favoured cell adhesion and rapid fibrous tissue formation.