Surface modification of stainless steel for biomedical applications: Revisiting a century-old material

SPA, Naveen J, Khan T, Khahro SH. Advancement in biomedical implant materials-a mini review

Metal alloys like stainless steel, titanium, and cobalt-chromium alloys are preferable for bio-implants due to their exceptional strength, tribological properties, and biocompatibility. However, long-term implantation of metal alloys can lead to inflammation, swelling, and itching because of ion leaching. To address this issue, polymers are increasingly being utilized in orthopedic applications, replacing metallic components such as bone fixation plates, screws, and scaffolds, as well as minimizing metal-on-metal contact in total hip and knee joint replacements. Ceramics, known for their hardness, thermal barrier, wear, and corrosion resistance, find extensive application in electrochemical, fuel, and biomedical industries. This review delves into a variety of biocompatible materials engineered to seamlessly integrate with the body, reducing adverse reactions like inflammation, toxicity, or immune responses. Additionally, this review examines the potential of various biomaterials including metals, polymers, and ceramics for implant applications. While metallic biomaterials remain indispensable, polymers and ceramics show promise as alternative options. However, surface-modified metallic materials offer a hybrid effect, combining the strengths of different constituents. The future of biomedical implant materials lies in advanced fabrication techniques and personalized designs, facilitating tailored solutions for complex medical needs.

Rationale Design for Anchoring Pendant Groups of Zwitterionic Polymeric Medical Coatings

A biocompatible and antifouling polymeric medical coating was developed through rational design for anchoring pendant groups for the modification of stainless steel. Zwitterionic 2-methacryloyloxyethyl phosphorylcholine (MPC) was copolymerized individually with three anchoring monomers of carboxyl acrylamides with different alkyl spacers, including acryloylglycine (2-AE), 6-acrylamidohexanoic acid (6-AH), and 11-acrylamidoundecanoic acid (11-AU). The carboxylic acid groups are responsible for the stable grafting of copolymers onto stainless steel via a coordinative interaction with metal oxides. Due to hydrophobic interaction and hydrogen bonding, the anchoring monomers enable the formation of self-assembling structures in solution and at a metallic interface, which can play an important role in the thin film formation and functionality of the coatings. Therefore, surface characterizations of anchoring monomers on stainless steel were conducted to analyze the packing density and strength of the intermolecular hydrogen bonds. The corresponding copolymers were synthesized, and their aggregate structures were assessed, showing micelle aggregation for copolymers with higher hydrophobic compositions. The synergistic effects of inter/intramolecular interactions and hydrophobicity of the anchoring monomers result in the diversity of the thickness, surface coverage, wettability, and friction of the polymeric coatings on stainless steel. More importantly, the antifouling properties of the coatings against bacteria and proteins were strongly correlated to thin film formation. Ultimately, the key lies in deciphering the molecular structure of the anchoring pendants in thin film formation and assessing the effectiveness of the coatings, which led to the development of medical coatings through the graft-onto approach.

Biocompatibility and Antibacterial Properties of NiTiAg Porous Alloys for Bone Implants

In order to reduce infections, porous NiTi alloys with 62% porosity were obtained by self-propagating high-temperature synthesis with the addition of 0.2 and 0.5 at. % silver nanoparticles. Silver significantly improved the alloys' antibacterial activity without compromising cytocompatibility. An alloy with 0.5 at. % Ag showed the best antibacterial ability against Staphylococcus epidermidis. All alloys exhibited good biocompatibility with no cellular toxicity against embryonic fibroblast 3T3 cells. Clinical evaluation of the results after implantation showed a complete absence of purulent-inflammatory complications in all animals. Even distribution of silver nanoparticles in the surface layer of the porous NiTi alloy provides a uniform antibacterial effect.

Functionalized orthopaedic implant as pH electrochemical sensing tool for smart diagnosis of hardware infection

In the orthopaedic surgery field, the use of medical implants to treat a patient's bone fracture is nowadays a common practice, nevertheless, it is associated with possible cases of infection. The consequent hardware infection can lead to implant failure and systemic infections, with prolonged hospitalization, time-consuming rehabilitation treatments, and extended antibiotic therapy. Hardware infections are strictly related to bacterial adhesion to the implant, leading to infection occurrence and consequent pH decreasing from physiological level to acid pH. Here, we demonstrate the new strategy to use an orthopaedic implant functionalized with iridium oxide film as the working electrode for the potentiometric monitoring of pH in hardware infection diagnosis. A functional investigation was focused on selecting the implant material, namely titanium, titanium alloy, and stainless steel, and the component, namely screws and implants. After selecting the titanium-based implant as the working electrode and a silver wire as the reference electrode in the final configuration of the smart sensing orthopaedic implant, a calibration curve was performed in standard solutions. An equation equal to y = (0.76 ± 0.02) - (0.068 ± 0.002) x, R2 = 0.996, was obtained in the pH range of 4-8. Subsequently, hysteresis, interference, matrix effect, recovery study, and storage stability were investigated to test the overall performance of the sensing device, demonstrating the tremendous potential of electrochemical sensors to deliver the next generation of smart orthopaedic implants.

Therapeutic biliary stents: applications and opportunities

INTRODUCTION

Biliary stents are used to optimize ductal patency and enable bile flow in the management of obstruction or injury related to biliary tract tumors, strictures, stones, or leaks. Although direct therapeutic applications of biliary stents are less well developed, stents can be used to deliver drugs, radioisotopes, and photodynamic therapy.

AREAS COVERED

This report provides an in-depth overview of the clinical indications, and therapeutic utility of biliary stents. Unique considerations for the design of biliary stents are described. The properties and functionalities of materials used for stents such as metal alloys, plastic polymers, or biodegradable materials are described, and opportunities for design of future stents are outlined. Current and potential applications of stents for therapeutic applications for biliary tract diseases are described.

EXPERT OPINION

Therapeutic biliary stents could be used to minimize inflammation, prevent stricture formation, reduce infections, or provide localized anti-cancer therapy for biliary tract cancers. Stents could be transformed into therapeutic platforms using advanced materials, 3D printing, nanotechnology, and artificial intelligence. Whilst clinical study and validation will be required for adoption, future advances in stent design and materials are expected to expand the use of therapeutic biliary stents for the treatment of biliary tract disorders.

An Overview on the Big Players in Bone Tissue Engineering: Biomaterials, Scaffolds and Cells

Presently, millions worldwide suffer from degenerative and inflammatory bone and joint issues, comprising roughly half of chronic ailments in those over 50, leading to prolonged discomfort and physical limitations. These conditions become more prevalent with age and lifestyle factors, escalating due to the growing elderly populace. Addressing these challenges often entails surgical interventions utilizing implants or bone grafts, though these treatments may entail complications such as pain and tissue death at donor sites for grafts, along with immune rejection. To surmount these challenges, tissue engineering has emerged as a promising avenue for bone injury repair and reconstruction. It involves the use of different biomaterials and the development of three-dimensional porous matrices and scaffolds, alongside osteoprogenitor cells and growth factors to stimulate natural tissue regeneration. This review compiles methodologies that can be used to develop biomaterials that are important in bone tissue replacement and regeneration. Biomaterials for orthopedic implants, several scaffold types and production methods, as well as techniques to assess biomaterials' suitability for human use-both in laboratory settings and within living organisms-are discussed. Even though researchers have had some success, there is still room for improvements in their processing techniques, especially the ones that make scaffolds mechanically stronger without weakening their biological characteristics. Bone tissue engineering is therefore a promising area due to the rise in bone-related injuries.

Surface (bio)-functionalization of metallic materials: How to cope with real interfaces?

Metallic materials are an important class of biomaterials used in various medical devices, owing to a suitable combination of their mechanical properties. The (bio)-functionalization of their surfaces is frequently performed for biocompatibility requirements, as it offers a powerful way to control their interaction with biological systems. This is particularly important when physicochemical processes and biological events, mainly involving proteins and cells, are initiated at the host-material interface. This review addresses the state of "real interfaces" in the context of (bio)-functionalization of metallic materials, and the necessity to cope with it to avoid frequent improper evaluation of the procedure used. This issue is, indeed, well-recognized but often neglected and emerges from three main issues: (i) ubiquity of surface contamination with organic compounds, (ii) reactivity of metallic surfaces in biological medium, and (iii) discrepancy in (bio)-functionalization procedures between expectations and reality. These disturb the assessment of the strategies adopted for surface modifications and limit the possibilities to provide guidelines for their improvements. For this purpose, X-ray photoelectrons spectroscopy (XPS) comes to the rescue. Based on significant progresses made in methodological developments, and through a large amount of data compiled to generate statistically meaningful information, and to insure selectivity, precision and accuracy, the state of "real interfaces" is explored in depth, while looking after the two main constituents: (i) the bio-organic adlayer, in which the discrimination between the compounds of interest (anchoring molecules, coupling agents, proteins, etc) and organic contaminants can be made, and (ii) the metallic surface, which undergoes dynamic processes due to their reactivity. Moreover, through one of the widespread (bio)-functionalization strategy, given as a case study, a particular attention is devoted to describe the state of the interface at different stages (composition, depth distribution of contaminants and (bio)compounds of interest) and the mode of protein retention. It is highlighted, in particular, that the occurrence or improvement of bioactivity does not demonstrate that the chemical schemes worked in reality. These aspects are particularly essential to make progress on the way to choose the suitable (bio)-functionalization strategy and to provide guidelines to improve its efficiency.

Powder Bed Fusion 3D Printing in Precision Manufacturing for Biomedical Applications: A Comprehensive Review

Precision manufacturing requirements are the key to ensuring the quality and reliability of biomedical implants. The powder bed fusion (PBF) technique offers a promising solution, enabling the creation of complex, patient-specific implants with a high degree of precision. This technology is revolutionizing the biomedical industry, paving the way for a new era of personalized medicine. This review explores and details powder bed fusion 3D printing and its application in the biomedical field. It begins with an introduction to the powder bed fusion 3D-printing technology and its various classifications. Later, it analyzes the numerous fields in which powder bed fusion 3D printing has been successfully deployed where precision components are required, including the fabrication of personalized implants and scaffolds for tissue engineering. This review also discusses the potential advantages and limitations for using the powder bed fusion 3D-printing technology in terms of precision, customization, and cost effectiveness. In addition, it highlights the current challenges and prospects of the powder bed fusion 3D-printing technology. This work offers valuable insights for researchers engaged in the field, aiming to contribute to the advancement of the powder bed fusion 3D-printing technology in the context of precision manufacturing for biomedical applications.

Fucoidan/collagen composite coating on magnesium alloy for better corrosion resistance and pro-endothelialization potential

Magnesium alloy stents (MAS) have broad application prospects in the treatment of cardiovascular diseases. However, poor corrosion resistance and biocompatibility greatly limit the clinical application of MAS. In this work, the coating consisting of MgF2 layer, polydopamine layer, fucoidan and collagen IV was constructed on Mg-Zn-Y-Nd (ZE21B) alloy to improve its corrosion resistance and pro-endothelialization potential. The fucoidan and collagen IV in the coating could obviously enhance the hemocompatibility and pro-endothelialization potential respectively. Compared with bare ZE21B alloy, the fucoidan/collagen composite coating modified ZE21B alloy possessed lower corrosion current density and better corrosion resistance. Moreover, the modified ZE21B alloy exhibited relatively low hemolysis rate, fibrinogen adsorption and platelet adhesion in the blood experiments, suggesting the improved hemocompatibility. Furthermore, the modified ZE21B alloy favorably supported the adhesion and proliferation of vascular endothelial cells (ECs) and effectively regulated the phenotype of smooth muscle cells (SMCs), thus improving the pro-endothelialization potential of vascular stent materials. The fucoidan/collagen composite coating can significantly improve the corrosion resistance and pro-endothelialization potential of ZE21B alloy, showing great potential in the development of degradable MAS.

Bioabsorbable Composites Based on Polymeric Matrix (PLA and PCL) Reinforced with Magnesium (Mg) for Use in Bone Regeneration Therapy: Physicochemical Properties and Biological Evaluation

Improvements in Tissue Engineering and Regenerative Medicine (TERM)-type technologies have allowed the development of specific materials that, together with a better understanding of bone tissue structure, have provided new pathways to obtain biomaterials for bone tissue regeneration. In this manuscript, bioabsorbable materials are presented as emerging materials in tissue engineering therapies related to bone lesions because of their ability to degrade in physiological environments while the regeneration process is completed. This comprehensive review aims to explore the studies, published since its inception (2010s) to the present, on bioabsorbable composite materials based on PLA and PCL polymeric matrix reinforced with Mg, which is also bioabsorbable and has recognized osteoinductive capacity. The research collected in the literature reveals studies based on different manufacturing and dispersion processes of the reinforcement as well as the physicochemical analysis and corresponding biological evaluation to know the osteoinductive capacity of the proposed PLA/Mg and PCL/Mg composites. In short, this review shows the potential of these composite materials and serves as a guide for those interested in bioabsorbable materials applied in bone tissue engineering.

Surface antibacterial properties enhanced through engineered textures and surface roughness: A review

The spread of bacteria through contaminated surfaces is a major issue in healthcare, food industry, and other economic sectors. The widespread use of antibiotics is not a sustainable solution in the long term due to the development of antibiotic resistance. Therefore, surfaces with antibacterial properties have the potential to be a disruptive approach to combat microbial contamination. Different methods and approaches have been studied to impart or enhance antibacterial properties on surfaces. The surface roughness and texture are inherent parameters that significantly impact the antibacterial properties of a surface. They are also directly related to the previously employed machining and treatment methods. This review article discusses the correlation between surface roughness and antibacterial properties is presented and discussed. It begins with an introduction to the concepts of surface roughness and texture, followed by a description of the most commonly utilized machining methods and surface. A thorough analysis of bacterial adhesion and growth is then presented. Finally, the most recent studies in this research area are comprehensively reviewed. The studies are sorted and classified based on the utilized machining and treatment methods, which are divided into mechanical processes, surface treatments and coatings. Through the systematic review and record of the recent advances, the authors aim to assist and promote further research in this very promising and extremely important direction, by providing a systematic review of recent advances.

Nickel ion release and surface analyses on instrument fragments fractured beyond the apex: a laboratory investigation

BACKGROUND

To analyse the changes in surface and nickel ion release characteristics of fractured root canal shaping instruments in a simulated body fluid environment.

METHODS

A total of 54 new instruments were studied. The instrument groups consisted of five different NiTi alloys and a stainless-steel alloy. To standardize instrument fracture, a torsional type of failure was created on each instrument. The fractured specimens of each instrument group were randomly divided into three static immersion subgroups of 1 h, 7-day, and 30-day (n = 3). Simulated body fluid (SBF) was prepared to mimic human blood plasma by Kokubo&Takadama protocol for ex situ static immersions at 37ºC. The surfaces were examined via scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy. To determine the quantitative ion release, the retrieved SBFs were analyzed using inductively coupled plasma mass spectrometry. Two-way ANOVA and Tukey post hoc tests sought the statistical significance of the nickel ion values(p < 0.05).

RESULTS

In 1 h of immersion, the newly formed structures, exhibiting mostly oxygen signals, were widespread and evident on NiTi surfaces. In contrast, fewer structures were detected on the SS surface in that subgroup. In 7 days of immersion, a tendency for a decrease in the density of the new structures was revealed in NiTi groups. The oxygen signals on NiTi group surfaces significantly increased, contrary to their decrease in SS. Signals of sodium, chlorine, and calcium were detected, indicating salt precipitates in groups. In 30 days of immersion, salt precipitates continued to form. The Ni-ion release values in all instrument groups presented significant differences in comparison to the SBF control in all immersion periods(p < 0.001). No significant differences were observed in immersion time periods or instrument groups(p > 0.05).

CONCLUSIONS

Within the limitations of the presented study, it was concluded that the fractured SS and NiTi root canal instruments release Ni ions in contact with body fluid. However, the Ni ion release values determined during the observation periods are lower than the critical toxic or allergic thresholds defined for the human body. This was due to the ionic dissolution cycle reaching a stable state from 1-hour to 30-day exposure to the body fluid of fractured instruments.

Cryogenically treated and untreated stainless steel grade 317 in sustainable wire electrical discharge machining process: a comparative study

In this research, the influences of cryogenically treated stainless steel grade 317 on the eco-friendly near-dry wire-cut electrical discharge machining (NDWEDM) processes have been investigated using the minimum quantity of water mixed with oxygen gas (oxygen mist) dielectric fluid. The stainless steel grade 317 has been applied to make the various biomedical and industrial components due to its high creep strength. The wire wear ratio (WWR) and cutting rate (CR) of NDWEDM are compared using cryogenically treated and untreated work materials by Taguchi's analysis. The water flow rate, gas pressure, spark current, and pulse width had been considered as process parameters. The microstructure of wire electrode and machined surfaces of treated/untreated materials had been compared by scanning electron microscope (SEM) images. The WWR and CR of cryogenically treated materials in NDWEDM are 20.31% lower and 22.32% higher than untreated materials, respectively.

Biocompatibility and efficacy of prostatic urethral lift in benign prostate hyperplasia: an in vivo and in vitro study

The study aimed to assess the biocompatibility and efficacy of a prostatic urethral lift (PUL) for benign prostatic hyperplasia (BPH). Human BPH-1 cells were co-cultured with implant anchors and sutures, and cytotoxicity was measured. Scanning electron microscopy (SEM) was used to observe adhesion and growth of cells and to evaluate implant biocompatibility. Fifteen male beagle dogs were randomly assigned to the surgical (n = 9) or sham-operated (n = 6) groups. The surgical group underwent cystotomy, and PUL was used to insert two implants in each lobe of the prostate to compress the enlarged prostate and dilate the urethra; the sham group underwent cystotomy without implant insertion. Compared with the control group, no significant difference in cell viability among the groups with different co-culture times of implant anchors and sutures (P > 0.05) was observed. SEM revealed good adhesion and growth of prostate cells on the implants. Improvements in urine flow rates remained stable at 7, 28, and 180 days after surgery, and the urethral diameter in the prostate region was significantly increased compared with that before surgery. PUL is a biocompatible and effective treatment for BPH, improving the urine flow rate without causing inflammation, tissue damage, or cytotoxic effects. Here, the basis for further PUL application was provided.

Analysis of Ultrasonic Vibration-Assisted Ball Burnishing Process on the Tribological Behavior of AISI 316L Cylindrical Specimens

In this study, we analyzed the effects of vibration assistance, combined with a ball burnishing process, in terms of topology, residual stresses, and tribological properties on 316L shafts. The burnishing variables consisted of the variation of the input force, the number of passes, and the activation of the vibration assistance, which is based on a 40 kHz frequency and 8 μm of vibration amplitude, derived in a screening design of three factors. The results show that the medium-high level of burnishing force, high level of the number of passes, and the activation of the vibration assistance are the best options in order to improve the average roughness, the microstructure, the increase in the compressive residual stresses, and the wear enhancement, besides all variables being significant in the p-value analysis through ANOVA. Statistically, the vibration-assisted ball burnishing improved the average roughness by 2.9%, enlarged the von Mises stress on the surface by 11.5% and enhanced the wear resistance of a 316L shaft and WC-Co ball contact up to 7.3%.

Effect of Si Content on the Thermal Expansion of Ti15Mo(0-2 Si) Biomaterial Alloys during Different Heating Rates

Thermal expansion measurements were used to characterize phase transformations in metastable β-Ti alloys (Ti15MoxSi) without and with various Si additions (where x = 0, 0.5, 1.0, 1.5, and 2 in wt.%) during linear heating at two heating rates of 5 and 10 °C/min up to 850 °C. For this study, five alloys were developed and examined in terms of their presence phases, microstructures, and starting and final transformation temperatures. According to the results, all of the as-cast samples primarily include an equiaxed β-Ti phase. The influence of phase transformation on the material dimensions was discussed and compared with the variations in Si contents. The transformation was investigated using a dilatometric technique for the developed alloys during continuous heating and cooling. The dilatometric curve of heating revealed two distinct reflection points as the heating temperature increased. The starting transformation temperature (T_s) to obtain the ω-phase was reported at 359 °C without Si addition; whereas the final transformation temperature (T_f) of the dissolution of α-phase was obtained at 572 °C at a heating rate of 10 °C/min. At 2 wt.% Si, the first derivative curves reported T_s and T_f transforming temperatures of 314-565 °C (at a 5 °C/min heating rate) and 270-540 °C (at a 10 °C/min heating rate), respectively. The T_s and T_f transforming temperatures were significantly decreased with Si additions, which decreased the β-transus temperature. Moreover, the thermal expansion coefficient curves of the investigated alloys without and with 2 wt.% Si were studied. The transformation heating curves have an S-shaped pattern, according to the results.

Immobilization of Natural Antimicrobial Compounds on Food-Grade Supports as a New Strategy to Preserve Fruit-Derived Foods

The use of natural antimicrobials in the food industry is being proposed as an eco-friendly postharvest technology to preserve fruit-derived foods. In this context, this systematic review aims to describe and discuss the application of naturally occurring antimicrobial compounds in the processing of fruit-derived foods by the PRISMA methodology. In a first step, the use of free natural antimicrobials was investigated as an approach to identify the main families of bioactive compounds employed as food preservatives and the current limitations of this dosage form. Then, the use of immobilized antimicrobials, in an innovative dosage form, was studied by distinguishing two main applications: addition to the food matrix as preservatives or use during processing as technological aids. Having identified the different examples of the immobilization of natural antimicrobial compounds on food-grade supports, the mechanisms of immobilization were studied in detail to provide synthesis and characterization guidelines for future developments. Finally, the contribution of this new technology to decarbonization and energy efficiency of the fruit-derived processing sector and circular economy is discussed in this review.

Immune cell response to orthopedic and craniofacial biomaterials depends on biomaterial composition

Materials for craniofacial and orthopedic implants are commonly selected based on mechanical properties and corrosion resistance. The biocompatibility of these materials is typically assessed in vitro using cell lines, but little is known about the response of immune cells to these materials. This study aimed to evaluate the inflammatory and immune cell response to four common orthopedic materials [pure titanium (Ti), titanium alloy (TiAlV), 316L stainless steel (SS), polyetheretherketone (PEEK)]. Following implantation into mice, we found high recruitment of neutrophils, pro-inflammatory macrophages, and CD4+ T cells in response to PEEK and SS implants. Neutrophils produced higher levels of neutrophil elastase, myeloperoxidase, and neutrophil extracellular traps in vitro in response to PEEK and SS than neutrophils on Ti or TiAlV. Macrophages co-cultured on PEEK, SS, or TiAlV increased polarization of T cells towards Th1/Th17 subsets and decreased Th2/Treg polarization compared to Ti substrates. Although SS and PEEK are considered biocompatible materials, both induce a more robust inflammatory response than Ti or Ti alloy characterized by high infiltration of neutrophils and T cells, which may cause fibrous encapsulation of these materials. STATEMENT OF SIGNIFICANCE: Materials for craniofacial and orthopedic implants are commonly selected based on their mechanical properties and corrosion resistance. This study aimed to evaluate the immune cell response to four common orthopedic and craniofacial biomaterials: pure titanium, titanium-aluminum-vanadium alloy, 316L stainless steel, and PEEK. Our results demonstrate that while the biomaterials tested have been shown to be biocompatible and clinically successful, the inflammatory response is largely driven by chemical composition of the biomaterials.

Influence of the type of substrate on the properties of carbon nanotubes layer studied by Raman spectroscopy

The development of nanomaterials technology allows to design a novel medical strategies, and could also be useful in the field of regenerative medicine. The paper presents a study on the functionalized multi-walled carbon nanotubes (MWCNTs-f) layers deposited by electrophoretic method (EPD) on the surfaces of two types of substrates: titanium (Ti) and stainless steel. SEM and EDS analyses confirm that incubation in a simulated body fluid (SBF) caused a formation of hydroxyapatite on the surface of the Ti/MWCNTs-f. Raman micro-spectroscopy was a method of choice to study presented materials. The MWCNTs-f layer on the surface of the titanium plate shows better layer order than the corresponding layer deposited on the stainless steel. The structure and ordering of the nanocarbon layer play a key role in the biological activity of the materials. This was confirmed by the incubation of the plates with deposited layer of carbon nanotubes in SBF. A titanium substrate with a MWCNTs-f layer supports the deposition of some components from the environment, while a stainless steel substrate promotes the formation of a carbon film that inhibits the deposition of certain components from the environment. A two-trace two-dimensional (2T2D) analysis confirmed a different effect of SBF on the MWCNTs-f layer depending on the type of substrate. The MWCNTs-f layer on titanium substrate seems to represent an interesting proposition for novel bioactive strategies.

Anodized Nanostructured 316L Stainless Steel Enhances Osteoblast Functions and Exhibits Anti-Fouling Properties

Poor osseointegration and infection are among the major challenges of 316L stainless steel (SS) implants in orthopedic applications. Surface modifications to obtain a nanostructured topography seem to be a promising method to enhance cellular interactions of 316L SS implants. In this study, arrays of nanodimples (NDs) having controlled feature sizes between 25 and 250 nm were obtained on 316L SS surfaces by anodic oxidation (anodization). Results demonstrated that the fabrication of NDs increased the surface area and, at the same time, altered the surface chemistry of 316L SS to provide chromium oxide- and hydroxide-rich surface oxide layers. In vitro experiments showed that ND surfaces promoted up to a 68% higher osteoblast viability on the fifth day of culture. Immunofluorescence images confirmed a well-spread cytoskeleton organization on the ND surfaces. In addition, higher alkaline phosphate activity and calcium mineral synthesis were observed on the ND surfaces compared to non-anodized 316L SS. Furthermore, a 71% reduction in Staphylococcus aureus (S. aureus) and a 58% reduction in Pseudomonas aeruginosa (P. aeruginosa) colonies were observed on the ND surfaces having a 200 nm feature size compared to non-anodized surfaces at 24 h of culture. Cumulatively, the results showed that a ND surface topography fabricated on 316L SS via anodization upregulated the osteoblast viability and functions while preventing S. aureus and P. aeruginosa biofilm synthesis.

Open-porous magnesium-based scaffolds withstand in vitro corrosion under cyclic loading: A mechanistic study

The successful application of magnesium (Mg) alloys as biodegradable bone substitutes for critical-sized defects may be comprised by their high degradation rate resulting in a loss of mechanical integrity. This study investigates the degradation pattern of an open-porous fluoride-coated Mg-based scaffold immersed in circulating Hanks' Balanced Salt Solution (HBSS) with and without in situ cyclic compression (30 N/1 Hz). The changes in morphological and mechanical properties have been studied by combining in situ high-resolution X-ray computed tomography mechanics and digital volume correlation. Although in situ cyclic compression induced acceleration of the corrosion rate, probably due to local disruption of the coating layer where fatigue microcracks were formed, no critical failures in the overall scaffold were observed, indicating that the mechanical integrity of the Mg scaffolds was preserved. Structural changes, due to the accumulation of corrosion debris between the scaffold fibres, resulted in a significant increase (p < 0.05) in the material volume fraction from 0.52 ± 0.07 to 0.47 ± 0.03 after 14 days of corrosion. However, despite an increase in fibre material loss, the accumulated corrosion products appear to have led to an increase in Young's modulus after 14 days as well as lower third principal strain (εp3) accumulation (−91000 ± 6361 με and −60093 ± 2414 με after 2 and 14 days, respectively). Therefore, this innovative Mg scaffold design and composition provide a bone replacement, capable of sustaining mechanical loads in situ during the postoperative phase allowing new bone formation to be initially supported as the scaffold resorbs.

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First report on in vitro cyclic loading of MgF₂ coated open-porous Mg scaffolds in HBSS simulating 2–3 months in humans.

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Fluoride-coating slows down corrosion under cyclic loading in vitro.

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Entangled scaffold structure accumulates local corrosion debris which keeps the mechanical integrity over 14 days in vitro.

Animal models for the study of acute cutaneous wound healing

The process of wound healing is critical to maintaining homeostasis after injury. Although a considerable amount has been learned about this complex process, much remains unknown. Whereas, studies with human volunteers are ideal given the unique nature of the human skin anatomy and immune system, the lack of such clinical access has made animal models prime candidates for use in preclinical studies. This review aims to discuss the strengths and limitations of the commonly used mammalian species in wound healing studies: murine, rabbit and porcine. Thereafter, a survey of models of various acute wounds such as cutaneous, ear, and implant are presented and representative studies that use them are described. This review is intended to acquaint readers with the vast spectrum of models available, each of which has a distinct utility. At the same time, it highlights the importance of utilising clinical samples to complement investigations conducted in animal models. Through this strategy, it is hoped that forthcoming research may be more reflective of the acute wound healing process as it occurs in humans.

Tribo-corrosive behavior of additive manufactured parts for orthopaedic applications

Background

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

Objectives and Rationale

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

Conclusion

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

Drug-Eluting, Bioresorbable Cardiovascular Stents─Challenges and Perspectives

Globally, the leading causes of natural death are attributed to coronary heart disease and type 1 and type 2 diabetes. High blood pressure levels, high cholesterol levels, smoking, and poor eating habits lead to the agglomeration of plaque in the arteries, reducing the blood flow. The implantation of devices used to unclog vessels, known as stents, sometimes results in a lack of irrigation due to the excessive proliferation of endothelial tissue within the blood vessels and is known as restenosis. The use of drug-eluting stents (DESs) to deliver antiproliferative drugs has led to the development of different encapsulation techniques. However, due to the potency of the drugs used in the initial stent designs, a chronic inflammatory reaction of the arterial wall known as thrombosis can cause a myocardial infarction (MI). One of the most promising drugs to reduce this risk is everolimus, which can be encapsulated in lipid systems for controlled release directly into the artery. This review aims to discuss the current status of stent design, fabrication, and functionalization. Variables such as the mechanical properties, metals and their alloys, drug encapsulation and controlled elution, and stent degradation are also addressed. Additionally, this review covers the use of polymeric surface coatings on stents and the recent advances in layer-by-layer coating and drug delivery. The advances in nanoencapsulation techniques such as liposomes and micro- and nanoemulsions and their functionalization in bioresorbable, drug-eluting stents are also highlighted.

Effect of Alloying Elements and Low Temperature Plasma Nitriding on Corrosion Resistance of Stainless Steel

Although nitriding treatment usually improves the hardness and wear resistance of stainless steel, it also reduces its corrosion resistance. The effects of different nitriding temperatures and time and main alloying elements in stainless steel on the properties of the martensitic precipitation hardening of stainless steel were studied by first-principles calculations and experiments in this study. The results showed that the corrosion resistance of the martensitic stainless steel 0Cr17Ni4Cu4Nb was much lower than that of 1Cr15Ni2Mo2Cu before and after nitriding. According to the density functional theory calculation results, the molybdenum-containing stainless steel had higher stability and corrosion resistance and a lower Fermi level, electron conduction concentration and electrochemical activity than the niobium-containing stainless steel before and after nitriding. In addition, at the same temperature, the surface hardness of the 1Cr15Ni2Mo2Cu steel increased linearly with the prolongation of nitriding time, but its corrosion resistance decreased. Under the same nitriding time (24 h), the nitriding temperature increased from 300 to 450 °C, and the surface hardness and nitriding layer depth of the nitriding steel increased gradually, while the corrosion resistance decreased gradually. These results were attributed to the Cr-poor phenomenon caused by the formation of CrN. The 1Cr15Ni2Mo2Cu martensitic stainless steel obtained a high surface hardness after nitriding at 300 °C for 24 h, and the corrosion resistance did not decrease.

Effect of Saccharides Coating on Antibacterial Potential and Drug Loading and Releasing Capability of Plasma Treated Polylactic Acid Films

More than half of the hospital-associated infections worldwide are related to the adhesion of bacteria cells to biomedical devices and implants. To prevent these infections, it is crucial to modify biomaterial surfaces to develop the antibacterial property. In this study, chitosan (CS) and chondroitin sulfate (ChS) were chosen as antibacterial coating materials on polylactic acid (PLA) surfaces. Plasma-treated PLA surfaces were coated with CS either direct coating method or the carbodiimide coupling method. As a next step for the combined saccharide coating, CS grafted samples were immersed in ChS solution, which resulted in the polyelectrolyte complex (PEC) formation. Also in this experiment, to test the drug loading and releasing efficiency of the thin film coatings, CS grafted samples were immersed into lomefloxacin-containing ChS solution. The successful modifications were confirmed by elemental composition analysis (XPS), surface topography images (SEM), and hydrophilicity change (contact angle measurements). The carbodiimide coupling resulted in higher CS grafting on the PLA surface. The coatings with the PEC formation between CS-ChS showed improved activity against the bacteria strains than the separate coatings. Moreover, these interactions increased the lomefloxacin amount adhered to the film coatings and extended the drug release profile. Finally, the zone of inhibition test confirmed that the CS-ChS coating showed a contact killing mechanism while drug-loaded films have a dual killing mechanism, which includes contact, and release killing.

Functionalized Self-Assembled Monolayers: Versatile Strategies to Combat Bacterial Biofilm Formation

Bacterial infections due to biofilms account for up to 80% of bacterial infections in humans. With the increased use of antibiotic treatments, indwelling medical devices, disinfectants, and longer hospital stays, antibiotic resistant infections are sharply increasing. Annual deaths are predicted to outpace cancer and diabetes combined by 2050. In the past two decades, both chemical and physical strategies have arisen to combat biofilm formation on surfaces. One such promising chemical strategy is the formation of a self-assembled monolayer (SAM), due to its small layer thickness, strong covalent bonds, typically facile synthesis, and versatility. With the goal of combating biofilm formation, the SAM could be used to tether an antibacterial agent such as a small-molecule antibiotic, nanoparticle, peptide, or polymer to the surface, and limit the agent’s release into its environment. This review focuses on the use of SAMs to inhibit biofilm formation, both on their own and by covalent grafting of a biocidal agent, with the potential to be used in indwelling medical devices. We conclude with our perspectives on ongoing challenges and future directions for this field.

Zn-Mn-Doped Mesoporous Bioactive Glass Nanoparticle-Loaded Zein Coatings for Bioactive and Antibacterial Orthopedic Implants

In recent years, natural polymers have replaced synthetic polymers for antibacterial orthopedic applications owing to their excellent biocompatibility and biodegradability. Zein is a biopolymer found in corn. The lacking mechanical stability of zein is overcome by incorporating bioceramics, e.g., mesoporous bioactive glass nanoparticles (MBGNs). In the present study, pure zein and zein/Zn–Mn MBGN composite coatings were deposited via electrophoretic deposition (EPD) on 316L stainless steel (SS). Zn and Mn were co-doped in MBGNs in order to make use of their antibacterial and osteogenic potential, respectively. A Taguchi design of experiment (DoE) study was established to evaluate the effect of various working parameters on the morphology of the coatings. It was observed that coatings deposited at 20 V for 5 min with 4 g/L concentration (conc.) of Zn–Mn MBGNs showed the highest deposition yield. Uniform coatings with highly dispersed MBGNs were obtained adopting these optimized parameters. Scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), X-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FTIR) were employed to investigate the morphology and elemental composition of zein/Zn–Mn MBGN composite coatings. Surface properties, i.e., coating roughness and wettability analysis, concluded that composite coatings were appropriate for cell attachment and proliferation. For adhesion strength, various techniques, including a tape test, bend test, pencil hardness test, and tensile test, were performed. Wear and corrosion analysis highlighted the mechanical and chemical stability of the coatings. The colony forming unit (CFU) test showed that the zein/Zn–Mn MBGN composite coating was highly effective against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) due to the presence of Zn. The formation of a hydroxyapatite (HA)-like structure upon immersion in the simulated body fluid (SBF) validated the in vitro bioactivity of the coating. Moreover, a WST-8 assay depicted that the MG-63 cells proliferate on the composite coating. It was concluded that the zein/Zn–Mn MBGN coating synthesized in this work can be used for bioactive and antibacterial orthopedic applications.

Mesenchymal stem cell-seeded porous tantalum-based biomaterial: A promising choice for promoting bone regeneration

Porous tantalum-based biomaterial is a novel tissue engineering material widely used in repairing bone defects due to its corrosion resistance, low elastic modulus, high friction coefficient, and excellent biocompatibility. Bone marrow-derived mesenchymal stem cells (BMSCs), a type of pluripotent stem cell, can travel from their original ecological niche to bone injury sites, where they differentiate into osteoblasts and osteocytes. Multiple factors regulate the proliferation, migration, and differentiation of BMSCs. In recent years, the regulatory effects of porous tantalum on BMSCs have been widely studied. Hence, in this study, we reviewed the characteristics of porous tantalum-based biomaterials and the mechanism of action of their regulatory effects on BMSCs. Further, we discuss the feasibility of seeding BMSCs in porous tantalum-based biomaterials for use in tissue repair.

Non-coding RNA delivery for bone tissue engineering: progress, challenges and potential solutions

More than 20 million individuals worldwide suffer from congenital or acquired bone defects annually. The development of bone scaffold materials that simulate natural bone for bone defect repair remains challenging. Recently, ncRNA-based therapies for bone defects have attracted increasing interest because of the great potential of ncRNAs in disease treatment. Various types of ncRNAs regulate gene expression in osteogenesis-related cells via multiple mechanisms. The delivery of ncRNAs to the site of bone loss through gene vectors or scaffolds is a potential therapeutic option for bone defect repair. Therefore, this study discusses and summarizes the regulatory mechanisms of miRNAs, siRNAs, and piRNAs in osteogenic signaling and reviews the widely used current RNA delivery vectors and scaffolds for bone defect repair. Additionally, current challenges and potential solutions of delivery scaffolds for bone defect repair are proposed, with the aim of providing a theoretical basis for their future clinical applications.

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

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

Recent Advancements in Materials and Coatings for Biomedical Implants

Metallic materials such as stainless steel (SS), titanium (Ti), magnesium (Mg) alloys, and cobalt-chromium (Co-Cr) alloys are widely used as biomaterials for implant applications. Metallic implants sometimes fail in surgeries due to inadequate biocompatibility, faster degradation rate (Mg-based alloys), inflammatory response, infections, inertness (SS, Ti, and Co-Cr alloys), lower corrosion resistance, elastic modulus mismatch, excessive wear, and shielding stress. Therefore, to address this problem, it is necessary to develop a method to improve the biofunctionalization of metallic implant surfaces by changing the materials’ surface and morphology without altering the mechanical properties of metallic implants. Among various methods, surface modification on metallic surfaces by applying coatings is an effective way to improve implant material performance. In this review, we discuss the recent developments in ceramics, polymers, and metallic materials used for implant applications. Their biocompatibility is also discussed. The recent trends in coatings for biomedical implants, applications, and their future directions were also discussed in detail.

Review on Grain Refinement of Metallic Materials to Regulate Cellular Behavior

Metallic materials have been widely used as orthopedic implants in clinics for their good mechanical, physical, and chemical properties, but their slow osseointegration rate is still one of the main issues causing implantation failure. Grain refinement has recently attracted wide attention for its effective improvement of cell–material interaction for biometals. In this review, the surface and bulk grain refinement mode and the influence of grain size reduction of various metallic materials including titanium, stainless steel, magnesium, zirconium, tantalum, and their alloys as well as NiTi shape memory alloys on the cell responses is summarized in detail. It is hoped that this review could help biomaterials-related researchers to understand the grain refinement of metallic materials in a timely manner, thus boosting the development of biomedical metals for clinical use.

Duplex Surface Modification of 304-L SS Substrates by an Electron-Beam Treatment and Subsequent Deposition of Diamond-like Carbon Coatings

In this study, we present the results of the effect of duplex surface modification of 304-L stainless steel substrates by an electron-beam treatment (EBT) and subsequent deposition of diamond-like carbon coatings on the surface roughness and corrosion behavior. During the EBT process, the beam power was varied from 1000 to 1500 W. The successful deposition of the DLC coatings was confirmed by FTIR and Raman spectroscopy experiments. The results showed a presence of C–O, C=N, graphite-like sp2, and mixed sp2-sp3 C–C bond vibrations. The surface topography was studied by atomic force microscopy. The rise in the beam power leads to a decrease in the surface roughness of the deposited DLC coatings. The studies on the corrosion resistance of the samples have been performed using three electrochemical techniques: open circuit potential (OCP), cyclic voltammetry (polarization measurements), and non-destructive electrochemical impedance spectroscopy (EIS). The measured corrosion potentials suggest that these samples are corrosion-resistant even in a medium, containing corrosive agents such as chloride ions. It can be concluded that the most corrosion-resistant specimen is DLC coating deposited on electron-beam-treated 304-L SS substrate by a beam power of 1500 W.

Sulfur-Mediated Polycarbonate Polyurethane for Potential Application of Blood-Contacting Materials

In this study, a sulfur-mediated polycarbonate polyurethane (PCU-SS) is developed by mimicking the catalyzing ability of glutathione peroxidase (GPx) on nitric oxide (NO) in the human body. The PCU-SS is endowed with the capability to produce NO based on disulfide bonds, which could strongly improve the biocompatibility of the materials. The characterization results indicate that PCU-SS could not only decrease the adhesion of platelets but also enhance the capability of anti-thrombus. Moreover, it is shown that PCU-SS has a good compatibility with endothelial cells (ECs), while has a marked inhibition capacity of the proliferation of smooth muscle cells (SMCs) and macrophages (MA). Meanwhile, the result of animal implantation experiments further demonstrates the good abilities of PCU-SS on anti-inflammation, anti-thrombus, and anti-hyperplasia. Our results offer a novel strategy for the modification of blood-contacting materials based on disulfide bonds. It is expected that the PCU-SS could shed new light on biocompatibility improvement of cardiovascular stents.

Structural Characterization of Ion Nitrided 316L Austenitic Stainless Steel: Influence of Treatment Temperature and Time

The ion nitriding behavior of AISI 316L austenite stainless steel was investigated at different nitriding times (2 h, 4 h, and 9 h) and temperatures (450 °C, 500 °C, and 550 °C). The structural characterization has been assessed by several considerations which can be listed: (i) the evaluation of phase distribution through Rietveld analysis of X-ray diffraction patterns and accompanying peak fitting process, (ii) hardness profile and related nitride layer thickness by microhardness and microscopic measurements, and (iii) displacement measurements to assess the residual stress accumulation. The diffusion of nitrogen atomic species into the sample surface caused a transformation of the γ phase matrix into an expanded austenite (γN) phase, which is recognized with its high hardness and wear resistance. Furthermore, depending on the nitriding condition, chromium nitride (Cr1-2N) and iron nitride (ε-Fe2-3N and γ′-Fe4N) phases were detected, which can be detrimental to the corrosion resistance of the 316L austenite stainless steel. The γN phase was observed in all nitriding conditions, resulting in a significant increase in the surface hardness. However, decomposition of the γN phase with an increase in nitriding temperature eventually altered the surface hardness distribution in the nitriding layer. Considering the phase-type and distribution with the consequent hardness characteristics in the nitride layer, to our best knowledge, this is the first report in which an ion-nitriding temperature of 500 °C (higher than 450 °C) and time of 9 h can be proposed as ideal processing parameters leading to optimal phase composition and hardness distribution for 316L austenite stainless steels particularly for the applications requiring a combination of both wear and corrosion resistance.

Strontium-Containing Barium Titanate-Modified Titanium for Enhancement of Osteointegration

One of the major challenges for Ti-based implants is insufficient osteointegration, which might result in the loosening of the implant. In this study, we fabricated strontium (Sr)-containing barium titanate (BST) on the surface of Ti to improve the bioactivity for osteointegration enhancement. The introduction of Sr significantly reduced the crystallization time and improved crystallinity, which was proved by X-ray diffraction, X-ray photoelectron spectroscopy, and transmission electron microscopy. Compared with Ti, the BST film showed greater wettability surface and lower elastic modulus and hardness. Furthermore, in synergy with the release of Sr ions, the BST film improved early adhesion and followed osteogenic differentiation of rat bone mesenchymal stem cells. Furthermore, the bone implantation experiment suggested that the BST film could significantly improve the in vivo osteogenesis and osteointegration capabilities of Ti implants. In summary, this study revealed that BST-modified Ti has potential application in bone repair.

Corrosion Resistance of Electrochemically Synthesized Modified Zaccagnaite LDH-Type Films on Steel Substrates

Modified zaccagnaite layered double hydroxide (LDH) type films were synthesized on steel substrates by pulsed electrochemical deposition from aqueous solutions. The resulting films were characterized by X-ray diffraction, scanning electron microscopy/X-ray dispersive spectroscopy, and Fourier transform infrared spectroscopy. Structural characterization indicated a pure layered double hydroxide phase; however, elemental analysis revealed that the surface of the films contained Zn:Al ratios outside the typical ranges of layered double hydroxides. Layer thickness for the deposited films ranged from approximately 0.4 to 3.0 μm. The corrosion resistance of the film was determined using potentiodynamic polarization experiments in 3.5 wt.% NaCl solution. The corrosion current density for the coatings was reduced by 82% and the corrosion potential was shifted 126 mV more positive when 5 layers of modified LDH coatings were deposited onto the steel substrates. A mechanism was proposed for the corroding reactions at the coating.

Advances in coatings on magnesium alloys for cardiovascular stents - A review

Magnesium (Mg) and its alloys, as potential biodegradable materials, have drawn wide attention in the cardiovascular stent field because of their appropriate mechanical properties and biocompatibility. Nevertheless, the occurrence of thrombosis, inflammation, and restenosis of implanted Mg alloy stents caused by their poor corrosion resistance and insufficient endothelialization restrains their anticipated clinical applications. Numerous surface treatment tactics have mainly striven to modify the Mg alloy for inhibiting its degradation rate and enduing it with biological functionality. This review focuses on highlighting and summarizing the latest research progress in functionalized coatings on Mg alloys for cardiovascular stents over the last decade, regarding preparation strategies for metal oxide, metal hydroxide, inorganic nonmetallic, polymer, and their composite coatings; and the performance of these strategies in regulating degradation behavior and biofunction. Potential research direction is also concisely discussed to help guide biological functionalized strategies and inspire further innovations. It is hoped that this review can give assistance to the surface modification of cardiovascular Mg-based stents and promote future advancements in this emerging research field.

A rat model of ischemic osteonecrosis for investigating local therapeutics using biomaterials

Osteonecrosis is one of the most disabling diseases affecting pediatric and adult populations. Local application of biomaterials is a promising therapeutic strategy for osteonecrosis. Currently, there is a lack of low-cost animal models of osteonecrosis for testing and developing biomaterials-driven therapeutics. To develop a rat model of ischemic osteonecrosis (IO), the distal femoral epiphysis was selected due to its size 7.7 folds larger than the proximal femoral epiphysis (p<0.0001). The feasibility of intraosseous drillings and the local application of biomaterials were determined. Four model biomaterials were successfully applied: injectable hydrogel, microsphere, bone cement, and implant. The IO was induced by surgically cauterizing the blood vessels supplying the distal femoral epiphysis. Osteonecrosis of the whole epiphysis was achieved with a complete absence of blood flow and near 100% of apoptotic osteocytes. At eight weeks after IO, severe bone deformity and osteoarthritis developed in the affected epiphysis. The histological analysis showed 50% lacunae empty in the IO group compared to 2% in the control group (p<0.0001). The μCT analysis showed the epiphyseal quotient decreased to 0.46 in the IO group compared to 0.53 in the control group (p<0.0001), and the distal femoral epiphysis in the IO group was 19% smaller than the control group (p<0.01). The Safranin O stained sections showed articular cartilage erosions and subchondral bone fractures in the IO group. In summary, we established a clinically relevant IO model on rats that is compatible with the application of biomaterials for treatment. STATEMENT OF SIGNIFICANCE: Osteonecrosis is one of the most serious orthopedic conditions, leading to permanent joint deformity and end-stage osteoarthritis. An efficient and low-cost animal model is essential for development and testing of new treatment strategies for osteonecrosis. This is the first study to develop a clinically relevant model of osteonecrosis on the distal femoral epiphysis of rats. The model is highly efficient in developing osteonecrosis with relatively low cost and it provides suitable skeletal size to apply various forms of biomaterials. More importantly, it mimicked the pathological features and progression of osteonecrosis in humans. The study is expected to have an important impact on the development and testing of innovative biological therapeutics for osteonecrosis.

Effects of Substrate Bias Voltage on Structure of Diamond-Like Carbon Films on AISI 316L Stainless Steel: A Molecular Dynamics Simulation Study

With the recent significant advances in micro- and nanoscale fabrication techniques, deposition of diamond-like carbon films on stainless steel substrates has been experimentally achieved. However, the underlying mechanism for the formation of film microstructures has remained elusive. In this study, the growth processes of diamond-like carbon films on AISI 316L substrate are studied via the molecular dynamics method. Effects of substrate bias voltage on the structure properties and sp³ hybridization ratio are investigated. A diamond-like carbon film with a compact structure and smooth surface is obtained at 120 V bias voltage. Looser structures with high surface roughness are observed in films deposited under bias voltages of 0 V or 300 V. In addition, sp³ fraction increases with increasing substrate bias voltage from 0 V to 120 V, while an opposite trend is obtained when the bias voltage is further increased from 120 V to 300 V. The highest magnitude of sp³ fraction was about 48.5% at 120 V bias voltage. The dependence of sp³ fraction in carbon films on the substrate bias voltage achieves a high consistency within the experiment results. The mechanism for the dependence of diamond-like carbon structures on the substrate bias voltage is discussed as well.

Engineering the Multi-Enzymatic Activity of Cerium Oxide Nanoparticle Coatings for the Antioxidant Protection of Implants

Imbalance of oxidants is a universal contributor to the failure of implanted devices and tissues. A sustained oxidative environment leads to cytotoxicity, prolonged inflammation, and ultimately host rejection of implanted devices/grafts. The incorporation of antioxidant materials can inhibit this redox/inflammatory cycle and enhance implant efficacy. Cerium oxide nanoparticles (CONP) is a highly promising agent that exhibits potent, ubiquitous, and self-renewable antioxidant properties. Integrating CONP as surface coatings provides ease in translating antioxidant properties to various implants/grafts. Herein, we describe the formation of CONP coatings, generated via the sequential deposition of CONP and alginate, and the impact of coating properties, pH, and polymer molecular weight, on their resulting redox profile. Investigation of CONP deposition, layer formation, and coating uniformity/thickness on their resulting oxidant scavenging activity identified key parameters for customizing global antioxidant properties. Results found lower molecular weight alginates and physiological pH shift CONP activity to a higher H2O2 to O2 --scavenging capability. The antioxidant properties measured for these various coatings translated to distinct antioxidant protection to the underlying encapsulated cells. Information gained from this work can be leveraged to tailor coatings towards specific oxidant-scavenging applications and prolong the function of medical devices and cellular implants.