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Chen Z, Wang B, Yang C, Lv Z, Wei Y, Pan T, Xuan F, Zhou X, Chen H, Shen H, Wang L, Zhang Y. 3D Printed Pedicle Screws with Microarc Oxidation Ceramic Interfaces Enhance Osteointegration and Orthopedic Fixation Feasibility. ACS APPLIED MATERIALS & INTERFACES 2024; 16:31983-31996. [PMID: 38865688 DOI: 10.1021/acsami.4c03628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
Effective osteointegration is of great importance for pedicle screws in spinal fusion surgeries. However, the lack of osteoinductive activity of current screws diminishes their feasibility for osteointegration and fixation, making screw loosening a common complication worldwide. In this study, Ti-6Al-4V pedicle screws with full through-hole design were fabricated via selective laser melting (SLM) 3D printing and then deposited with porous oxide coatings by microarc oxidation (MAO). The porous surface morphology of the oxide coating and the release of bioactive ions could effectively support cell adhesion, migration, vascularization, and osteogenesis in vitro. Furthermore, an in vivo goat model demonstrated the efficacy of modified screws in improving bone maturation and osseointegration, thus providing a promising method for feasible orthopedic internal fixation.
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Affiliation(s)
- Zehao Chen
- Department of Spine Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
- Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai 200434, China
| | - Binghao Wang
- Guangxi Zhuang Autonomous Region Engineering Research Center for Biomaterials in Bone and Joint Degenerative Diseases, Guangxi Key Laboratory for Preclinical and Translational Research on Bone and Joint Degenerative Diseases, Affiliated Hospital of Youjiang Medical University, Baise, Guangxi 533000, China
- State Key Laboratory of Metal Matrix Composites, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Chengliang Yang
- Guangxi Zhuang Autonomous Region Engineering Research Center for Biomaterials in Bone and Joint Degenerative Diseases, Guangxi Key Laboratory for Preclinical and Translational Research on Bone and Joint Degenerative Diseases, Affiliated Hospital of Youjiang Medical University, Baise, Guangxi 533000, China
| | - Zhendong Lv
- Department of Spine Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Yu Wei
- Guangxi Zhuang Autonomous Region Engineering Research Center for Biomaterials in Bone and Joint Degenerative Diseases, Guangxi Key Laboratory for Preclinical and Translational Research on Bone and Joint Degenerative Diseases, Affiliated Hospital of Youjiang Medical University, Baise, Guangxi 533000, China
| | - Tianming Pan
- Danyang Hospital of Traditional Chinese Medicine, Jiangsu 212300, China
| | - Fuqing Xuan
- Department of Spine Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
- School of Mechatronic Engineering and Automation, Shanghai University, Shanghai 200444, China
| | - Xingdie Zhou
- Department of Spine Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
- School of Materials Science and Engineering, Shanghai University, Shanghai 200444, China
| | - Hao Chen
- Department of Spine Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Hongxing Shen
- Department of Spine Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Liqiang Wang
- State Key Laboratory of Metal Matrix Composites, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Yuhui Zhang
- Department of Spine Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
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Li X, Lin G, Zhou L, Prosser O, Malakooti MH, Zhang M. Green synthesis of iron-doped graphene quantum dots: an efficient nanozyme for glucose sensing. NANOSCALE HORIZONS 2024; 9:976-989. [PMID: 38568029 DOI: 10.1039/d4nh00024b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
Single-atom nanozymes with well-defined atomic structures and electronic coordination environments can effectively mimic the functions of natural enzymes. However, the costly and intricate preparation processes have hindered further exploration and application of these single-atom nanozymes. In this study, we presented a synthesis technique for creating Fe-N central single-atom doped graphene quantum dot (FeN/GQDs) nanozymes using a one-step solvothermal process, where individual iron atoms form strong bonds with graphene quantum dots through nitrogen coordination. Unlike previous studies, this method significantly simplifies the synthesis conditions for single-atom nanozymes, eliminating the need for high temperatures and employing environmentally friendly precursors derived from pineapple (ananas comosus) leaves. The resulting FeN/GQDs exhibited peroxidase-like catalytic activity and kinetics comparable to that of natural enzymes, efficiently converting H2O2 into hydroxyl radical species. Leveraging their excellent peroxide-like activity, FeN/GQDs nanozymes have been successfully applied to construct a colorimetric biosensor system characterized by remarkably high sensitivity for glucose detection. This achievement demonstrated a promising approach to designing single-atom nanozymes with both facile synthesis procedures and high catalytic activity, offering potential applications in wearable sensors and personalized health monitoring.
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Affiliation(s)
- Xinqi Li
- Department of Materials Science and Engineering, University of Washington, Seattle, Washington 98195, USA.
| | - Guanyou Lin
- Department of Materials Science and Engineering, University of Washington, Seattle, Washington 98195, USA.
| | - Lijun Zhou
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA.
| | - Octavia Prosser
- Department of Materials Science and Engineering, University of Washington, Seattle, Washington 98195, USA.
| | - Mohammad H Malakooti
- Department of Materials Science and Engineering, University of Washington, Seattle, Washington 98195, USA.
- Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, USA.
- Institute for Nano-Engineered Systems, University of Washington, Seattle, WA 98195, USA
| | - Miqin Zhang
- Department of Materials Science and Engineering, University of Washington, Seattle, Washington 98195, USA.
- Institute for Nano-Engineered Systems, University of Washington, Seattle, WA 98195, USA
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Wang Y, Jiang Q, Long H, Chen H, Wei J, Li X, Wang H, Xie D, Zeng C, Lei G. Trends and benefits of early hip arthroplasty for femoral neck fracture in China: a national cohort study. Int J Surg 2024; 110:1347-1355. [PMID: 38320106 PMCID: PMC10942226 DOI: 10.1097/js9.0000000000000794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/10/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND Limited studies have examined the benefits of early arthroplasty within 48 h from admission to surgery for femoral neck fractures (FNFs). Using the national inpatient database, the authors aimed to investigate the trends in early arthroplasty within 48 h for FNFs in China and to assess its effect on in-hospital complications and 30-day readmission patterns. MATERIALS AND METHODS This was a retrospective cohort study. Patients receiving primary total hip arthroplasty (THA) or hemiarthroplasty (HA) for FNFs in the Hospital Quality Monitoring System between 2013 and 2019 were included. After adjusting for potential confounders with propensity score matching, a logistic regression model was performed to compare the differences in in-hospital complications [i.e. in-hospital death, pulmonary embolism, deep vein thrombosis (DVT), wound infection, and blood transfusion], rates and causes of 30-day readmission between early and delayed arthroplasty. RESULTS During the study period, the rate of early THA increased from 18.0 to 19.9%, and the rate of early HA increased from 14.7 to 18.4% ( P <0.001). After matching, 11 731 pairs receiving THA and 13 568 pairs receiving HA were included. Compared with delayed THA, early THA was associated with a lower risk of pulmonary embolism [odds ratio (OR) 0.51, 95% CI: 0.30-0.88], DVT (OR 0.59, 95% CI: 0.50-0.70), blood transfusion (OR 0.62, 95% CI: 0.55-0.70), 30-day readmission (OR 0.82, 95% CI: 0.70-0.95), and venous thromboembolism-related readmission (OR 0.50, 95% CI: 0.34-0.74). Similarly, early HA was associated with a lower risk of DVT (OR 0.70, 95% CI: 0.61-0.80) and blood transfusion (OR 0.74, 95% CI: 0.68-0.81) than delayed HA. CONCLUSION Despite a slight increase, the rate of early arthroplasty remained at a low level in China. Given that early arthroplasty can significantly improve prognosis, more efforts are needed to optimize the procedure and shorten the time to surgery.
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Affiliation(s)
| | | | | | - Hu Chen
- Tibet Autonomous Region People’s Hospital, Lhasa, Tibet, People’s Republic of China
| | - Jie Wei
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education
- Health Management Center, Xiangya Hospital
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University
- Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, Hunan
| | - Xiaoxiao Li
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education
- Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, Hunan
| | - Haibo Wang
- China Standard Medical Information Research Center, Shenzhen
- Clinical Trial Unit, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong
| | | | - Chao Zeng
- Department of Orthopedics
- National Clinical Research Center for Geriatric Disorders
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education
- Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, Hunan
| | - Guanghua Lei
- Department of Orthopedics
- National Clinical Research Center for Geriatric Disorders
- Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education
- Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, Hunan
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Wu J, Cheng X, Wu J, Chen J, Pei X. The development of magnesium-based biomaterials in bone tissue engineering: A review. J Biomed Mater Res B Appl Biomater 2024; 112:e35326. [PMID: 37861271 DOI: 10.1002/jbm.b.35326] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/15/2023] [Accepted: 08/23/2023] [Indexed: 10/21/2023]
Abstract
Bone regeneration is a vital clinical challenge in massive or complicated bone defects. Recently, bone tissue engineering has come to the fore to meet the demand for bone repair with various innovative materials. However, the reported materials usually cannot satisfy the requirements, such as ideal mechanical and osteogenic properties, as well as biocompatibility at the same time. Mg-based biomaterials have considerable potential in bone tissue engineering owing to their excellent mechanical strength and biosafety. Moreover, the biocompatibility and osteogenic activity of Mg-based biomaterials have been the research focuses in recent years. The main limitation faced in the applications of Mg-based biomaterials is rapid degradation, which can produce excessive Mg2+ and hydrogen, affecting the healing of the bone defect. In order to overcome the limitations, researchers have explored several ways to improve the properties of Mg-based biomaterials, including alloying, surface modification with coatings, and synthesizing other composite materials to control the degradation rate upon implantation. This article reviewed the osteogenic mechanism and requirement for appropriate degradation rate and focused on current progress in the biomedical use of Mg-based biomaterials to inspire more clinical applications of Mg in bone regeneration in the future.
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Affiliation(s)
- Jiaxin Wu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xinting Cheng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jicenyuan Wu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Junyu Chen
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xibo Pei
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Li H, Chen H, She R, Li Y, Qin G, Gan F, Liang H, Hu B. Clinical observation of Gofried positive buttress reduction in the treatment of young femoral neck fracture: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e36424. [PMID: 38050256 PMCID: PMC10695552 DOI: 10.1097/md.0000000000036424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 11/10/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Femoral neck fractures in young adults(<65 years), have always been a difficult problem, characterized by high rates of nonunion and avascular necrosis (AVN). The clinical efficacy of anatomical reduction and non-anatomical reduction methods needs to be supported by clinical data. Therefore, we conduct a meta-analysis on the clinical efficacy of different reduction methods to better guide clinical practice. METHODS Relevant studies published using internal fixation to treat femoral neck fracture in several databases were searched. The outcomes sought included Harris score and the rate of AVN, nonunion and femoral neck shortening (<5 mm). Included studies were assessed for methodological bias and estimates of effect were calculated. Potential reasons for heterogeneity were explored. RESULTS The clinical results showed that compared with the anatomical reduction and positive buttress, there is no significant difference in the rate of AVN (OR = 0.87, 95%CI: 0.55-1.37, P = .55), nonunion (OR = 0.54, 95%CI: 0.21-1.41, P = .21), femoral neck shortening (<5 mm) (OR = 1.03,95%CI: 0.57-1.86, P = .92), the Harris score (MD = -0.28, 95%CI: -1.36-0.80, P = .61) and the excellent and good rate of Harris score (OR = 1.73, 95%CI: 0.84-3.56, P = .61). However, compared with negative buttress, the rate of AVN (OR = 0.62, 95%CI: 0.38-1.01, P = .05), nonunion (OR = 0.34, 95%CI: 0.12-1.00, P = .05) and femoral neck shortening (<5 mm) (OR = 0.27, 95%CI: 0.16-0.45, P < .00001) were significantly lower, and the Harris score (MD = 6.53, 95%CI: 2.55 ~ 10.51, P = .001) was significantly better in positive buttress. CONCLUSIONS In the case of difficult to achieve anatomical reduction, for young patients (< 65 years) with femoral neck fracture, reduction with positive buttress can be an excellent alternative and negative buttress should be avoided as much as possible.
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Affiliation(s)
- Huankun Li
- Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine, Zhongshan, Guangdong Province, China
| | - Hongjun Chen
- Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine, Zhongshan, Guangdong Province, China
| | - Ruihao She
- Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong Province, China
| | - Yanhong Li
- Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine, Zhongshan, Guangdong Province, China
| | - Gang Qin
- Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine, Zhongshan, Guangdong Province, China
| | - Fukai Gan
- Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine, Zhongshan, Guangdong Province, China
| | - Huahui Liang
- Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine, Zhongshan, Guangdong Province, China
| | - Baijun Hu
- Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine, Zhongshan, Guangdong Province, China
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Chen L, Yan Z, Qiu T, Zhu J, Liu G, Han J, Guo C. Long-Term Temporospatial Complementary Relationship between Degradation and Bone Regeneration of Mg-Al Alloy. ACS APPLIED BIO MATERIALS 2023; 6:4703-4713. [PMID: 37865928 PMCID: PMC10664755 DOI: 10.1021/acsabm.3c00488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/12/2023] [Indexed: 10/24/2023]
Abstract
The utilization of guided tissue regeneration membranes is a significant approach for enhancing bone tissue growth in areas with bone defects. Biodegradable magnesium alloys are increasingly being used as guided tissue regeneration membranes due to their outstanding osteogenic properties. However, the degradation rates of magnesium alloy bone implants documented in the literature tend to be rapid. Moreover, many studies focus only on the initial 3-month period post-implantation, limiting their applicability and impeding clinical adoption. Furthermore, scant attention has been given to the interplay between the degradation of magnesium alloy implants and the adjacent tissues. To address these gaps, this study employs a well-studied magnesium-aluminum (Mg-Al) alloy membrane with a slow degradation rate. This membrane is implanted into rat skull bone defects and monitored over an extended period of up to 48 weeks. Observations are conducted at various intervals (2, 4, 8, 12, 24, and 48 weeks) following the implantation. Assessment of degradation behavior and tissue regeneration response is carried out using histological sections, micro-CT scans, and scanning electron microscopy (SEM). The findings reveal that the magnesium alloy membranes demonstrate remarkable biocompatibility and osteogenic capability over the entire observation duration. Specifically, the Mg-Al alloy membranes sustain their structural integrity for 8 weeks. Notably, their osteogenic ability is further enhanced as a corrosion product layer forms during the later stages of implantation. Additionally, our in vitro experiments employing extracts from the magnesium alloy display a significant osteogenic effect, accompanied by a notable increase in the expression of osteogenic-related genes. Collectively, these results strongly indicate the substantial potential of Mg-Al alloy membranes in the context of guided tissue regeneration.
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Affiliation(s)
- Liangwei Chen
- Department
of Oral and Maxillofacial Surgery, Peking
University School and Hospital of Stomatology, Beijing 100081, China
| | - Ziyu Yan
- Department
of Oral and Maxillofacial Surgery, Peking
University School and Hospital of Stomatology, Beijing 100081, China
| | - Tiancheng Qiu
- Department
of Oral and Maxillofacial Surgery, Peking
University School and Hospital of Stomatology, Beijing 100081, China
| | - Jianhua Zhu
- Department
of Oral and Maxillofacial Surgery, Peking
University School and Hospital of Stomatology, Beijing 100081, China
| | - Guanqi Liu
- National
Engineering Laboratory for Digital and Material Technology of Stomatology,
Department of Dental Materials, Peking University
School and Hospital of Stomatology, Beijing 100081, China
| | - Jianmin Han
- National
Engineering Laboratory for Digital and Material Technology of Stomatology,
Department of Dental Materials, Peking University
School and Hospital of Stomatology, Beijing 100081, China
| | - Chuanbin Guo
- Department
of Oral and Maxillofacial Surgery, Peking
University School and Hospital of Stomatology, Beijing 100081, China
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Liu Y, Ren Z, Shao H, Wang X, Ma Y, Song W, Wu X, Zhang X, Li P, He Y, Wei X, Duan W. Titanium alloy cannulated screws and biodegrade ceramic nails for treatment of femoral neck fractures: A finite element analysis. Injury 2023; 54:110841. [PMID: 37316405 DOI: 10.1016/j.injury.2023.110841] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 05/06/2023] [Accepted: 05/21/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Our previous studies have demonstrated the mechanical effect of sclerosis around screw paths on the healing of femoral neck fractures (FNF) after internal fixation. Furthermore, we discussed the possibility of using bioceramic nails (BNs) to prevent sclerosis. However, all these studies were conducted under static conditions as the patient was standing on one leg, while the effect of the stress generated during movement is unknown. The purpose of this study was to evaluate the stress and displacement under dynamic stress loading conditions. METHODS Two types of internal fixation, namely cannulated screws and bioceramic nails, were utilized in conjunction with various finite element models of the femur. These models included the femoral neck fracture healing model, the femoral neck fracture model, and the sclerosis around screws model. The resulting stress and displacement were analyzed by applying the contact forces associated with the most demanding activities during gait, including walking, standing, and knee bending. The present study establishes a comprehensive framework for investigating the biomechanical properties of internal fixation devices in the context of femoral fractures. RESULTS The stress at the top of the femoral head in the sclerotic model was increased by roughly 15 MPa during the knee bend and walking phases and by about 30 MPa during the standing phase compared to the healing model. The area of high stress at the top of the femoral head was increased during the sclerotic model's walking and standing phases. Additionally, the stress distribution throughout the dynamic gait cycle was comparable before and after the removal of internal fixations following the healing of the FNF. The overall stress distribution of the entire fractured femoral model was lower and more evenly distributed in all combinations of internal fixation. Furthermore, the internal fixation stress concentration was lower when more BNs were used. In the fractured model with three cannulated screws (CSs), however, the majority of the stress was concentrated around the ends of the fractures.The maximal stress in the healing model with one CS and two BNs was the highest at all stages of gait over three combinations of internal fixation, and the stress was mainly carried by CS. CONCLUSIONS The presence of sclerosis around screw paths increases the risk of femoral head necrosis. Removal of CS has little effect on the mechanics of the femur after healing of the FNF. BNs have several advantages over conventional CSs after FNF. Replacing all internal fixations with BNs after the healing of FNF may solve the problem of sclerosis formation around CSs to improve bone reconstruction owing to their bioactivity.
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Affiliation(s)
- Yang Liu
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, 030001, China
| | - Zhiyuan Ren
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, 030001, China
| | - Huifeng Shao
- School of Mechanical Engineering, Hangzhou Dianzi University, Hangzhou, 310018, China; Key Laboratory of 3D Printing Process and Equipment of Zhejiang Province, School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Xueding Wang
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, 030001, China
| | - Yongsheng Ma
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, 030001, China
| | - Wenjie Song
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, 030001, China
| | - Xiaogang Wu
- Institute of Biomedical Engineering, College of biomedical Engineering, Taiyuan University of Technology, Taiyuan, 030024, China
| | - Xiangyu Zhang
- Institute of Biomedical Engineering, College of biomedical Engineering, Taiyuan University of Technology, Taiyuan, 030024, China
| | - Pengcui Li
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, 030001, China
| | - Yong He
- Key Laboratory of 3D Printing Process and Equipment of Zhejiang Province, School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Xiaochun Wei
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, 030001, China
| | - Wangping Duan
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, 030001, China.
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Degradation behavior of ZE21C magnesium alloy suture anchors and their effect on ligament-bone junction repair. Bioact Mater 2023; 26:128-141. [PMID: 36891259 PMCID: PMC9986500 DOI: 10.1016/j.bioactmat.2023.02.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 02/18/2023] [Accepted: 02/18/2023] [Indexed: 03/04/2023] Open
Abstract
Current materials comprising suture anchors used to reconstruct ligament-bone junctions still have limitation in biocompatibility, degradability or mechanical properties. Magnesium alloys are potential bone implant materials, and Mg2+ has been shown to promote ligament-bone healing. Here, we used Mg-2 wt.% Zn-0.5 wt.% Y-1 wt.% Nd-0.5 wt.% Zr (ZE21C) alloy and Ti6Al4V (TC4) alloy to prepare suture anchors to reconstruct the patellar ligament-tibia in SD rats. We studied the degradation behavior of the ZE21C suture anchor via in vitro and in vivo experiments and assessed its reparative effect on the ligament-bone junction. In vitro, the ZE21C suture anchor degraded gradually, and calcium and phosphorus products accumulated on its surface during degradation. In vivo, the ZE21C suture anchor could maintain its mechanical integrity within 12 weeks of implantation in rats. The tail of the ZE21C suture anchor in high stress concentration degraded rapidly during the early implantation stage (0-4weeks), while bone healing accelerated the degradation of the anchor head in the late implantation stage (4-12weeks). Radiological, histological, and biomechanical assays indicated that the ZE21C suture anchor promoted bone healing above the suture anchor and fibrocartilaginous interface regeneration in the ligament-bone junction, leading to better biomechanical strength than the TC4 group. Hence, this study provides a basis for further research on the clinical application of degradable magnesium alloy suture anchors.
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Liu Y, Xing Y, Shao H, Wu X, Ma Y, Yang W, Lin Q, Li P, He Y, Duan W, Wei X. Prevention of sclerosis around cannulated screw after treatment of femoral neck fractures with bioceramic nails: a finite element analysis. BMC Musculoskelet Disord 2023; 24:569. [PMID: 37438799 PMCID: PMC10337165 DOI: 10.1186/s12891-023-06677-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 06/29/2023] [Indexed: 07/14/2023] Open
Abstract
PURPOSE Conventional cannulated screws (CS) are the main treatment method for femoral neck fractures (FNF). However, the rate of femoral head necrosis remains high after FNF treatment. The study aimed to compare the biomechanical features of different internal fixation materials for the treatment of Pauwel type III FNF to explore new strategies for clinical management. METHODS A new material was prepared by applying casting, freeze drying and sintering process. The independently developed calcium magnesium silicate ceramic powder and hydrogel solution were evenly mixed to obtain a high-viscosity bio-ink, and a bioceramic nail (BN) with high mechanical strength and high fracture toughness was successfully prepared. Four internal fixations were developed to establish the Pauwel type III FNF and healed fracture finite element models: A, three CSs; B, three BNs; C, two BNs and one CS; D, one BN and two CSs. Von Mises stress and displacement of the implants and femur were observed. RESULTS The measured Mg content in ceramic powder was 2.08 wt%. The spectral data confirmed that the ceramic powder has high crystallinity, which coincides with the wollastonite-2 M (PDF# 27-0088). The maximum von Mises stresses for the four models were concentrated in the lower part of the fracture surface, at 318.42 Mpa, 103.52 MPa, 121.16 MPa, and 144.06 MPa in models A, B, C, and D, respectively. Moreover, the maximum Von-mises stresses of the implants of the four models were concentrated near the fracture end at 243.65 MPa (A) and 58.02 MPa (B), 102.18 MPa (C), and 144.06 MPa (D). The maximum displacements of the four models were 5.36 mm (A), 3.41 mm (B), 3.60 mm (C), and 3.71 mm (D). The displacements of the three models with BNs were similar and smaller than that of the triple CS fracture model. In the fracture healing models with and without three CSs, the greatest stress concentration was scattered among the lowest screw tail, femoral calcar region, and lateral femur shaft. The displacement and stress distributions in both models are generally consistent. The stress distribution and displacement of the three healed femoral models with BNs were essentially identical to the healing models with three CSs. The maximum von Mises stresses were 65.94 MPa (B), 64.61 MPa (C), and 66.99 MPa (D) while the maximum displacements of the three healed femoral models were 2.49 mm (B), 2.56 mm (C), and 2.49 mm (D), respectively. CONCLUSIONS Bioceramic nails offer greater advantages than conventional canulated screws after femoral neck fractures. However, the combination of bioceramic nails and CSs is more clinically realistic; replacing all internal fixations with bioceramic nails after the healing of femoral neck fractures can solve the problem of sclerosis formation around CSs and improve bone reconstruction by their bioactivity.
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Affiliation(s)
- Yang Liu
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, No. 382, Wuyi Road, 030001, Taiyuan, China
| | - Yugang Xing
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, No. 382, Wuyi Road, 030001, Taiyuan, China
| | - Huifeng Shao
- School of Mechanical Engineering, Hangzhou Dianzi University, Hangzhou, 310018, China.
- Key Laboratory of 3D Printing Process and Equipment of Zhejiang Province, School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, China.
| | - Xiaogang Wu
- Institute of Biomedical Engineering, College of biomedical Engineering, Taiyuan University of Technology, Taiyuan, 030024, China
| | - Yongsheng Ma
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, No. 382, Wuyi Road, 030001, Taiyuan, China
| | - Wenming Yang
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, No. 382, Wuyi Road, 030001, Taiyuan, China
| | - Qitai Lin
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, No. 382, Wuyi Road, 030001, Taiyuan, China
| | - Pengcui Li
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, No. 382, Wuyi Road, 030001, Taiyuan, China
| | - Yong He
- Key Laboratory of 3D Printing Process and Equipment of Zhejiang Province, School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Wangping Duan
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, No. 382, Wuyi Road, 030001, Taiyuan, China.
| | - Xiaochun Wei
- Department of Orthopaedics, Second Hospital of Shanxi Medical University, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, No. 382, Wuyi Road, 030001, Taiyuan, China
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Bian Y, Hu T, Lv Z, Xu Y, Wang Y, Wang H, Zhu W, Feng B, Liang R, Tan C, Weng X. Bone tissue engineering for treating osteonecrosis of the femoral head. EXPLORATION (BEIJING, CHINA) 2023; 3:20210105. [PMID: 37324030 PMCID: PMC10190954 DOI: 10.1002/exp.20210105] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 05/12/2022] [Indexed: 06/16/2023]
Abstract
Osteonecrosis of the femoral head (ONFH) is a devastating and complicated disease with an unclear etiology. Femoral head-preserving surgeries have been devoted to delaying and hindering the collapse of the femoral head since their introduction in the last century. However, the isolated femoral head-preserving surgeries cannot prevent the natural progression of ONFH, and the combination of autogenous or allogeneic bone grafting often leads to many undesired complications. To tackle this dilemma, bone tissue engineering has been widely developed to compensate for the deficiencies of these surgeries. During the last decades, great progress has been made in ingenious bone tissue engineering for ONFH treatment. Herein, we comprehensively summarize the state-of-the-art progress made in bone tissue engineering for ONFH treatment. The definition, classification, etiology, diagnosis, and current treatments of ONFH are first described. Then, the recent progress in the development of various bone-repairing biomaterials, including bioceramics, natural polymers, synthetic polymers, and metals, for treating ONFH is presented. Thereafter, regenerative therapies for ONFH treatment are also discussed. Finally, we give some personal insights on the current challenges of these therapeutic strategies in the clinic and the future development of bone tissue engineering for ONFH treatment.
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Affiliation(s)
- Yixin Bian
- Department of Orthopedic SurgeryState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina
| | - Tingting Hu
- State Key Laboratory of Chemical Resource EngineeringBeijing Advanced Innovation Center for Soft Matter Science and EngineeringBeijing University of Chemical TechnologyBeijingChina
| | - Zehui Lv
- Department of Orthopedic SurgeryState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina
| | - Yiming Xu
- Department of Orthopedic SurgeryState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina
| | - Yingjie Wang
- Department of Orthopedic SurgeryState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina
| | - Han Wang
- Department of Orthopedic SurgeryState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina
| | - Wei Zhu
- Department of Orthopedic SurgeryState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina
| | - Bin Feng
- Department of Orthopedic SurgeryState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina
| | - Ruizheng Liang
- State Key Laboratory of Chemical Resource EngineeringBeijing Advanced Innovation Center for Soft Matter Science and EngineeringBeijing University of Chemical TechnologyBeijingChina
| | - Chaoliang Tan
- Department of ChemistryCity University of Hong KongKowloonHong Kong SARChina
| | - Xisheng Weng
- Department of Orthopedic SurgeryState Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina
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11
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Javaid S, Gorji HT, Soulami KB, Kaabouch N. Identification and ranking biomaterials for bone scaffolds using machine learning and PROMETHEE. RESEARCH ON BIOMEDICAL ENGINEERING 2023; 39:129-138. [PMCID: PMC9938698 DOI: 10.1007/s42600-022-00257-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 12/26/2022] [Indexed: 11/25/2023]
Abstract
Purpose Bones have a complex hierarchical structure that supports their diverse chemical, biological, and mechanical functions. High rates of bone susceptibility to fractures and injury have attracted extensive research interest to find alternate biomaterials for bone scaffolds. Natural bone healing is only successful if the defect is very small and when a defect exceeds 1 cm3 then bone grafting is required. Large bone defects or injuries are very serious problems in orthopedics as they bring great harm to health and normal function of daily life routine. A scaffold should have good strength to maintain its own structure after implantation in a load bearing environment and without being stiff that shields surrounding bone from the load. Therefore, mechanical properties of bone scaffolds should match those of the host tissue and should be part of the natural environment of the body without any harm or further damage. Methods In this paper, we present two main contributions. First, we investigate the use of machine learning models in identifying biomaterials that are suitable for bone scaffolds. Second, we rank the best materials for biomedical scaffold applications using the multi-criteria decision analysis methods, the Preference Ranking Organization METhod for the Enrichment of Evaluations (PROMETHEE). Machine learning models investigated are AdaBoost, artificial neural network (ANN), Naïve Bayes (NB), Decision tree (DT), Support Vector Machine (SVM), and K-Nearest Neighbor (KNN). Mechanical properties such as comprehensive strength, tensile strength, and Young’s modulus with the cortical bone are used as the standard reference for classification. Results The results show that the ANN outperforms the other machine learning models in identifying the biomaterials suitable for bone tissue engineering, while the ranking results using PROMETHEE show that Brushite and Titanium alloy are the best appropriate biomaterials for the cancellous and cortical bones, respectively. Conclusion Brushite and Titanium alloy are the best biomaterials for the cancellous and cortical bones, respectively.
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Affiliation(s)
- Sabah Javaid
- Department of Biomedical Engineering, University of North Dakota, Grand Forks, ND USA
| | - Hamed Taheri Gorji
- School of Electrical Engineering and Computer Science, Grand Forks, ND USA
| | | | - Naima Kaabouch
- School of Electrical Engineering and Computer Science, Grand Forks, ND USA
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12
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Singh N, Batra U, Kumar K, Ahuja N, Mahapatro A. Progress in bioactive surface coatings on biodegradable Mg alloys: A critical review towards clinical translation. Bioact Mater 2023; 19:717-757. [PMID: 35633903 PMCID: PMC9117289 DOI: 10.1016/j.bioactmat.2022.05.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/06/2022] [Accepted: 05/06/2022] [Indexed: 02/07/2023] Open
Abstract
Mg and its alloys evince strong candidature for biodegradable bone implants, cardiovascular stents, and wound closing devices. However, their rapid degradation rate causes premature implant failure, constraining clinical applications. Bio-functional surface coatings have emerged as the most competent strategy to fulfill the diverse clinical requirements, besides yielding effective corrosion resistance. This article reviews the progress of biodegradable and advanced surface coatings on Mg alloys investigated in recent years, aiming to build up a comprehensive knowledge framework of coating techniques, processing parameters, performance measures in terms of corrosion resistance, adhesion strength, and biocompatibility. Recently developed conversion and deposition type surface coatings are thoroughly discussed by reporting their essential therapeutic responses like osteogenesis, angiogenesis, cytocompatibility, hemocompatibility, anti-bacterial, and controlled drug release towards in-vitro and in-vivo study models. The challenges associated with metallic, ceramic and polymeric coatings along with merits and demerits of various coatings have been illustrated. The use of multilayered hybrid coating comprising a unique combination of organic and inorganic components has been emphasized with future perspectives to obtain diverse bio-functionalities in a facile single coating system for orthopedic implant applications. The challenges and current status of coatings are reviewed in light of clinical requirements. Multilayered hybrid coatings have been emphasized to obtain diverse bio-functionalities. The future developments and research directions on coatings for biodegradable implants are highlighted.
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13
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Wang Z, Liu B, Yin B, Zheng Y, Tian Y, Wen P. Comprehensive review of additively manufactured biodegradable magnesium implants for repairing bone defects from biomechanical and biodegradable perspectives. Front Chem 2022; 10:1066103. [PMID: 36523749 PMCID: PMC9745192 DOI: 10.3389/fchem.2022.1066103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/21/2022] [Indexed: 10/21/2023] Open
Abstract
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.
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Affiliation(s)
- Zhengguang Wang
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
- Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Peking University Third Hospital, Beijing, China
| | - Bingchuan Liu
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
- Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Peking University Third Hospital, Beijing, China
| | - Bangzhao Yin
- Department of Mechanical Engineering, Tsinghua University, Beijing, China
| | - Yufeng Zheng
- School of Materials Science and Engineering, Peking University, Beijing, China
| | - Yun Tian
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
- Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Peking University Third Hospital, Beijing, China
| | - Peng Wen
- Department of Mechanical Engineering, Tsinghua University, Beijing, China
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Zhang J, Zhai B, Gao J, Li Z, Zheng Y, Ma M, Li Y, Zhang K, Guo Y, Shi X, Liu B, Gao G, Sun L. Plain metallic biomaterials: opportunities and challenges. Regen Biomater 2022; 10:rbac093. [PMID: 36683734 PMCID: PMC9847527 DOI: 10.1093/rb/rbac093] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/31/2022] [Accepted: 11/12/2022] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Jiazhen Zhang
- Correspondence address. E-mail: (J.Z.); (Y.Z.); (M.M.)
| | - Bao Zhai
- Center for Medical Device Evaluation, National Medical Product Administration, Beijing 100081, China
| | - Jintao Gao
- Guangdong-Hong Kong-Macao Greater Bay Area, Center for Medical Device Evaluation and Inspection of NMPA, Shenzhen 518045, China
| | - Zheng Li
- Center for Medical Device Evaluation, National Medical Product Administration, Beijing 100081, China
| | - Yufeng Zheng
- Correspondence address. E-mail: (J.Z.); (Y.Z.); (M.M.)
| | - Minglong Ma
- Correspondence address. E-mail: (J.Z.); (Y.Z.); (M.M.)
| | - Yongjun Li
- State Key Laboratory of Nonferrous Metals and Process, GRINM Group Corporation Limited (General Research Institute for Nonferrous Metals), Beijing 100088, China
| | - Kui Zhang
- State Key Laboratory of Nonferrous Metals and Process, GRINM Group Corporation Limited (General Research Institute for Nonferrous Metals), Beijing 100088, China
| | - Yajuan Guo
- Center for Medical Device Evaluation, National Medical Product Administration, Beijing 100081, China
| | - Xinli Shi
- Center for Medical Device Evaluation, National Medical Product Administration, Beijing 100081, China
| | - Bin Liu
- Guangdong-Hong Kong-Macao Greater Bay Area, Center for Medical Device Evaluation and Inspection of NMPA, Shenzhen 518045, China
| | - Guobiao Gao
- Center for Medical Device Evaluation, National Medical Product Administration, Beijing 100081, China
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15
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Shan Z, Xie X, Wu X, Zhuang S, Zhang C. Development of degradable magnesium-based metal implants and their function in promoting bone metabolism (A review). J Orthop Translat 2022; 36:184-193. [PMID: 36263386 PMCID: PMC9552026 DOI: 10.1016/j.jot.2022.09.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/05/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022] Open
Abstract
Background Use of degradable magnesium (Mg)-based metal implants in orthopaedic surgeries can avoid drawbacks associated with subsequent removal of the non-degradable metallic implants, reducing cost and trauma of patients. Although Mg has been applied in the clinic for orthopaedic treatment, the use of Mg-based metal implants is largely in the research phase. But its application is potentially beneficial in this context as it has been shown that Mg can promote osteogenesis and inhibit osteoclast activity. Methods A systematic literature search about “degradable magnesium (Mg)-based metal implants” was performed in PubMed and Web of Science. Meanwhile, relevant findings have been reviewed and quoted. Results In this review, we summarize the latest developments in Mg-based metal implants and their role in bone regeneration. We also review the various molecular mechanisms by which Mg ions regulate bone metabolic processes, including osteogenesis, osteoclast activity, angiogenesis, immunity, and neurology. Finally, we discuss the remaining research challenges and opportunities for Mg-based implants and their applications. Conclusion Currently, establishment of the in vitro and in vivo biological evaluation systems and phenotypic modification improvement of Mg-based implants are still needed. Clarifying the functions of Mg-based metal implants in promoting bone metabolism is beneficial for their clinical application. The Translational potential of this article All current reviews on Mg-based implants are mainly concerned with the improvement of Mg alloy properties or the progress of applications. However, there are few reviews that provides a systematic narrative on the effect of Mg on bone metabolism. This review summarized the latest developments in Mg-based metal implants and various molecular mechanisms of Mg ions regulating bone metabolism, which is beneficial to further promote the translation of Mg based implants in the clinic and is able to provide a strong basis for the clinical application of Mg based implants.
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Affiliation(s)
- Zhengming Shan
- School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China
| | - Xinhui Xie
- School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China
- The Department of Orthopaedics, ZhongDa Hospital, Nanjing, Jiangsu, 210009, China
- Corresponding author. The Department of Orthopaedics, ZhongDa hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China.
| | - Xiaotao Wu
- School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China
- The Department of Orthopaedics, ZhongDa Hospital, Nanjing, Jiangsu, 210009, China
- Corresponding author. The Department of Orthopaedics, ZhongDa hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China.
| | - Suyang Zhuang
- School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China
- The Department of Orthopaedics, ZhongDa Hospital, Nanjing, Jiangsu, 210009, China
| | - Cong Zhang
- School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China
- The Department of Orthopaedics, ZhongDa Hospital, Nanjing, Jiangsu, 210009, China
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16
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Rotator cuff repair with biodegradable high-purity magnesium suture anchor in sheep model. J Orthop Translat 2022; 35:62-71. [PMID: 36186661 PMCID: PMC9471965 DOI: 10.1016/j.jot.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/01/2022] [Accepted: 07/21/2022] [Indexed: 11/24/2022] Open
Abstract
Background Rotator cuff tear has become one of the diseases affecting people's living quality. Conventional anchor materials such as titanium alloy and poly-lactic acid can lead to postoperative complications like bone defects and aseptic inflammation. Magnesium (Mg)-based implants are biodegradable and biocompatible, with strong potential to be applied in orthopaedics. Methods In this study, we developed a high-purity (HP) Mg suture anchor and studied its mechanical properties and degradation behavior in vitro. Furthermore, we described the use of high-purity Mg to prepare suture anchor for the rotator cuff repair in sheep. Results The in vitro tests showed that HP Mg suture anchor possess proper degradation behavior and appropriate mechanical property. Animal experiment indicated that HP Mg suture anchor provided reliable anchoring function in 12 weeks and showed no toxic effect on animal organs. Conclusion In summary, the HP Mg anchor presented in this study had favorable mechanical property and biosecurity. The translational potential of this article: The translational potential of this article is to use high-purity Mg to develop a degradable suture anchor and verify the feasibility of the application in animal model. This study provides a basis for further research on the clinical application of biodegradable high-purity Mg suture anchor.
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17
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Chen J, Dai J, Qian J, Li W, Li R, Pang D, Wan G, Li P, Xu S. Influence of Surface Roughness on Biodegradability and Cytocompatibility of High-Purity Magnesium. MATERIALS 2022; 15:ma15113991. [PMID: 35683285 PMCID: PMC9182346 DOI: 10.3390/ma15113991] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/25/2022] [Accepted: 05/29/2022] [Indexed: 11/16/2022]
Abstract
High-purity magnesium (Mg) is a promising biodegradable metal for oral and maxillofacial implants. Appropriate surface roughness plays a critical role in the degradation behavior and the related cellular processes of biodegradable Mg-based metals. Nevertheless, the most optimized surface roughness has been questionable, especially for Mg-based oral and maxillofacial implants. Three representative scales of surface roughness were investigated in this study, including smooth (Sa < 0.5 µm), moderately rough (Sa between 1.0−2.0 µm), and rough (Sa > 2.0 µm). The results indicated that the degradation rate of the Mg specimen in the cell culture medium was significantly accelerated with increased surface roughness. Furthermore, an extract test revealed that Mg with different roughness did not induce an evident cytotoxic effect. Nonetheless, the smooth Mg surface had an adversely affected cell attachment. Therefore, the high-purity Mg with a moderately rough surface exhibited the most optimized balance between biodegradability and overall cytocompatibility.
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Affiliation(s)
- Jiahao Chen
- Department of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China; (J.C.); (J.D.)
| | - Jingtao Dai
- Department of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China; (J.C.); (J.D.)
| | - Junyu Qian
- Key Laboratory of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu 610031, China; (J.Q.); (G.W.)
| | - Weirong Li
- Medical Device Division, Dongguan Eontec Co., Ltd., Dongguan 523662, China; (W.L.); (R.L.); (D.P.)
| | - Ronghui Li
- Medical Device Division, Dongguan Eontec Co., Ltd., Dongguan 523662, China; (W.L.); (R.L.); (D.P.)
| | - Dong Pang
- Medical Device Division, Dongguan Eontec Co., Ltd., Dongguan 523662, China; (W.L.); (R.L.); (D.P.)
| | - Guojiang Wan
- Key Laboratory of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu 610031, China; (J.Q.); (G.W.)
| | - Ping Li
- Department of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China; (J.C.); (J.D.)
- Correspondence: (P.L.); (S.X.)
| | - Shulan Xu
- Department of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China; (J.C.); (J.D.)
- Correspondence: (P.L.); (S.X.)
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18
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Bone Union Quality after Fracture Fixation of Mandibular Head with Compression Magnesium Screws. MATERIALS 2022; 15:ma15062230. [PMID: 35329682 PMCID: PMC8950275 DOI: 10.3390/ma15062230] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 02/13/2022] [Accepted: 03/15/2022] [Indexed: 12/22/2022]
Abstract
For some years now, fixation devices created with resorbable magnesium alloys for the mandibular head have been clinically available and are beginning to be used. It is thus valuable to evaluate the quality of unions in these cases. The aim of this study was radiological comparison of magnesium versus titanium open reduction and rigid fixations in the mandible condylar head. Thirty-one patients were treated for fractures of the mandibular head with magnesium WE43 alloy headless compression screws (diameter 2.3 mm) and, as a reference group, 29 patients were included with similar construction titanium screws (diameter 1.8 mm). The 12-month results of the treatment were evaluated by the texture analysis of CT. Near similar treatment results were found with magnesium screws in traditional titanium fixation. Magnesium screws result in a higher density of the bone structure in the mandibular head. Conclusions: The quantitative evaluation of bone union after surgical treatment of mandibular head fracture with magnesium compression headless screws indicates that stable consolidation was achieved. Undoubtedly, the resorption process of the screws was found to be incomplete after 12 months, evidenced by a marked densification of the bone structure at the fracture site.
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19
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Li D, Zhang D, Yuan Q, Liu L, Li H, Xiong L, Guo X, Yan Y, Yu K, Dai Y, Xiao T, Li Y, Wen C. In vitro and in vivo assessment of the effect of biodegradable magnesium alloys on osteogenesis. Acta Biomater 2022; 141:454-465. [PMID: 34971787 DOI: 10.1016/j.actbio.2021.12.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/09/2021] [Accepted: 12/24/2021] [Indexed: 12/17/2022]
Abstract
Magnesium (Mg) and some of its alloys are considered promising biodegradable metallic biomaterials for bone implant applications. The osteogenesis effect of Mg alloys is widely reported; however, the underlying mechanisms are still not clear. In this study, pure Mg, Mg-3Zn, and Mg-2Zn-1Mn were prepared, and their degradation behavior, biocompatibility, and osteogenesis effect were systematically assessed both in vitro and in vivo. Primary rat bone marrow-derived mesenchymal stem cells (BMSCs) were used to evaluate the biocompatibility of the prepared Mg alloys, and a rat femur fracture model was used to assess the stimulating effect of these alloys on bone-tissue formation. Mg-2Zn-1Mn showed higher corrosion resistance and more stable degradation behavior than pure Mg and Mg-3Zn. Extracts of the three materials showed significant stimulating effects on osteogenic differentiation of BMSCs along with non-cytotoxicity. Implantation of Mg-2Zn-1Mn wires into the femur of rats demonstrated superior histocompatibility, stable degradation, and notable promotion of osteogenesis without systemic toxicity. Moreover, the results of both in vitro and in vivo assessments demonstrated that bone morphogenetic proteins and fibroblast growth factor receptors are involved in the stimulating effect of Mg alloys. STATEMENT OF SIGNIFICANCE: This work reports the degradation behavior, biocompatibility, and osteogenic effect of pure Mg and Mg-3Zn and Mg-2Zn-1Mn alloys in both in vitro and in vivo conditions. Mg-2Zn-1Mn showed higher corrosion resistance and more stable degradation behavior than pure Mg and Mg-3Zn. The extracts of the three materials showed a significant stimulating effect on osteogenic differentiation of rat bone marrow-derived mesenchymal stem cells (BMSCs) along with non-cytotoxicity. Mg-2Zn-1Mn wires implanted into the femur of rats showed good histocompatibility, stable degradation, and notable promotion of osteogenesis without systemic toxicity. The results of the present study suggest that bone morphogenetic proteins (BMPs) and fibroblast growth factor receptors (FGFRs) are involved in the stimulating effect of Mg alloys on osteogenesis.
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Affiliation(s)
- Ding Li
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, 410011, China; Orthopedic Biomedical Materials Engineering Laboratory of Hunan Province, Changsha 410011, China
| | - Dechuang Zhang
- School of Materials Science and Engineering, Xiangtan University, Xiangtan, Hunan 411105, China.
| | - Qi Yuan
- Department of Hepatopathy, The Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha 410002, China
| | - Lihong Liu
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, 410011, China; Orthopedic Biomedical Materials Engineering Laboratory of Hunan Province, Changsha 410011, China
| | - Hui Li
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, 410011, China; Orthopedic Biomedical Materials Engineering Laboratory of Hunan Province, Changsha 410011, China
| | - Liang Xiong
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, 410011, China; Orthopedic Biomedical Materials Engineering Laboratory of Hunan Province, Changsha 410011, China
| | - Xiaoning Guo
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, 410011, China; Orthopedic Biomedical Materials Engineering Laboratory of Hunan Province, Changsha 410011, China
| | - Yang Yan
- School of Materials Science and Engineering, Central South University, Changsha 410083, China
| | - Kun Yu
- School of Materials Science and Engineering, Central South University, Changsha 410083, China
| | - Yilong Dai
- School of Materials Science and Engineering, Central South University, Changsha 410083, China.
| | - Tao Xiao
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, 410011, China; Orthopedic Biomedical Materials Engineering Laboratory of Hunan Province, Changsha 410011, China.
| | - Yuncang Li
- School of Engineering, RMIT University, Melbourne, Victoria 3001, Australia
| | - Cuie Wen
- School of Engineering, RMIT University, Melbourne, Victoria 3001, Australia.
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20
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Construction of a magnesium hydroxide/graphene oxide/hydroxyapatite composite coating on Mg–Ca–Zn–Ag alloy to inhibit bacterial infection and promote bone regeneration. Bioact Mater 2022; 18:354-367. [PMID: 35415306 PMCID: PMC8965913 DOI: 10.1016/j.bioactmat.2022.02.030] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/20/2022] [Accepted: 02/24/2022] [Indexed: 12/17/2022] Open
Abstract
The improved corrosion resistance, osteogenic activity, and antibacterial ability are the key factors for promoting the large-scale clinical application of magnesium (Mg)-based implants. In the present study, a novel nanocomposite coating composed of inner magnesium hydroxide, middle graphene oxide, and outer hydroxyapatite (Mg(OH)2/GO/HA) is constructed on the surface of Mg-0.8Ca–5Zn-1.5Ag by a combined strategy of hydrothermal treatment, electrophoretic deposition, and electrochemical deposition. The results of material characterization and electrochemical corrosion test showed that all the three coatings have high bonding strength, hydrophilicity and corrosion resistance. In vitro studies show that Mg(OH)2 indeed improves the antibacterial activity of the substrate. The next GO and GO/HA coating procedures both promote the osteogenic differentiation of MC3T3-E1 cells and show no harm to the antibacterial activity of Mg(OH)2 coating, but the latter exhibits the best promoting effect. In vivo studies demonstrate that the Mg alloy with the composite coating not only ameliorates osteolysis induced by bacterial invasion but also promotes bone regeneration under both normal and infected conditions. The current study provides a promising surface modification strategy for developing multifunctional Mg-based implants with good corrosion resistance, antibacterial ability and osteogenic activity to enlarge their biomedical applications. A Mg(OH)2/GO/HA composite coating with high bonding strength was constructed on the surface of Mg–Ca–Zn–Ag alloy. The outer HA layer with excellent osteogenic activity recovered the high corrosion resistance of inner Mg(OH)2 layer. The Mg(OH)2/GO/HA composite coating promoted new bone regeneration significantly under both normal and infected conditions.
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21
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Zhu WY, Guo J, Yang WF, Tao ZY, Lan X, Wang L, Xu J, Qin L, Su YX. Biodegradable magnesium implant enhances angiogenesis and alleviates medication-related osteonecrosis of the jaw in rats. J Orthop Translat 2022; 33:153-161. [PMID: 35415073 PMCID: PMC8965768 DOI: 10.1016/j.jot.2022.03.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/26/2022] [Accepted: 03/12/2022] [Indexed: 01/01/2023] Open
Abstract
Background Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication associated with antiresorptive and antiangiogenic medications, of which impaired angiogenesis is a key pathological alteration. Since Magnesium (Mg)-based implants possess proangiogenic effects, we hypothesized that the biodegradable Mg implant could alleviate the development of MRONJ via enhancing angiogenesis. Methods MRONJ model was established and divided into the Veh + Ti group (Vehicle-treated rat, with Titanium (Ti) implant), BP + Ti group (Bisphosphonate (BP)-treated rat, with Ti implant), BP + Mg group (BP-treated rat, with Mg implant), BP + Mg + SU5416 group (BP-treated rat, with Mg implant and vascular endothelial growth factor (VEGF) receptor-2 inhibitor), BP + Mg + BIBN group (BP-treated rat, with Mg implant and calcitonin gene-related peptide (CGRP) receptor antagonist), and BP + Mg + SU5416+BIBN group (BP-treated rat, with Mg implant and VEGF receptor-2 inhibitor and CGRP receptor antagonist). The occurrence of MRONJ, alveolar bone necrosis, new bone formation and vessel formation were assessed by histomorphometry, immunohistochemistry, and micro-CT analysis. Results Eight weeks after surgery, the BP + Mg group had significantly reduced occurrence of MRONJ-like lesion and histological osteonecrosis, increased bone microstructural parameters, and increased expressions of VEGFA and CGRP, than the BP + Ti group. By simultaneously blocking VEGF receptor-2 and CGRP receptor, the vessel volume and new bone formation in the BP + Mg group were significantly decreased, meanwhile the occurrence of MRONJ-like lesion and histological bone necrosis were significantly increased. Conclusion Biodegradable Mg implant could alleviate the development of MRONJ-like lesion, possibly via upregulating VEGF- and CGRP-mediated angiogenesis. Mg-based implants have the translational potential to be developed as a novel internal fixation device for patients with the risk of MRONJ. The Translational potential of this article This work reports a biodegradable Mg implant which ameliorates the development of MRONJ-like lesions possibly due to its angiogenic property. Mg-based implants have the potential to be developed as a novel internal fixation device for patients at the risk of MRONJ.
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Affiliation(s)
- Wang-yong Zhu
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Jiaxin Guo
- Musculoskeletal Research Laboratory of Department of Orthopaedics & Traumatology and Innovative Orthopaedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Wei-fa Yang
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Zhuo-ying Tao
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Xinmiao Lan
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Leilei Wang
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Jiankun Xu
- Musculoskeletal Research Laboratory of Department of Orthopaedics & Traumatology and Innovative Orthopaedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Ling Qin
- Musculoskeletal Research Laboratory of Department of Orthopaedics & Traumatology and Innovative Orthopaedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yu-xiong Su
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
- Corresponding author.
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22
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Magnesium-Based Alloys Used in Orthopedic Surgery. MATERIALS 2022; 15:ma15031148. [PMID: 35161092 PMCID: PMC8840615 DOI: 10.3390/ma15031148] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/27/2022] [Accepted: 01/29/2022] [Indexed: 02/04/2023]
Abstract
Magnesium (Mg)-based alloys have become an important category of materials that is attracting more and more attention due to their high potential use as orthopedic temporary implants. These alloys are a viable alternative to nondegradable metals implants in orthopedics. In this paper, a detailed overview covering alloy development and manufacturing techniques is described. Further, important attributes for Mg-based alloys involved in orthopedic implants fabrication, physiological and toxicological effects of each alloying element, mechanical properties, osteogenesis, and angiogenesis of Mg are presented. A section detailing the main biocompatible Mg-based alloys, with examples of mechanical properties, degradation behavior, and cytotoxicity tests related to in vitro experiments, is also provided. Special attention is given to animal testing, and the clinical translation is also reviewed, focusing on the main clinical cases that were conducted under human use approval.
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23
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Li D, Yang Z, Luo Y, Zhao X, Tian M, Kang P. Delivery of MiR335-5p-Pendant Tetrahedron DNA Nanostructures Using an Injectable Heparin Lithium Hydrogel for Challenging Bone Defects in Steroid-Associated Osteonecrosis. Adv Healthc Mater 2022; 11:e2101412. [PMID: 34694067 DOI: 10.1002/adhm.202101412] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/01/2021] [Indexed: 02/05/2023]
Abstract
Corticosteroids-induced Dickkopf-1 (DKK1) upregulation and Wnt signaling inhibition result in bone metabolism disorder and steroid-associated osteonecrosis (SAON). Implanting biomaterials to regulate the Wnt pathway is a promising method to repair challenging bone defects associated with SAON. Here, tetrahedral DNA nanostructures (TDNs) are fabricated as gene carriers to deliver MiR335-5p, which targets DKK1 translation. Heparin lithium hydrogel (Li-hep-gel) is synthesized to act as a lithium and MiR@TDNs delivery agent. Finally, the repair effects on challenging bone defect in SAON using a MiR@TDNs/Li-hep-gel composite are assessed in vivo. The results reveal that MiR@TDNs are absorbed by bone mesenchymal stem cells (BMSCs) and increase cell viability and reduce apoptosis. Moreover, MiR@TDNs promote alkaline phosphatase expression and calcium nodular deposition, decrease lipid droplet expression of BMSCs, and improve vascular endothelial growth factor secretion and vascular-like structure formation in vitro. After MiR@TDNs/Li-hep-gel is implanted into the SAON model, the internal bone defect of osteonecrosis is repaired with a large area of new bone accompanied with neovascularization and reduced empty lacunae. In conclusion, MiR@TDNs/Li-hep-gel can provide dual delivery of lithium and MiR@TDNs, which synergistically upregulate the Wnt signaling pathway, enhancing bone regeneration in challenging bone defects, and can be potentially used in SAON repair.
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Affiliation(s)
- Donghai Li
- Orthopedic Research Institution Department of Orthopaedics West China Hospital Sichuan University 37# Wuhou Guoxue Road Chengdu 610041 P. R. China
| | - Zhouyuan Yang
- Orthopedic Research Institution Department of Orthopaedics West China Hospital Sichuan University 37# Wuhou Guoxue Road Chengdu 610041 P. R. China
| | - Yue Luo
- Orthopedic Research Institution Department of Orthopaedics West China Hospital Sichuan University 37# Wuhou Guoxue Road Chengdu 610041 P. R. China
| | - Xin Zhao
- Orthopedic Research Institution Department of Orthopaedics West China Hospital Sichuan University 37# Wuhou Guoxue Road Chengdu 610041 P. R. China
| | - Meng Tian
- Neurosurgery Research Laboratory West China Hospital Sichuan University Chengdu Sichuan 610041 P. R. China
| | - Pengde Kang
- Orthopedic Research Institution Department of Orthopaedics West China Hospital Sichuan University 37# Wuhou Guoxue Road Chengdu 610041 P. R. China
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24
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Lu X, Guo H, Li J, Sun T, Xiong M. Recombinant Human Bone Morphogenic Protein-2 Immobilized Fabrication of Magnesium Functionalized Injectable Hydrogels for Controlled-Delivery and Osteogenic Differentiation of Rat Bone Marrow-Derived Mesenchymal Stem Cells in Femoral Head Necrosis Repair. Front Cell Dev Biol 2021; 9:723789. [PMID: 34900987 PMCID: PMC8656218 DOI: 10.3389/fcell.2021.723789] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Abstract
Femoral head necrosis (FHN) is a clinically progressive disease that leads to overwhelming complications without an effective therapeutic approach. In recent decades, transplantation of mesenchymal stem cells (MSCs) has played a promising role in the treatment of FHN in the initial stage; however, the success rate is still low because of unsuitable cell carriers and abridged osteogenic differentiation of the transplanted MSCs. Biopolymeric-derived hydrogels have been extensively applied as effective cell carriers and drug vesicles; they provide the most promising contributions in the fields of tissue engineering and regenerative medicine. However, the clinical potential of hydrogels may be limited because of inappropriate gelation, swelling, mechanical characteristics, toxicity in the cross-linking process, and self-healing ability. Naturally, gelated commercial hydrogels are not suitable for cell injection and infiltration because of their static network structure. In this study, we designed a novel thermogelling injectable hydrogel using natural silk fibroin-blended chitosan (CS) incorporated with magnesium (Mg) substitutes to improve physical cross-linking, stability, and cell osteogenic compatibility. The presented observations demonstrate that the developed injectable hydrogels can facilitate the controlled delivery of immobilized recombinant human bone morphogenic protein-2 (rhBMP-2) and rat bone marrow-derived MSCs (rBMSCs) with greater cell encapsulation efficiency, compatibility, and osteogenic differentiation. In addition, outcomes of in vivo animal studies established promising osteoinductive, bone mineral density, and bone formation rate after implantation of the injectable hydrogel scaffolds. Therefore, the developed hydrogels have great potential for clinical applications of FHN therapy.
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Affiliation(s)
- Xueliang Lu
- Department of Orthopedics, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China
| | - Hongyu Guo
- Clinical Medical College, Henan University of Science and Technology, Luoyang, China
| | - Jiaju Li
- Clinical Medical College, Henan University of Science and Technology, Luoyang, China
| | - Tianyu Sun
- Clinical Medical College, Henan University of Science and Technology, Luoyang, China
| | - Mingyue Xiong
- Department of Orthopedics, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China
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25
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Wu Q, Xu S, Wang F, He B, Wang X, Sun Y, Ning C, Dai K. Double-edged effects caused by magnesium ions and alkaline environment regulate bioactivities of magnesium-incorporated silicocarnotite in vitro. Regen Biomater 2021; 8:rbab016. [PMID: 34484805 PMCID: PMC8411036 DOI: 10.1093/rb/rbab016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/18/2021] [Accepted: 04/01/2021] [Indexed: 12/17/2022] Open
Abstract
Magnesium (Mg) is an important element for its enhanced osteogenic and angiogenic properties in vitro and in vivo, however, the inherent alkalinity is the adverse factor that needs further attention. In order to study the role of alkalinity in regulating osteogenesis and angiogenesis in vitro, magnesium-silicocarnotite [Mg-Ca5(PO4)2SiO4, Mg-CPS] was designed and fabricated. In this study, Mg-CPS showed better osteogenic and angiogenic properties than CPS within 10 wt.% magnesium oxide (MgO), since the adversity of alkaline condition was covered by the benefits of improved Mg ion concentrations through activating Smad2/3-Runx2 signaling pathway in MC3T3-E1 cells and PI3K-AKT signaling pathway in human umbilical vein endothelial cells in vitro. Besides, provided that MgO was incorporated with 15 wt.% in CPS, the bioactivities had declined due to the environment consisting of higher-concentrated Mg ions, stronger alkalinity and lower Ca/P/Si ions caused. According to the results, it indicated that bioactivities of Mg-CPS in vitro were regulated by the double-edged effects, which were the consequence of Mg ions and alkaline environment combined. Therefore, if MgO is properly incorporated in CPS, the improved bioactivities could cover alkaline adversity, making Mg-CPS bioceramics promising in orthopedic clinical application for its enhancement of osteogenesis and angiogenesis in vitro.
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Affiliation(s)
- Qiang Wu
- The Education Ministry Key Lab of Resource Chemistry and Shanghai Key Laboratory of Rare Earth Functional Materials, Shanghai Normal University, Shanghai Key Laboratory of Orthopedic Implant, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639, Zhizaoju Road, Shanghai, Huangpu District 200011, China
| | - Shunxiang Xu
- The Education Ministry Key Lab of Resource Chemistry and Shanghai Key Laboratory of Rare Earth Functional Materials, Shanghai Normal University, No. 100, Guilin Road, Shanghai, Xuhui District 200234, China
| | - Fei Wang
- The Education Ministry Key Lab of Resource Chemistry and Shanghai Key Laboratory of Rare Earth Functional Materials, Shanghai Normal University, No. 100, Guilin Road, Shanghai, Xuhui District 200234, China
| | - Bo He
- The Education Ministry Key Lab of Resource Chemistry and Shanghai Key Laboratory of Rare Earth Functional Materials, Shanghai Normal University, No. 100, Guilin Road, Shanghai, Xuhui District 200234, China
| | - Xin Wang
- Department of Orthopedics Trauma and Microsurgery, Zhongnan Hospital of Wuhan University, No.169, East Lake Road, Wuchang District, Wuhan 430071, China
| | - Ye Sun
- Department of Orthopaedics, The First Affiliated Hospital of Nanjing Medical University, No.300, Guangzhou Road, Drum-tower District, Nanjing, 210029, China
| | - Congqin Ning
- The Education Ministry Key Lab of Resource Chemistry and Shanghai Key Laboratory of Rare Earth Functional Materials, Shanghai Normal University, No. 100, Guilin Road, Shanghai, Xuhui District 200234, China.,State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, No.1295, Dingxi Road, Changning District, Shanghai 200050, China
| | - Kerong Dai
- The Education Ministry Key Lab of Resource Chemistry and Shanghai Key Laboratory of Rare Earth Functional Materials, Shanghai Normal University, Shanghai Key Laboratory of Orthopedic Implant, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639, Zhizaoju Road, Shanghai, Huangpu District 200011, China
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26
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Zhao G, Liu M, Li B, Sun H, Wei B. Clinical observation and finite element analysis of cannulated screw internal fixation in the treatment of femoral neck fracture based on different reduction quality. J Orthop Surg Res 2021; 16:450. [PMID: 34256786 PMCID: PMC8276405 DOI: 10.1186/s13018-021-02580-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 06/24/2021] [Indexed: 02/04/2023] Open
Abstract
Objective Femoral neck fracture is one of the most common bone types. The effect of reduction quality on hip joint function and complications after screw internal fixation is not fully understood. To investigate the clinical efficacy and mechanical mechanism of positive buttress, anatomical reduction, and negative buttress in the treatment of femoral neck fracture after cannulated screw fixation. Methods Retrospective analysis of patients with femoral neck fracture treated with three cannulated screws internal fixation in our hospital from January 2013 to December 2018. According to the quality of fracture reduction, the patients were divided into positive buttress group, anatomical reduction group, and negative buttress group. Basic information such as injury mechanism, time from injury to surgery, Garden classification and Pauwels classification was collected, Harris scores were performed at 3 months, 6 months, and 12 months after surgery, and postoperative complications (femoral head necrosis, femoral neck shortening, and femoral neck nonunion) were collected. At the same time, three groups of finite element models with different reduction quality were established for stress analysis, their stress clouds were observed and the average displacement and stress of the three groups of models were compared. P < 0.05 was used to represent a statistically significant difference. Results A total of 225 cases of unilateral femoral neck fractures were included and followed up for an average of 4.12 ± 0.69 years. There was no significant difference in age, gender, side, injury mechanism, time from injury to surgery, BMI, Garden classification, Pauwels classification, and follow-up time among the three groups (P > 0.05). However, there was significant difference in Harris score at 6 and 12 months after operation among the three groups (P < 0.05), which was higher in the positive buttress group and anatomical reduction group than in the negative buttress group. In addition, the incidence of osteonecrosis of the femoral head in the negative buttress group (32.2%) was greater than that in the anatomical reduction group (13.4%) and the positive buttress group (5.4%) (P < 0.05). In addition, the incidence of femoral neck nonunion and femoral neck shortening in the negative buttress group was also higher than that in the anatomical reduction positive buttress group (P < 0.05). The finite element results showed that the stress and fracture end displacement in the negative buttress group were greater than those in the positive buttress group (P < 0.05). Conclusion Both positive buttress and anatomical reduction in the treatment of femoral neck fracture with cannulated screw internal fixation can obtain better clinical effect and lower postoperative complications. Positive brace support and anatomic reduction can limit the restoration of femoral stress conduction. Therefore, it is not necessary to pursue anatomical reduction too deliberately during surgery, while negative buttress reduction should be avoided.
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Affiliation(s)
- Gan Zhao
- Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.,Department of Sports Medicine, Linyi Traditional Chinese Medicine Hospital, Linyi, 276000, Shandong, China
| | - Ming Liu
- Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.,Department of Pain, Linyi People's Hospital, Linyi, 276000, Shandong Province, China
| | - Bin Li
- Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China
| | - Haizhong Sun
- Department of Orthopedic, Linyi People's Hospital, Linyi, 276000, Shandong Province, China
| | - Biaofang Wei
- Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China. .,Department of Orthopedic, Linyi People's Hospital, Linyi, 276000, Shandong Province, China.
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27
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Klíma K, Ulmann D, Bartoš M, Španko M, Dušková J, Vrbová R, Pinc J, Kubásek J, Ulmannová T, Foltán R, Brizman E, Drahoš M, Beňo M, Čapek J. Zn-0.8Mg-0.2Sr (wt.%) Absorbable Screws-An In-Vivo Biocompatibility and Degradation Pilot Study on a Rabbit Model. MATERIALS (BASEL, SWITZERLAND) 2021; 14:3271. [PMID: 34199249 PMCID: PMC8231803 DOI: 10.3390/ma14123271] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/09/2021] [Accepted: 06/09/2021] [Indexed: 12/20/2022]
Abstract
In this pilot study, we investigated the biocompatibility and degradation rate of an extruded Zn-0.8Mg-0.2Sr (wt.%) alloy on a rabbit model. An alloy screw was implanted into one of the tibiae of New Zealand White rabbits. After 120 days, the animals were euthanized. Evaluation included clinical assessment, microCT, histological examination of implants, analyses of the adjacent bone, and assessment of zinc, magnesium, and strontium in vital organs (liver, kidneys, brain). The bone sections with the implanted screw were examined via scanning electron microscopy and energy dispersive spectroscopy (SEM-EDS). This method showed that the implant was covered by a thin layer of phosphate-based solid corrosion products with a thickness ranging between 4 and 5 µm. Only negligible changes of the implant volume and area were observed. The degradation was not connected with gas evolution. The screws were fibrointegrated, partially osseointegrated histologically. We observed no inflammatory reaction or bone resorption. Periosteal apposition and formation of new bone with a regular structure were frequently observed near the implant surface. The histological evaluation of the liver, kidneys, and brain showed no toxic changes. The levels of Zn, Mg, and Sr after 120 days in the liver, kidneys, and brain did not exceed the reference values for these elements. The alloy was safe, biocompatible, and well-tolerated.
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Affiliation(s)
- Karel Klíma
- Department of Stomatology—Maxillofacial Surgery, General Teaching Hospital and First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic; (K.K.); (D.U.); (M.B.); (M.Š.); (R.V.); (T.U.); (R.F.); (E.B.); (M.D.); (M.B.)
| | - Dan Ulmann
- Department of Stomatology—Maxillofacial Surgery, General Teaching Hospital and First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic; (K.K.); (D.U.); (M.B.); (M.Š.); (R.V.); (T.U.); (R.F.); (E.B.); (M.D.); (M.B.)
| | - Martin Bartoš
- Department of Stomatology—Maxillofacial Surgery, General Teaching Hospital and First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic; (K.K.); (D.U.); (M.B.); (M.Š.); (R.V.); (T.U.); (R.F.); (E.B.); (M.D.); (M.B.)
| | - Michal Španko
- Department of Stomatology—Maxillofacial Surgery, General Teaching Hospital and First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic; (K.K.); (D.U.); (M.B.); (M.Š.); (R.V.); (T.U.); (R.F.); (E.B.); (M.D.); (M.B.)
- Department of Anatomy, First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic
| | - Jaroslava Dušková
- Department of Pathology, First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic;
| | - Radka Vrbová
- Department of Stomatology—Maxillofacial Surgery, General Teaching Hospital and First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic; (K.K.); (D.U.); (M.B.); (M.Š.); (R.V.); (T.U.); (R.F.); (E.B.); (M.D.); (M.B.)
| | - Jan Pinc
- Department of Functional Materials, FZU The Institute of Physics of the Czech Academy of Sciences, Na Slovance 1999/2, 182 21 Prague, Czech Republic;
| | - Jiří Kubásek
- Department of Metals and Corrosion Engineering, University of Chemistry and Technology, Technická 6, 166 28 Prague, Czech Republic;
| | - Tereza Ulmannová
- Department of Stomatology—Maxillofacial Surgery, General Teaching Hospital and First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic; (K.K.); (D.U.); (M.B.); (M.Š.); (R.V.); (T.U.); (R.F.); (E.B.); (M.D.); (M.B.)
| | - René Foltán
- Department of Stomatology—Maxillofacial Surgery, General Teaching Hospital and First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic; (K.K.); (D.U.); (M.B.); (M.Š.); (R.V.); (T.U.); (R.F.); (E.B.); (M.D.); (M.B.)
| | - Eitan Brizman
- Department of Stomatology—Maxillofacial Surgery, General Teaching Hospital and First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic; (K.K.); (D.U.); (M.B.); (M.Š.); (R.V.); (T.U.); (R.F.); (E.B.); (M.D.); (M.B.)
| | - Milan Drahoš
- Department of Stomatology—Maxillofacial Surgery, General Teaching Hospital and First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic; (K.K.); (D.U.); (M.B.); (M.Š.); (R.V.); (T.U.); (R.F.); (E.B.); (M.D.); (M.B.)
| | - Michal Beňo
- Department of Stomatology—Maxillofacial Surgery, General Teaching Hospital and First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic; (K.K.); (D.U.); (M.B.); (M.Š.); (R.V.); (T.U.); (R.F.); (E.B.); (M.D.); (M.B.)
| | - Jaroslav Čapek
- Department of Functional Materials, FZU The Institute of Physics of the Czech Academy of Sciences, Na Slovance 1999/2, 182 21 Prague, Czech Republic;
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Amukarimi S, Mozafari M. Biodegradable magnesium-based biomaterials: An overview of challenges and opportunities. MedComm (Beijing) 2021; 2:123-144. [PMID: 34766139 PMCID: PMC8491235 DOI: 10.1002/mco2.59] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/10/2021] [Accepted: 01/14/2021] [Indexed: 12/26/2022] Open
Abstract
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.
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Affiliation(s)
- Shukufe Amukarimi
- Department of Tissue Engineering & Regenerative Medicine, Faculty of Advanced Technologies in MedicineIran University of Medical Sciences (IUMS)TehranIran
| | - Masoud Mozafari
- Department of Tissue Engineering & Regenerative Medicine, Faculty of Advanced Technologies in MedicineIran University of Medical Sciences (IUMS)TehranIran
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29
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Tang G, Liu Z, Liu Y, Yu J, Wang X, Tan Z, Ye X. Recent Trends in the Development of Bone Regenerative Biomaterials. Front Cell Dev Biol 2021; 9:665813. [PMID: 34026758 PMCID: PMC8138062 DOI: 10.3389/fcell.2021.665813] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/01/2021] [Indexed: 12/12/2022] Open
Abstract
The goal of a biomaterial is to support the bone tissue regeneration process at the defect site and eventually degrade in situ and get replaced with the newly generated bone tissue. Biomaterials that enhance bone regeneration have a wealth of potential clinical applications from the treatment of non-union fractures to spinal fusion. The use of bone regenerative biomaterials from bioceramics and polymeric components to support bone cell and tissue growth is a longstanding area of interest. Recently, various forms of bone repair materials such as hydrogel, nanofiber scaffolds, and 3D printing composite scaffolds are emerging. Current challenges include the engineering of biomaterials that can match both the mechanical and biological context of bone tissue matrix and support the vascularization of large tissue constructs. Biomaterials with new levels of biofunctionality that attempt to recreate nanoscale topographical, biofactor, and gene delivery cues from the extracellular environment are emerging as interesting candidate bone regenerative biomaterials. This review has been sculptured around a case-by-case basis of current research that is being undertaken in the field of bone regeneration engineering. We will highlight the current progress in the development of physicochemical properties and applications of bone defect repair materials and their perspectives in bone regeneration.
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Affiliation(s)
- Guoke Tang
- Department of Orthopedic Surgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Spine Surgery, The Affiliated Zhuzhou Hospital of Xiangya School of Medical CSU, Hunan, China
- Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Zhiqin Liu
- Department of Spine Surgery, The Affiliated Zhuzhou Hospital of Xiangya School of Medical CSU, Hunan, China
| | - Yi Liu
- Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Jiangming Yu
- Department of Orthopedic Surgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xing Wang
- Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Zhihong Tan
- Department of Spine Surgery, The Affiliated Zhuzhou Hospital of Xiangya School of Medical CSU, Hunan, China
| | - Xiaojian Ye
- Department of Orthopedic Surgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
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30
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Chow DHK, Wang J, Wan P, Zheng L, Ong MTY, Huang L, Tong W, Tan L, Yang K, Qin L. Biodegradable magnesium pins enhanced the healing of transverse patellar fracture in rabbits. Bioact Mater 2021; 6:4176-4185. [PMID: 33997501 PMCID: PMC8099917 DOI: 10.1016/j.bioactmat.2021.03.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 03/29/2021] [Accepted: 03/29/2021] [Indexed: 12/20/2022] Open
Abstract
Displaced fractures of patella often require open reduction surgery and internal fixation to restore the extensor continuity and articular congruity. Fracture fixation with biodegradable magnesium (Mg) pins enhanced fracture healing. We hypothesized that fixation with Mg pins and their degradation over time would enhance healing of patellar fracture radiologically, mechanically, and histologically. Transverse patellar fracture surgery was performed on thirty-two 18-weeks old female New Zealand White Rabbits. The fracture was fixed with a pin made of stainless steel or pure Mg, and a figure-of-eight stainless steel band wire. Samples were harvested at week 8 or 12, and assessed with microCT, tensile testing, microindentation, and histology. Microarchitectural analysis showed that Mg group showed 12% higher in the ratio of bone volume to tissue volume at week 8, and 38.4% higher of bone volume at week 12. Tensile testing showed that the failure load and stiffness of Mg group were 66.9% and 104% higher than the control group at week 8, respectively. At week 12, Mg group was 60.8% higher in ultimate strength than the control group. Microindentation showed that, compared to the Control group, Mg group showed 49.9% higher Vickers hardness and 31% higher elastic modulus at week 8 and 12, respectively. At week 12, the new bone of Mg group remodelled to laminar bone, but those of the control group remained woven bone-like. Fixation of transverse patellar fracture with Mg pins and its degradation enhanced new bone formation and mechanical properties of the repaired patella compared to the Control group. Kirschner wires (K-wire) with tension band wire is widely used fixation implants for repairing of displaced patellar fractures. Fixation of patellar fracture with Mg pins enhanced new bone formation and mechanical properties of the repaired patella. With a stainless steel tension band wire, Mg pins may be an alternative to K-wire for fixation of patellar fractures.
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Affiliation(s)
- Dick Ho Kiu Chow
- Musculoskeletal Research Laboratory, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China.,Innovative Orthopaedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Jiali Wang
- Musculoskeletal Research Laboratory, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China.,Innovative Orthopaedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Peng Wan
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang, China.,School of Materials Science and Engineering, Dongguan University of Technology, Dongguan, China
| | - Lizhen Zheng
- Musculoskeletal Research Laboratory, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China.,Innovative Orthopaedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Michael Tim Yun Ong
- Musculoskeletal Research Laboratory, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Le Huang
- Musculoskeletal Research Laboratory, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China.,Innovative Orthopaedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Wenxue Tong
- Musculoskeletal Research Laboratory, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China.,Innovative Orthopaedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Lili Tan
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang, China
| | - Ke Yang
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang, China
| | - Ling Qin
- Musculoskeletal Research Laboratory, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China.,Innovative Orthopaedic Biomaterial and Drug Translational Research Laboratory, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
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31
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Lin J, Nguyen NYT, Zhang C, Ha A, Liu HH. Antimicrobial Properties of MgO Nanostructures on Magnesium Substrates. ACS OMEGA 2020; 5:24613-24627. [PMID: 33015479 PMCID: PMC7528336 DOI: 10.1021/acsomega.0c03151] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/25/2020] [Indexed: 05/19/2023]
Abstract
Magnesium (Mg) and its alloys have attracted increasing attention in recent years as medical implants for repairing musculoskeletal injuries because of their promising mechanical and biological properties. However, rapid degradation of Mg and its alloys in physiological fluids limited their clinical translation because the accumulation of hydrogen (H2) gas and fast release of OH- ions could adversely affect the healing process. Moreover, infection is a major concern for internally implanted devices because it could lead to biofilm formation, prevent host cell attachment on the implants, and interfere osseointegration, resulting in implant failure or other complications. Fabricating nanostructured magnesium oxide (MgO) on magnesium (Mg) substrates is promising in addressing both problems because it could slow down the degradation process and improve the antimicrobial activity. In this study, nanostructured MgO layers were created on Mg substrates using two different surface treatment techniques, i.e., anodization and electrophoretic deposition (EPD), and cultured with Staphylococcus aureus in vitro to determine their antimicrobial properties. At the end of the 24-h bacterial culture, the nanostructured MgO layers on Mg prepared by anodization or EPD both showed significant bactericidal effect against S. aureus. Thus, nanostructured MgO layers on Mg are promising for reducing implant-related infections and complications and should be further explored for clinical translation toward antimicrobial biodegradable implants.
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Affiliation(s)
- Jiajia Lin
- Material
Science & Engineering Program, University
of California, Riverside, 900 University Avenue, Riverside, California 92521, United States
| | - Nhu-Y Thi Nguyen
- Microbiology
Program, University of California, Riverside, 900 University Avenue, Riverside, California 92521, United States
| | - Chaoxing Zhang
- Material
Science & Engineering Program, University
of California, Riverside, 900 University Avenue, Riverside, California 92521, United States
| | - Alexandra Ha
- Department
of Bioengineering, University of California,
Riverside, 900 University
Avenue, Riverside, California 92521, United States
| | - Huinan Hannah Liu
- Material
Science & Engineering Program, University
of California, Riverside, 900 University Avenue, Riverside, California 92521, United States
- Microbiology
Program, University of California, Riverside, 900 University Avenue, Riverside, California 92521, United States
- Department
of Bioengineering, University of California,
Riverside, 900 University
Avenue, Riverside, California 92521, United States
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