Controlling the degradation kinetics of porous iron by poly(lactic-co-glycolic acid) infiltration for use as temporary medical implants

Recent advances in Fe-based bioresorbable stents: Materials design and biosafety

Fe-based materials have received more and more interests in recent years as candidates to fabricate bioresorbable stents due to their appropriate mechanical properties and biocompatibility. However, the low degradation rate of Fe is a serious limitation for such application. To overcome this critical issue, many efforts have been devoted to accelerate the corrosion rate of Fe-based stents, through the structural and surface modification of Fe matrix. As stents are implantable devices, the released corrosion products (Fe2+ ions) in vessels may alter the metabolism, by generating reactive oxygen species (ROS), which might in turn impact the biosafety of Fe-based stents. These considerations emphasize the importance of combining knowledge in both materials and biological science for the development of efficient and safe Fe-based stents, although there are still only limited numbers of reviews regarding this interdisciplinary field. This review aims to provide a concise overview of the main strategies developed so far to design Fe-based stents with accelerated degradation, highlighting the fundamental mechanisms of corrosion and the methods to study them as well as the reported approaches to accelerate the corrosion rates. These approaches will be divided into four main sections, focusing on (i) increased active surface areas, (ii) tailored microstructures, (iii) creation of galvanic reactions (by alloying, ion implantation or surface coating of noble metals) and (iv) decreased local pH induced by degradable surface organic layers. Recent advances in the evaluation of the in vitro biocompatibility of the final materials and ongoing in vivo tests are also provided.

Fucoidan- and Ciprofloxacin-Doped Plasma-Activated Polymer Coatings on Biodegradable Zinc: Hemocompatibility and Drug Release

Blood-contacting medical devices such as biodegradable metallic bone implant materials are expected to show excellent hemocompatibility both in vitro and in vivo. Different approaches are being studied and used to modify biomaterial surfaces for enhanced biocompatibility and hemocompatibility. However, the composition of degradable biomaterial must address several drawbacks at once. Iron-reinforced zinc material was used as a metallic substrate with improved mechanical properties when compared with those of pure zinc. Poly(lactic) acid (PLA) or polyethylenimine (PEI) was selected as a polymeric matrix for further doping with antibiotic ciprofloxacin (CPR) and marine-sourced polysaccharide fucoidan (FU), which are known for their antibacterial and potential anticoagulant properties, respectively. Radiofrequency air plasma was employed to induce metallic/polymer-coated surface activation before further modification with FU/CPR. Sample surface morphology and composition were studied and evaluated (contact angle measurements, AFM, SEM, and FT-IR) along with the hemolysis ratio and platelet adhesion test. Successful doping of the polymer layer by FU/CRP was confirmed. While PEI induced severe hemolysis over 12%, the PLA-coated samples exhibited even lower hemolysis (∼2%) than uncoated samples while the uncoated samples showed the lowest platelet adhesion. Moreover, gradual antibiotic release from PLA determined by the electrochemical methods using screen-printed carbon electrodes was observed after 24, 48, and 72 h, making the PLA-coated zinc-based material an attractive candidate for biodegradable material design.

Iron-Gold Composites for Biodegradable Implants: In Vitro Investigation on Biodegradation and Biomineralization

The biocompatibility and biodegradation of iron (Fe) make it a suitable candidate for developing biodegradable metallic implants. However, the degradation rate of Fe in a physiological environment is extremely slow and needs to be enhanced to a rate compatible with tissue growth. Incorporating noble metals improves the Fe degradation rate by forming galvanic couples. This study incorporated gold (Au) into Fe at very low concentrations of 1.25 and 2.37 μg/g to improve the degradation rate. The electrochemical corrosion test of the samples revealed that the Au-containing samples showed a four-time and nine-time faster degradation rate than pure Fe. Furthermore, the immersion test and long-term electrochemical impedance spectroscopy conducted in simulated body fluid (SBF) revealed that the Au-incorporated samples exhibited increased bioactivity and degraded faster than pure Fe. Integrating nanogold into a Fe matrix increased the in situ formation of hydroxyapatite on the sample's surface and did not cause toxicity to L929-murine fibroblast cells. It is suggested that Fe-Au composites with low concentrations of Au can be used to tailor the biodegradation rate and promote the biomineralization of Fe-based implants in the physiological environment.

Zinc-based subcuticular absorbable staples: An in vivo and in vitro study

A zinc-nutrient element alloy (Zn-1.0Cu-0.5Ca) was developed into subcuticular absorbable staples (SAS) as a robust alternative to the commercially available poly(l-lactide-co-glycolide) (PLGA) SAS for the first time. The fixation properties of the Zn SAS were measured via pull-out tests and in-situ lap-shear pull-out test comparatively against the PLGA SAS. The Zn SAS exhibited fixation force of 18.9±0.2 N, which was over three times higher than that of PLGA SAS (5.5±0.1 N). The Zn SAS was used to close incision wounds in a SD rat model for biodegradability and biocompatibility characterisation at 1, 4 and 12 weeks. The Zn SAS showed uniform degradation behaviour after in vivo implantation at the average rate of 198±54, 112±28, and 70±24 μm/y after 1, 4, and 12 weeks, which reduced the fixation force to 16.8±1.1 N, 15.4±0.9 N, 12.7±0.7 N, respectively. These findings showed the potential of the Zn SAS for the closure of heavy loading and slowing healing tissues. The Zn SAS enabled successful closure and healing of the incision wound, similar to the PLGA staples. However, the slow long-term degradation rate of the Zn SAS may lead to unnecessary implant retention. In addition, the alloy SAS resulted in higher local foreign body responses due to their stiffness. Reducing the implant cross-section profile and applying low stiffness and a corrosion-accelerating coating are suggested as possible approaches to reduce post-service implant retention and improve the biocompatibility of the Zn SAS. STATEMENT OF SIGNIFICANCE: This work reports the fabrication of the first metallic subcuticular absorbable staples (SAS) made from Zn-Cu-Ca alloy for skin wound closure applications. The Zn-based SAS were characterised in vitro and in vivo (SD rat model) for biodegradability, fixation properties, biocompatibility and inflammatory responses, which were compared against the commercially available PLGA-based SAS. The Zn-based SAS provided a secure attachment of the full-thickness wounds on SD rats and allowed successful healing during the 12-week service period. In addition, the in vitro results showed that the Zn-based SAS provided more than three times higher fixation strength than the commercial PLGA, indicating the potential of the Zn-based SAS for load-bearing wound closure application.

Biocompatibility and Biological Performance of Additive-Manufactured Bioabsorbable Iron-Based Porous Interference Screws in a Rabbit Model: A 1-Year Observational Study

This study evaluated the mid-term (12-month) biomechanical, biocompatibility, and biological performance of additive-manufactured bioabsorbable iron-based interference screws (ISs). Two bioabsorbable iron IS types-manufactured using pure iron powder (iron_IS) and using pure iron powder with 0.2 wt% tricalcium phosphate (TCP_IS)-were compared with conventional metallic IS (control) using in vitro biocompatibility and degradation analyses and an in vivo animal study. The in vitro ultimate failure strength was significantly higher for iron_IS and TCP_IS than for control ISs at 3 months post-operatively; however, the difference between groups were nonsignificant thereafter. Moreover, at 3 months after implantation, iron_IS and TCP_IS increased bone volume fraction, bone surface area fraction, and percent intersection surface; the changes thereafter were nonsignificant. Iron_IS and TCP_IS demonstrated degradation over time with increased implant surface, decreased implant volume, and structure thickness; nevertheless, the analyses of visceral organs and biochemistry demonstrated normal results, except for time-dependent iron deposition in the spleen. Therefore, compared with conventional ISs, bioabsorbable iron-based ISs exhibit higher initial mechanical strength. Although iron-based ISs demonstrate high biocompatibility 12 months after implantation, their corrosive iron products may accumulate in the spleen. Because they demonstrate mechanical superiority along with considerable absorption capability after implantation, iron-based ISs may have potential applications in implantable medical-device development in the future.

Grain Growth upon Annealing and Its Influence on Biodegradation Rate for Pure Iron

Biodegradable pure iron has gained significant interest as a biomedical material. For biodegradable implant applications, the biodegradation behavior of pure iron is important. In this work, the influence of ferrite grain size on the biodegradation rate for pure iron was studied by means of heat treatment that was annealed below the austenized temperature using as-forged pure iron. Grains were coarsened and a spectrum of ferrite grain sizes was gained by changing the annealed temperature. Biodegradation behavior was studied through weight loss tests, electrochemical measurements and microscopic analyses. Hardness (HV) and biodegradation rate (P_i or P_w) were linearly ferrite grain size-dependent: HV=58.9+383.2d-12, and Pi=-0.023+0.425d-12 or Pw=0.056+0.631d-12. The mechanism by which the role of grain size on biodegradation rate was attributed to the ferrite grain boundary traits.

Progress in manufacturing and processing of degradable Fe-based implants: a review

Biodegradable metals have gained vast attention as befitting candidates for developing degradable metallic implants. Such implants are primarily employed for temporary applications and are expected to degrade or resorbed after the tissue is healed. Fe-based materials have generated considerable interest as one of the possible biodegradable metals. Like other biometals such as Mg and Zn, Fe exhibits good biocompatibility and biodegradability. The versatility in the mechanical behaviour of Fe-based materials makes them a better choice for load-bearing applications. However, the very low degradation rate of Fe in the physiological environment needs to be improved to make it compatible with tissue growth. Several studies on tailoring the degradation behaviour of Fe in the human body are already reported. Majority of these works include studies on the effect of manufacturing and processing techniques on biocompatibility and biodegradability. This article focuses on a comprehensive review and analysis of the various manufacturing and processing techniques so far reported for developing biodegradable iron-based orthopaedic implants. The current status of research in the field is neatly presented, and a summary of the works is included in the article for the benefit of researchers in the field to contextualise their research and effectively find the lacunae in the existing scholarship.

Surface processing for iron-based degradable alloys: A preliminary study on the importance of acid pickling

The formation of a heterogeneous oxidized layer, also called scale, on metallic surfaces is widely recognized as a rapid manufacturing event for metals and their alloys. Partial or total removal of the scale represents a mandatory integrated step for the industrial fabrication processes of medical devices. For biodegradable metals, acid pickling has already been reported as a preliminary surface preparation given further processes, such as electropolishing. Unfortunately, biodegradable medical prototypes presented discrepancies concerning acid pickling studies based on samples with less complex geometry (e.g., non-uniform scale removal and rougher surface). Indeed, this translational knowledge lacks a detailed investigation on this process, deep characterization of treated surfaces properties, as well as a comprehensive discussion of the involved mechanisms. In this study, the effects of different acidic media (HCl, HNO3, H3PO4, CH3COOH, H2SO4 and HF), maintained at different temperatures (21 and 60 °C) for various exposition time (15-240 s), on the chemical composition and surface properties of a Fe-13Mn-1.2C biodegradable alloy were investigated. Changes in mass loss, morphology and wettability evidenced the combined effect of temperature and time for all conditions. Pickling in HCl and HF solutions favor mass loss (0.03-0.1 g/cm2) and effectively remove the initial scale.

Biomedical Ti-Nb-Zr Foams Prepared by Means of Thermal Dealloying Process and Electrochemical Modification

The paper presents results of preparation and modification of Ti20Nb5Zr foams by a thermal dealloying method followed by electrochemical modification. The first step of this study was the preparation of Ti20Nb5Zr30Mg nanopowder using mechanical alloying (MA). The second was forming green compacts by cold pressing and then sintering with magnesium dealloyed from the structure, which resulted in pores formation. The next step was surface modification by electrochemical etching and silver nanoparticle deposition. Porosity, morphology, mechanical properties as well as biocompatibility and antibacterial behavior were investigated. Titanium foam porosity up to approximately 60% and wide pore size distribution were successfully prepared. The new materials have shown positive behavior in the MTT assay as well as antibacterial properties. These results confirmed great potential for thermal dealloying in preparation of porous structures.

Interaction of thin polyethyleneimine layer with the iron surface and its effect on the electrochemical behavior

Polymer-coated metals may act as biodegradable orthopedic implants with adjustable corrosion rates. Metallic surfaces represent a dynamic system with specific interactions occurring after the material is implanted into the human body. An additional layer, in the form of polymeric thin film, changes the nature of this metal-body fluids interface. Moreover, the interaction between polymer and metal itself can differ for various systems. Iron-based material modified with a thin layer of polyethyleneimine (PEI) coating was prepared and studied as potential absorbable implant. Computational methods were employed to study the interaction between the metallic surface and polymer functional monomer units at atomic levels. Various spectroscopical and optical methods (SEM, AFM, Confocal, and Raman spectroscopy) were also used to characterize prepared material. Electrochemical measurements have been chosen to study the polymer adsorption process onto the iron surface and corrosion behavior which is greatly influenced by the PEI presence. The adsorption mechanism of PEI onto iron was proposed alongside the evaluation of Fe and Fe-PEI degradation behavior studied using the impedance method. Bonding via amino -NH₂ group of PEI onto Fe and enhanced corrosion rate of coated samples were observed and confirmed.

Transformation of nanoparticles into compacts: A study on PLGA and celecoxib nanoparticles

Oral delivery of nanoparticles possesses many advantages for delivery of active pharmaceutical ingredients (APIs) to the gastrointestinal tract. However, the poor physical stability of nanoparticles in liquid state is often a challenge. Removing water from the nanosuspensions and transforming the nanoparticles into solid particulate matter in the form of, e.g., tablets could be a potential approach to increase the stability of nanoparticles. The aim of this study was to transform nanoparticles into compacts and to investigate the redispersion of nanoparticles from compacts as well as the dissolution behavior of these compacts. DL-lactide-co-glycolide copolymer (PLGA) nanoparticles and celecoxib (CLX) nanoparticles were used as two model nanoparticle systems and fabricated into nano-embedded microparticles (NEMs) and subsequently compressed into compacts. The compacts were evaluated with respect to the redispersibility of the nanoparticles, as well as the dissolution characteristics of CLX. The results showed that the NEMs could be readily compressed into compacts with sufficient mechanical strength. The size of the redispersed PLGA nanoparticles from the compacts using 2-hydroxypropyl-β-cyclodextrin (HPβCD) as stabilizer was comparable to the original nanoparticles. In contrast, the redispersibility of CLX nanoparticles from the compacts was not as effective as for the PLGA nanoparticles evidenced by a significant increase in the size and polydispersity index (PDI) of the redispersed nanoparticles. Nonetheless, an obvious enhancement in dissolution rate of CLX was observed from the compacts with CLX nanoparticles. It is concluded that transforming polymeric nanoparticles into compacts via NEMs provides stabilization and allows redispersion into original nanoparticles. Despite the reduced redispersibility, compacts loaded with nanoparticles exhibited improved dissolution rate compared with the crystalline drug. Loading of nanoparticles into compacts is a promising approach to overcome the poor stability of nanoparticle within oral drug delivery of nanoparticles.

Modifications on porous absorbable Fe-based scaffolds for bone applications: A review from corrosion and biocompatibility viewpoints

Iron (Fe) and Fe-based scaffolds have become a research frontier in absorbable materials which is inherent to their promising mechanical properties including fatigue strength and ductility. Nevertheless, their slow corrosion rate and low biocompatibility have been their major obstacles to be applied in clinical applications. Over the last decade, various modifications on porous Fe-based scaffolds have been performed to ameliorate both properties encompassing surface coating, microstructural alteration via alloying, and advanced topologically order structural design produced by additive manufacturing (AM) techniques. The recent advent of AM produces topologically ordered porous Fe-based structures with an optimized architecture having controllable pore size and strut thickness, intricate internal design, and larger exposed surface area. This undoubtedly opens up new options for controlling Fe corrosion and its structural strengths. However, the in vitro biocompatibility of the AM porous Fe still needs to be addressed considering its higher corrosion rate due to the larger exposed surface area. This review summarizes the latest progress of the modifications on porous Fe-based scaffolds with a specific focus on their responses on the corrosion behavior and biocompatibility.

A review on current research status of the surface modification of Zn-based biodegradable metals

Recently, zinc and its alloys have been proposed as promising candidates for biodegradable metals (BMs), owning to their preferable corrosion behavior and acceptable biocompatibility in cardiovascular, bone and gastrointestinal environments, together with Mg-based and Fe-based BMs. However, there is the desire for surface treatment for Zn-based BMs to better control their biodegradation behavior. Firstly, the implantation of some Zn-based BMs in cardiovascular environment exhibited intimal activation with mild inflammation. Secondly, for orthopedic applications, the biodegradation rates of Zn-based BMs are relatively slow, resulting in a long-term retention after fulfilling their mission. Meanwhile, excessive Zn2+ release during degradation will cause in vitro cytotoxicity and in vivo delayed osseointegration. In this review, we firstly summarized the current surface modification methods of Zn-based alloys for the industrial applications. Then we comprehensively summarized the recent progress of biomedical bulk Zn-based BMs as well as the corresponding surface modification strategies. Last but not least, the future perspectives towards the design of surface bio-functionalized coatings on Zn-based BMs for orthopedic and cardiovascular applications were also briefly proposed.

Electrochemical behavior, biocompatibility and mechanical performance of biodegradable iron with PEI coating

Coating of the biodegradable metals represents an effective way of modification of their properties. Insufficient biological, mechanical, or degradation performance of pure metals may be enhanced when the proper type of organic polymer coating is used. In our previous work, the significant effect of the polyethyleneimine (PEI) coating not only on the rate but also on the type of corrosion was discovered. To bring a comprehensive overview of the Fe-PEI system performance, iron-based biodegradable scaffolds with polyethyleneimine coating were studied and their cytocompatibility and hemocompatibility, and mechanical properties were evaluated and discussed in this work. Electrochemical impedance spectroscopy (EIS) measurements were conducted for further study of material behavior. Biological analyses (MTS assay, fluorescent imaging, hemocompatibility tests) showed better cell proliferation on the surface of Fe-PEI samples but not sufficient overall cytocompatibility. Good anti-platelet adhesion properties but higher hemolysis when compared to the pure iron was also observed for the coated samples. Mechanical properties of the prepared Fe-PEI material were enhanced after coating. These findings suggest that the Fe-PEI may be an interesting potential biomaterial after further composition optimization resulting in lower cytotoxicity and better hemocompatibility.

Insight into the bioabsorption of Fe-based materials and their current developments in bone applications

Iron (Fe) and Fe-based materials have been vigorously explored in orthopedic applications in the past decade mainly owing to their promising mechanical properties including high yield strength, elastic modulus and ductility. Nevertheless, their corrosion products and low corrosion kinetics are the major concerns that need to be improved further despite their appealing mechanical strengths. The current studies on porous Fe-based scaffolds show an improved corrosion rate but the in vitro biocompatibility is still problematic in general. Unlike the Mg implants, the biodegradation and bioabsorption of Fe-based implants are still not well described. This vague issue could implicate the development of Fe-based materials as potential medical implants as they have not reached the clinical trial stage yet. Thus, there is a need to understand in-depth the Fe corrosion behavior and its bioabsorption mechanism to facilitate the material design of Fe-based scaffolds and further improve its biocompatibility. This manuscript provides an important insight into the basic bioabsorption of the multi-ranged Fe-based corrosion products with a review of the latest progress on the corrosion & in vitro biocompatibility of porous Fe-based scaffolds together with the remaining challenges and the perspective on the future direction.

Biocompatibility and Biological Performance Evaluation of Additive-Manufactured Bioabsorbable Iron-Based Porous Suture Anchor in a Rabbit Model

This study evaluated the biocompatibility and biological performance of novel additive-manufactured bioabsorbable iron-based porous suture anchors (iron_SAs). Two types of bioabsorbable iron_SAs, with double- and triple-helical structures (iron_SA_2_helix and iron_SA_3_helix, respectively), were compared with the synthetic polymer-based bioabsorbable suture anchor (polymer_SAs). An in vitro mechanical test, MTT assay, and scanning electron microscope (SEM) analysis were performed. An in vivo animal study was also performed. The three types of suture anchors were randomly implanted in the outer cortex of the lateral femoral condyle. The ultimate in vitro pullout strength of the iron_SA_3_helix group was significantly higher than the iron_SA_2_helix and polymer_SA groups. The MTT assay findings demonstrated no significant cytotoxicity, and the SEM analysis showed cells attachment on implant surface. The ultimate failure load of the iron_SA_3_helix group was significantly higher than that of the polymer_SA group. The micro-CT analysis indicated the iron_SA_3_helix group showed a higher bone volume fraction (BV/TV) after surgery. Moreover, both iron SAs underwent degradation with time. Iron_SAs with triple-helical threads and a porous structure demonstrated better mechanical strength and high biocompatibility after short-term implantation. The combined advantages of the mechanical superiority of the iron metal and the possibility of absorption after implantation make the iron_SA a suitable candidate for further development.

Biodegradable Iron-Based Materials-What Was Done and What More Can Be Done?

Iron, while attracting less attention than magnesium and zinc, is still one of the best candidates for biodegradable metal stents thanks its biocompatibility, great elastic moduli and high strength. Due to the low corrosion rate, and thus slow biodegradation, iron stents have still not been put into use. While these problems have still not been fully resolved, many studies have been published that propose different approaches to the issues. This brief overview report summarises the latest developments in the field of biodegradable iron-based stents and presents some techniques that can accelerate their biocorrosion rate. Basic data related to iron metabolism and its biocompatibility, the mechanism of the corrosion process, as well as a critical look at the rate of degradation of iron-based systems obtained by several different methods are included. All this illustrates as the title says, what was done within the topic of biodegradable iron-based materials and what more can be done.

Degradation-triggered release from biodegradable metallic surfaces

This work is dedicated to the investigation of drug-release control by a direct effect of degradation from biodegradable metallic surfaces. Degradation behaviors characterized by surface morphology, immersion, and electrochemical techniques demonstrated that curcumin-coated zinc (c-Zn) had a higher degradation rate compared to curcumin-coated Fe (c-Fe). High anodic dissolution rate due to the higher degradation rate and widely extended groove-like degradation structure of c-Zn propelled a higher curcumin release. On the other hand, a slower curcumin release rate shown by c-Fe scaffolds is ascribed to its lower anodic dissolution and to its pitting degradation regime with relatively smaller pits. These findings illuminate the remarkable advantage of different degradation behaviors of degradable metallic surfaces in directly controlling the drug release without the need for external electrical stimulus.

Tailoring grain sizes of the biodegradable iron-based alloys by pre-additive manufacturing microalloying

We demonstrated the design of pre-additive manufacturing microalloying elements in tuning the microstructure of iron (Fe)-based alloys for their tunable mechanical properties. We tailored the microalloying stoichiometry of the feedstock to control the grain sizes of the metallic alloy systems. Two specific microalloying stoichiometries were reported, namely biodegradable iron powder with 99.5% purity (BDFe) and that with 98.5% (BDFe-Mo). Compared with the BDFe, the BDFe-Mo powder was found to have lower coefficient of thermal expansion (CTE) value and better oxidation resistance during consecutive heating and cooling cycles. The selective laser melting (SLM)-built BDFe-Mo exhibited high ultimate tensile strength (UTS) of 1200 MPa and fair elongation of 13.5%, while the SLM-built BDFe alloy revealed a much lower UTS of 495 MPa and a relatively better elongation of 17.5%, indicating the strength enhancement compared with the other biodegradable systems. Such an enhanced mechanical behavior in the BDFe-Mo was assigned to the dominant mechanism of ferrite grain refinement coupled with precipitate strengthening. Our findings suggest the tunability of outstanding strength-ductility combination by tailoring the pre-additive manufacturing microalloying elements with their proper concentrations.

Extrusion-based 3D printed biodegradable porous iron

Extrusion-based 3D printing followed by debinding and sintering is a powerful approach that allows for the fabrication of porous scaffolds from materials (or material combinations) that are otherwise very challenging to process using other additive manufacturing techniques. Iron is one of the materials that have been recently shown to be amenable to processing using this approach. Indeed, a fully interconnected porous design has the potential of resolving the fundamental issue regarding bulk iron, namely a very low rate of biodegradation. However, no extensive evaluation of the biodegradation behavior and properties of porous iron scaffolds made by extrusion-based 3D printing has been reported. Therefore, the in vitro biodegradation behavior, electrochemical response, evolution of mechanical properties along with biodegradation, and responses of an osteoblastic cell line to the 3D printed iron scaffolds were studied. An ink formulation, as well as matching 3D printing, debinding and sintering conditions, was developed to create iron scaffolds with a porosity of 67%, a pore interconnectivity of 96%, and a strut density of 89% after sintering. X-ray diffracometry confirmed the presence of the α-iron phase in the scaffolds without any residuals from the rest of the ink. Owing to the presence of geometrically designed macropores and random micropores in the struts, the in vitro corrosion rate of the scaffolds was much improved as compared to the bulk counterpart, with 7% mass loss after 28 days. The mechanical properties of the scaffolds remained in the range of those of trabecular bone despite 28 days of in vitro biodegradation. The direct culture of MC3T3-E1 preosteoblasts on the scaffolds led to a substantial reduction in living cell count, caused by a high concentration of iron ions, as revealed by the indirect assays. On the other hand, the ability of the cells to spread and form filopodia indicated the cytocompatibility of the corrosion products. Taken together, this study shows the great potential of extrusion-based 3D printed porous iron to be further developed as a biodegradable bone substituting biomaterial.

Additively manufactured biodegradable porous metals

Partially due to the unavailability of ideal bone substitutes, the treatment of large bony defects remains one of the most important challenges of orthopedic surgery. Additively manufactured (AM) biodegradable porous metals that have emerged since 2018 provide unprecedented opportunities for fulfilling the requirements of an ideal bone implant. First, the multi-scale geometry of these implants can be customized to mimic the human bone in terms of both micro-architecture and mechanical properties. Second, a porous structure with interconnected pores possesses a large surface area, which is favorable for the adhesion and proliferation of cells and, thus, bony ingrowth. Finally, the freeform geometrical design of such biomaterials could be exploited to adjust their biodegradation behavior so as to maintain the structural integrity of the implant during the healing process while ensuring that the implant disappears afterwards, paving the way for full bone regeneration. While the AM biodegradable porous metals that have been studied so far have shown many unique properties as compared to their solid counterparts, the unprecedented degree of flexibility in their geometrical design has not yet been fully exploited to optimize their properties and performance. In order to develop the ideal bone implants, it is important to take advantage of the full potential of AM biodegradable porous metals through detailed and systematic study on their biodegradation behavior, mechanical properties, biocompatibility, and bone regeneration performance. This review paper presents the state of the art in AM biodegradable porous metals and is focused on the effects of material type, processing, geometrical design, and post-AM treatments on the mechanical properties, biodegradation behavior, in vitro biocompatibility, and in vivo bone regeneration performance of AM porous Mg, Fe, and Zn as well as their alloys. We also identify a number of knowledge gaps and the challenges encountered in adopting AM biodegradable porous metals for orthopedic applications and suggest some promising areas for future research.

Degradation Performance of Open-Cell Biomaterials from Phosphated Carbonyl Iron Powder with PEG Coating

Advances in biomedicine and development of modern technologies in the last century have fostered the improvement in human longevity and well-being. This progress simultaneously initiated the need for novel biomaterials. Recently, degradable metallic biomaterials have attracted serious attention in scientific and clinical research owing to their utilization in some specific applications. This work investigates the effect of the polyethylene glycol (PEG) coating of open-cell iron and phosphorus/iron foams on their microstructure and corrosion properties. The addition of phosphorus causes a slight increase in pore size and the deposition of a polymer coating results in a smoothened surface and a moderate decrease in pore diameter. The PEG coating leads to an increase in corrosion rates in both foams and potentially a more desirable product.

Controlling the dissolution of iron through the development of nanostructured Fe-Mg for biomedical applications

In the field of biodegradable metallic materials, rapid and non-uniform biodegradation, caused by uncontrolled corrosion rates, is a potential shortcoming. Among the prominent biodegradable materials, magnesium is an attractive choice, however, it is prone to rapid dissolution. In contrast, iron possesses a slow dissolution rate. To approach the middle ground, instead of making magnesium more corrosion-resistant, the less-explored approach of making iron less corrosion-resistant is employed here. In this study, iron, and magnesium, having contrasting corrosion rates, are combined via magnetron co-sputtering. The idea of combinatorial synthesis is employed to fabricate two model nanostructured Fe-Mg samples, i.e. CSFM-1 (Fe₈₅Mg₁₅), and CSFM-2 (Fe₆₅Mg₃₅), exhibiting a controlled and uniform degradation in phosphate-buffer saline solution. The structural characterization of the two samples demonstrates a substitutional solid solution of bcc-Fe-Mg in CSFM-1 and an amorphous short-range-ordered structure in the CSFM-2 sample. Electrochemical investigation shows increased corrosion rates for the two Fe-Mg samples in comparison to pure Fe, validated by relatively active corrosion potentials, higher corrosion current densities, faster anodic dissolution, and lower charge transfer resistances, governed by chemical composition and non-equilibrium nanostructures. Finally, nano-indentation testing of the two samples reveals relatively higher hardness and lower elastic moduli, a suitable combination for bio-implants. STATEMENT OF SIGNIFICANCE: The use of Mg as a biodegradable in-vivo  implant material is problematic because of its high dissolution rate and potential for hydrogen gas generation. This is the first time that the idea of combinatorial synthesis is employed to fabricate two model nanostructured Fe-Mg systems, i.e. CSFM-1 (Fe₈₅Mg₁₅), and CSFM-2 (Fe₆₅Mg₃₅), exhibiting a controlled and uniform degradation. The structural characterization of the two systems demonstrates a substitutional solid solution of bcc-Fe-Mg in CSFM-1 and an amorphous short-range-ordered structure in the CSFM-2 system. Electrochemical investigation shows increased biodegradation rates for the two Fe-Mg systems in comparison to pure Fe, validated by relatively active corrosion potentials, higher corrosion current densities, faster anodic dissolution, and lower charge transfer resistances, governed by chemical composition and non-equilibrium nanostructures.

Surface Modifications of Biodegradable Metallic Foams for Medical Applications

Significant progress was achieved presently in the development of metallic foam-like materials improved by biocompatible coatings. Material properties of the iron, magnesium, zinc, and their alloys are promising for their uses in medical applications, especially for orthopedic and bone tissue purposes. Current processing technologies and a variety of modifications of the surface and composition facilitate the design of adjusted medical devices with desirable mechanical, morphological, and functional properties. This article reviews the recent progress in the design of advanced degradable metallic biomaterials perfected by different coatings: polymer, inorganic ceramic, and metallic. Appropriate coating of metallic foams could improve the biocompatibility, osteogenesis, and bone tissue-bonding properties. In this paper, a comprehensive review of different coating types used for the enhancement of one or several properties of biodegradable porous implants is given. An outline of the conventional preparation methods of metallic foams and a brief overview of different alloys for medical applications are also provided. In addition, current challenges and future research directions of processing and surface modifications of biodegradable metallic foams for medical applications are suggested.

Evaluation of in vitro and in vivo biocompatibility of iron produced by powder metallurgy

Biodegradable metallic materials (BMMs) are expected to corrode gradually in vivo after providing the structural support to the tissue during its regeneration and healing processes. These characteristics make them promising candidates for use in stents. These endoprostheses are produced from metal alloys by casting and thermomechanical treatment. Since porous alloys and metals have less corrosion resistance than dense ones, the use of powder metallurgy becomes an option to produce them. Among the metals, iron has been proposed as a material in the manufacturing of stents because of its mechanical properties. However, even then it is unclear what toxicity threshold is safe to the body. Thus, the objective of this research was to verify the biocompatibility of sintered 99.95% and 99.5% pure iron by powder metallurgy in vitro with Adipose-derived mesenchymal stromal cells (ADSCs) and in vivo with a Wistar rat model. Herein, characterizations of iron powder samples produced by the powder metallurgy and the process parameters as compression pressure, atmosphere, sintering time and temperature were determined to evaluate the potential of production of biodegradable implants. The samples obtained from pure iron were submitted to tests of green and sintered density, porosity, microhardness, hardness and metallography. The biocompatibility study was performed by indirect and direct cell culture with iron. The effects of corrosion products of iron on morphology, viability, and proliferation of ADSCs were evaluated in vitro. Hemolysis assay was performed to verify the hemocompatibility of the samples. In vivo biocompatibility was evaluated after pure iron discs were implanted subcutaneously into the dorsal area of Wistar rats that were followed up to 6 months. The results presented in this paper validated the potential to produce biodegradable medical implants by powder metallurgy. Both iron samples were hemocompatible and biocompatible in vitro and in vivo, although the 99.95% iron had better performance in vitro than 99.5%.

In Vitro Corrosion Behavior of Biodegradable Iron Foams with Polymeric Coating

Research in the field of biodegradable metallic scaffolds has advanced during the last decades. Resorbable implants based on iron have become an attractive alternative to the temporary devices made of inert metals. Overcoming an insufficient corrosion rate of pure iron, though, still remains a problem. In our work, we have prepared iron foams and coated them with three different concentrations of polyethyleneimine (PEI) to increase their corrosion rates. Scanning electron microscopy (SEM) coupled with energy dispersive X-ray analysis (EDX), Fourier-transform infrared spectroscopy (FT-IR), and Raman spectroscopy were used for characterization of the polymer coating. The corrosion behavior of the powder-metallurgically prepared samples was evaluated electrochemically using an anodic polarization method. A 12 weeks long in vitro degradation study in Hanks’ solution at 37 °C was also performed. Surface morphology, corrosion behavior, and degradation rates of the open-cell foams were studied and discussed. The use of PEI coating led to an increase in the corrosion rates of the cellular material. The sample with the highest concentration of PEI film showed the most rapid corrosion in the environment of simulated body fluids.

Accelerated biodegradation and improved mechanical performance of pure iron through surface grain refinement

Pure iron and its biocompatible and biodegradable alloys have a high potential to be used for temporary load bearing medical implants. Nevertheless, the formation of passive iron oxide and hydroxide layers, which lead to a considerably low degradation rate at the physiological environment, has highly restricted their application. Herein we used numerical and experimental methods to evaluate the effect of severe shot peening, as a scalable mechanical surface treatment, on adjusting the performance of pure iron for biomedical applications. The developed numerical model was used to identify the range of peening parameters that would promote grain refinement on the pure iron surface. Experimental tests were then performed to analyze the gradient structure and the characteristics of the interface free surface layer created on peened samples. The results indicated that severe shot peening could notably increase the surface roughness and wettability, induce remarkable surface deformation and grain refinement, enhance surface hardness and generate high in-depth compressive residual stresses. The increased surface roughness besides the high concentration of micro cracks and dislocation density in the grain refined top layer promoted pure iron's degradation in the biologically simulated environment. STATEMENT OF SIGNIFICANCE: Biodegradable metallic materials with resorbable degradation products have a high potential to be used for temporary implants such as screws, pins, staples, etc. They can eliminate the need for implant retrieval surgery after the damaged tissue is healed, and result in reduced patient suffering besides lowered hospitalization costs. Pure iron is biodegradable and is an essential nutrient in human body; however, its application as biomedical implant is highly restricted by its slow degradation rate in physiological environment. We applied a scalable surface treatment able to induce grain refinement and increase surface roughness. This treatment enhances mechanical performance of pure iron and accelerates its degradation rate, paving the way for its broader applications for biomedical implants.

In vitro degradation behaviour, cytocompatibility and hemocompatibility of topologically ordered porous iron scaffold prepared using 3D printing and pressureless microwave sintering

Biodegradable porous iron having topologically ordered porosity and tailorable properties as per the required application has been the major requirement in the field of biodegradable biomaterials. Hence, in the present study, iron scaffolds with the topologically ordered porous structure were developed and for the first time, the effect of the variation in the topology on the in vitro degradation behaviour, cytocompatibility and hemocompatibility were investigated. Iron scaffold samples were fabricated using a novel process based on the combination of 3D printing and pressureless microwave sintering. To investigate the effect of topology, two different types of topological structures namely Truncated Octahedron (TO) (with variable strut size) and Cubic (C) were used. From the morphological characterization, it was found that fabricated iron scaffold possessed interconnected porosity varying from 50.70%-80.97% which included the random microporosities in the strut and designed macroporosity. Furthermore, it was inferred that the topology of the iron scaffold significantly affected its degradation properties and cytocompatibility. Increase in the weight loss, corrosion rate and reduction in cell viability with the reduction in porosity were obtained. The maximum corrosion rate and weight loss achieved was 1.64 mmpy and 6.4% respectively. Direct cytotoxicity test results revealed cytotoxicity, while prepared iron scaffold samples exhibited excellent hemocompatibility and anti-platelet adhesion property. A comparative study with relevant literature was performed and it was established that the developed iron scaffold exhibited favorable degradation and biological properties which could be tailored to suit appropriate bone tissue engineering applications.

In-Vivo Corrosion Characterization and Assessment of Absorbable Metal Implants

Absorbable metals have been introduced as materials to fabricate temporary medical implants. Iron, magnesium and zinc have been considered as major base elements of such metals. The metallurgical characterization and in-vitro corrosion assessment of these metals have been covered by the new ASTM standards F3160 and F3268. However, the in-vivo corrosion characterization and assessment of absorbable metal implants are not yet well established. The corrosion of metals in the in-vivo environment leads to metal ion release and corrosion product formation that may cause excessive toxicity. The aim of this work is to introduce the techniques to assess absorbable metal implants and their in-vivo corrosion behavior. This contains the existing approaches, e.g., implant retrieval and histological analysis, ultrasonography and radiography, and the new techniques for real-time in-vivo corrosion monitoring.

A Wearable Iron-Based Implant as an Intramedullary Nail in Tibial Shaft Fracture of Sheep

A stable repaired fracture is the key factor responsible for the recovery of a damaged bone. The iron-based implant is one of the biodegradable metals that have been proven safe as a fracture fixation device. The objective of our experimental approach was to examine the potential of the iron-based implant as a biodegradable metal in tibia shaft fracture in sheep chronically. The samples used for this experiment were iron-based and stainless steel implants. Each had a diameter of 5 mm. These samples were analyzed through 3 phases which are material characterization, in vitro and in vivo examination. The samples were examined using a scanning electron microscope with energy dispersive spectrometer and X-ray diffraction. Based on the analysis carried out, the samples contained 90,02% and 60,81% Fe for iron-based implant and stainless implant, respectively. Both implants maintained high viability when being in contact with calf pulmonary artery endothelial cells, indicating that both implants had a minimum response to the cell in a hemocytometer and methyl tetrazolium (MTT) assay. The systemic effect of the implants was observed using hematology and blood chemistry examination. Data collection also shows that both implants also had a minimum response to the erythrocytes, leucocytes, blood chemistry, and blood mineral during the period of observation. Therefore, it could be concluded that the iron-based implant is tolerable for a period of 9 months. It also has the potential to be used as a biodegradable orthopedic implant.

Mechanism of Acceleration of Iron Corrosion by a Polylactide Coating

Strong and biodegradable materials are key to the development of next-generation medical devices for interventional treatment. Biodegradable polymers such as polylactide (PLA) have controllable degradation profiles, but their mechanical strength is much weaker than some metallic materials such as iron; on the other hand, tuning the corrosion rate of iron to a proper time range for biomedical applications has always been a challenge. Very recently, we have achieved a complete corrosion of iron stent in vivo within the clinically required time frame by combining a PLA coating, which provides a new biomaterial type for the next-generation biodegradable coronary stents termed as a metal-polymer composite stent. The underlying mechanism of accelerating iron corrosion by a PLA coating remains an open fundamental topic. Herein, we investigated the corrosion mechanism of an iron sheet under a PLA coating in the biomimetic in vitro condition. The Pourbaix diagram (potential vs pH) was calculated to present the thermodynamic driving force of iron corrosion in the biomimetic aqueous medium. Electrochemical methods were applied to track the dynamic corrosion process and inspect various potential cues influencing iron corrosion. The present work reveals that acceleration of iron corrosion by the PLA coating arises mainly from decreasing the local pH owing to PLA hydrolysis and from alleviating the deposition of the passivation layer by the polymer coating.

Updates on the research and development of absorbable metals for biomedical applications

Absorbable metals, metals that corrode in physiological environment, constitute a new class of biomaterials intended for temporary medical implant applications. The introduction of these metals has shifted the established paradigm of metal implants from preventing corrosion to its direct application. Interest toward absorbable metals has been growing in the past decade. This is proved by the rapid increase in scientific publication, progressive development of standards, and launching the first commercial products. Iron, magnesium, zinc, and their alloys are the current three absorbable metals families. Magnesium-based metals are the most progressing family with a large data set obtained from both basic and translational research. Iron-based metals are still facing a major challenge of low in vivo corrosion rate despite the significant efforts that have been put to overcome its weakness. Zinc-based metals are the new alternative absorbable metals with moderate corrosion rates that fall between those of iron and magnesium. This manuscript provides a brief review on the latest progress in the research and development of absorbable metals, the most important findings, the remaining challenges, and the perspective on the future direction.

Strategy of Metal-Polymer Composite Stent To Accelerate Biodegradation of Iron-Based Biomaterials

The new principle and technique to tune biodegradation rates of biomaterials is one of the keys to the development of regenerative medicine and next-generation biomaterials. Biodegradable stents are new-generation medical devices applied in percutaneous coronary intervention, etc. Recently, both corrodible metals and degradable polymers have drawn much attention in biodegradable stents or scaffolds. It is, however, a dilemma to achieve good mechanical properties and appropriate degradation profiles. Herein, we put forward a metal-polymer composite strategy to achieve both. Iron stents exhibit excellent mechanical properties but low corrosion rate in vivo. We hypothesized that coating of biodegradable aliphatic polyester could accelerate iron corrosion due to the acidic degradation products, etc. To demonstrate the feasibility of this composite material technique, we first conducted in vitro experiments to affirm that iron sheet corroded faster when covered by polylactide (PLA) coating. Then, we fabricated three-dimensional metal-polymer stents (MPS) and implanted the novel stents in the abdominal aorta of New Zealand white rabbits, setting metal-based stents (MBS) as a control. A series of in vivo experiments were performed, including measurements of residual mass and radial strength of the stents, histological analysis, micro-computed tomography, and optical coherence tomography imaging at the implantation site. The results showed that MPS could totally corrode in some cases, whereas iron struts of MBS in all cases remained several months after implantation. Corrosion rates of MPS could be easily regulated by adjusting the composition of PLA coatings.

Electrophoretic Deposition of Gentamicin-Loaded Silk Fibroin Coatings on 3D-Printed Porous Cobalt-Chromium-Molybdenum Bone Substitutes to Prevent Orthopedic Implant Infections

In addition to customizing shapes of metal bone substitutes for patients, the 3D printing technique can reduce the modulus of the substitutes through the design and manufacture of interconnected porous structures, achieving the modulus match between substitute and surrounding bone to improve implant longevity. However, the porous bone substitutes take more risks of postoperative infection due to its much larger surface area compared with the traditional casting solid bone substitute. Here, we prepared of gentamicin-loaded silk fibroin coatings on 3D-printed porous cobalt-chromium-molybdenum (CoCrMo) bone substitutes via electrophoretic deposition technique. Through optimization, relatively intact, continuous, homogeneous, and conformal coatings with a thickness of 2.30 ± 0.58 μm were deposited around the struts with few pore blocked. The porous metal structures exhibited no loss in mechanical properties after the anode galvanic corrosion in EPD process. The initial osteoblastic response on coatings was better than that on metal surface, including cell spreading, proliferation and cytotoxicity. Antibacterial efficacy experiments showed that the coatings had an antibacterial effect on both adherent and planktonic bacteria within 1 week. These results suggested that the beneficial properties of anode electrophoretic deposited silk fibroin coatings could be exploited to improve the biological functionality of porous structures made of medical metals.

Biodegradable elastic nanofibrous platforms with integrated flexible heaters for on-demand drug delivery

Delivery of drugs with controlled temporal profiles is essential for wound treatment and regenerative medicine applications. For example, bacterial infection is a key challenge in the treatment of chronic and deep wounds. Current treatment strategies are based on systemic administration of high doses of antibiotics, which result in side effects and drug resistance. On-demand delivery of drugs with controlled temporal profile is highly desirable. Here, we have developed thermally controllable, antibiotic-releasing nanofibrous sheets. Poly(glycerol sebacate)- poly(caprolactone) (PGS-PCL) blends were electrospun to form elastic polymeric sheets with fiber diameters ranging from 350 to 1100 nm and substrates with a tensile modulus of approximately 4-8 MPa. A bioresorbable metallic heater was patterned directly on the nanofibrous substrate for applying thermal stimulation to release antibiotics on-demand. In vitro studies confirmed the platform’s biocompatibility and biodegradability. The released antibiotics were potent against tested bacterial strains. These results may pave the path toward developing electronically controllable wound dressings that can deliver drugs with desired temporal patterns.

Utilizing Iron's Attractive Chemical and Magnetic Properties in Microrocket Design, Extended Motion, and Unique Performance

All-in-one material for microrocket propulsion featuring acid-based bubble generation and magnetic guidance is presented. Electrochemically deposited iron serves as both a propellant, toward highly efficient self-propulsion in acidic environments, and as a magnetic component enabling complete motion control. The new microrockets display longer lifetime and higher propulsion efficiency compared to previously reported active metal zinc-based microrockets due to the chemical properties of iron and the unique structure of the microrockets. These iron-based microrockets also demonstrate unique and attractive cargo towing and autonomous release capabilities. The latter is realized upon loss of the magnetic properties due to acid-driven iron dissolution. More interestingly, these bubble-propelled microrockets assemble via magnetic interactions into a variety of complex configurations and train structures, which enrich the behavior of micromachines. Modeling of the magnetic forces during the microrocket assembly and cargo capture confirms these unique experimentally observed assembly and cargo-towing behaviors. These findings provide a new concept of blending propellant and magnetic components into one, toward simplifying the design and fabrication of artificial micro/nanomachines, realizing new functions and capabilities for a variety of future applications.

Transient Micromotors That Disappear When No Longer Needed

Transient self-destroyed micromotors that autonomously disappear in biological media at controlled rates upon completing their task, without leaving a toxic residue, are presented. The propulsion and degradation characteristics of the self-destroyed Mg/ZnO, Mg/Si, and Zn/Fe Janus micromotors and single-component Zn micromotors are described. The degradation of the Janus micromotors relies on the different corrosion rates of their core-shell components. Inductively coupled plasma optical emission spectrometry measurements are used to probe the time-dependent degradation of the different constituents of the micromotors. The toxicity of the transient micromotors is discussed toward their potential use in biomedical applications. This concept of transient micromotors offers considerable potential for diverse practical applications in the near future.

Advances in Fe-based biodegradable metallic materials

This review systematically summarizes recent studies on Fe-based biodegradable metallic materials and discusses these findings in terms of their processing methods, mechanical properties, degradability and biocompatibility.