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Ahmed E, Mulay P, Ramirez C, Tirado-Mansilla G, Cheong E, Gormley AJ. Mapping Biomaterial Complexity by Machine Learning. Tissue Eng Part A 2024. [PMID: 39135398 DOI: 10.1089/ten.tea.2024.0067] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2024] Open
Abstract
Biomaterials often have subtle properties that ultimately drive their bespoke performance. Given this nuanced structure-function behavior, the standard scientific approach of one experiment at a time or design of experiment methods is largely inefficient for the discovery of complex biomaterials. More recently, high-throughput experimentation coupled with machine learning methods has matured beyond expert users allowing scientists and engineers from diverse backgrounds to access these powerful data science tools. As a result, we now have the opportunity to strategically utilize all available data from high-throughput experiments to train efficacious models and map the structure-function behavior of biomaterials for their discovery. Herein, we discuss this necessary shift to data-driven determination of structure-function properties of biomaterials as we highlight how machine learning is leveraged in identifying physicochemical cues for biomaterials in tissue engineering, gene delivery, drug delivery, protein stabilization, and antifouling materials. We also discuss data-mining approaches that are coupled with machine learning to map biomaterial functions that reduce the load on experimental approaches for faster biomaterial discovery. Ultimately, harnessing the prowess of machine learning will lead to accelerated discovery and development of optimal biomaterial designs.
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Affiliation(s)
- Eman Ahmed
- Department of Biomedical Engineering, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Prajakatta Mulay
- Department of Biomedical Engineering, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Cesar Ramirez
- Department of Biomedical Engineering, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Gabriela Tirado-Mansilla
- Department of Biomedical Engineering, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Eugene Cheong
- Department of Biomedical Engineering, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
| | - Adam J Gormley
- Department of Biomedical Engineering, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA
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Cojocaru VD, Șerban N, Cojocaru EM, Zărnescu-Ivan N, Gălbinașu BM. The Effect of Solution Treatment Duration on the Microstructural and Mechanical Properties of a Cold-Deformed-by-Rolling Ti-Nb-Zr-Ta-Sn-Fe Alloy. MATERIALS (BASEL, SWITZERLAND) 2024; 17:864. [PMID: 38399115 PMCID: PMC10890699 DOI: 10.3390/ma17040864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/21/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024]
Abstract
The study presented in this paper is focused on the effect of varying the solution treatment duration on both the microstructural and mechanical properties of a cold-deformed by rolling Ti-30Nb-12Zr-5Ta-2Sn-1.25Fe (wt.%) alloy, referred to as TNZTSF. Cold-crucible induction using the levitation synthesis technique, conducted under an argon-controlled atmosphere, was employed to fabricate the TNZTSF alloy. After synthesis, the alloy underwent cold deformation by rolling, reaching a total deformation degree (total applied thickness reduction) of 60%. Subsequently, a solution treatment was conducted at 850 °C, with varying treatment durations ranging from 2 to 30 min in 2 min increments. X-ray diffraction (XRD) and scanning electron microscopy (SEM) techniques were utilized for the structural analysis, while the mechanical properties were assessed using both tensile and hardness testing. The findings indicate that (i) in both the cold-deformed-by-rolling and solution-treated states, the TNZTSF alloy exhibits a microstructure consisting of a single β-Ti phase; (ii) in the solution-treated state, the microstructure reveals a rise in the average grain size and a decline in the internal average microstrain as the duration of the solution treatment increases; and (iii) owing to the β-phase stability, a favorable mix of elevated strength and considerable ductility properties can be achieved.
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Affiliation(s)
- Vasile Dănuț Cojocaru
- Faculty of Materials Science and Engineering, National University of Science and Technology Politehnica of Bucharest, 060042 Bucharest, Romania; (V.D.C.); (N.Ș.); (E.M.C.)
| | - Nicolae Șerban
- Faculty of Materials Science and Engineering, National University of Science and Technology Politehnica of Bucharest, 060042 Bucharest, Romania; (V.D.C.); (N.Ș.); (E.M.C.)
| | - Elisabeta Mirela Cojocaru
- Faculty of Materials Science and Engineering, National University of Science and Technology Politehnica of Bucharest, 060042 Bucharest, Romania; (V.D.C.); (N.Ș.); (E.M.C.)
| | - Nicoleta Zărnescu-Ivan
- Faculty of Materials Science and Engineering, National University of Science and Technology Politehnica of Bucharest, 060042 Bucharest, Romania; (V.D.C.); (N.Ș.); (E.M.C.)
| | - Bogdan Mihai Gălbinașu
- Dental Medicine Faculty, University of Medicine and Pharmacy “Carol Davila” Bucharest, 020021 Bucharest, Romania;
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Bonanni R, Abbondante L, Cariati I, Gasbarra E, Tarantino U. Metallosis after Hip Arthroplasty Damages Skeletal Muscle: A Case Report. Geriatrics (Basel) 2023; 8:92. [PMID: 37736892 PMCID: PMC10514854 DOI: 10.3390/geriatrics8050092] [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: 08/10/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/23/2023] Open
Abstract
Good musculoskeletal quality dramatically influences the outcome of an arthroplasty operation in geriatric patients, as well as is a key element for optimal osseointegration. In this context, metallosis is a complication associated with the type of prosthesis used, as implants with a chromium-cobalt interface are known to alter the bone microarchitecture and reduce the ratio of muscle to fat, resulting in lipid accumulation. Therefore, the aim of our study was to investigate possible muscle changes by histological, morphometric, and immunohistochemical analyses in a patient undergoing hip replacement revision with elevated blood and urinary concentrations of chromium and cobalt. Interestingly, the muscle tissue showed significant structural changes and a massive infiltration of adipose tissue between muscle fibers in association with an altered expression pattern of important biomarkers of musculoskeletal health and oxidative stress, such as myostatin and NADPH Oxidase 4. Overall, our results confirm the very serious impact of metallosis on musculoskeletal health, suggesting the need for further studies to adopt a diagnostic approach to identify the cause of metallosis early and eliminate it as part of the prosthesis revision surgery.
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Affiliation(s)
- Roberto Bonanni
- Department of Biomedicine and Prevention, “Tor Vergata” University of Rome, Via Montpellier 1, 00133 Rome, Italy;
| | - Lorenzo Abbondante
- Department of Orthopaedics and Traumatology, “Policlinico Tor Vergata” Foundation, Viale Oxford 81, 00133 Rome, Italy; (L.A.); (E.G.); (U.T.)
| | - Ida Cariati
- Department of Systems Medicine, “Tor Vergata” University of Rome, Via Montpellier 1, 00133 Rome, Italy
| | - Elena Gasbarra
- Department of Orthopaedics and Traumatology, “Policlinico Tor Vergata” Foundation, Viale Oxford 81, 00133 Rome, Italy; (L.A.); (E.G.); (U.T.)
| | - Umberto Tarantino
- Department of Orthopaedics and Traumatology, “Policlinico Tor Vergata” Foundation, Viale Oxford 81, 00133 Rome, Italy; (L.A.); (E.G.); (U.T.)
- Department of Clinical Sciences and Translational Medicine, “Tor Vergata” University of Rome, Via Montpellier 1, 00133 Rome, Italy
- Centre of Space Bio-Medicine, “Tor Vergata” University of Rome, Via Montpellier 1, 00133 Rome, Italy
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Levaillant M, Rony L, Hamel-Broza JF, Soula J, Vallet B, Lamer A. In France, distance from hospital and health care structure impact on outcome after arthroplasty of the hip for proximal fractures of the femur. J Orthop Surg Res 2023; 18:418. [PMID: 37296484 DOI: 10.1186/s13018-023-03893-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Hip arthroplasty is a frequently performed procedure in orthopedic surgery, carried out in almost all health structures for two main issues: fracture and coxarthrosis. Even if volume-outcome relationship appeared associated in many surgeries recently, data provided are not sufficient to set surgical thresholds neither than closing down low-volumes centers. QUESTION With this study, we wanted to identify surgical, health care-related and territorial factors influencing patient' mortality and readmission after a HA for a femoral fracture in 2018 in France. PATIENTS AND METHODS Data were anonymously collected from French nationwide administrative databases. All patients who underwent a hip arthroplasty for a femoral fracture through 2018 were included. Patient outcome was 90-day mortality and 90-day readmission rate after surgery. RESULTS Of the 36,252 patients that underwent a HA for fracture in France in 2018, 0.7% died within 90-day year and 1.2% were readmitted. Male and Charlson comorbidity index were associated with a higher 90-day mortality and readmission rate in multivariate analysis. High volume was associated with a lower mortality rate. Neither time of travel nor distance upon health facility were associated with mortality nor with readmission rate in the analysis. CONCLUSION Even if volume appears to be associated with lower mortality rate even for longer distance and time of travel, the persistence of exogenous factors not documented in the French databases suggests that regionalization of hip arthroplasty should be organized with caution. CLINICAL RELEVANCE As volume-outcome relationship must be interpreted with caution, policy makers should not regionalize such surgery without further investigation.
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Affiliation(s)
- Mathieu Levaillant
- Univ. Lille, CHU Lille, ULR 2694 - METRICS : Évaluation des technologies de santé et des pratiques médicales, 59000, Lille, France.
- Centre Hospitalier Universitaire d'Angers, Angers, France.
| | - Louis Rony
- Centre Hospitalier Universitaire d'Angers, Angers, France
| | | | - Julien Soula
- Univ. Lille, CHU Lille, ULR 2694 - METRICS : Évaluation des technologies de santé et des pratiques médicales, 59000, Lille, France
| | - Benoît Vallet
- Univ. Lille, CHU Lille, ULR 2694 - METRICS : Évaluation des technologies de santé et des pratiques médicales, 59000, Lille, France
| | - Antoine Lamer
- Univ. Lille, CHU Lille, ULR 2694 - METRICS : Évaluation des technologies de santé et des pratiques médicales, 59000, Lille, France
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Choi SR, Kwon JW, Suk KS, Kim HS, Moon SH, Park SY, Lee BH. The Clinical Use of Osteobiologic and Metallic Biomaterials in Orthopedic Surgery: The Present and the Future. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16103633. [PMID: 37241260 DOI: 10.3390/ma16103633] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/21/2023] [Accepted: 05/03/2023] [Indexed: 05/28/2023]
Abstract
As the area and range of surgical treatments in the orthopedic field have expanded, the development of biomaterials used for these treatments has also advanced. Biomaterials have osteobiologic properties, including osteogenicity, osteoconduction, and osteoinduction. Natural polymers, synthetic polymers, ceramics, and allograft-based substitutes can all be classified as biomaterials. Metallic implants are first-generation biomaterials that continue to be used and are constantly evolving. Metallic implants can be made from pure metals, such as cobalt, nickel, iron, or titanium, or from alloys, such as stainless steel, cobalt-based alloys, or titanium-based alloys. This review describes the fundamental characteristics of metals and biomaterials used in the orthopedic field and new developments in nanotechnology and 3D-printing technology. This overview discusses the biomaterials that clinicians commonly use. A complementary relationship between doctors and biomaterial scientists is likely to be necessary in the future.
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Affiliation(s)
- Sung-Ryul Choi
- Department of Orthopedic Surgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
| | - Ji-Won Kwon
- Department of Orthopedic Surgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
| | - Kyung-Soo Suk
- Department of Orthopedic Surgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
| | - Hak-Sun Kim
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Seong-Hwan Moon
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Si-Young Park
- Department of Orthopedic Surgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
| | - Byung Ho Lee
- Department of Orthopedic Surgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea
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Niu Y, Du T, Liu Y. Biomechanical Characteristics and Analysis Approaches of Bone and Bone Substitute Materials. J Funct Biomater 2023; 14:jfb14040212. [PMID: 37103302 PMCID: PMC10146666 DOI: 10.3390/jfb14040212] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/24/2023] [Accepted: 04/04/2023] [Indexed: 04/28/2023] Open
Abstract
Bone has a special structure that is both stiff and elastic, and the composition of bone confers it with an exceptional mechanical property. However, bone substitute materials that are made of the same hydroxyapatite (HA) and collagen do not offer the same mechanical properties. It is important for bionic bone preparation to understand the structure of bone and the mineralization process and factors. In this paper, the research on the mineralization of collagen is reviewed in terms of the mechanical properties in recent years. Firstly, the structure and mechanical properties of bone are analyzed, and the differences of bone in different parts are described. Then, different scaffolds for bone repair are suggested considering bone repair sites. Mineralized collagen seems to be a better option for new composite scaffolds. Last, the paper introduces the most common method to prepare mineralized collagen and summarizes the factors influencing collagen mineralization and methods to analyze its mechanical properties. In conclusion, mineralized collagen is thought to be an ideal bone substitute material because it promotes faster development. Among the factors that promote collagen mineralization, more attention should be given to the mechanical loading factors of bone.
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Affiliation(s)
- Yumiao Niu
- Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Tianming Du
- Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
| | - Youjun Liu
- Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China
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Nkhwa S, Montshiwa T, de Beer D, Booysen G, van den Heever C, Els J, Heydenrych A, Kebaetse M. Local design and manufacturing of patient-specific implant using Anatomage Medical Design Studio software: proof of concept - Botswana's 1st case report. 3D Print Med 2023; 9:7. [PMID: 36952034 PMCID: PMC10035237 DOI: 10.1186/s41205-023-00170-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/17/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Botswana, like most sub-Sahara African nations, uses conventional orthopaedic implants that are sourced from major manufactures in the West. The implants are mass-produced and designed with universal configurations to fit an average patient. During surgery, surgeons thus sometimes bend the implants to match the individual bone anatomy, especially for paediatric patients and those with unique deformities, thus risking implant failure. The purpose of this project was to show the feasibility of developing safe and effective patient-specific orthopaedic implants in a low-resourced market. METHODS CT Scan slice files of a paediatric patient with Ollier's disease were used to reconstruct the lower limb anatomy. The resultant files were 3D printed into prototypes that showed severe right knee valgus deformity. The surgeon used the prototype to plan for corrective femoral osteotomy and the required implant. The implant design and planned surgery were subsequently simulated on the Medical Design Studio software for proper fitting before final implant printing. Surgery was then performed, followed by 12 weeks of physiotherapy. RESULTS Post-surgical x-rays demonstrated good implant positioning and knee joint alignment. At 18 months of post-surgical follow-up, the child was pain-free, could perform full squats, and ambulation was near-normal, without the use of an assistive device. CONCLUSIONS It is feasible to develop effective, patient-specific implants for selected orthopaedic cases in a low-resourced country. This work could improve surgical and rehabilitation outcomes for selected paediatric patients and those with severe bone deformities.
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Affiliation(s)
- Shathani Nkhwa
- Faculty of Medicine, Department of Biomedical Sciences, University of Botswana, Corner of Notwane and Mobuto Road, Pvt Bag, 00713, Gaborone, Botswana
| | - Thapelo Montshiwa
- Sidilega Private Hospital, Orthopaedic Surgery, P.O. Box 70905, Gaborone, Botswana
| | - Deon de Beer
- Free State, Centre for Rapid Prototyping and Manufacturing, Central University of Technology, Private Bag X20539, Bloemfontein, 9300, South Africa
| | - Gerrie Booysen
- Free State, Centre for Rapid Prototyping and Manufacturing, Central University of Technology, Private Bag X20539, Bloemfontein, 9300, South Africa
| | - Cules van den Heever
- Free State, Centre for Rapid Prototyping and Manufacturing, Central University of Technology, Private Bag X20539, Bloemfontein, 9300, South Africa
| | - Johan Els
- Free State, Centre for Rapid Prototyping and Manufacturing, Central University of Technology, Private Bag X20539, Bloemfontein, 9300, South Africa
| | - Andre Heydenrych
- Free State, Centre for Rapid Prototyping and Manufacturing, Central University of Technology, Private Bag X20539, Bloemfontein, 9300, South Africa
| | - Maikutlo Kebaetse
- Faculty of Medicine, Department of Biomedical Sciences, University of Botswana, Corner of Notwane and Mobuto Road, Pvt Bag, 00713, Gaborone, Botswana.
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Behavior of Calcium Phosphate-Chitosan-Collagen Composite Coating on AISI 304 for Orthopedic Applications. Polymers (Basel) 2022; 14:polym14235108. [PMID: 36501503 PMCID: PMC9735702 DOI: 10.3390/polym14235108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
Calcium phosphate/chitosan/collagen composite coating on AISI 304 stainless steel was investigated. Coatings were realized by galvanic coupling that occurs without an external power supply because it begins with the coupling between two metals with different standard electrochemical potentials. The process consists of the co-deposition of the three components with the calcium phosphate crystals incorporated into the polymeric composite of chitosan and collagen. Physical-chemical characterizations of the samples were executed to evaluate morphology and chemical composition. Morphological analyses have shown that the surface of the stainless steel is covered by the deposit, which has a very rough surface. XRD, Raman, and FTIR characterizations highlighted the presence of both calcium phosphate compounds and polymers. The coatings undergo a profound variation after aging in simulated body fluid, both in terms of composition and structure. The tests, carried out in simulated body fluid to scrutinize the corrosion resistance, have shown the protective behavior of the coating. In particular, the corrosion potential moved toward higher values with respect to uncoated steel, while the corrosion current density decreased. This good behavior was further confirmed by the very low quantification of the metal ions (practically absent) released in simulated body fluid during aging. Cytotoxicity tests using a pre-osteoblasts MC3T3-E1 cell line were also performed that attest the biocompatibility of the coating.
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Metallosis after using distal fibular locking plate for lateral malleolar fractures: a retrospective study. Arch Orthop Trauma Surg 2022; 142:2157-2163. [PMID: 33646355 DOI: 10.1007/s00402-020-03713-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 12/06/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Studies regarding the development of metallosis following open reduction and internal fixation (ORIF) of fractures are rarely found in orthopedic literature. The aim of the current study was to assess metallosis following ORIF using distal fibular locking plates to treat distal fibular fractures. MATERIALS AND METHODS 69 patients who underwent surgery using locking compression plates to treat lateral malleolar fractures, with a minimum 1-year follow-up period and subsequent hardware removal were enrolled in our study. We divided the patients into 2 groups, to compare the complications and demographics: 38 patients, treated with ZPLP plate; 31 patients, treated with other plates. RESULTS During 1 year of postoperative follow-up, 20 complications developed: 6 superficial infections at the operative site, 1 case of nonunion, 3 cases of osteitis, 4 cases of hypaesthesia, 2 cases of peripheral neuropathy, and 4 cases of metallosis. No statistical difference was found in the rate of complications when comparing the treatment groups (Mann-Whitney U test, p < .05) except for metallosis. All 4 patients who developed metallosis were treated using a ZPLP plate, and metallosis did not develop at all in patients who underwent surgery using other plates. CONCLUSION In our study, metallosis developed more than was previously known, particularly after using LCPs to treat lateral malleolar fractures. Our findings and those in recent publications support the possibility that metallosis can occur not only in patients with arthroplasties, but also in patients with open reduction and internal fixation with LCPs. Surgeons should be aware of such risk of metallosis and be careful to select proper plates for internal fixation.
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Kumar M, Kumar R, Kumar S. Nanomaterial reinforced composite for biomedical implants applications: a mini-review. BIOINSPIRED BIOMIMETIC AND NANOBIOMATERIALS 2022. [DOI: 10.1680/jbibn.21.00061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
There is heavy demand for suitable implant materials with improved mechanical and biological properties. Classically, the demand was catered by conventional materials like metals, alloys, and polymer-based materials. Recently, nanomaterial reinforced composites have played a significant role in replacing conventional materials due to their excellent properties such as biocompatibility, bioactivity, high strength to weight ratio, long life, corrosion & wear resistance, and tailor-ability. Herein, we composed a systematic focus review on the role of nanoparticles in the form of composite materials for the advancements in orthopedic implants. Several nano materials-based reinforcements have been reviewed with various matrix materials, including metals, alloys, ceramics, composites, and polymers for biomedical implant applications. Moreover, the improved biological properties, mechanical properties, and other functionalities like infection resistance, drug delivery at the target, sensing, and detection of bone diseases, and corrosion & wear resistance are elaborated. At last, a particular focus has been given to the un-resolved challenges in orthopedic implant development.
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Affiliation(s)
- Manjeet Kumar
- Department of Mechanical Engineering, UIET, Panjab University, Chandigarh, India
| | - Rajesh Kumar
- Department of Mechanical Engineering, UIET, Panjab University, Chandigarh, India
| | - Sandeep Kumar
- Department of Bio and Nanotechnology, Guru Jambheshwar University, Hissar, India
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11
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Cakir F, Özkal FM, Sensoz E. Performance Assessment of Biocompatible Metals Used in the Treatment of Femoral Neck Fractures. ACS APPLIED BIO MATERIALS 2022; 5:3013-3022. [PMID: 35674244 PMCID: PMC9214763 DOI: 10.1021/acsabm.2c00321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
![]()
Femoral neck fractures
(FNFs) are among the most common types of
hip fractures. Particularly in young patients, these fractures require
adequate fixation. These fractures, which are prevalent in elderly
patients, are usually treated with implant applications. In implant
applications, it is possible to find many different fixation configurations
with various implant materials. The purpose of this study is to investigate
the effects of metallic implant materials on fixation performance
in the application of cannulated screws in an inverted triangle (CSIT),
which are most preferred by orthopedic surgeons. Therefore, a femur
bone with a type 2 fracture was numerically modeled and performances
of CSIT implants with different biocompatible metals were investigated
over nonlinear finite-element analyses (FEA). Within the study, stainless
steel (SS), pure titanium (pTi), titanium alloy (Ti6Al4V), cobalt–chromium
alloy (Co–Cr), and magnesium alloy (WE43) materials, frequently
used as biocompatible implant materials, were taken into consideration
and their performances were evaluated under static, vibration, and
fatigue analyses. Throughout the comparison of analysis results and
an optimality indicator formula, the optimum material was found to
be the Co–Cr alloy on the basis of considered performance characteristics.
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Affiliation(s)
- Ferit Cakir
- Department of Civil Engineering, Gebze Technical University, 41400 Kocaeli, Turkey
| | - Fatih Mehmet Özkal
- Department of Civil Engineering, Atatürk University, 25240 Erzurum, Turkey
| | - Ersin Sensoz
- Department of Orthopedics and Traumatology, Kartal Dr. Lütfü Kırdar Training and Research Hospital, 34865 İstanbul, Turkey
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Rony L, Aguado E, Verlee B, Pascaretti-Grizon F, Chappard D. Osseointegration of two types of titanium cylinders with geometric or trabecular microarchitecture: A nanotomographic and histomorphometric study. Morphologie 2022; 106:80-91. [PMID: 33812797 DOI: 10.1016/j.morpho.2021.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 06/12/2023]
Abstract
Porous biomaterials promote osseointegration. We have prepared porous titanium cylinders by additive manufacturing from titanium beads. Two types of morphology were tested: cylinders with geometric pores or mimicking trabecular microarchitecture. Cylinders were decontaminated and cleaned by HF/HNO3 to remove unmelted balls. Surgical implantation in ewes was performed under general anesthesia and the animals were housed for 90 and 270days. The femoral condyles were collected and analyzed by nanoCT, embedded in pMMA and analyzed by histomorphometry. No significant difference was found in terms of bone volume or bone/titanium interface between the two types of cylinders. There was no evolution over time except for the mineralization rates which decreased, reflecting the effect of the aging of the animals. The influence of the pores (geometrical or "natural") did not influence osseointegration. HF/HNO3 etching treatments are effective on the outermost surfaces but do not seem to reach the central cavities of the samples. Finally, osseointegration seems to occur only in the few millimeters around the periphery of the implants and does not extend in the center. This is explained by the absence of stress transmission within the very rigid metal cylinders, preventing bone modeling and remodeling.
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Affiliation(s)
- L Rony
- GEROM - Groupe Etudes Remodelage Osseux et bioMatériaux, LabCom NextBone, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, 49933 Angers, France
| | - E Aguado
- GEROM - Groupe Etudes Remodelage Osseux et bioMatériaux, LabCom NextBone, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, 49933 Angers, France; ONIRIS, Ecole Vétérinaire de Nantes, 44307 Nantes Cedex 3, France
| | - B Verlee
- SIRRIS Liège Science Park, Rue du bois St Jean 12, 4102 Seraing, Belgium
| | - F Pascaretti-Grizon
- GEROM - Groupe Etudes Remodelage Osseux et bioMatériaux, LabCom NextBone, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, 49933 Angers, France
| | - D Chappard
- GEROM - Groupe Etudes Remodelage Osseux et bioMatériaux, LabCom NextBone, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, 49933 Angers, France; SCIAM, Service Commun d'Imagerie et Analyses Microscopiques, IRIS-IBS Institut de Biologie en Santé, Univ-Angers, 49933 Angers Cedex, France.
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Neurological emergency from rare spinal metalloma: Case report and literature review. Radiol Case Rep 2022; 17:1540-1548. [PMID: 35282321 PMCID: PMC8908052 DOI: 10.1016/j.radcr.2022.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/14/2022] [Accepted: 01/16/2022] [Indexed: 11/22/2022] Open
Abstract
Metallosis is a rare and poorly understood long-term complication of instrumented surgery that can result in an inflammatory pseudotumor termed metalloma. We describe a particularly unique case and compare it to 6 analogous cases identified by PubMed and/or Medline search through July 2020. A 79-year-old male with multiple prior spinal lumbar fusion procedures presented with progressive weakness and pain. Imaging revealed a large mass surrounding the right-sided paraspinal rod with extension into the spinal canal, neural foramina, extraforaminal spaces, psoas muscle, marrow spaces, and right sided pedicles. The case presented is a unique example of a unilateral metalloma with mixed-metal instrumentation that created a progressive neurologic deficit without infection, pseudoarthrosis, or hardware failure. This case highlights the lack of understanding regarding the pathophysiology of metallosis and metalloma in spinal instrumentation. We highlight the imaging findings of metalloma to encourage early identification for removal and decompression.
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14
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Guo Y, Liu F, Bian X, Lu K, Huang P, Ye X, Tang C, Li X, Wang H, Tang K. Effect of Pore Size of Porous-Structured Titanium Implants on Tendon Ingrowth. Appl Bionics Biomech 2022; 2022:2801229. [PMID: 35510044 PMCID: PMC9061050 DOI: 10.1155/2022/2801229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/27/2022] [Accepted: 04/05/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The reconstruction of a tendon insertion on metal prostheses is a challenge in orthopedics. Of the available metal prostheses, porous metal prostheses have been shown to have better biocompatibility for tissue integration. Therefore, this study is aimed at identifying an appropriate porous structure for the reconstruction of a tendon insertion on metal prostheses. Methods Ti6Al4V specimens with a diamond-like porous structure with triply periodic minimal surface pore sizes of 300, 500, and 700 μm and a porosity of 58% (designated Ti300, Ti500, and Ti700, respectively) were manufactured by selective laser melting and were characterized with micro-CT and scanning electron microscopy for their porosity, pore size, and surface topography. The porous specimens were implanted into the patellar tendon of rabbits. Tendon integration was evaluated after implantation into the tendon at 4, 8, and 12 weeks by histology, and the fixation strength was evaluated with a pull-out test at week 12. Results The average pore sizes of the Ti300, Ti500, and Ti700 implants were 261, 480, and 668 μm, respectively. The Ti500 and Ti700 implants demonstrated better tissue growth than the Ti300 implant at weeks 4, 8, and 12. At week 12, the histological score of the Ti500 implant was 13.67 ± 0.58, and it had an area percentage of type I collagen of 63.90% ± 3.41%; both of these results were significantly higher than those for the Ti300 and Ti700 implants. The pull-out load at week 12 was also the highest in the Ti500 group. Conclusion Ti6Al4V implants with a diamond-like porous structure with triply periodic minimal surface pore size of 500 μm are suitable for tendon integration.
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Affiliation(s)
- Yupeng Guo
- Department of Orthopedics/Sports Medicine Center, State Key Laboratory of Trauma, Burn, and Combined Injury, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Fei Liu
- Department of Orthopedics/Sports Medicine Center, State Key Laboratory of Trauma, Burn, and Combined Injury, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Xuting Bian
- Department of Orthopedics/Sports Medicine Center, State Key Laboratory of Trauma, Burn, and Combined Injury, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Kang Lu
- Department of Orthopedics/Sports Medicine Center, State Key Laboratory of Trauma, Burn, and Combined Injury, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Pan Huang
- Department of Orthopedics/Sports Medicine Center, State Key Laboratory of Trauma, Burn, and Combined Injury, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Xiao Ye
- Department of Orthopedics/Sports Medicine Center, State Key Laboratory of Trauma, Burn, and Combined Injury, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Chuyue Tang
- Department of Orthopedics/Sports Medicine Center, State Key Laboratory of Trauma, Burn, and Combined Injury, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Xinxin Li
- Department of Orthopedics/Sports Medicine Center, State Key Laboratory of Trauma, Burn, and Combined Injury, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Huan Wang
- Department of Orthopedics/Sports Medicine Center, State Key Laboratory of Trauma, Burn, and Combined Injury, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Kanglai Tang
- Department of Orthopedics/Sports Medicine Center, State Key Laboratory of Trauma, Burn, and Combined Injury, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing 400038, China
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15
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Nadammal N, Rajput M, Gupta SK, Ivanov E, Reddy AS, Suwas S, Chatterjee K. Laser Powder Bed Fusion Additive Manufacturing of a Low-Modulus Ti-35Nb-7Zr-5Ta Alloy for Orthopedic Applications. ACS OMEGA 2022; 7:8506-8517. [PMID: 35309459 PMCID: PMC8928530 DOI: 10.1021/acsomega.1c06261] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 02/17/2022] [Indexed: 06/14/2023]
Abstract
Laser powder bed fusion (L-PBF) was attempted here to additively manufacture a new generation orthopedic β titanium alloy Ti-35Nb-7Zr-5Ta toward engineering patient-specific implants. Parts were fabricated using four different values of energy density (ED) input ranging from 46.6 to 54.8 J/mm3 through predefined laser beam parameters from prealloyed powders. All the conditions yielded parts of >98.5% of theoretical density. X-ray microcomputed tomography analyses of the fabricated parts revealed minimal imperfections with enhanced densification at a higher ED input. X-ray diffraction analysis indicated a marginally larger d-spacing and tensile residual stress at the highest ED input that is ascribed to the steeper temperature gradients. Cellular to columnar dendritic transformation was observed at the highest ED along with an increase in the size of the solidified features indicating the synergetic effects of the temperature gradient and solidification growth rate. Density measurements indicated ≈99.5% theoretical density achieved for an ED of 50.0 J/mm3. The maximum tensile strength of ≈660 MPa was obtained at an ED of 54.8 J/mm3 through the formation of the columnar dendritic substructure. High ductility ranging from 25 to 30% was observed in all the fabricated parts irrespective of ED. The assessment of cytocompatibility in vitro indicated good attachment and proliferation of osteoblasts on the fabricated samples that were similar to the cell response on commercially pure titanium, confirming the potential of the additively manufactured Ti-35Nb-7Zr-5Ta as a suitable material for biomedical applications. Taken together, these results demonstrate the feasibility of L-PBF of Ti-35Nb-7Zr-5Ta for potentially engineering patient-specific orthopedic implants.
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Affiliation(s)
- Naresh Nadammal
- Department
of Materials Engineering, Indian Institute
of Science, Bangalore 560012, India
| | - Monika Rajput
- Department
of Materials Engineering, Indian Institute
of Science, Bangalore 560012, India
| | - Saurabh Kumar Gupta
- Department
of Materials Engineering, Indian Institute
of Science, Bangalore 560012, India
| | - Eugene Ivanov
- Tosoh
SMD Inc., Grove City, Ohio 43123, United
States
| | | | - Satyam Suwas
- Department
of Materials Engineering, Indian Institute
of Science, Bangalore 560012, India
| | - Kaushik Chatterjee
- Department
of Materials Engineering, Indian Institute
of Science, Bangalore 560012, India
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16
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Addressing the Needs of the Rapidly Aging Society through the Development of Multifunctional Bioactive Coatings for Orthopedic Applications. Int J Mol Sci 2022; 23:ijms23052786. [PMID: 35269928 PMCID: PMC8911303 DOI: 10.3390/ijms23052786] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 02/27/2022] [Accepted: 02/28/2022] [Indexed: 12/15/2022] Open
Abstract
The unprecedented aging of the world's population will boost the need for orthopedic implants and expose their current limitations to a greater extent due to the medical complexity of elderly patients and longer indwelling times of the implanted materials. Biocompatible metals with multifunctional bioactive coatings promise to provide the means for the controlled and tailorable release of different medications for patient-specific treatment while prolonging the material's lifespan and thus improving the surgical outcome. The objective of this work is to provide a review of several groups of biocompatible materials that might be utilized as constituents for the development of multifunctional bioactive coatings on metal materials with a focus on antimicrobial, pain-relieving, and anticoagulant properties. Moreover, the review presents a summary of medications used in clinical settings, the disadvantages of the commercially available products, and insight into the latest development strategies. For a more successful translation of such research into clinical practice, extensive knowledge of the chemical interactions between the components and a detailed understanding of the properties and mechanisms of biological matter are required. Moreover, the cost-efficiency of the surface treatment should be considered in the development process.
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17
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Davis R, Singh A, Jackson MJ, Coelho RT, Prakash D, Charalambous CP, Ahmed W, da Silva LRR, Lawrence AA. A comprehensive review on metallic implant biomaterials and their subtractive manufacturing. THE INTERNATIONAL JOURNAL, ADVANCED MANUFACTURING TECHNOLOGY 2022; 120:1473-1530. [PMID: 35228769 PMCID: PMC8865884 DOI: 10.1007/s00170-022-08770-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 01/17/2022] [Indexed: 05/08/2023]
Abstract
There is a tremendous increase in the demand for converting biomaterials into high-quality industrially manufactured human body parts, also known as medical implants. Drug delivery systems, bone plates, screws, cranial, and dental devices are the popular examples of these implants - the potential alternatives for human life survival. However, the processing techniques of an engineered implant largely determine its preciseness, surface characteristics, and interactive ability with the adjacent tissue(s) in a particular biological environment. Moreover, the high cost-effective manufacturing of an implant under tight tolerances remains a challenge. In this regard, several subtractive or additive manufacturing techniques are employed to manufacture patient-specific implants, depending primarily on the required biocompatibility, bioactivity, surface integrity, and fatigue strength. The present paper reviews numerous non-degradable and degradable metallic implant biomaterials such as stainless steel (SS), titanium (Ti)-based, cobalt (Co)-based, nickel-titanium (NiTi), and magnesium (Mg)-based alloys, followed by their processing via traditional turning, drilling, and milling including the high-speed multi-axis CNC machining, and non-traditional abrasive water jet machining (AWJM), laser beam machining (LBM), ultrasonic machining (USM), and electric discharge machining (EDM) types of subtractive manufacturing techniques. However, the review further funnels down its primary focus on Mg, NiTi, and Ti-based alloys on the basis of the increasing trend of their implant applications in the last decade due to some of their outstanding properties. In the recent years, the incorporation of cryogenic coolant-assisted traditional subtraction of biomaterials has gained researchers' attention due to its sustainability, environment-friendly nature, performance, and superior biocompatible and functional outcomes fitting for medical applications. However, some of the latest studies reported that the medical implant manufacturing requirements could be more remarkably met using the non-traditional subtractive manufacturing approaches. Altogether, cryogenic machining among the traditional routes and EDM among the non-traditional means along with their variants, were identified as some of the most effective subtractive manufacturing techniques for achieving the dimensionally accurate and biocompatible metallic medical implants with significantly modified surfaces.
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Affiliation(s)
- Rahul Davis
- Department of Mechanical Engineering, National Institute of Technology Patna, Patna, 800005 India
- Department of Mechanical Engineering, Vaugh Institute of Agricultural Engineering and Technology, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, 211007 India
| | - Abhishek Singh
- Department of Mechanical Engineering, National Institute of Technology Patna, Patna, 800005 India
| | - Mark James Jackson
- School of Integrated Studies, College of Technology and Aviation, Kansas State University, Salina, KS 67401 USA
| | | | - Divya Prakash
- Department of Mechanical Engineering, Vaugh Institute of Agricultural Engineering and Technology, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, 211007 India
| | | | - Waqar Ahmed
- School of Mathematics and Physics, College of Science, University of Lincoln, Brayford Pool, Lincoln, LN6 7TS UK
| | - Leonardo Rosa Ribeiro da Silva
- School of Mechanical Engineering, Federal University of Uberlandia, Av. João Naves de Ávila, Uberlândia, MG 38400-902 Brazil
| | - Abner Ankit Lawrence
- Department of Mechanical Engineering, Vaugh Institute of Agricultural Engineering and Technology, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, 211007 India
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18
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Ovchinnikov EN, Godovykh NV, Dyuryagina OV, Stogov MV, Ovchinnikov DN, Ovchinnikov NV. Antimicrobial Efficacy of Exposure of Medical Metal Implants to Direct Electric Current. BIOMEDICAL ENGINEERING 2022; 55:323-327. [DOI: 10.1007/s10527-022-10128-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Indexed: 09/03/2023]
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19
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Mukhamadiyarov RA, Bogdanov LA, Mishinov SV, Kutikhin AG. A Novel Technique for Preparation, Staining, and Visualization of Tissue with Metal Implants and Extraskeletal Calcification Areas. Sovrem Tekhnologii Med 2021; 12:13-20. [PMID: 34795988 PMCID: PMC8596281 DOI: 10.17691/stm2020.12.4.02] [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: 09/11/2019] [Indexed: 11/27/2022] Open
Abstract
The aim of the study was to evaluate the efficacy of a novel technique for preparation, staining, and visualization of tissues containing extra-skeletal mineralization areas, all-metal implants or their prototypes for their subsequent examination using scanning electron microscopy in the backscattered electron mode.
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Affiliation(s)
- R A Mukhamadiyarov
- Senior Researcher, Laboratory for Fundamental Aspects of Atherosclerosis, Department of Experimental and Clinical Cardiology; Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo, 650002, Russia
| | - L A Bogdanov
- Junior Researcher, Laboratory for Fundamental Aspects of Atherosclerosis, Department of Experimental and Clinical Cardiology; Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo, 650002, Russia
| | - S V Mishinov
- Senior Researcher, Neurosurgeon, Neurosurgery Unit; Novosibirsk Scientific Research Institute of Traumatology and Orthopedics named after Ya.L. Tsivyan of the Ministry of Health of the Russian Federation, 17 Frunze St., Novosibirsk, 630091, Russia
| | - A G Kutikhin
- Head of the Laboratory for Fundamental Aspects of Atherosclerosis, Department of Experimental and Clinical Cardiology Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo, 650002, Russia
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20
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Rony L, Aguado E, Verlee B, Pascaretti-Grizon F, Chappard D. Microarchitecture of titanium cylinders obtained by additive manufacturing does not influence osseointegration in the sheep. Regen Biomater 2021; 8:rbab021. [PMID: 34188953 PMCID: PMC8226111 DOI: 10.1093/rb/rbab021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/19/2021] [Accepted: 04/25/2021] [Indexed: 12/15/2022] Open
Abstract
Large bone defects are a challenge for orthopedic surgery. Natural (bone grafts) and synthetic biomaterials have been proposed but several problems arise such as biomechanical resistance or viral/bacterial safety. The use of metallic foams could be a solution to improve mechanical resistance and promote osseointegration of large porous metal devices. Titanium cylinders have been prepared by additive manufacturing (3D printing/rapid prototyping) with a geometric or trabecular microarchitecture. They were implanted in the femoral condyles of aged ewes; the animals were left in stabling for 90 and 270 days. A double calcein labeling was done before sacrifice; bones were analyzed by histomorphometry. Neither bone volume, bone/titanium interface nor mineralization rate were influenced by the cylinder's microarchitecture; the morphometric parameters did not significantly increase over time. Bone anchoring occurred on the margins of the cylinders and some trabeculae extended in the core of the cylinders but the amount of bone inside the cylinders remained low. The rigid titanium cylinders preserved bone cells from strains in the core of the cylinders. Additive manufacturing is an interesting tool to prepare 3D metallic scaffolds, but microarchitecture does not seem as crucial as expected and anchoring seems limited to the first millimeters of the graft.
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Affiliation(s)
- Louis Rony
- GEROM-Groupe Etudes Remodelage Osseux et bioMatériaux, LabCom NextBone, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, 49933 Angers, France
| | - Eric Aguado
- GEROM-Groupe Etudes Remodelage Osseux et bioMatériaux, LabCom NextBone, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, 49933 Angers, France
| | - Bruno Verlee
- SIRRIS Liège Science Park, Rue du bois St Jean 12, Seraing 4102, Belgium
| | - Florence Pascaretti-Grizon
- GEROM-Groupe Etudes Remodelage Osseux et bioMatériaux, LabCom NextBone, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, 49933 Angers, France
| | - Daniel Chappard
- GEROM-Groupe Etudes Remodelage Osseux et bioMatériaux, LabCom NextBone, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, 49933 Angers, France
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21
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Abstract
Additive manufacturing's attributes include print customization, low per-unit cost for small- to mid-batch production, seamless interfacing with mainstream medical 3D imaging techniques, and feasibility to create free-form objects in materials that are biocompatible and biodegradable. Consequently, additive manufacturing is apposite for a wide range of biomedical applications including custom biocompatible implants that mimic the mechanical response of bone, biodegradable scaffolds with engineered degradation rate, medical surgical tools, and biomedical instrumentation. This review surveys the materials, 3D printing methods and technologies, and biomedical applications of metal 3D printing, providing a historical perspective while focusing on the state of the art. It then identifies a number of exciting directions of future growth: (a) the improvement of mainstream additive manufacturing methods and associated feedstock; (b) the exploration of mature, less utilized metal 3D printing techniques; (c) the optimization of additively manufactured load-bearing structures via artificial intelligence; and (d) the creation of monolithic, multimaterial, finely featured, multifunctional implants.
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Affiliation(s)
| | - Yosef Kornbluth
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
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22
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Clindamycin-Based 3D-Printed and Electrospun Coatings for Treatment of Implant-Related Infections. MATERIALS 2021; 14:ma14061464. [PMID: 33802712 PMCID: PMC8002500 DOI: 10.3390/ma14061464] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/10/2021] [Accepted: 03/15/2021] [Indexed: 02/07/2023]
Abstract
This study presents the development and characterisation of two novel bioactive coatings deposited on TiAlV and AISI 316LVM substrates. The coatings were prepared using 3D printing and electrospinning. The 3D-printed coating consisted of the cellulose nanofibril suspension, alginate, and carboxymethylcellulose (CMC), while CMC and polyethylene oxide were used to prepare the electrospun coating. Both coatings were loaded with the antibiotic clindamycin (CLIN), which is a bacteriostatic lincosamide known for its activity against streptococci, staphylococci, pneumococci, Bacteroides species, and other anaerobes. Initial characterisation of the coatings was performed by attenuated total reflectance Fourier transform infrared spectroscopy, field emission scanning electron microscopy, and atomic force microscopy. Furthermore, the contact angle measurements, swelling rate, and biodegradability of the coatings were investigated. The released concentration of CLIN in PBS (pH = 7.4 at 25 °C) was determined by UV-VIS spectrophotometry. The coatings’ biocompatibility was determined using an MTT (3(4,5 dimethylthiazolyl-2)-2,5-diphenyltetrazolium bromide) assay using an osteoblast cell culture (hFOB 1.19, ATCC CRL 11372).
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Rony L, Pascaretti-Grizon F, Hubert L, Chappard D. Histochemical identification of wear debris released by alumina-on-alumina hip prostheses in the periprosthetic tissues. Orthop Traumatol Surg Res 2021; 107:102636. [PMID: 33023845 DOI: 10.1016/j.otsr.2020.03.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 03/09/2020] [Accepted: 03/18/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Tribological studies have shown that the most used couples for hip prostheses consist of metal-on-polyethylene and alumina-on-alumina prostheses. Over time, wear products accumulate in the joint cavity and in the periprosthetic tissues. Although polyethylene and metal are easily identifiable by microscopy in periprosthetic tissues, alumina particles are very difficult to identify. HYPOTHESIS The fluorescent azo-dye lumogallion was evaluated as a suitable histochemical stain for alumina particles in periprosthetic tissues. MATERIAL AND METHOD In 28 patients who had a prosthetic revision of an alumina-on-alumina prosthesis, periprosthetic tissues were removed and embedded in paraffin; sections were stained with HPS (for conventional diagnosis) or with lumogallion. Sections were examined for wear particles in light and fluorescence microscopy. Some sections were counter-stained using DAPI for visualization of cell nuclei. RESULTS The wear particles of the alumina-alumina prostheses were very difficult to identify on the HPS stained sections; they were clearly evidenced by lumogallion staining with a bright orange fluorescence. The stain revealed large quantities of particles (of the order of several thousand per section). Only two patients had no particles. The staining technique identified numerous particles that were not visible on HPS-stained sections in macrophages, synoviocytes and fibroblasts. CONCLUSION This staining, which has been validated in neuromuscular pathology for the identification of alumina used as a vaccine adjuvant, gave successful results in the present study. Alumina particles are modified when they are phagocytized by macrophages. lumogallion staining easily shows the presence of thousands of wear particles released by alumina-on-alumina prostheses in periprosthetic tissues. LEVEL OF EVIDENCE V expert opinion study.
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Affiliation(s)
- Louis Rony
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA-4658, SFR-4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU-Angers, 49933 Angers, France; Département de chirurgie osseuse, CHU-Angers, 49033 Angers, France
| | - Florence Pascaretti-Grizon
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA-4658, SFR-4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU-Angers, 49933 Angers, France
| | - Laurent Hubert
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA-4658, SFR-4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU-Angers, 49933 Angers, France; Département de chirurgie osseuse, CHU-Angers, 49033 Angers, France
| | - Daniel Chappard
- Département de chirurgie osseuse, CHU-Angers, 49033 Angers, France.
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24
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Gao J, Min J, Chen X, Yu P, Tan X, Zhang Q, Yu H. Effects of two fretting damage modes on the dental implant–abutment interface and the generation of metal wear debris: An in vitro study. FATIGUE & FRACTURE OF ENGINEERING MATERIALS & STRUCTURES 2020. [DOI: 10.1111/ffe.13399] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Jing Gao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology Sichuan University Chengdu 610041 China
| | - Jie Min
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology Sichuan University Chengdu 610041 China
| | - Xin Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Dental Technology, West China Hospital of Stomatology Sichuan University Chengdu 610041 China
| | - Ping Yu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology Sichuan University Chengdu 610041 China
| | - Xin Tan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology Sichuan University Chengdu 610041 China
| | - Qianqian Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Dental Technology, West China Hospital of Stomatology Sichuan University Chengdu 610041 China
| | - Haiyang Yu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology Sichuan University Chengdu 610041 China
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25
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Tan W, Gao C, Feng P, Liu Q, Liu C, Wang Z, Deng Y, Shuai C. Dual-functional scaffolds of poly(L-lactic acid)/nanohydroxyapatite encapsulated with metformin: Simultaneous enhancement of bone repair and bone tumor inhibition. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 120:111592. [PMID: 33545810 DOI: 10.1016/j.msec.2020.111592] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/01/2020] [Accepted: 09/30/2020] [Indexed: 12/16/2022]
Abstract
Bone defects caused by tumors are difficult to repair clinically because of their poor morphology and residual tumor cell-induced recurrence. Scaffolds with the dual function of bone repair and bone tumor treatment are urgently needed to resolve this problem. In this study, a poly(L-lactic acid) (PLLA)/nanoscale hydroxyapatite (nHA)/metformin (MET) nanocomposite scaffold was constructed via selective laser sintering. The scaffolds were expected to combine the excellent mechanical strength and biodegradability of PLLA, the good bioactivity of nHA, and the water solubility and antitumor properties of MET. The PLLA/nHA/MET scaffolds showed improved cell adhesion, appropriate porosity, good biocompatibility and osteogenic-induced ability in vitro because metformin improves water solubility and promotes the osteogenic differentiation of cells within the scaffold. The PLLA/nHA/MET scaffold had an extended drug release time because the MET particles were wrapped in the biodegradable polymer PLLA and the wrapped MET particles were slowly released into body fluids as the PLLA was degraded. Moreover, the scaffold induced osteosarcoma (OS) cell apoptosis by upregulating apoptosis-related gene expression and showed excellent tumor inhibition characteristics in vitro. In addition, the scaffold induced osteogenic differentiation of bone marrow mesenchymal cells (BMSCs) by promoting osteogenic gene expression. The results suggest that the PLLA/nHA/MET composite scaffold has the dual function of tumor inhibition and bone repair and therefore it provides a promising new approach for the treatment of tumor-induced bone defects.
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Affiliation(s)
- Wei Tan
- Department of Spine Surgery, The Third Xiangya Hospital of Central South University, No.138, Tongzipo Road, Changsha, Hunan 410013, People's Republic of China; Department of Spinal Orthopedics, Huizhou Third People's Hospital, Guangzhou Medical University, No.1, Xuebei Road, Huizhou, Guangdong 516002, People's Republic of China
| | - Chengde Gao
- State Key Laboratory of High Performance Complex Manufacturing, College of Mechanical and Electrical Engineering, Central South University, Changsha, Hunan, People's Republic of China
| | - Pei Feng
- State Key Laboratory of High Performance Complex Manufacturing, College of Mechanical and Electrical Engineering, Central South University, Changsha, Hunan, People's Republic of China
| | - Qing Liu
- Department of Spine Surgery, The Third Xiangya Hospital of Central South University, No.138, Tongzipo Road, Changsha, Hunan 410013, People's Republic of China
| | - Congcong Liu
- Department of Spine Surgery, Shenzhen People's Hospital, Shenzhen, Guangdong 518020, PR China
| | - Zhenting Wang
- Department of Urinary Surgery, Haikou People's Hospital, Haikou, Hainan 570208, P.R. China
| | - Youwen Deng
- Department of Spine Surgery, The Third Xiangya Hospital of Central South University, No.138, Tongzipo Road, Changsha, Hunan 410013, People's Republic of China.
| | - Cijun Shuai
- State Key Laboratory of High Performance Complex Manufacturing, College of Mechanical and Electrical Engineering, Central South University, Changsha, Hunan, People's Republic of China.
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Chappard D, Rony L, Ducellier F, Steiger V, Hubert L. Wear debris released by hip prosthesis analysed by microcomputed tomography. J Microsc 2020; 282:13-20. [PMID: 33118633 DOI: 10.1111/jmi.12971] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/30/2020] [Accepted: 10/18/2020] [Indexed: 11/28/2022]
Abstract
Total hip arthroplasty uses commercial devices that combine different types of biomaterials. Among them, metals, ceramics and metal oxides can be used either in the prosthesis itself or in the cement used to anchor them in the bone. Over time, all of these materials can wear out and release particles that accumulate in the periprosthetic tissues or can migrate away. We used histology blocks from 15 patients (5 titanium metallosis, 5 alumina prostheses, 5 with altered methacrylic cement) to perform a microCT study and compare it with conventional histology data. An EDS-SEM analysis was done to characterise the atomic nature of the materials involved. A morphometric analysis was also performed in 3D to count the particles and assess their density and size. The metallic particles appeared to be the largest and the ceramic particles the finest. However, microCT could not reveal the wear particles of radiolucent biomaterials such as polyethylene and the very fine zirconia particles from cement fragmentation. MicroCT analysis can reveal the extent of the accumulation of these debris in the periprosthetic tissues. LAYOUT DESCRIPTION: Hip prostheses progressively degrade in the body by releasing wear debris. They accumulate in the periprosthetic tissues. Microcomputed tomography was used to image three types of radio-opaque wear debris: metal, ceramic and zirconia used in the bone cements.
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Affiliation(s)
- D Chappard
- Groupe Etudes Remodelage Osseux et bioMatériaux, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU-Angers, Angers, France
| | - L Rony
- Groupe Etudes Remodelage Osseux et bioMatériaux, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU-Angers, Angers, France.,Département de Chirurgie Osseuse, CHU-Angers, Angers, France
| | - F Ducellier
- Département de Chirurgie Osseuse, CHU-Angers, Angers, France
| | - V Steiger
- Département de Chirurgie Osseuse, CHU-Angers, Angers, France
| | - L Hubert
- Groupe Etudes Remodelage Osseux et bioMatériaux, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU-Angers, Angers, France.,Département de Chirurgie Osseuse, CHU-Angers, Angers, France
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Kün-Darbois JD, Libouban H, Camprasse G, Camprasse S, Chappard D. In vivo osseointegration and erosion of nacre screws in an animal model. J Biomed Mater Res B Appl Biomater 2020; 109:780-788. [PMID: 33089667 DOI: 10.1002/jbm.b.34743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 08/05/2020] [Accepted: 10/07/2020] [Indexed: 12/18/2022]
Abstract
The use of resorbable devices for osteosynthesis has become a subject of interest. Nacre has been proposed as a resorbable and osteoconductive material favoring bone apposition without triggering an inflammatory reaction. We compared the in vivo osseointegration and erosion of nacre screws in an animal model with titanium screws. Implantation of similar nacre and titanium screws was performed in the femoral condyles of adult rats. Animals (n = 41) were randomized in four groups sacrificed at day one, 1, 6, and 12 months. Microcomputed tomography (microCT) allowed 3D morphometry of erosion of nacre. Osseointegration was measured as the volume of trabecular bone bone volume/tissue volume (BV/TV) in a standardized volume of interest around each screw. Undecalcified bone histology was also done. Gross examination revealed a similar clinical osseointegration for titanium and nacre screws. A progressive erosion of nacre screws, but no erosion of titanium screws, was observed in microCT. The volume of nacre screws progressively decreased over time whereas no modification occurred for titanium. For titanium screws, BV/TV remained stable throughout the study. For nacre screws, the BV/TV decrease was not statistically different. A significant difference was found between nacre and titanium screws at 6 months but not at 12 months. The screw heads, outside the bone shaft, were not eroded even after 12 months. Erosion of nacre occurred during the entire study period, only within the bone shaft in direct contact with bone marrow. Bone apposition was observed on nacre surfaces without signs of erosion. Nacre is a promising biomaterial in maxillofacial surgery.
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Affiliation(s)
- Jean-Daniel Kün-Darbois
- GEROM Groupe d'Etude Remodelage Osseux et bioMatériaux, LHEA, IRIS-IBS Institut de Biologie en Santé, Université d'Angers, CHU d'Angers, Angers Cedex, France.,Service de chirurgie maxillo-faciale et stomatologie, CHU d'Angers, Angers Cedex, France
| | - Hélène Libouban
- GEROM Groupe d'Etude Remodelage Osseux et bioMatériaux, LHEA, IRIS-IBS Institut de Biologie en Santé, Université d'Angers, CHU d'Angers, Angers Cedex, France
| | | | | | - Daniel Chappard
- GEROM Groupe d'Etude Remodelage Osseux et bioMatériaux, LHEA, IRIS-IBS Institut de Biologie en Santé, Université d'Angers, CHU d'Angers, Angers Cedex, France
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Chae K, Jang WY, Park K, Lee J, Kim H, Lee K, Lee CK, Lee Y, Lee SH, Seo J. Antibacterial infection and immune-evasive coating for orthopedic implants. SCIENCE ADVANCES 2020; 6:6/44/eabb0025. [PMID: 33115733 PMCID: PMC7608784 DOI: 10.1126/sciadv.abb0025] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 09/08/2020] [Indexed: 05/22/2023]
Abstract
Bacterial infection and infection-induced immune response have been a life-threatening risk for patients having orthopedic implant surgeries. Conventional biomaterials are vulnerable to biocontamination, which causes bacterial invasion in wounded areas, leading to postoperative infection. Therefore, development of anti-infection and immune-evasive coating for orthopedic implants is urgently needed. Here, we developed an advanced surface modification technique for orthopedic implants termed lubricated orthopedic implant surface (LOIS), which was inspired by slippery surface of Nepenthes pitcher plant. LOIS presents a long-lasting, extreme liquid repellency against diverse liquids and biosubstances including cells, proteins, calcium, and bacteria. In addition, we confirmed mechanical durability against scratches and fixation force by simulating inevitable damages during surgical procedure ex vivo. The antibiofouling and anti-infection capability of LOIS were thoroughly investigated using an osteomyelitis femoral fracture model of rabbits. We envision that the LOIS with antibiofouling properties and mechanical durability is a step forward in infection-free orthopedic surgeries.
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Affiliation(s)
- Kyomin Chae
- School of Electrical and Electronic Engineering, Yonsei University, Seoul 03722, Republic of Korea
| | - Woo Young Jang
- Department of Orthopedic Surgery, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - Kijun Park
- School of Electrical and Electronic Engineering, Yonsei University, Seoul 03722, Republic of Korea
| | - Jinhyeok Lee
- Department of Orthopedic Surgery, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - Hyunchul Kim
- School of Electrical and Electronic Engineering, Yonsei University, Seoul 03722, Republic of Korea
| | - Kyoungbun Lee
- Department of Pathology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Chang Kyu Lee
- Department of Laboratory Medicine, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - Yeontaek Lee
- School of Electrical and Electronic Engineering, Yonsei University, Seoul 03722, Republic of Korea
| | - Soon Hyuck Lee
- Department of Orthopedic Surgery, Korea University Anam Hospital, Seoul 02841, Republic of Korea.
| | - Jungmok Seo
- School of Electrical and Electronic Engineering, Yonsei University, Seoul 03722, Republic of Korea.
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Fedotchev A, Parin S, Savchuk L, Polevaya S. Mechanisms of Light and Music Stimulation Controlled by a Person's own Brain and Heart Biopotentials or Those of another Person. Sovrem Tekhnologii Med 2020; 12:23-28. [PMID: 34795989 PMCID: PMC8596279 DOI: 10.17691/stm2020.12.4.03] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Indexed: 11/14/2022] Open
Abstract
The aim of the study was to carry out comparative analysis of effects observed in subjects exposed to light and music stimulation controlled by their own brain and heart biopotentials (closed-loop method) or biopotentials of another person. MATERIALS AND METHODS Volunteers under stress participated in two experiments in pairs. In the first experiment, light and music stimulation effects formed in each subject in a pair on the basis of their own brain and heart biopotentials, while in the second experiment, they formed on the basis of biopotentials of the other subject. RESULTS Both types of exposure caused reducing the tension of the regulatory systems in the body, reducing stress levels and improving the emotional state due to the mechanisms of multisensory integration and neuroplasticity. A significant increase in the power of the main EEG rhythms, accompanied by significant positive changes in psychological testing results and positive emotional responses to stimulation was observed only during light and music stimulation controlled by the subjects' own brain and heart biopotentials. These data are attributable to the integration of perception and processing of interoceptive signals significant for humans into the resonance mechanisms of the central nervous system, providing normalization of functional state due to stimulation. CONCLUSION The data obtained can be used for developing the effective methods of personalized light and music stimulation aimed at timely elimination of functional disorders and returning the human body to homeostasis.
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Affiliation(s)
- A.I. Fedotchev
- Leading Researcher, Laboratory of Reception Mechanisms; Institute of Cell Biophysics, Russian Academy of Sciences, 3 Institutskaya St., Pushchino, Moscow Region, 142290, Russia
| | - S.B. Parin
- Professor, Department of Psychophysiology ; National Research Lobachevsky State University of Nizhni Novgorod, 23 Prospekt Gagarina, Nizhny Novgorod, 603950, Russia
| | - L.V. Savchuk
- PhD Student; National Research Lobachevsky State University of Nizhni Novgorod, 23 Prospekt Gagarina, Nizhny Novgorod, 603950, Russia
| | - S.A. Polevaya
- Head of the Department of Psychophysiology National Research Lobachevsky State University of Nizhni Novgorod, 23 Prospekt Gagarina, Nizhny Novgorod, 603950, Russia
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Influence of the pore size and porosity of selective laser melted Ti6Al4V ELI porous scaffold on cell proliferation, osteogenesis and bone ingrowth. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 106:110289. [DOI: 10.1016/j.msec.2019.110289] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 10/03/2019] [Accepted: 10/05/2019] [Indexed: 12/19/2022]
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Recent Trends, Technical Concepts and Components of Computer-Assisted Orthopedic Surgery Systems: A Comprehensive Review. SENSORS 2019; 19:s19235199. [PMID: 31783631 PMCID: PMC6929084 DOI: 10.3390/s19235199] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/08/2019] [Accepted: 11/12/2019] [Indexed: 12/17/2022]
Abstract
Computer-assisted orthopedic surgery (CAOS) systems have become one of the most important and challenging types of system in clinical orthopedics, as they enable precise treatment of musculoskeletal diseases, employing modern clinical navigation systems and surgical tools. This paper brings a comprehensive review of recent trends and possibilities of CAOS systems. There are three types of the surgical planning systems, including: systems based on the volumetric images (computer tomography (CT), magnetic resonance imaging (MRI) or ultrasound images), further systems utilize either 2D or 3D fluoroscopic images, and the last one utilizes the kinetic information about the joints and morphological information about the target bones. This complex review is focused on three fundamental aspects of CAOS systems: their essential components, types of CAOS systems, and mechanical tools used in CAOS systems. In this review, we also outline the possibilities for using ultrasound computer-assisted orthopedic surgery (UCAOS) systems as an alternative to conventionally used CAOS systems.
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Coupry A, Rony L, Ducellier F, Hubert L, Chappard D. Texture analysis of trabecular bone around RM-Pressfit cementless acetabulum in a series of 46 patients during a 5 year period. Orthop Traumatol Surg Res 2019; 105:1283-1287. [PMID: 31477444 DOI: 10.1016/j.otsr.2019.06.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 05/27/2019] [Accepted: 06/06/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Cementless total hip arthroplasty (THA) is a common procedure producing excellent clinical results. Their long-term survival is nevertheless burdened by loosening of the acetabular part caused by changes in the distribution of strains around the cup. In this context the RM-Pressfit® cup has been developed, resulting in a more harmonious distribution of the strains. HYPOTHESIS Texture analysis of X-ray films can evaluate the evolution of trabecular bone micro-architecture during the five years following THA with a RM-Pressfit® cup. MATERIAL AND METHOD A monocentric series of 46 hips was reviewed regularly within five years post- surgery. Radiographic evaluation of the operated hip was done on frontal digitized radiographs of the pelvis to follow evolution of bone micro-architecture in the #2 zone of De Lee and Charnley. Texture analysis using fractal algorithms was done at D0, 6 months, 1, 2 and 5 years post-THA. The fractal methods used included the skyscrapers and the dynamic blanket methods with 3 different structuring elements (a cross, a horizontal and a vertical vector). RESULTS The RM-Pressfit® caused significant changes in the distribution of strains around the acetabulum that preserved the bone volume over a 5-year period post-surgery. This corresponds to an improvement of the trabecular micro-architecture around the acetabular cups. CONCLUSION A statistically significant increase in the four fractal dimensions considered corresponded to an improved trabecular bone micro-architecture revealed by texture analysis, a non-invasive method that can be used on digitized X-ray images. LEVEL OF EVIDENCE IIIb, Case control study, retrospective design.
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Affiliation(s)
- Augustin Coupry
- Département de chirurgie osseuse, CHU-Angers, 49033 Angers, France
| | - Louis Rony
- Département de chirurgie osseuse, CHU-Angers, 49033 Angers, France; Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA-4658, SFR-4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU-Angers, 49933 Angers, France
| | | | - Laurent Hubert
- Département de chirurgie osseuse, CHU-Angers, 49033 Angers, France; Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA-4658, SFR-4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU-Angers, 49933 Angers, France
| | - Daniel Chappard
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA-4658, SFR-4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU-Angers, 49933 Angers, France.
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Chappard D, Kün-Darbois JD, Pascaretti-Grizon F, Camprasse G, Camprasse S. Giant cells and osteoclasts present in bone grafted with nacre differ by nuclear cytometry evaluated by texture analysis. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2019; 30:100. [PMID: 31468139 DOI: 10.1007/s10856-019-6293-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 07/26/2019] [Indexed: 06/10/2023]
Abstract
Nacre (mother of pearl) is a natural biomaterial used to prepare orthopedic devices. We have implanted screws and plates made with nacre in five sheeps. Bone were harvested after two months and embedded in poly(methyl methacrylate). Blocks were saws and the thick slabs were grinded, polished and surface stained. Sections were photographed at an ×1000 magnification. Giant cells were found in contact with nacre in eroded areas and true osteoclasts were found at distance in the neighboring bone in Howship lacunae. A texture analysis of the nuclei of giant cells and osteoclasts was done using the run-length method of the MaZda freeware. The size of the nuclei was reduced in osteoclast and their mean gray level appeared reduced. Texture analysis revealed that chromatin had a completely different pattern in giant cells when compared to osteoclasts. Giant cells had a fine repartition of the chromatin with large clear areas around prominent nucleoli. On the contrary, osteoclast nuclei had chromatin blocks evenly dispersed in the nuclei. This reflects the different origin of these cells expressing different functions.
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Affiliation(s)
- Daniel Chappard
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA-4658, SFR-4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU-Angers, 49933, Angers, France.
| | - Jean-Daniel Kün-Darbois
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA-4658, SFR-4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU-Angers, 49933, Angers, France
| | - Florence Pascaretti-Grizon
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, EA-4658, SFR-4208, Univ-Angers, IRIS-IBS Institut de Biologie en Santé, CHU-Angers, 49933, Angers, France
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Ti-Zr-Si-Nb Nanocrystalline Alloys and Metallic Glasses: Assessment on the Structural Development, Thermal Stability, Corrosion and Mechanical Properties. MATERIALS 2019; 12:ma12091551. [PMID: 31083618 PMCID: PMC6540074 DOI: 10.3390/ma12091551] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/02/2019] [Accepted: 05/10/2019] [Indexed: 11/17/2022]
Abstract
The development of novel Ti-based amorphous or β-phase nanostructured metallic materials could have significant benefits for implant applications, due to improved corrosion and mechanical characteristics (lower Young’s modulus, better wear performance, improved fracture toughness) in comparison to the standardized α+β titanium alloys. Moreover, the devitrification phenomenon, occurring during heating, could contribute to lower input power during additive manufacturing technologies. Ti-based alloy ribbons were obtained by melt-spinning, considering the ultra-fast cooling rates this method can provide. The titanium alloys contain in various proportions Zr, Nb, and Si (Ti60Zr10Si15Nb15, Ti64Zr10Si15Nb11, Ti56Zr10Si15Nb19) in various proportions. These elements were chosen due to their reported biological safety, as in the case of Zr and Nb, and the metallic glass-forming ability and biocompatibility of Si. The morphology and chemical composition were analyzed by scanning electron microscopy and energy-dispersive X-ray spectroscopy, while the structural features (crystallinity, phase attribution after devitrification (after heat treatment)) were assessed by X-ray diffraction. Some of the mechanical properties (hardness, Young’s modulus) were assessed by instrumented indentation. The thermal stability and crystallization temperatures were measured by differential thermal analysis. High-intensity exothermal peaks were observed during heating of melt-spun ribbons. The corrosion behavior was assessed by electrocorrosion tests. The results show the potential of these alloys to be used as materials for biomedical applications.
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Surface Modification of Biomedical Titanium Alloy: Micromorphology, Microstructure Evolution and Biomedical Applications. COATINGS 2019. [DOI: 10.3390/coatings9040249] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
With the increasing demand for bone implant therapy, titanium alloy has been widely used in the biomedical field. However, various potential applications of titanium alloy implants are easily hampered by their biological inertia. In fact, the interaction of the implant with tissue is critical to the success of the implant. Thus, the implant surface is modified before implantation frequently, which can not only improve the mechanical properties of the implant, but also polish up bioactivity and osseoconductivity on a cellular level. This paper aims at reviewing titanium surface modification techniques for biomedical applications. Additionally, several other significant aspects are described in detail in this article, for example, micromorphology, microstructure evolution that determines mechanical properties, as well as a number of issues concerning about practical application of biomedical implants.
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