Preclinical investigation of an innovative magnesium-based bone graft substitute for potential orthopaedic applications

Potential use of extracted flax seed mucilage in the construction of macroporous cryo-scaffolds

Mucilage is a natural source of polysaccharides that has recently attracted attention for use in biomaterial production. It attracts attention with its easy and fast extraction, biocompatibility, high water retention capacity, and biodegradability. Although there are studies on the characterization of mucilage obtained from different plant sources, the interaction of this polymer with other polymers and its potential to form new biomaterials have not yet been sufficiently investigated. Based on this, in this study, the potential of mucilage extracted from flaxseed for the production of cryogels for tissue engineering applications was demonstrated. Firstly, yield, basic physicochemical properties, morphology, and surface charge-dependent isoelectric point determination studies were carried out for the characterization of the extracted mucilage. The successful preparation of mucilage was evaluated for the construction of cryo-scaffolds and 3D, spongy, and porous structures were obtained in the presence of chitosan and polyvinyl alcohol polymers. A heterogeneous morphology with interconnected macro and micro porosity in the range of approximately 85-115 m pore diameter was exhibited. Due to the high hydrophilic structure of the mucilage, which is attached to the structure with weak hydrogen bonds, the contact angle values of the scaffolds were obtained below 80° and they showed the ability to absorb 1000 times their dry weight in approximately 30 min. As a preliminary optimization study for the evaluation of mucilage in cryogel formation, this work introduced a new construct to be developed as wound dressing scaffold for deep and chronic wounds.

Pioneering nanomedicine in orthopedic treatment care: a review of current research and practices

A developing use of nanotechnology in medicine involves using nanoparticles to administer drugs, genes, biologicals, or other materials to targeted cell types, such as cancer cells. In healthcare, nanotechnology has brought about revolutionary changes in the treatment of various medical and surgical conditions, including in orthopedic. Its clinical applications in surgery range from developing surgical instruments and suture materials to enhancing imaging techniques, targeted drug delivery, visualization methods, and wound healing procedures. Notably, nanotechnology plays a significant role in preventing, diagnosing, and treating orthopedic disorders, which is crucial for patients' functional rehabilitation. The integration of nanotechnology improves standards of patient care, fuels research endeavors, facilitates clinical trials, and eventually improves the patient's quality of life. Looking ahead, nanotechnology holds promise for achieving sustained success in numerous surgical disciplines, including orthopedic surgery, in the years to come. This review aims to focus on the application of nanotechnology in orthopedic surgery, highlighting the recent development and future perspective to bridge the bridge for clinical translation.

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

Background

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

Methods

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

Results

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

Conclusion

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

The translational potential of this article

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

Endowing biodegradable Zinc implants with dual-function of antibacterial ability and osteogenic activity by micro-addition of Mg and Ag (≤ 0.1 wt.%)

Infection remains the devastating complications associated with surgical fixation of bones fractured during trauma. In this study, we report a low-alloyed Zn-Mg-Ag that simultaneously has optimized strength degeneration profiles during degradation, outstanding antibacterial efficacy and osteogenic activity. Our results showed that Zn-0.05Mg-0.1Ag alloy had favorable mechanical properties (UTS: 247.8 ± 1.6 MPa, Elong.: 35 ± 2.2 %) and presented a better hold of mechanical integrity than pure Zn during 28 days corrosion, 2.6 % vs. 18.7 % reduction. After one-year of natural aging, the alloy still preserved an elongation of 24.07 ± 3.84 %. As verified by microbial cultures, Zn-0.05Mg-0.1Ag alloy demonstrated high antibacterial performance against Gram-positive and Gram-negative strains, as well as antibiotic-resistant strains (MRSA) in vitro and in vivo due to the synergistic antibacterial actions of Zn²⁺ and Ag⁺. Meanwhile, Zn-Mg-Ag alloy also exhibited enhanced viability, osteogenic differentiation, and gene expressions of osteoblasts in vitro, as well as promoted osteogenic activity than pure Zn in the femoral condyle defect repair model. The co-releasing of Zn, Mg and Ag ions did not induce toxic side effects. Collectively, low alloyed Zn-0.05Mg-0.1Ag indicated long-lasting mechanical integrity during degradation, and presented the ability to synergistically inhibit bacteria and promote osteogenesis, possessing tremendous potential in treating implant-associated infections. STATEMENT OF SIGNIFICANCE: Infection after fracture fixation (IAFF) remains the most common and serious side effects of orthopedic surgery. Additionally, widespread antibiotic use contributes to the development of multi-drug resistant bacteria such as methicillin-resistant staphylococcus aureus (MRSA), which exacerbates IAFF treatment and prevention. IAFF treatment and prevention remain clinically challenging, so implants with dual antibacterial and osteogenic functions are in high demand. The antibacterial efficacy and osteogenic activity of low-alloyed Zn-Mg-Ag (≤0.1 wt.% Mg, Ag) alloys were investigated in vitro and in vivo. The results showed that micro addition of Mg and Ag could significantly improve osseointegration function, mechanical properties, and antibacterial performance. These quantification findings shed new light on the development and understanding of dual functional Zn-based orthopedic implants.

Role of Biomaterials Used for Periodontal Tissue Regeneration-A Concise Evidence-Based Review

Periodontal infections are noncommunicable chronic inflammatory diseases of multifactorial origin that can induce destruction of both soft and hard tissues of the periodontium. The standard remedial modalities for periodontal regeneration include nonsurgical followed by surgical therapy with the adjunctive use of various biomaterials to achieve restoration of the lost tissues. Lately, there has been substantial development in the field of biomaterial, which includes the sole or combined use of osseous grafts, barrier membranes, growth factors and autogenic substitutes to achieve tissue and bone regeneration. Of these, bone replacement grafts have been widely explored for their osteogenic potential with varied outcomes. Osseous grafts are derived from either human, bovine or synthetic sources. Though the biologic response from autogenic biomaterials may be better, the use of bone replacement synthetic substitutes could be practical for clinical practice. This comprehensive review focuses initially on bone graft replacement substitutes, namely ceramic-based (calcium phosphate derivatives, bioactive glass) and autologous platelet concentrates, which assist in alveolar bone regeneration. Further literature compilations emphasize the innovations of biomaterials used as bone substitutes, barrier membranes and complex scaffold fabrication techniques that can mimic the histologically vital tissues required for the regeneration of periodontal apparatus.

Mg-, Zn-, and Fe-Based Alloys With Antibacterial Properties as Orthopedic Implant Materials

Implant-associated infection (IAI) is one of the major challenges in orthopedic surgery. The development of implants with inherent antibacterial properties is an effective strategy to resolve this issue. In recent years, biodegradable alloy materials have received considerable attention because of their superior comprehensive performance in the field of orthopedic implants. Studies on biodegradable alloy orthopedic implants with antibacterial properties have gradually increased. This review summarizes the recent advances in biodegradable magnesium- (Mg-), iron- (Fe-), and zinc- (Zn-) based alloys with antibacterial properties as orthopedic implant materials. The antibacterial mechanisms of these alloy materials are also outlined, thus providing more basis and insights on the design and application of biodegradable alloys with antibacterial properties as orthopedic implants.

In Vitro Corrosion Performance of As-Extruded Mg–Gd–Dy–Zr Alloys for Potential Orthopedic Applications

In this study, different contents of rare earth elements with high solid solubility (Gd and Dy) were added into Mg and fabricated through homogenization and hot extrusion processes that enable few second phase formation to efficaciously inhibit the galvanic corrosion. The microstructure and phase characterization of the as-extruded Mg–Gd–Dy–Zr alloys were analyzed by scanning electron microscopy, electron backscattered diffraction, and X-ray diffraction. The in vitro biodegradation behavior of the as-extruded Mg–Gd–Dy–Zr alloys was investigated via the electrochemical measurement and immersion test. The results revealed that all the as-extruded alloys with different RE additions exerted fully recrystallized microstructures. The average grain size was appropriately 20 μm to 30 μm for all alloys and gradually increased by adding more RE. Only a few tiny second-phase particles less than 5 μm dispersed for all the samples and the volume fraction of particles increased slightly with the increase in RE content. The as-extruded Mg–Gd–Dy–Zr alloys with low RE content (GD0.6) allowed for a satisfactory corrosion resistance in Hank’s solution with a controlled corrosion rate less than 0.5 mm/year, which is considered as the tolerance limit for the corrosion rate of orthopedic implants. This study provides a cost-effective choice for promoting biodegradable magnesium alloys for potential orthopedic applications with low rare earth content in Mg alloys.

The advances in nanomedicine for bone and cartilage repair

With the gradual demographic shift toward an aging and obese society, an increasing number of patients are suffering from bone and cartilage injuries. However, conventional therapies are hindered by the defects of materials, failing to adequately stimulate the necessary cellular response to promote sufficient cartilage regeneration, bone remodeling and osseointegration. In recent years, the rapid development of nanomedicine has initiated a revolution in orthopedics, especially in tissue engineering and regenerative medicine, due to their capacity to effectively stimulate cellular responses on a nanoscale with enhanced drug loading efficiency, targeted capability, increased mechanical properties and improved uptake rate, resulting in an improved therapeutic effect. Therefore, a comprehensive review of advancements in nanomedicine for bone and cartilage diseases is timely and beneficial. This review firstly summarized the wide range of existing nanotechnology applications in the medical field. The progressive development of nano delivery systems in nanomedicine, including nanoparticles and biomimetic techniques, which are lacking in the current literature, is further described. More importantly, we also highlighted the research advancements of nanomedicine in bone and cartilage repair using the latest preclinical and clinical examples, and further discussed the research directions of nano-therapies in future clinical practice.

Magnesium Modified β-Tricalcium Phosphate Induces Cell Osteogenic Differentiation In Vitro and Bone Regeneration In Vivo

In vitro, in vivo, and clinical studies have shown how the physicochemical and biological properties of β-tricalcium phosphate (β-TCP) work in bone regeneration. This study aimed to improve the properties of β-TCP by achieving optimum surface and bulk β-TCP chemical/physical properties through the hydrothermal addition of magnesium (Mg) and to later establish the biocompatibility of β-TCP/Mg for bone grafting and tissue engineering treatments. Multiple in vitro and in vivo analyses were used to complete β-TCP/Mg physicochemical and biological characterization. The addition of MgO brought about a modest rise in the number of β-TCP surface particles, indicating improvements in alkaline phosphatase (ALP) activity on day 21 (p < 0.05) and in the WST-1assay on all days (p < 0.05), with a corresponding increase in the upregulation of ALP and bone sialoprotein. SEM analyses stated that the surfaces of the β-TCP particles were not altered after the addition of Mg. Micro-CT and histomorphometric analysis from rabbit calvaria critical defects resulted in β-TCP/Mg managing to reform more new bone than the control defects and β-TCP control at 2, 6, and 8 weeks (* p ≤ 0.05, ** p ≤ 0.01, *** p ≤ 0.001, and **** p ≤ 0.0001). The hydrothermal addition of MgO to the β-TCP surfaces ameliorated its biocompatibility without altering its surface roughness resulting from the elemental composition while enhancing cell viability and proliferation, inducing more bone regeneration by osteoconduction in vivo and osteoblastic differentiation in vitro.

Hydroxyapatite coating on an aluminum/bioplastic scaffold for bone tissue engineering

Three-dimensional printing can produce scaffolds with shapes and dimensions tailored for practical clinical applications. Enhanced osteoconductivity of such scaffolds is generally desired. Hydroxyapatite (HA) is an inorganic ceramic that can be used to coat such scaffolds and to accelerate healing during the bone restoration process. In this study, HA-coated aluminum/bioplastic scaffolds were fabricated, and their structural characteristics and osteoconductivity were evaluated. Aluminum/bioplastic scaffolds were fabricated by three-dimensional printing, and HA slurries with solids loadings of 10–20 vol% were used for coating. As solids loadings increased, the thickness of the coating layers slightly increased, whereas pore sizes decreased. The average compressive strength was comparable to that of cancellous bone. Potential osteoconductivity was tested by simulated body fluid immersion for 28 days, and the formation of the HA phase on the surface along with a weight increase indicates the potential bioactivity of the samples.

Schematic representation of hydroxyapatite synthesis, 3D printing of Al/PLA scaffolds, and hydrothermal coating of the scaffolds. The best uniformity of coating and the greatest compressive strength were observed in samples coated with 10 vol% slurry.

The effect of different coatings on bone response and degradation behavior of porous magnesium-strontium devices in segmental defect regeneration

Regeneration of long-bone segmental defects remains a challenge for orthopedic surgery. Current treatment options often require several revision procedures to maintain acceptable alignment and achieve osseous healing. A novel hollow tubular system utilizing magnesium-strontium (Mg-Sr) alloy with autogenous morselized bone filled inside to repair segmental defects was developed. To improve the corrosion and biocompatible properties, two coatings, Ca-P and Sr-P coatings, were prepared on surface of the implants. Feasibility of applying these coated implants was systematically evaluated in vitro and in vivo, and simultaneously to have a better understanding on the relationship of degradation and bone regeneration on the healing process. According to the in vitro corrosion study by electrochemical measurements, greater corrosion resistance was obtained for Ca-P coated sample, and attributed to the double-layer protective structure. The cytotoxicity and alkaline phosphatase (ALP) assays demonstrated enhanced bioactivity for Sr-P coated group because of the long-lasting release of beneficial Sr2+. At 12 weeks post-implantation with Mg-Sr alloy porous device, the segmental defects were effectively repaired with respect to both integrity and continuity. In addition, compared with the Ca-P coated implant, the Sr-P coated implant was more proficient at promoting bone formation and mineralization. In summary, the Sr-P coated implants have bioactive properties and exceptional durability, and promote bone healing that is close to the natural rate, implying their potential application for the regeneration of segmental defects.

Bone Grafts and Substitutes in Dentistry: A Review of Current Trends and Developments

After tooth loss, bone resorption is irreversible, leaving the area without adequate bone volume for successful implant treatment. Bone grafting is the only solution to reverse dental bone loss and is a well-accepted procedure required in one in every four dental implants. Research and development in materials, design and fabrication technologies have expanded over the years to achieve successful and long-lasting dental implants for tooth substitution. This review will critically present the various dental bone graft and substitute materials that have been used to achieve a successful dental implant. The article also reviews the properties of dental bone grafts and various dental bone substitutes that have been studied or are currently available commercially. The various classifications of bone grafts and substitutes, including natural and synthetic materials, are critically presented, and available commercial products in each category are discussed. Different bone substitute materials, including metals, ceramics, polymers, or their combinations, and their chemical, physical, and biocompatibility properties are explored. Limitations of the available materials are presented, and areas which require further research and development are highlighted. Tissue engineering hybrid constructions with enhanced bone regeneration ability, such as cell-based or growth factor-based bone substitutes, are discussed as an emerging area of development.

Early osteoimmunomodulatory effects of magnesium-calcium-zinc alloys

Today, substantial attention is given to biomaterial strategies for bone regeneration, and among them, there is a growing interest in using immunomodulatory biomaterials. The ability of a biomaterial to induce neo vascularization and macrophage polarization is a major factor in defining its success. Magnesium (Mg)-based degradable alloys have attracted significant attention for bone regeneration owing to their biodegradability and potential for avoiding secondary removal surgeries. However, there is insufficient evidence in the literature regarding the early inflammatory responses to these alloys in vivo. In this study, we investigated the early body responses to Mg-0.45wt%Zn-0.45wt%Ca pin-shaped alloy (known as ZX00 alloy) in rat femora 2, 5, and 10 days after implantation. We used 3D micro computed tomography (µCT), histological, immunohistochemical, histomorphometrical, and small angle X-ray scattering (SAXS) analyses to study new bone formation, early macrophage polarization, neo vascularization, and bone quality at the implant bone interface. The expression of macrophage type 2 biological markers increased significantly after 10 days of Mg alloy implantation, indicating its potential in stimulating macrophage polarization. Our biomineralization results using µCT as well as histological stained sections did not indicate any statistically significant differences between different time points for both groups. The activity of alkaline phosphatase (ALP) and Runt-related transcription factor 2 (Runx 2) biological markers decreased significantly for Mg group, indicating less osteoblast activity. Generally, our results supported the potential of ZX00 alloy to enhance the expression of macrophage polarization in vivo; however, we could not observe any statistically significant changes regarding biomineralization.

Mechanical and biocorrosive properties of magnesium-aluminum alloy scaffold for biomedical applications

This study investigates the morphology, microstructure, compressive behavior, biocorrosion properties, and cytocompatibility of magnesium (Mg)-aluminum (Al) alloy (AE42) scaffolds for their potential use in biodegradable biomedical applications. Mg alloy scaffolds were successfully synthesized via a camphene-based freeze-casting process with precisely controlled heat treatment. The average porosity was approximately 52% and the median pore diameter was ∼13 μm. Salient deformation mechanisms were identified using acoustic emission (AE) signals and adaptive sequential k-means (ASK) analysis. Twinning, dislocation slip, strut bending, and collapse were dominant during compressive deformation. Nonetheless, the overall compressive behavior and deformation mechanisms were similar to those of bulk Mg based on ASK analysis. The corrosion potential of the Mg alloy scaffold (-1.44 V) was slightly higher than that of bulk AE42 (-1.60 V), but the corrosion rate of the Mg alloy scaffold was faster than that of bulk AE42 due to the enhanced surface area of the Mg alloy scaffold. As a result of cytocompatibility evaluation following ISO10993-5, the concentration of the Mg alloy scaffold extract reducing cell growth rate to 50% (IC₅₀) was 10.7%, which is higher (less toxic) than 5%, suggesting no severe inflammation by implantation into muscle.

The physicochemical and biomechanical profile of forsterite and its osteogenic potential of mesenchymal stromal cells

It has been demonstrated that nanocrystalline forsterite powder synthesised using urea as a fuel in sol-gel combustion method had produced a pure forsterite (FU) and possessed superior bioactive characteristics such as bone apatite formation and antibacterial properties. In the present study, 3D-scaffold was fabricated using nanocrystalline forsterite powder in polymer sponge method. The FU scaffold was used in investigating the physicochemical, biomechanics, cell attachment, in vitro biocompatibility and osteogenic differentiation properties. For physicochemical characterisation, Fourier-transform infrared spectroscopy (FTIR), Energy dispersive X-ray (EDX), X-ray diffraction (XRD), Raman spectroscopy, X-ray photoemission spectrometer (XPS) and Brunauer-Emmett-Teller (BET) were used. FTIR, EDX, XRD peaks and Raman spectroscopy demonstrated correlating to FU. The XPS confirmed the surface chemistry associating to FU. The BET revealed FU scaffold surface area of 12.67 m2/g and total pore size of 0.03 cm3/g. Compressive strength of the FU scaffold was found to be 27.18 ± 13.4 MPa. The human bone marrow derived mesenchymal stromal cells (hBMSCs) characterisation prior to perform seeding on FU scaffold verified the stromal cell phenotypic and lineage commitments. SEM, confocal images and presto blue viability assay suggested good cell attachment and proliferation of hBMSCs on FU scaffold and comparable to a commercial bone substitutes (cBS). Osteogenic proteins and gene expression from day 7 onward indicated FU scaffold had a significant osteogenic potential (p<0.05), when compared with day 1 as well as between FU and cBS. These findings suggest that FU scaffold has a greater potential for use in orthopaedic and/or orthodontic applications.

Bone regeneration of hollow tubular magnesium‑strontium scaffolds in critical-size segmental defects: Effect of surface coatings

Segmental defects are formidable challenges for orthopedic surgeons that are caused by large osseous defects such as open injury, comminuted fracture as well as other severe traumas and infection. Current treatment options have practical and clinical shortcomings, calling for innovative bone graft materials. This study is related to hollow tubular magnesium‑strontium (MgSr) alloy scaffolds with autologous morselized bone filled inside and three different coatings were individually applied on MgSr scaffolds, respectively, to study the effects of degradation and bioactivity of the grafts on new bone growth. The optimal coating method was screened using immersion tests, cell proliferation and adhesion, alkaline phosphatase (ALP) assay in vitro, and 4 weeks' implantation in a critical-size segmental defect in vivo. More new bone formation was observed by radiographic tests and histology along the ulna defects, when magnesium scaffold grafts were implanted. Meanwhile, depression occurred for blank control group with only autologous morselized bone filled, because of rapid absorption rate of morselized bone during initial implantation. Therefore, biodegradable MgSr alloy grafts showed their potential application in treating the critical-size segmental defects. As for different coating methods, CaP chemically deposited (CaP) coated sample showed least H₂ evolution in vivo, demonstrating highest corrosion resistance and relative stable interfaces, however, the least beneficial ion release meanwhile. Micro-arc oxidation coating (MAO) degraded faster comparing with CaP, while with the main composition of MgO. They both indicate insufficient bioactivity in bone formation. The results suggest superior combination of bioactive surface, beneficial ions release and appropriate corrosion rate of Strontium phosphate conversion (SrP) coating, indicating superior comprehensive oeteoconductive and osteoinductive properties of coatings on hollow tubular MgSr alloy scaffold.

An innovative Mg/Ti hybrid fixation system developed for fracture fixation and healing enhancement at load-bearing skeletal site

Magnesium (Mg) is a potential biomaterial suitable for developing biodegradable orthopaedic implants, especially as internal fixators for fracture fixation at non-load bearing skeletal sites. However, Mg alone cannot provide sufficient mechanical support for stable fracture fixation at load bearing sites due to its rapid degradation in the early stage after implantation. In consideration of the strengths and weaknesses of Mg, we developed an innovative magnesium/titanium (Mg/Ti) hybrid fixation system for long bone fracture fixation and investigated the fixation efficacy. The finite element analysis (FEA) results indicated that the Mg/Ti hybrid fixation system provided sufficient mechanical support for fracture fixation at load-bearing skeletal site. As a proof-of-concept, we performed a "Z-shaped" open osteotomy at the mid-shaft of rabbit tibia. For comparison, the animals were divided into two groups: Mg/Ti group (fixated with Mg screws and Ti fixators) and Ti control group (fixated with Ti screws and Ti fixators). The radiographic, four-point bending mechanical test, histological and histomorphometric analysis were postoperatively performed in a temporal manner up to 12 weeks. Both X-ray and micro-CT images of the Mg/Ti group showed a larger callus (14.7% at 3rd week and 24.8% at 6th week, n = 5-7, p < 0.05) in the regions of interest (ROIs) over time, especially at the opposite cortex of the fixation plate. At the 12th week post-operation, the biomechanical test result indicated that the rabbit tibia in the Mg/Ti group healed better and the overall mechanical strength was approximately 3-fold higher (n = 8, p < 0.05) than that at 6th week. Furthermore, the FEA revealed that the Mg/Ti group had a higher mechanical strength (19.5% at week 6 and 31.5% at week 12) at the specified ROI and resulted in an earlier and faster endochondral ossification (68.0% at week 3 and 71.4% at week 6) with a higher expression of osteocalcin (54.0%) and collagen I (34.2%) than the Ti control group (n = 4, p < 0.05). Further evaluation suggested that a higher expression of calcitonin gene-related peptide (CGRP), a known osteogenic neuron peptide, in the fracture callus of the Mg/Ti group might be a major underlying mechanism of enhanced fracture healing attributed to the release of Mg ions during the degradation of Mg screws.

Biodegradable Magnesium Alloys Developed as Bone Repair Materials: A Review

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

Bacterial inhibition potential of 3D rapid-prototyped magnesium-based porous composite scaffolds--an in vitro efficacy study

Bone infections are common in trauma-induced open fractures with bone defects. Therefore, developing anti-infection scaffolds for repairing bone defects is desirable. This study develoepd novel Mg-based porous composite scaffolds with a basal matrix composed of poly(lactic-co-glycolicacid) (PLGA) and tricalcium phosphate (TCP). A unique low-temperature rapid prototyping technology was used to fabricate the scaffolds, including PLGA/TCP (PT), PLGA/TCP/5%Mg (PT5M), PLGA/TCP/10%Mg (PT10M), and PLGA/TCP/15%Mg (PT15M). The bacterial adhesion and biofilm formation of Staphylococcus aureus were evaluated. The results indicated that the Mg-based scaffolds significantly inhibited bacterial adhesion and biofilm formation compared to PT, and the PT10M and PT15M exhibited significantly stronger anti-biofilm ability than PT5M. In vitro degratation tests revealed that the degradation of the Mg-based scaffolds caused an increase of pH, Mg(2+) concentration and osmolality, and the increased pH may be one of the major contributing factors to the antibacterial function of the Mg-based scaffolds. Additionally, the PT15M exhibited an inhibitory effect on cell adhesion and proliferation of MC3T3-E1 cells. In conclusion, the PLGA/TCP/Mg scaffolds could inhibit bacterial adhesion and biofilm formation, and the PT10M scaffold was considered to be an effective composition with considerable antibacterial ability and good cytocompatibility.

Biodegradable Materials for Bone Repair and Tissue Engineering Applications

This review discusses and summarizes the recent developments and advances in the use of biodegradable materials for bone repair purposes. The choice between using degradable and non-degradable devices for orthopedic and maxillofacial applications must be carefully weighed. Traditional biodegradable devices for osteosynthesis have been successful in low or mild load bearing applications. However, continuing research and recent developments in the field of material science has resulted in development of biomaterials with improved strength and mechanical properties. For this purpose, biodegradable materials, including polymers, ceramics and magnesium alloys have attracted much attention for osteologic repair and applications. The next generation of biodegradable materials would benefit from recent knowledge gained regarding cell material interactions, with better control of interfacing between the material and the surrounding bone tissue. The next generations of biodegradable materials for bone repair and regeneration applications require better control of interfacing between the material and the surrounding bone tissue. Also, the mechanical properties and degradation/resorption profiles of these materials require further improvement to broaden their use and achieve better clinical results.

Degradation and biological properties of Ca-P contained micro-arc oxidation self-sealing coating on pure magnesium for bone fixation

Poor corrosion resistance is one of the main disadvantages for biodegradable magnesium-based metals, especially applied for bone fixation, where there is a high demand of bio-mechanical strength and stability. Surface coating has been proved as an effective method to control the in vivo degradation. In this study a Ca-P self-sealing micro-arc oxidation (MAO) coating was studied to verify its efficacy and biological properties by in vitro and in vivo tests. It was found that the MAO coating could effectively retard the degradation according to immersion and electrochemical tests as well as 3D reconstruction by X-ray tomography after implantation. The MAO coating exhibited no toxicity and could stimulate the new bone formation. Therefore, the Ca-P self-sealing MAO coating could be a potential candidate for application of biodegradable Mg-based implant in bone fixations.