1
|
Hassan N, Krieg T, Kopp A, Bach AD, Kröger N. Challenges and Pitfalls of Research Designs Involving Magnesium-Based Biomaterials: An Overview. Int J Mol Sci 2024; 25:6242. [PMID: 38892430 PMCID: PMC11172609 DOI: 10.3390/ijms25116242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/31/2024] [Accepted: 06/01/2024] [Indexed: 06/21/2024] Open
Abstract
Magnesium-based biomaterials hold remarkable promise for various clinical applications, offering advantages such as reduced stress-shielding and enhanced bone strengthening and vascular remodeling compared to traditional materials. However, ensuring the quality of preclinical research is crucial for the development of these implants. To achieve implant success, an understanding of the cellular responses post-implantation, proper model selection, and good study design are crucial. There are several challenges to reaching a safe and effective translation of laboratory findings into clinical practice. The utilization of Mg-based biomedical devices eliminates the need for biomaterial removal surgery post-healing and mitigates adverse effects associated with permanent biomaterial implantation. However, the high corrosion rate of Mg-based implants poses challenges such as unexpected degradation, structural failure, hydrogen evolution, alkalization, and cytotoxicity. The biocompatibility and degradability of materials based on magnesium have been studied by many researchers in vitro; however, evaluations addressing the impact of the material in vivo still need to be improved. Several animal models, including rats, rabbits, dogs, and pigs, have been explored to assess the potential of magnesium-based materials. Moreover, strategies such as alloying and coating have been identified to enhance the degradation rate of magnesium-based materials in vivo to transform these challenges into opportunities. This review aims to explore the utilization of Mg implants across various biomedical applications within cellular (in vitro) and animal (in vivo) models.
Collapse
Affiliation(s)
- Nourhan Hassan
- Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital Cologne, 50937 Cologne, Germany
- Institute for Laboratory Animal Science and Experimental Surgery, University of Aachen Medical Center, Faculty of Medicine, RWTH-Aachen University, 52074 Aachen, Germany
- Biotechnology Department, Faculty of Science, Cairo University, Giza 12613, Egypt
| | - Thomas Krieg
- Translational Matrix Biology, Medical Faculty, University of Cologne, 50937 Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50937 Cologne, Germany
- Center for Molecular Medicine (CMMC), University of Cologne, 50937 Cologne, Germany
| | | | - Alexander D. Bach
- Department of Plastic, Aesthetic and Hand Surgery, St. Antonius Hospital Eschweiler, 52249 Eschweiler, Germany
| | - Nadja Kröger
- Institute for Laboratory Animal Science and Experimental Surgery, University of Aachen Medical Center, Faculty of Medicine, RWTH-Aachen University, 52074 Aachen, Germany
- Department of Plastic, Aesthetic and Hand Surgery, St. Antonius Hospital Eschweiler, 52249 Eschweiler, Germany
| |
Collapse
|
2
|
Zhong C, Zhu H, Sheng Y, Wo J, You D, Sun G, Yu Z, Li W, Wang X. Biocompatibility and osteogenic potential of choline phosphate chitosan-coated biodegradable Zn1Mg. Acta Biomater 2024; 175:395-410. [PMID: 38096961 DOI: 10.1016/j.actbio.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 12/25/2023]
Abstract
Zinc alloys have demonstrated considerable potentials as implant materials for biodegradable vascular and orthopedic applications. However, the high initial release of Zn2+ can trigger intense immune responses that impede tissue healing. To address this challenge and enhance the osteogenic capacity of zinc alloys, the surface of Zn1Mg was subjected to CO2 plasma modification (Zn1Mg-PP) followed by grafting with choline phosphate chitosan (Zn1Mg-PP-PCCs). This study aims to investigate the in vitro and in vivo biocompatibility of the surface-modified Zn1Mg. The effect of the surface modification on the inflammatory response and osteogenic repair process was investigated. Compared with unmodified Zn1Mg, the degradation rate of Zn1Mg-PP-PCCs was significantly decreased, avoiding the cytotoxicity triggered by the release of large amounts of Zn2+. Moreover, PCCs significantly enhanced the cell-material adhesion, promoted the proliferation of osteoblasts (MC3T3-E1) and upregulated the expression of key osteogenic factors in vitro. Notably, the in vivo experiments revealed that the surface modification of Zn1Mg suppressed inhibited the expression of inflammatory cytokines, promoting the secretion of anti-inflammatory factors, thereby reducing inflammation and promoting bone tissue repair. Furthermore, histological analysis of tissue sections exhibited strong integration between the material and the bone, along with well-defined new bone formation and reduced osteoclast aggregation on the surface. This was attributed to the improved immune microenvironment by PCCs, which promoted osteogenic differentiation of osteoblasts. These findings highlight that the preparation of PCCs coatings on zinc alloy surfaces effectively inhibited ion release and modulated the immune environment to promote bone tissue repair. STATEMENT OF SIGNIFICANCE: Surface modification of biodegradable Zn alloys facilitates the suppression of intense immune responses caused by excessive ion release concentrations from implants. We modified the surface of Zn1Mg with choline phosphate chitosan (PCCs) and investigated the effects of surface modification on the inflammatory response and osteogenic repair process. In vitro results showed that the PCCs coating effectively reduced the degradation rate of Zn1Mg to avoid cytotoxicity caused by high Zn2+ concentration, favoring the proliferation of osteoblasts. In addition, in vivo results indicated that Zn1Mg-PP-PCCs attenuated inflammation to promote bone repair by modulating the release of inflammation-related factors. The surface-modified Zn1Mg implants demonstrated strong osseointegration, indicating that the PCCs coating effectively modulated the immune microenvironment and promoted bone healing.
Collapse
Affiliation(s)
- Chen Zhong
- Institute of Advanced Wear & Corrosion Resistant and Functional Materials, Jinan University, Guangzhou 510632, China
| | - Haoran Zhu
- Guandgong Provincial Key Laboratory of Spine and Spinal Cord Reconstruction, The Fifth Affiliated Hospital (Heyuan Shenhe People's Hospital), Heyuan 517000, China
| | - Yinying Sheng
- Institute of Corrosion Science and Technology, Guangzhou 510530, China.
| | - Jin Wo
- Department of Orthopedics, The First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Deqiang You
- Institute of Advanced Wear & Corrosion Resistant and Functional Materials, Jinan University, Guangzhou 510632, China
| | - Guodong Sun
- Guandgong Provincial Key Laboratory of Spine and Spinal Cord Reconstruction, The Fifth Affiliated Hospital (Heyuan Shenhe People's Hospital), Heyuan 517000, China; Department of Orthopedics, The First Affiliated Hospital, Jinan University, Guangzhou 510630, China.
| | - Zhentao Yu
- Institute of Advanced Wear & Corrosion Resistant and Functional Materials, Jinan University, Guangzhou 510632, China
| | - Wei Li
- Institute of Advanced Wear & Corrosion Resistant and Functional Materials, Jinan University, Guangzhou 510632, China
| | - Xiaojian Wang
- Institute of Advanced Wear & Corrosion Resistant and Functional Materials, Jinan University, Guangzhou 510632, China; Shaoguan Research Institute of Jinan University, 168 Muxi Avenue, Shaoguan 512029, China.
| |
Collapse
|
3
|
Zhao G, Wang S, Wang G, Zhang B, Huang H, Yao Y. Enhancing bone formation using absorbable AZ31B magnesium alloy membranes during distraction osteogenesis: A new material study. Heliyon 2023; 9:e18032. [PMID: 37534007 PMCID: PMC10391921 DOI: 10.1016/j.heliyon.2023.e18032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 06/24/2023] [Accepted: 07/05/2023] [Indexed: 08/04/2023] Open
Abstract
Purpose To investigate whether the use of absorble AZ31B magnesium alloys over distraction gaps improves the quality and quantity of regenerated bone better than the use of Collagen membranes. Methods Fifteen mixed-breed dogs were randomly divided into the experimental (n = 10) and control (n = 5) groups. In the experimental group, two devices were implanted along the mandible; one side with absorble AZ31B and the other side with Collagen. The control animals did not undergo osteotomy or distraction. After a consolidation time of two months, 30 specimens were harvested, and newly created bone was identified using CBCT and micro-CT. Results The Collagen membranes were absorbed completely, and the AZ31B membranes became irregular and rough. Mandible length was successfully extended approximately 1 cm. More bone formation was found after using AZ31B than Collagen, and there was a significant difference in width reduction between experimental sites treated with AZ31B (0.11 ± 0.04 cm) and Collagen (0.42 ± 0.06 cm) (p < 0.05). Trabecular thickness was also significantly higher in AZ31B (0.338 ± 0.08 cm) and control (0.417 ± 0.05 cm) than Collagen (0.178 ± 0.04 cm) (p < 0.05). Conclusion An AZ31B membrane barrier is biocompatible and absorbable which can maintain the distraction gap and provide support to the attached osteoprogenitors by providing space for them to proliferate.
Collapse
Affiliation(s)
- Guiran Zhao
- Department of Oral and Maxillofacial Surgery. First Affiliated Hospital of Jinzhou Medical University, Jinzhou City, Liaoning Province, China
| | - Shu Wang
- Second Affiliated Hospital of Jinzhou Medical University, Jinzhou City, Liaoning Province, China
| | - Guijun Wang
- First Affiliated Hospital of Jinzhou Medical University, Jinzhou City, Liaoning Province, China
| | - Bin Zhang
- First Affiliated Hospital of Jinzhou Medical University, Jinzhou City, Liaoning Province, China
| | - Han Huang
- First Affiliated Hospital of Jinzhou Medical University, Jinzhou City, Liaoning Province, China
| | - Yusheng Yao
- Third Affiliated Hospital of Jinzhou Medical University, No.2, Section5, Heping Road, Linghe District, Jinzhou City, Liaoning Province, China
| |
Collapse
|
4
|
Lupescu Ș, Munteanu C, Sindilar EV, Istrate B, Mihai I, Oprisan B, Pasca AS. Long-Term Examination of Degradation and In Vivo Biocompatibility of Some Mg-0.5Ca-xY Alloys in Sprague Dawley Rats. MATERIALS (BASEL, SWITZERLAND) 2022; 15:5958. [PMID: 36079340 PMCID: PMC9456631 DOI: 10.3390/ma15175958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/11/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
The medical field has undergone constant development in recent years, and a segment of this development is occupied by biodegradable alloys. The most common alloys in this field are those based on Mg, their main advantage being the ability to degrade gradually, without affecting the patient, and also their ability to be fully absorbed by the human body. One of their most important conditions is the regeneration and replacement of human tissue. Tissue can be engineered in different ways, one being tissue regeneration in vivo, which can serve as a template. In vivo remodeling aims to restore tissue or organs. The key processes of tissue formation and maturation are: proliferation (sorting and differentiation of cells), proliferation and organization of the extracellular matrix, biodegradation of the scaffold-remodeling, and potential tissue growth. In the present paper, the design of the alloys in the Mg-Ca-Y system is formed from the beginning using high-purity components, Mg-98.5%, master-alloys: Mg-Y (70 wt.%-30 wt.%) and Mg-Ca (85 wt.%-15 wt.%). After 8 weeks of implantation, the degradation of the implanted material is observed, and only small remaining fragments are found. At the site of implantation, no inflammatory reaction is observed, but it is observed that the process of integration and reabsorption, over time, accentuates the prosaic surface of the material. The aim of the work is to test the biocompatibility of magnesium-based alloys on laboratory rats in order to use these alloys in medical applications. The innovative parts of these analyses are the chemical composition of the alloys used and the tests performed on laboratory animals.
Collapse
Affiliation(s)
- Ștefan Lupescu
- Department of Mechanics and Technologies, Stefan cel Mare University of Suceava, 13 University Street, 720229 Suceava, Romania
| | - Corneliu Munteanu
- Mechanical Engineering Department, Gheorghe Asachi University of Iasi, 6 D. Mangeron Blvd, 700050 Iasi, Romania
- Technical Sciences Academy of Romania, 26 Dacia Blvd, 030167 Bucharest, Romania
| | - Eusebiu Viorel Sindilar
- Faculty of Veterinary Medicine of Lasi, “Ion Ionescu de la Brad” Iași University of Life Sciences (IULS), nr.8, Mihail Sadoveanu Alley, 700490 Iasi, Romania
| | - Bogdan Istrate
- Mechanical Engineering Department, Gheorghe Asachi University of Iasi, 6 D. Mangeron Blvd, 700050 Iasi, Romania
| | - Iuliana Mihai
- Faculty of Veterinary Medicine of Lasi, “Ion Ionescu de la Brad” Iași University of Life Sciences (IULS), nr.8, Mihail Sadoveanu Alley, 700490 Iasi, Romania
| | - Bogdan Oprisan
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy from Iasi, Universității 16 Street, 700115 Iasi, Romania
| | - Aurelian-Sorin Pasca
- Faculty of Veterinary Medicine of Lasi, “Ion Ionescu de la Brad” Iași University of Life Sciences (IULS), nr.8, Mihail Sadoveanu Alley, 700490 Iasi, Romania
| |
Collapse
|
5
|
Millán-Ramos B, Morquecho-Marín D, Silva-Bermudez P, Ramírez-Ortega D, Depablos-Rivera O, García-López J, Fernández-Lizárraga M, Almaguer-Flores A, Victoria-Hernández J, Letzig D, Rodil SE. Degradation Behavior and Mechanical Integrity of a Mg-0.7Zn-0.6Ca (wt.%) Alloy: Effect of Grain Sizes and Crystallographic Texture. MATERIALS 2022; 15:ma15093142. [PMID: 35591473 PMCID: PMC9102660 DOI: 10.3390/ma15093142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/08/2022] [Accepted: 04/22/2022] [Indexed: 02/01/2023]
Abstract
The microstructural characteristics of biodegradable Mg alloys determine their performance and appropriateness for orthopedic fixation applications. In this work, the effect of the annealing treatment of a Mg-0.7Zn-0.6Ca (ZX11) alloy on the mechanical integrity, corrosive behavior, and biocompatibility-osteoinduction was studied considering two annealing temperatures, 350 and 450 °C. The microstructure showed a recrystallized structure, with a lower number of precipitates, grain size, and stronger basal texture for the ZX11-350 condition than the ZX11-450. The characteristics mentioned above induce a higher long-term degradation rate for the ZX11-450 than the ZX11-350 on days 7th and 15th of immersion. In consequence, the mechanical integrity changes within this period. The increased degradation rate of the ZX11-450 condition reduces 40% the elongation at failure, in contrast with the 16% reduction for the ZX11-350 condition. After that period, the mechanical integrity remained unchanged. No cytotoxic effects were observed for both treatments and significant differentiation of mesenchymal stem cells into the osteoblast phenotype was observed.
Collapse
Affiliation(s)
- Benjamin Millán-Ramos
- Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico; (D.R.-O.); (O.D.-R.); (S.E.R.)
- Posgrado en Ciencia e Ingeniería de Materiales, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
- Correspondence: (B.M.-R.); (J.V.-H.)
| | - Daniela Morquecho-Marín
- Unidad de Ingeniería de Tejidos, Terapia Celular y Medicina Regenerativa, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City 14389, Mexico; (D.M.-M.); (P.S.-B.); (J.G.-L.); (M.F.-L.)
- Posgrado en Ciencias Médicas, Odontológicas y de la Salud, Ciencias Odontológicas, Universidad Nacional Autónoma de México, Mexico City 14389, Mexico
| | - Phaedra Silva-Bermudez
- Unidad de Ingeniería de Tejidos, Terapia Celular y Medicina Regenerativa, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City 14389, Mexico; (D.M.-M.); (P.S.-B.); (J.G.-L.); (M.F.-L.)
| | - David Ramírez-Ortega
- Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico; (D.R.-O.); (O.D.-R.); (S.E.R.)
| | - Osmary Depablos-Rivera
- Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico; (D.R.-O.); (O.D.-R.); (S.E.R.)
- Departamento de Ingeniería Metalúrgica, Facultad de Química, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Julieta García-López
- Unidad de Ingeniería de Tejidos, Terapia Celular y Medicina Regenerativa, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City 14389, Mexico; (D.M.-M.); (P.S.-B.); (J.G.-L.); (M.F.-L.)
| | - Mariana Fernández-Lizárraga
- Unidad de Ingeniería de Tejidos, Terapia Celular y Medicina Regenerativa, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City 14389, Mexico; (D.M.-M.); (P.S.-B.); (J.G.-L.); (M.F.-L.)
- Posgrado de Doctorado en Ciencias en Biomedicina y Biotecnología Molecular, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City 11340, Mexico
| | - Argelia Almaguer-Flores
- Laboratorio de Biointerfaces, Facultad de Odontología, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico;
| | - José Victoria-Hernández
- Institute of Material and Process Design, Helmholtz-Zentrum Hereon, 21502 Geesthacht, Germany;
- Correspondence: (B.M.-R.); (J.V.-H.)
| | - Dietmar Letzig
- Institute of Material and Process Design, Helmholtz-Zentrum Hereon, 21502 Geesthacht, Germany;
| | - Sandra E. Rodil
- Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico; (D.R.-O.); (O.D.-R.); (S.E.R.)
| |
Collapse
|
6
|
Jung O, Hesse B, Stojanovic S, Seim C, Weitkamp T, Batinic M, Goerke O, Kačarević ŽP, Rider P, Najman S, Barbeck M. Biocompatibility Analyses of HF-Passivated Magnesium Screws for Guided Bone Regeneration (GBR). Int J Mol Sci 2021; 22:ijms222212567. [PMID: 34830451 PMCID: PMC8624161 DOI: 10.3390/ijms222212567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Magnesium (Mg) is one of the most promising materials for human use in surgery due to material characteristics such as its elastic modulus as well as its resorbable and regenerative properties. In this study, HF-coated and uncoated novel bioresorbable magnesium fixation screws for maxillofacial and dental surgical applications were investigated in vitro and in vivo to evaluate the biocompatibility of the HF coating. Methods: Mg alloy screws that had either undergone a surface treatment with hydrofluoric-acid (HF) or left untreated were investigated. In vitro investigation included XTT, BrdU and LDH in accordance with the DIN ISO 10993-5/-12. In vivo, the screws were implanted into the tibia of rabbits. After 3 and 6 weeks, degradation, local tissue reactions and bony integration were analyzed histopathologically and histomorphometrically. Additionally, SEM/EDX analysis and synchrotron phase-contrast microtomography (µCT) measurements were conducted. The in vitro analyses revealed that the Mg screws are cytocompatible, with improved results when the surface had been passivated with HF. In vivo, the HF-treated Mg screws implanted showed a reduction in gas formation, slower biodegradation and a better bony integration in comparison to the untreated Mg screws. Histopathologically, the HF-passivated screws induced a layer of macrophages as part of its biodegradation process, whereas the untreated screws caused a slight fibrous tissue reaction. SEM/EDX analysis showed that both screws formed a similar layer of calcium phosphates on their surfaces and were surrounded by bone. Furthermore, the µCT revealed the presence of a metallic core of the screws, a faster absorbing corrosion front and a slow absorbing region of corroded magnesium. Conclusions: Overall, the HF-passivated Mg fixation screws showed significantly better biocompatibility in vitro and in vivo compared to the untreated screws.
Collapse
Affiliation(s)
- Ole Jung
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany;
| | | | - Sanja Stojanovic
- Department of Biology and Human Genetics, Faculty of Medicine, University of Niš, 18108 Niš, Serbia; (S.S.); (S.N.)
- Scientific Research Center for Biomedicine, Faculty of Medicine, Department for Cell and Tissue Engineering, University of Niš, 18108 Niš, Serbia
| | | | - Timm Weitkamp
- Synchrotron SOLEIL, Gif-sur-Yvette, 91190 Saint-Aubin, France;
| | - Milijana Batinic
- Department of Ceramic Materials, Chair of Advanced Ceramic Materials, Institute for Materials Science and Technologies, Technical University of Berlin, 10623 Berlin, Germany; (M.B.); (O.G.)
- Department of Anatomy Histology, Embryology, Pathology Anatomy and Pathology Histology, Faculty of Dental Medicine and Health, University of Osijek, 31000 Osijek, Croatia;
| | - Oliver Goerke
- Department of Ceramic Materials, Chair of Advanced Ceramic Materials, Institute for Materials Science and Technologies, Technical University of Berlin, 10623 Berlin, Germany; (M.B.); (O.G.)
| | - Željka Perić Kačarević
- Department of Anatomy Histology, Embryology, Pathology Anatomy and Pathology Histology, Faculty of Dental Medicine and Health, University of Osijek, 31000 Osijek, Croatia;
| | - Patrick Rider
- Department of Anatomy Histology, Embryology, Pathology Anatomy and Pathology Histology, Faculty of Dental Medicine and Health, University of Osijek, 31000 Osijek, Croatia;
| | - Stevo Najman
- Department of Biology and Human Genetics, Faculty of Medicine, University of Niš, 18108 Niš, Serbia; (S.S.); (S.N.)
- Scientific Research Center for Biomedicine, Faculty of Medicine, Department for Cell and Tissue Engineering, University of Niš, 18108 Niš, Serbia
| | - Mike Barbeck
- Department of Anatomy Histology, Embryology, Pathology Anatomy and Pathology Histology, Faculty of Dental Medicine and Health, University of Osijek, 31000 Osijek, Croatia;
- Correspondence: ; Tel.: +49-176-810-224-6
| |
Collapse
|
7
|
Zhang J, Jiang Y, Shang Z, Zhao B, Jiao M, Liu W, Cheng M, Zhai B, Guo Y, Liu B, Shi X, Ma B. Biodegradable metals for bone defect repair: A systematic review and meta-analysis based on animal studies. Bioact Mater 2021; 6:4027-4052. [PMID: 33997491 PMCID: PMC8089787 DOI: 10.1016/j.bioactmat.2021.03.035] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 12/18/2022] Open
Abstract
Biodegradable metals are promising candidates for bone defect repair. With an evidence-based approach, this study investigated and analyzed the performance and degradation properties of biodegradable metals in animal models for bone defect repair to explore their potential clinical translation. Animal studies on bone defect repair with biodegradable metals in comparison with other traditional biomaterials were reviewed. Data was carefully collected after identification of population, intervention, comparison, outcome, and study design (PICOS), and following the inclusion criteria of biodegradable metals in animal studies. 30 publications on pure Mg, Mg alloys, pure Zn and Zn alloys were finally included after extraction from a collected database of 2543 publications. A qualitative systematic review and a quantitative meta-analysis were performed. Given the heterogeneity in animal model, anatomical site and critical size defect (CSD), biodegradable metals exhibited mixed effects on bone defect repair and degradation in animal studies in comparison with traditional non-degradable metals, biodegradable polymers, bioceramics, and autogenous bone grafts. The results indicated that there were limitations in the experimental design of the included studies, and quality of the evidence presented by the studies was very low. To enhance clinical translation of biodegradable metals, evidence-based research with data validity is needed. Future studies should adopt standardized experimental protocols in investigating the effects of biodegradable metals on bone defect repair with animal models.
Collapse
Affiliation(s)
- Jiazhen Zhang
- Center for Medical Device Evaluation, National Medical Products Administration, Beijing, 100081, PR China
| | - Yanbiao Jiang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, PR China
| | - Zhizhong Shang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, PR China
| | - Bing Zhao
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, PR China
| | - Mingyue Jiao
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, PR China
| | - Wenbo Liu
- Center for Medical Device Evaluation, National Medical Products Administration, Beijing, 100081, PR China
| | - Maobo Cheng
- Center for Medical Device Evaluation, National Medical Products Administration, Beijing, 100081, PR China
| | - Bao Zhai
- Center for Medical Device Evaluation, National Medical Products Administration, Beijing, 100081, PR China
| | - Yajuan Guo
- Center for Medical Device Evaluation, National Medical Products Administration, Beijing, 100081, PR China
| | - Bin Liu
- Center for Medical Device Evaluation, National Medical Products Administration, Beijing, 100081, PR China
| | - Xinli Shi
- Center for Medical Device Evaluation, National Medical Products Administration, Beijing, 100081, PR China
| | - Bin Ma
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, PR China
- Institute of Health Data Science, Lanzhou University, Lanzhou, 730000, PR China
| |
Collapse
|
8
|
Long Term Evaluation of Biodegradation and Biocompatibility In-Vivo the Mg-0.5Ca-xZr Alloys in Rats. CRYSTALS 2021. [DOI: 10.3390/cryst11010054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Biodegradable alloys in Mg have the advantages of traditional metallic materials and those of biodegradable polymers with superior strength, lower density and ideal rigidity for fixing bone fractures. The biocompatibility and biodegradability of the five concentrations of Mg-0.5Ca-xZr alloys used were assessed using clinical and laboratory examinations that followed over time: tissue reaction, histological and imaging (RX, CT and SEM) evolution at 1, 2, 4 and 8 weeks after implant. The main purpose of this study was to investigate in vivo the long-term effect of Mg-0.5Ca-xZr alloys in rats. The results confirmed that Mg-0.5Ca-xZr alloys are biocompatible and biodegradable and are recommended to be used as possible materials for new orthopedics devices.
Collapse
|
9
|
Chagnon M, Guy LG, Jackson N. Evaluation of Magnesium-based Medical Devices in Preclinical Studies: Challenges and Points to Consider. Toxicol Pathol 2019; 47:390-400. [PMID: 30712470 DOI: 10.1177/0192623318816936] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Absorbable metallic implants have been under investigation for more than a century. Animal and human studies have shown that magnesium (Mg) alloys can be safely used in bioresorbable scaffolds. Several cardiovascular and orthopedic biodegradable metallic devices have recently been approved for use in humans. Bioresorbable Mg implants present many advantages when compared to bioabsorbable polymer or nonabsorbable metallic implants, including similar strength and mechanical properties as existing implant-grade metals without the drawbacks of permanence or need for implant removal. Imaging visibility is also improved compared to polymeric devices. Additionally, with Mg-based cardiovascular stents, the risk of late stent thrombosis and need for long-term anti-platelet therapy may be reduced as the host tissue absorbs the Mg degradation products and the morphology of the vessel returns to a near-normal state. Absorbable Mg implants present challenges in the conduct of preclinical animal studies and interpretation of pathology data due to their particular degradation process associated with gas production and release of by-products. This article will review the different uses of Mg implants, the Mg alloys, the distinctive degradation features of Mg, and the challenges confronting pathologists at tissue collection, fixation, imaging, slide preparation, evaluation, and interpretation of Mg implants.
Collapse
|
10
|
Patil A, Zaky SH, Chong R, Verdelis K, Beniash E. In vivo study of self-assembled alkylsilane coated degradable magnesium devices. J Biomed Mater Res B Appl Biomater 2019; 107:342-351. [PMID: 29638047 PMCID: PMC6371401 DOI: 10.1002/jbm.b.34126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 02/21/2018] [Accepted: 03/14/2018] [Indexed: 12/12/2022]
Abstract
Magnesium (Mg) and its alloys are candidate materials for resorbable implantable devices, such as orthopedic devices or cardiovascular stents. Mg has a number advantages, including mechanical properties, light weight, its osteogenic effects and the fact that its degradation products are nontoxic and naturally present in the body. However, production of H2 gas during the corrosion reaction can cause formation of gas pockets at the implantation site, posing a barrier to clinical applications of Mg. It is therefore desirable to develop methods to control corrosion rate and gas pocket formation around the implants. Here we evaluate the potential of self-assembled multilayer alkylsilane (AS) coatings to control Mg device corrosion and formation of gas pockets in vivo and to assess effects of the AS coatings on the surrounding tissues in a subcutaneous mouse model over a 6 weeks' period. The coating significantly slowed down corrosion and gas pocket formation as evidenced by smaller gas pockets around the AS coated implants (ANOVA; p = 0.013) and decrease in the weight loss values (t test; p = 0.07). Importantly, the microCT and profilometry analyses demonstrated that the coating inhibited the pitting corrosion. Specifically, the roughness of the coated samples was ∼30% lower than uncoated specimen (p = 0.02). Histological assessment of the tissues under the implant revealed no inflammation or foreign body reaction. Overall, our results demonstrate the feasibility of use of the seld assembled AS coatings for reduction of gas pocket formation around the resorbable Mg devices. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 107B: 342-351, 2019.
Collapse
Affiliation(s)
- Avinash Patil
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261
- Center for Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261
| | - Samer H Zaky
- Center for Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261
- Department of Restorative Dentistry, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261
| | - Rong Chong
- Center for Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261
| | - Kostas Verdelis
- Center for Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, 15219
| | - Elia Beniash
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261
- Center for Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261
- Department of Restorative Dentistry, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261
| |
Collapse
|
11
|
Riaz U, Shabib I, Haider W. The current trends of Mg alloys in biomedical applications-A review. J Biomed Mater Res B Appl Biomater 2018; 107:1970-1996. [PMID: 30536973 DOI: 10.1002/jbm.b.34290] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 11/10/2018] [Accepted: 11/15/2018] [Indexed: 01/25/2023]
Abstract
Magnesium (Mg) has emerged as an ideal alternative to the permanent implant materials owing to its enhanced properties such as biodegradation, better mechanical strengths than polymeric biodegradable materials and biocompatibility. It has been under investigation as an implant material both in cardiovascular and orthopedic applications. The use of Mg as an implant material reduces the risk of long-term incompatible interaction of implant with tissues and eliminates the second surgical procedure to remove the implant, thus minimizes the complications. The hurdle in the extensive use of Mg implants is its fast degradation rate, which consequently reduces the mechanical strength to support the implant site. Alloy development, surface treatment, and design modification of implants are the routes that can lead to the improved corrosion resistance of Mg implants and extensive research is going on in all three directions. In this review, the recent trends in the alloying and surface treatment of Mg have been discussed in detail. Additionally, the recent progress in the use of computational models to analyze Mg bioimplants has been given special consideration. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1970-1996, 2019.
Collapse
Affiliation(s)
- Usman Riaz
- School of Engineering and Technology, Central Michigan University, Mount Pleasant, Michigan, 48859
| | - Ishraq Shabib
- School of Engineering and Technology, Central Michigan University, Mount Pleasant, Michigan, 48859.,Science of Advanced Materials, Central Michigan University, Mount Pleasant, Michigan, 48859
| | - Waseem Haider
- School of Engineering and Technology, Central Michigan University, Mount Pleasant, Michigan, 48859.,Science of Advanced Materials, Central Michigan University, Mount Pleasant, Michigan, 48859
| |
Collapse
|
12
|
Yu Y, Lu H, Sun J. Long-term in vivo evolution of high-purity Mg screw degradation - Local and systemic effects of Mg degradation products. Acta Biomater 2018; 71:215-224. [PMID: 29505891 DOI: 10.1016/j.actbio.2018.02.023] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 02/08/2018] [Accepted: 02/22/2018] [Indexed: 12/12/2022]
Abstract
Magnesium (Mg) based materials are the focus of research for use as degradable materials in orthopedics and cranio-maxillofacial surgery. However, corrosion rate control and biosecurity are still the key issues that need to be solved prior to their clinical applications. In the present study, as-rolled high-purity magnesium (HP Mg, 99.99 wt%) screws were implanted in rabbit tibiae for up to 52 weeks in order to investigate their long-term in vivo degradation and the local and systemic effects of their degradation products. A series of long-term monitoring were performed at various time points (4w, 12w, 26w and 52w) after implantation using numerous investigations such as micro-CT assay, histomorphometric analysis, local micro-environment testing and biochemical analysis of serum and urine. It was revealed that HP Mg screws had a uniform degradation morphology and a slow degradation rate in vivo during the period of 52 weeks. Their degradation products not only increased the local pH values but also changed the local Mg2+ ions concentration and gas cavity area in the peri-implant tissues in a dynamic manner. More importantly, both the new bone formation and bone-implant contact rate were increased at bone-implant interfaces at 26 weeks and 52 weeks post-implantation. Furthermore, neither abnormal elevation of serum magnesium and urine magnesium level, nor liver and kidney dysfunction were detected during the monitoring period of 26 weeks. All these results of long-term investigation suggest that HP Mg screws possess a slow degradation rate, desirable bone repair capacity and long-term local/systemic biosafety, and consequently may have good potential for application as bone fixation devices. STATEMENT OF SIGNIFICANCE The corrosion resistance control and biosecurity issues of Mg alloys limited their clinical applications in some extent. Mg purification is another effective way to improve corrosion resistance of Mg-based materials. However, the long-term in vivo degradation of high-purity magnesium (HP Mg) and the local and systemic effects of its degradation products have not been fully investigated yet, which are the key factors to determine the clinical application prospect of HP Mg. Especially the changes in peri-implant microenvironment may greatly influence the local physiological response and bone repair. In this study, the long-term evolution tendency of in vivo degradation behavior of HP Mg screws was discovered from the view of space-time. Furthermore, not only the dynamic changes of local microenvironment and the long-term evolution process of bone repair, but also the dynamic systemic responses were systematically revealed. Conclusions of this study may help us to further understand the long-term in vivo evolution of HP Mg degradation and the local/systemic effects of its degradation products and help to guide the design of biodegradable bone fixation material.
Collapse
|
13
|
Yang H, Qu X, Lin W, Wang C, Zhu D, Dai K, Zheng Y. In vitro and in vivo studies on zinc-hydroxyapatite composites as novel biodegradable metal matrix composite for orthopedic applications. Acta Biomater 2018. [PMID: 29530820 DOI: 10.1016/j.actbio.2018.03.007] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Recent studies indicate that there is a great demand to optimize pure Zn with tunable degradation rates and more desirable biocompatibility as orthopedic implants. Metal matrix composite (MMC) can be a promising approach for this purpose. In this study, MMC with pure Zn as a matrix and hydroxyapatite (HA) as reinforcements were prepared by spark plasma sintering (SPS). Feasibility of novel Zn-HA composites to be used as orthopedic implant applications was systematically evaluated. After sintering, HA distributed in the Zn particle boundaries uniformly. Corrosion tests indicated that the degradation rates of Zn-HA composites were adjustable due to the biphasic effects of HA. Zn-HA composites showed significantly improved cell viability of osteoblastic MC3T3-E1 cells compared with pure Zn. Both pure Zn and composites exhibited a low thrombosis risk and hemolysis rates while a Zn ion concentration-dependent effect was found on coagulation time. An effective antibacterial property was observed as well. The volume loss of pure Zn and Zn-5HA composite was 1.7% and 3.2% after 8 weeks' implantation. Histological analysis found newly formed bone surrounding pure Zn and Zn-5HA composite at week 4 and increased bone mass over time. With prolonged implantation time, Zn-5HA composite was more effective on stimulating new bone formation than pure Zn. In summary, MMC is a feasible way to design Zn based materials with adjustable degradation rates and improved biocompatibility. STATEMENT OF SIGNIFICANCE Biodegradable zinc materials are promising candidates for the new generation of orthopedic implants. However, the slow degradation rates and unsatisfactory cytocompatibility of pure Zn in bone environments limit its future clinical applications. Generally, alloying is a common way to improve the performance of pure Zn. In this study, metal matrix composite was chosen as a novel strategy to solve the problems. Hydroxyapatite, as a bioactive component, was added into Zn matrix via spark plasma sintering. We find that Zn-HA composites exhibited adjustable degradation rates and improved biocompatibility both in vitro and in vivo. This study provides exhaustive and significant information including microstructure, mechanical performance, degradation behavior, biocompatibility, hemocompatibility and antibacterial property for the future Zn based implants design.
Collapse
|
14
|
Mechanical and degradation property improvement in a biocompatible Mg-Ca-Sr alloy by thermomechanical processing. J Mech Behav Biomed Mater 2018; 80:285-292. [DOI: 10.1016/j.jmbbm.2018.02.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 11/07/2017] [Accepted: 02/01/2018] [Indexed: 01/10/2023]
|
15
|
Berglund IS, Dirr EW, Ramaswamy V, Allen JB, Allen KD, Manuel MV. The effect of Mg-Ca-Sr alloy degradation products on human mesenchymal stem cells. J Biomed Mater Res B Appl Biomater 2018; 106:697-704. [PMID: 28323384 PMCID: PMC5811831 DOI: 10.1002/jbm.b.33869] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 01/12/2017] [Accepted: 02/13/2017] [Indexed: 11/12/2022]
Abstract
Biodegradable Mg alloys have the potential to replace currently used metallic medical implant devices, likely eliminating toxicity concerns and the need for secondary surgeries, while also providing a potentially stimulating environment for tissue growth. A recently developed Mg-Ca-Sr alloy possesses advantageous characteristics over other Mg alloys, having a good combination of strength and degradation behavior, while also displaying potentially osteogenic properties. To better understand the effect of alloy degradation products on cellular mechanisms, in vitro studies using human bone marrow-derived mesenchymal stem cells were conducted. Ionic products of alloy dissolution were found to be nontoxic but changed the proliferation profile of stem cells. Furthermore, their presence changed the progress of osteogenic development, while concentrations of Mg in particular appeared to induce stem cell differentiation. The work presented herein provides a foundation for future alloy design where structures can be tailored to obtain specific implant performance. These potentially bioactive implants would reduce the risks for patients by shortening their healing time, minimizing discomfort and toxicity concerns, while reducing hospital costs. © 2017 The Authors Journal of Biomedical Materials Research Part B: Applied Biomaterials Published by Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 697-704, 2018.
Collapse
Affiliation(s)
- Ida S. Berglund
- Department of Materials Science and EngineeringUniversity of FloridaGainesvilleFlorida32611
| | - Elliott W. Dirr
- Department of Biomedical EngineeringUniversity of FloridaGainesvilleFlorida32611
| | - Vidhya Ramaswamy
- Department of Materials Science and EngineeringUniversity of FloridaGainesvilleFlorida32611
| | - Josephine B. Allen
- Department of Materials Science and EngineeringUniversity of FloridaGainesvilleFlorida32611
- Institute of Cell and Tissue Science and Engineering, University of FloridaGainesvilleFlorida32611
| | - Kyle D. Allen
- Department of Biomedical EngineeringUniversity of FloridaGainesvilleFlorida32611
| | - Michele V. Manuel
- Department of Materials Science and EngineeringUniversity of FloridaGainesvilleFlorida32611
| |
Collapse
|
16
|
Rehman M, Madni A, Webster TJ. The era of biofunctional biomaterials in orthopedics: what does the future hold? Expert Rev Med Devices 2018; 15:193-204. [DOI: 10.1080/17434440.2018.1430569] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Mubashar Rehman
- Department of Chemical Engineering, Northeastern University, Boston, MA, USA
- Department of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
- Nanobiotechnology Group, National Institute of Biotechnology and Genetic Engineering, Faisalabad, Pakistan
| | - Asadullah Madni
- Department of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
- Nanobiotechnology Group, National Institute of Biotechnology and Genetic Engineering, Faisalabad, Pakistan
| | - Thomas J. Webster
- Department of Chemical Engineering, Northeastern University, Boston, MA, USA
| |
Collapse
|
17
|
Li M, Yang X, Wang W, Zhang Y, Wan P, Yang K, Han Y. Evaluation of the osteo-inductive potential of hollow three-dimensional magnesium-strontium substitutes for the bone grafting application. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 73:347-356. [DOI: 10.1016/j.msec.2016.12.028] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 11/28/2016] [Accepted: 12/07/2016] [Indexed: 12/29/2022]
|
18
|
Katiella KAA, Yanru Z, Hui Z. Magnesium alloy transfected BMSCs-BMP-2 composite in repair of femoral head necrosis with assessment of visceral organs. SPRINGERPLUS 2016; 5:1857. [PMID: 27818895 PMCID: PMC5075330 DOI: 10.1186/s40064-016-3472-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 10/05/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND This study was designed to investigate the effect of BMSCs transfected BMP-2 composite with magnesium alloy rod in the repair of the femoral head necrosis in New Zealand white rabbits. Multifactorial but mostly traumatic, osteonecrosis of the femoral head account for 10 % of the 250,000 total hip arthroplasties done annually in the United States while its prevalence in most countries in not known. However, early intervention prior to collapse is critical to successful outcomes in joint preserving procedures. METHODS The pcDNA3.1 plasmid from cultured BMSCs was successfully transfected into BMSCs-BMP-2 by electroporation. Femoral head necrosis were established in 40 rabbits by liquid nitrogen freezing method. Animals were randomly divided into four groups (n = 10): Mg rod/BMSCs group, Mg rod group, BMSCs group, and blank control group. The composite of BMSCs-BMP-2 on Mg alloy rods were implanted respectively into the left femoral metaphysis of rabbits till the femoral head. Radiographic X-ray examination, histological hematoxilin and eosin (H&E) analysis and immunohistochemistry techniques were performed postoperatively; to observe and compare by the schedule; the newly formed bone and the degradation of the Mg rod at 6 and 12 weeks, sacrificing five animals at each time. RESULTS Twelfth week histological and immunohistochemical examinations showed complete magnesium alloy absorption in experimental and control group. H&E staining and immunohistochemistry showed obvious differences, Mg rod/BMSCs group having the best recovery than the other groups. BPM-2 level of gene expression of experimental group was also higher than those of controlled group. CONCLUSION BMP-2 coated Mg alloy promotes the expression of bone growth factors at the implant in marrow of rabbits thus delaying femoral head necrosis and improving repair.
Collapse
Affiliation(s)
- Kaka A A Katiella
- Medical College of Zhengzhou University, School of International Education, Zhengzhou University, Zhengzhou, 450051 Henan People's Republic of China
| | - Zhang Yanru
- Institute of Clinical Anatomy, Southern Medical University-Guangzhou, Guangdong, 510515 People's Republic of China ; Medical College of Zhengzhou University, School of International Education, Zhengzhou University, Zhengzhou, 450051 Henan People's Republic of China
| | - Zhang Hui
- Orthopedic Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 Henan People's Republic of China
| |
Collapse
|