Biocorrosion and Cytotoxicity Studies on Biodegradable Mg-Based Multicomponent Alloys

Magnesium-based multicomponent alloys with different compositions, namely Mg60Al20Zn5Cu10Mn5 (Mg60 alloy), Mg70Al15Zn5Cu5Mn5 (Mg70 alloy), and Mg80Al5Cu5Mn5Zn5 (Mg 80) alloys, were prepared using the disintegrated melt deposition technique. The DMD technique is a distinctive method that merges the benefits from gravity die casting and spray forming. This approach facilitates high solidification rates, process yields, and reduced metal wastage, resulting in materials with a fine microstructure and minimal porosity. Their potential as biodegradable materials was assessed through corrosion in different simulated body fluids (SBFs), microstructure, and cytotoxicity tests. It was observed that the Mg60 alloy exhibited low corrosion rates (~× 10-5 mm/year) in all SBF solutions, with a minor amount of corrosive products, and cracks were observed. This can be attributed to the formation of the Mg32(AlZn)49 phase and to its stability due to Mg(OH)2 film, leading to excellent corrosion resistance when compared to the Mg70 and M80 alloys. Conversely, the Mg80 alloy exhibited high corrosion rates, along with more surface degradation and cracks, due to active intermetallic phases, such as Al6Mn, Al2CuMg, and Al2Cu phases. The order of corrosion resistance for the Mg alloy was found to be ASS > HBSS > ABP > PBS. Further, in vitro cytotoxicity studies were carried out using MDA-MB-231 tumor cells. By comparing all three alloys, in terms of proliferation and vitality, the Mg80 alloy emerged as a promising material for implants, with potential antitumor activity.

Corrosion Activity of Ultrafine-Grained Pure Magnesium and ZK60 Magnesium Alloy in Phosphate Buffered Saline Solution

The magnesium alloy ZK60 is a promising candidate as a material for biodegradable implants. One of the most important factors for biodegradable implants is the modification of their corrosion behavior to match the requirements for the healing bone or tissue. The corrosion behavior can be influenced by different factors, among them the grain size, which can be changed by severe plastic deformation processes such as High Pressure Torsion Extrusion (HPTE). This study focuses on the corrosion behavior of samples of pure magnesium and ZK60 before and after HPTE, and the influence of the microstructure on the corrosion activity. The samples are subjected to immersion tests in phosphate buffered saline solution (PBS). The corrosion activity is defined by the emerging hydrogen volume from the corrosion process which is collected and by subsequently observing the resulting sample surfaces. The findings of this study suggest that pure magnesium shows lower corrosion activities than ZK60 and that HPTE processing leads to higher corrosion activities in PBS.

Synergistic Improvement of Antibacterial and Osteogenic Differentiation of Thermomechanically Processed Mg-Zr-Sr-Ce Alloy: Insights into the Role of Precipitate Evolution Supported by AIMD Simulation Study

In the present study, we have discussed the influence of forging temperature (623 K (FT623), 723 K (FT723) and 823 K (FT823)) on microstructure and texture evolution and its implication on mechanical behavior, in vitro-in vivo biocorrosion, antibacterial response, and cytocompatibility of microalloyed Mg-Zr-Sr-Ce alloy. Phase analysis, SEM, and TEM characterization confirm the presence of Mg12Ce precipitate, and its stability was further validated by performing ab initio molecular dynamic simulation study. FT723 exhibits strengthened basal texture, higher fraction of second phases, and particle-stimulated nucleation-assisted DRX grains compared to other two specimens, resulting in superior strength with comparable ductility. FT723 also exhibits superior corrosion resistance mainly due to the strengthened basal texture and lower dislocation density. All the specimens exhibit excellent antibacterial behavior with Gram-negative E. coli, Gram-positive Staphylococcus aureus, and Pseudomonas aeruginosa bacteria. 100% reduction of bacterial growth is observed within 24 h of culture of the specimens. Cytocompatibility was determined by challenging specimen extracts with the MC3T3-E1 cell lines. FT723 specimen exhibits the highest cell proliferation and alkaline phosphatase activity (ALP) because of its superior corrosion resistance. The ability of the specimens to be used in orthopedic implant application was evaluated by in vivo study in rabbit femur. Neither tissue-related infection nor the detrimental effect surrounding the implant was confirmed from histological analysis. Significant higher bone regeneration surrounding the FT723 specimen was observed in SEM analysis and fluorochrome labeling. After 60 days, the FT723 specimen exhibits the highest bone formation, suggesting it is a suitable candidate for orthopedic implant application.

Mg-based implants with a sandwiched composite coating simultaneously facilitate antibacterial and osteogenic properties

Insufficient antibacterial effects and over-fast degradation are the main limitations of magnesium (Mg)-based orthopedic implants. In this study, a sandwiched composite coating containing a triclosan (TCS)-loaded poly(lactic acid) (PLA) layer inside and brushite (DCPD) layer outside was prepared on the surface of the Mg-Nd-Zn-Zr (denoted as JDBM) implant. In vitro degradation tests revealed a remarkable improvement in the corrosion resistance and moderate degradation rate. The drug release profile demonstrated a controllable and sustained TCS release for at least two weeks in vitro. The antibacterial rates of the implant were all over 99.8% for S. aureus, S. epidermidis, and E. coli, demonstrating superior antibacterial effects. Additionally, this coated JDBM implant exhibited no cytotoxicity but improved cell adhesion and proliferation, indicating excellent cytocompatibility. In vivo assays were conducted by implant-related femur osteomyelitis and osseointegration models in rats. Few bacteria were attached to the implant surface and the surrounding bone tissue. Furthermore, the coated JDBM implant exhibited more new bone formation than other groups due to the synergistic biological effects of released TCS and Mg2+, revealing excellent osteogenic ability. In summary, the JDBM implant with the sandwiched composite coating could significantly enhance the antibacterial activities and osteogenic properties simultaneously by the controllable release of TCS and Mg2+, presenting great potential for clinical transformation.

Finite element model with realistic bone geometries for the optimal design of internal fixation during the fibula healing process

A finite element model with realistic bone geometries is developed to design optimal internal fixation during the fibula healing process in this study. The effect of bone plate parameters on fibula fracture healing is studied. The relationship between differences in plate length, thickness and working length, and bone healing performance is focused. The optimal combination form of the bone plate parameters was selected by the orthogonal experimental design and fracture block strain to achieve bone healing maximize the performance. The model results show that the maximum equivalent force of the bone plate was below the material yield limit; the higher mean contact stresses in the bone fragments indicate that the bone plate is prone to higher contact stresses when they are long. The working length of the bone plate has a greater effect on callus healing than the thickness and length of the bone plate. The optimal internal fixation option for distal fibula fractures is achieved when it provides the stability required for internal fixation during bone healing. It ensures lower contact stresses in the fibula as well as maximum Young's modulus during callus healing process.

The development of magnesium-based biomaterials in bone tissue engineering: A review

Bone regeneration is a vital clinical challenge in massive or complicated bone defects. Recently, bone tissue engineering has come to the fore to meet the demand for bone repair with various innovative materials. However, the reported materials usually cannot satisfy the requirements, such as ideal mechanical and osteogenic properties, as well as biocompatibility at the same time. Mg-based biomaterials have considerable potential in bone tissue engineering owing to their excellent mechanical strength and biosafety. Moreover, the biocompatibility and osteogenic activity of Mg-based biomaterials have been the research focuses in recent years. The main limitation faced in the applications of Mg-based biomaterials is rapid degradation, which can produce excessive Mg2+ and hydrogen, affecting the healing of the bone defect. In order to overcome the limitations, researchers have explored several ways to improve the properties of Mg-based biomaterials, including alloying, surface modification with coatings, and synthesizing other composite materials to control the degradation rate upon implantation. This article reviewed the osteogenic mechanism and requirement for appropriate degradation rate and focused on current progress in the biomedical use of Mg-based biomaterials to inspire more clinical applications of Mg in bone regeneration in the future.

Development of Zn-2Cu-xMn/Mg Alloys for Orthopedic Applications: Mechanical Performance to In Vitro Degradation under Different Physiological Environments

Zinc (Zn) and its alloys are considered futuristic biodegradable materials for their acceptable mechanical properties, suitable corrosion rate, and good biocompatibility. In this study, we report newly developed biodegradable Zn-2Cu-xMn/Mg (x = 0, 0.1, and 0.5) alloys, aiming to achieve good mechanical strength with excellent elongation, desirable wear resistance, and suitable corrosion rate. The effect of Mn/Mg addition on the structural, mechanical, wear, and degradation behaviors of the Zn-2Cu-xMn/Mg alloys was thoroughly investigated. Degradation and tribological behaviors of the alloys were explored in the presence of simulated body fluid (SBF), Dulbecco's modified Eagle medium (DMEM), and DMEM with a 10% fetal bovine serum (FBS) solution. Alloy elements and hot rolling improve their mechanical properties significantly due to precipitation hardening, grain refinement, and solid solution strengthening owing to the formation of MnZn13 and Mg2Zn11 phases. Among all the alloys, the Zn-2Cu-0.5Mn alloy achieved the highest ultimate tensile strength (UTS) of ∼405 MPa and yield strength (YS) of ∼293 MPa with an excellent elongation of ∼51%. The corrosion behavior of the alloys as determined by a potentiodynamic polarization study under different solutions follows the sequence Zn-2Cu < Zn-2Cu-0.5Mn < Zn-2Cu-0.1Mn < Zn-2Cu-0.1Mg < Zn-2Cu-0.5Mg. The corrosion rate by immersion testing for 30 and 90 days also follows the same sequence. The corrosion rate in different solutions follows the order SBF > DMEM + 10%FBS > DMEM. The addition of Mn/Mg also improves the wear resistance and slows the wear rate under wet conditions. The bending test results also indicate the highest bending strength of ∼375 MPa for the Zn-2Cu-0.5Mn alloy, among all the alloys. The bending and tensile strengths deteriorate continuously after the immersion for 30 and 90 days in the solution of SBF, DMEM, and DMEM + 10%FBS. Therefore, the Zn-2Cu-xMn/Mg (x = 0.1 and 0.5) alloys can be considered potential biodegradable implant materials.

In vitro and in vivo study on fine-grained Mg-Zn-RE-Zr alloy as a biodegradeable orthopedic implant produced by friction stir processing

Magnesium alloys containing biocompatible components show tremendous promise for applications as temporary biomedical devices. However, to ensure their safe use as biodegradeable implants, it is essential to control their corrosion rates. In concentrated Mg alloys, a microgalvanic coupling between the α-Mg matrix and secondary precipitates exists which results in increased corrosion rate. To address this challenge, we engineered the microstructure of a biodegradable Mg-Zn-RE-Zr alloy by friction stir processing (FSP), improving its corrosion resistance and mechanical properties simultaneously. The FS processed alloy with refined grains and broken and uniformly distributed secondary precipitates showed a relatively uniform corrosion morphology accompanied with the formation of a stable passive layer on the alloy surface. In vivo corrosion evaluation of the processed alloy in a small animal model showed that the material was well-tolerated with no signs of inflammation or harmful by-products. Remarkably, the processed alloy supported bone until it healed till eight weeks with a low in vivo corrosion rate of 0.7 mm/year. Moreover, we analyzed blood and histology of the critical organs such as liver and kidney, which showed normal functionality and consistent ion and enzyme levels, throughout the 12-week study period. These results demonstrate that the processed Mg-Zn-RE-Zr alloy offers promising potential for osseointegration in bone tissue healing while also exhibiting controlled biodegradability due to its engineered microstructure. The results from the present study will have profound benefit for bone fracture management, particularly in pediatric and elderly patients.

Fabrication of a gradient AZ91-bioactive glass composite with good biodegradability

This study used friction stir-back extrusion to fabricate the AZ91 + 3 wt% bioactive glass gradient composite wire. The microstructure, mechanical properties, and corrosion resistance of a material in a simulated body fluid were investigated. Three 2-mm diameter holes with varying hole patterns were drilled in the cross-section of the AZ91 rod to apply 3 wt % bioactive glass to the AZ91 matrix. The results demonstrated that the hole pattern strongly influenced the material's flow in the extruded wire's cross-section. By increasing the distance between the center of the initial rod and the center of the holes, a higher temperature and more uniform distribution of plastic strain are formed during friction stir back extrusion, resulting in uniform distribution of bioactive glass particles and α + β eutectic structure near the surface of composite wires. Introducing bioactive glass particles into the zone near the surface of the AZ91 rod results in the formation of a uniform distribution of bioactive glass particles near the surface and their absence in the central zone of the composite wire. A higher amount of discontinuous β-Mg17Al12 phase and α + β eutectic formed at the grain boundaries by increasing the temperature and plastic strain during friction stir-back extrusion. The crystallographic texture of the AZ91 rod changed from prismatic to basal and pyramidal due to the friction stir-back extrusion method. A gradient AZ91-bioactive glass composite wire with ultimate tensile strength, yield strength, elongation, and corrosion resistance 58, 64, 62, and 34%, respectively, greater than AZ91 as-cat rod can be produced by inserting bioactive glass powder using a hole drilling method and applying a friction stir back extrusion process.

Effect of Rare Earth Elements (Y, La) on Microstructural Characterization and Corrosion Behavior of Ternary Mg-Y-La Alloys

In this study, the microstructural properties and corrosion behavior of RE elements (Y, La) added to magnesium in varying minors after casting and homogenization heat treatment were investigated. Three-phase structures, such as α-Mg, lamellae-like phases, and network-shaped eutectic compounds, were seen in the microstructure results. The dendrite-like phases were evenly distributed from the eutectic compounds to the interior of the α-Mg grains, while the eutectic compounds (α-Mg + Mg) RE (La/Y)) were distributed at the grain boundaries. According to the corrosion results, the typical hydroxide formation for lanthanum content caused the formation of crater structures in the material, and with the increase in lanthanum content, these crater structures increased both in depth and in density. In addition, the corrosion products formed by Y₂O₃ and Y(OH)₃ in the Mg-3.21Y-3.15 La alloy increased the thickness of the corrosion film and formed a barrier that protects the material against corrosion. The thinness of the protective barrier against corrosion in the Mg-4.71 Y-3.98 La alloy is due to the increased lanthanum and yttrium ratios. In addition, the corrosion resistance of both Mg-3.21Y-3.15 La and Mg-4.71 Y-3.98 La alloys decreases after homogenization. This negative effect on corrosion is due to the coaxial distribution of oxide/hydroxide layers formed by yttrium and lanthanum after homogenization.

Magnesium-Based Temporary Implants: Potential, Current Status, Applications, and Challenges

Biomedical implants are important devices used for the repair or replacement of damaged or diseased tissues or organs. The success of implantation depends on various factors, such as mechanical properties, biocompatibility, and biodegradability of the materials used. Recently, magnesium (Mg)-based materials have emerged as a promising class of temporary implants due to their remarkable properties, such as strength, biocompatibility, biodegradability, and bioactivity. This review article aims to provide a comprehensive overview of current research works summarizing the above-mentioned properties of Mg-based materials for use as temporary implants. The key findings from in-vitro, in-vivo, and clinical trials are also discussed. Further, the potential applications of Mg-based implants and the applicable fabrication methods are also reviewed.

Development, Processing and Aging of Novel Zn-Ag-Cu Based Biodegradable Alloys

The use of biodegradable materials for implants is a promising strategy to overcome known long-term clinical complications related to permanent implants. Ideally, biodegradable implants support the damaged tissue for a certain period and then degrade, while the physiological function of the surrounding tissue is restored. Although Mg-based alloys nearly ideally lend themselves to biodegradable implants, a few critical shortcomings promoted the development of alternative alloy systems. Due to their reasonably good biocompatibility, moderate corrosion rate without hydrogen evolution and adequate mechanical properties, increasing attention has been paid to Zn alloys. In this work, precipitation-hardening alloys in the system Zn-Ag-Cu were developed relying on thermodynamic calculations. After casting the alloys, their microstructures were refined by thermomechanical treatment. The processing was tracked and directed, respectively, by routine investigations of the microstructure, associated with hardness assessments. Although microstructure refinement increased the hardness, the material proved to be susceptible to aging as the homologous temperature of zinc is at 0.43 T_m. Besides mechanical performance and corrosion rate, long-term mechanical stability is another crucial factor that must be taken into consideration to ensure the safety of the implant and thus requires a profound understanding of the aging process.

Recent research advances on corrosion mechanism and protection, and novel coating materials of magnesium alloys: a review

Magnesium alloys have achieved a good balance between biocompatibility and mechanical properties, and have great potential for clinical application, and their performance as implant materials has been continuously improved in recent years. However, a high degradation rate of Mg alloys in a physiological environment remains a major limitation before clinical application. In this review, according to the human body's intake of elements, the current mainstream implanted magnesium alloy system is classified and discussed, and the corrosion mechanism of magnesium alloy in vivo and in vitro is described, including general corrosion, localized corrosion, pitting corrosion, and degradation of body fluid environment impact etc. The introduction of methods to improve the mechanical properties and biocorrosion resistance of magnesium alloys is divided into two parts: the alloying part mainly discusses the strengthening mechanisms of alloying elements, including grain refinement strengthening, solid solution strengthening, dislocation strengthening and precipitation strengthening etc.; the surface modification part introduces the ideas and applications of novel materials with excellent properties such as graphene and biomimetic materials in the development of functional coatings. Finally, the existing problems are summarized, and the future development direction is prospected.

A "built-up" composite film with synergistic functionalities on Mg-2Zn-1Mn bioresorbable stents improves corrosion control effects and biocompatibility

Control of premature corrosion of magnesium (Mg) alloy bioresorbable stents (BRS) is frequently achieved by the addition of rare earth elements. However, limited long-term experience with these elements causes concerns for clinical application and alternative methods of corrosion control are sought after. Herein, we report a "built-up" composite film consisting of a bottom layer of MgF₂ conversion coating, a sandwich layer of a poly (1, 3-trimethylene carbonate) (PTMC) and 3-aminopropyl triethoxysilane (APTES) co-spray coating (PA) and on top a layer of poly (lactic-co-glycolic acid) (PLGA) ultrasonic spray coating to decorate the rare earth element-free Mg-2Zn-1Mn (ZM21) BRS for tailoring both corrosion resistance and biological functions. The developed "built-up" composite film shows synergistic functionalities, allowing the compression and expansion of the coated ZM21 BRS on an angioplasty balloon without cracking or peeling. Of special importance is that the synergistic corrosion control effects of the "built-up" composite film allow for maintaining the mechanical integrity of stents for up to 3 months, where complete biodegradation and no foreign matter residue were observed about half a year after implantation in rabbit iliac arteries. Moreover, the functionalized ZM21 BRS accomplished re-endothelialization within one month.

Attaining High Functional Performance in Biodegradable Mg-Alloys: An Overview of Challenges and Prospects for the Mg-Zn-Ca System

This article presents a concise overview of modern achievements and existing knowledge gaps in the area of biodegradable magnesium alloys. Hundreds of Mg-based alloys have been proposed as candidates for temporary implants, and this number tends to increase day by day. Therefore, while reviewing common aspects of research in this field, we confine ourselves primarily to the popular Mg-Zn-Ca system, taken as a representative example. Over the last decades, research activities in this area have grown enormously and have produced many exciting results. Aiming at highlighting the areas where research efforts are still scarce, we review the state-of-the-art processing techniques and summarize the functional properties attained via a wide variety of processing routes devised towards achieving a desired properties profile, including the mechanical response in terms of strength, ductility, and fatigue resistance paired with biocompatibility and bio-corrosion resistance or controlled degradability. We pay keen attention to a summary of corrosion properties and mechano-chemical interactions between an aggressive environment and loaded Mg-based structures, resulting in stress corrosion cracking and premature corrosion fatigue failures. The polemic issues and challenges practitioners face in their laboratory research are identified and discussed.

Resorbable magnesium screws for fixation of medial epicondyle avulsion fractures in skeletally immature patients: A comparison with Kirschner wires

BACKGROUND

Displaced medial epicondyle fractures are treated with open reduction and internal fixation with K-wires or screws. Rates of implant prominence, failure, or non-union reported are considerable. Magnesium screws have demonstrated biocompatibility, osteoconductivity, and high pull-out strength. The aim of this study was to compare surgical fixation of medial epicondyle fracture using resorbable magnesium Herbert screws to K-wires, in skeletally immature patients.

METHODS

A retrospective analysis was performed from January 2015 to April 2020. Inclusion criteria were as follows displaced medial epicondyle fracture, <15 years, and absence of concomitant ipsilateral upper limb fractures. Two consecutive cohorts based on fixation device were made: Group A (wires) and Group B (magnesium screws). Alignment, pain, range of motion, Mayo Elbow Performance Score, and radiological healing were assessed.

RESULTS

A total of 27 patients were included: 15 in Group A and 12 in Group B. Groups were comparable for age and sex. Mean follow-up was higher in Group A (38.73 ± 3.15 vs 26.18 ± 4.85 months; p < 0.001). No significant differences were observed regarding range of motion, alignment, pain, and Mayo Elbow Performance Score, with excellent results in both groups. Two patients in Group A developed a deep wound pin site infection requiring antibiotics. X-rays revealed three cases of non-union in Group A and one in Group B, all of them asymptomatic. No patient required a second surgical procedure.

CONCLUSION

Open reduction and internal fixation of medial epicondyle fractures with magnesium screws showed comparable results to a widely accepted procedure such as the use of K-wires, potentially with a lower incidence of non-union and infection. No adverse reactions were recorded.

LEVEL OF EVIDENCE

level III.

Effect of pH fluctuations on the biodegradability of nanocomposite Mg-alloy in simulated bodily fluids

According to the National Institute of Health, the biodegradability, non-toxic nature, and remarkable natural and mechanical properties of magnesium and its components make them desirable choices for use in the production of supplies for biomedical implantation. Simulated bodily fluid (SBF) is used as a standard electrolyte for in vitro corrosion research. Each SBF module's independent and synergistic corrosion effects are studied in this study. Artificial pH variations increase degradation, according to the results. This experiment examined the Mg corrosion submerged in a SBF solution. The effect of pH changes on the rate of corrosion of Mg immersed in standard SBF solution was investigated. According to the previously published study, the corrosion process of Mg has been confirmed by scanning electron microscopy observations of damaged surface morphology. Because of these investigations, pH 7 was selected as the pH for bodily fluids since it is neutral.

Degradation behavior and osseointegration of Mg-Zn-Ca screws in different bone regions of growing sheep: a pilot study

Magnesium (Mg)-based implants are highly attractive for the orthopedic field and may replace titanium (Ti) as support for fracture healing. To determine the implant-bone interaction in different bony regions, we implanted Mg-based alloy ZX00 (Mg < 0.5 Zn < 0.5 Ca, in wt%) and Ti-screws into the distal epiphysis and distal metaphysis of sheep tibiae. The implant degradation and osseointegration were assessed in vivo and ex vivo after 4, 6 and 12 weeks, using a combination of clinical computed tomography, medium-resolution micro computed tomography (µCT) and high-resolution synchrotron radiation µCT (SRµCT). Implant volume loss, gas formation and bone growth were evaluated for both implantation sites and each bone region independently. Additionally, histological analysis of bone growth was performed on embedded hard-tissue samples. We demonstrate that in all cases, the degradation rate of ZX00-implants ranges between 0.23 and 0.75 mm/year. The highest degradation rates were found in the epiphysis. Bone-to-implant contact varied between the time points and bone types for both materials. Mostly, bone-volume-to-total-volume was higher around Ti-implants. However, we found an increased cortical thickness around the ZX00-screws when compared with the Ti-screws. Our results showed the suitability of ZX00-screws for implantation into the distal meta- and epiphysis.

A review on magnesium alloys for biomedical applications

Magnesium (Mg) and Mg alloys are considered as potential candidates for biomedical applications because of their high specific strength, low density, and elastic modulus, degradability, good biocompatibility and biomechanical compatibility. However, the rapid corrosion rate of Mg alloys results in premature loss of mechanical integrity, limiting their clinical application in load-bearing parts. Besides, the low strength of Mg alloys restricts their further application. Thus, it is essential to understand the characteristics and influencing factors of mechanical and corrosion behavior, as well as the methods to improve the mechanical performances and corrosion resistance of Mg alloys. This paper reviews the recent progress in elucidating the corrosion mechanism, optimizing the composition, and microstructure, enhancing the mechanical performances, and controlling the degradation rate of Mg alloys. In particular, the research progress of surface modification technology of Mg alloys is emphasized. Finally, the development direction of biomedical Mg alloys in the future is prospected.

In vivo and in vitro performances of chitosan-coated Mg-Zn-Zr-Gd-Ca alloys as bone biodegradable materials in rat models

Mg alloys have attracted significant attention as promising biomedical materials, specifically as fixation materials for promoting fracture healing. However, their unsatisfactory corrosion resistances hinder further clinical applications and thus require attention. This study aims to determine the performance of novel chitosan-coated Mg-1Zn-0.3Zr-2Gd-1Ca alloy and its ability to promote the healing of osteoporotic fractures. Moreover, its corrosion resistance and biocompatibility were assessed. Performance degradations of the samples were measured via electrochemical tests, weight loss test and morphological analysis, and the uncoated and chitosan-coated fixations were compared based on their effects on biocompatibility via the cytotoxicity test, X-rays, and hematoxylin and eosin staining. The effect of bone growth and healing was investigated via immunohistochemical test. Results of the electrochemical tests indicated that compared with the bare body, chitosan-coated Mg-Zn-Ca-Zr-Gd alloys improved by one order of magnitude. Additionally, scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), and weight loss test demonstrated that the corrosion resistance of the chitosan-coated Mg alloy is better than that of the uncoated alloy. In addition, cytotoxicity analysis indicated that the viability and morphology of the chitosan-coated alloy groups were superior to the uncoated groups in vitro. During in vivo analysis, chitosan-coated and uncoated Mg-1Zn-0.3Zr-2Gd-1Ca alloys were implanted into ovariectomized SD female rats with osteoporotic fractures for 1, 2, and 3 weeks. No displacement and shedding were observed through X-rays, and pathological analyses proved that the material was not harmful for liver and kidney tissues. Immunohistochemistry revealed that the chitosan-coated Mg-Zn-Ca-Zr-Gd alloy material contributed to the healing of osteoporotic fractures in the SD rat models. In conclusion, this study demonstrated the chitosan-coated Mg-Zn-Ca-Zr-Gd alloys have improved corrosion resistance and biocompatibility. Moreover, the alloy was found to accelerate the healing of osteoporotic fractures in SD rat models. Therefore, it has significant potential as a fixation material for osteoporotic fractures.

Effect of the Ca2Mg6Zn3 Phase on the Corrosion Behavior of Biodegradable Mg-4.0Zn-0.2Mn-xCa Alloys in Hank’s Solution

The effect of the Ca₂Mg₆Zn₃ phase on the corrosion behavior of biodegradable Mg-4.0Zn-0.2Mn-xCa (ZM-xCa, x = 0.1, 0.3, 0.5 and 1.0 wt.%) alloys in Hank’s solution was investigated with respect to phase spacing, morphology, distribution and volume fraction. With the increase in Ca addition, the volume fraction of the Ca₂Mg₆Zn₃ phase increased from 2.5% to 7.6%, while its spacing declined monotonically from 43 μm to 30 μm. The Volta potentials of secondary phases relative to the Mg matrix were measured by using scanning kelvin probe force microscopy (SKPFM). The results show that the Volta potential of the intragranular spherical Ca₂Mg₆Zn₃ phase (+109 mV) was higher than that of the dendritic Ca₂Mg₆Zn₃ phase (+80 mV). It is suggested that the Ca₂Mg₆Zn₃ acted as a cathode to accelerate the corrosion process due to the micro-galvanic effect. The corrosion preferred to occur around the spherical Ca₂Mg₆Zn₃ phase at the early stage and developed into the intragranular region. The corrosion rate increased slightly with increasing Ca content from 0.1 wt.% to 0.5 wt.% because of the enhanced micro-galvanic corrosion effect. The decrease in the phase spacing and sharp increase in the secondary phase content resulted in a dramatic increase in the corrosion rate of the ZM-1.0Ca alloy.

Biodegradable Magnesium Biomaterials—Road to the Clinic

In recent decades, we have witnessed radical changes in the use of permanent biomaterials. The intrinsic ability of magnesium (Mg) and its alloys to degrade without releasing toxic degradation products has led to a vast range of applications in the biomedical field, including cardiovascular stents, musculoskeletal, and orthopedic applications. With the use of biodegradable Mg biomaterials, patients would not suffer second surgery and surgical pain anymore. Be that as it may, the main drawbacks of these biomaterials are the high corrosion rate and unexpected degradation in physiological environments. Since biodegradable Mg-based implants are expected to show controllable degradation and match the requirements of specific applications, various techniques, such as designing a magnesium alloy and modifying the surface characteristics, are employed to tailor the degradation rate. In this paper, some fundamentals and particular aspects of magnesium degradation in physiological environments are summarized, and approaches to control the degradation behavior of Mg-based biomaterials are presented.

A First-Principle Study of Interactions between Magnesium and Metal-Atom-Doped Graphene

In this study, the interactions of magnesium (Mg) atom and Mg(001) surface with different metal-atom-doped graphene were investigated using a density functional theory (DFT) method. For the interactions of magnesium with Al-, Mn-, Zn-, and Zr-doped and intrinsic graphene, it was found that the magnesium atoms were physisorbed into the hollow sites of the intrinsic graphene with only the smallest interaction energy (approximately −1.900 eV). However, the magnesium atoms tended to be chemisorbed on the doped graphene, which exhibited larger interaction energies and charge transfers. Additionally, the Zn-doped graphene displayed the largest interaction energy with the Mg atom (approximately −3.833 eV). For the interactions of Mg(001) with Al-, Mn-, Zn-, and Zr-doped and intrinsic graphene (intrinsic and doped graphene/Mg interface), doped atoms interacted with a Mg layer to make graphene wrinkle, resulting in a higher specific surface area and better stability. Mg–C chemical bonds were formed at the Al-, Zn-, and Zr-doped interface, and Mg–Mn chemical bonds were formed at the Mn-doped interface. This study provided the fundamental research for future research into doped atoms on graphene reinforced magnesium matrix composites.

Corrosion Resistance and Cytocompatibility of Magnesium-Calcium Alloys Modified with Zinc- or Gallium-Doped Calcium Phosphate Coatings

In orthopedic surgery, metals are preferred to support or treat damaged bones due to their high mechanical strength. However, the necessity for a second surgery for implant removal after healing creates problems. Therefore, biodegradable metals, especially magnesium (Mg), gained importance, although their extreme susceptibility to galvanic corrosion limits their applications. The focus of this study was to control the corrosion of Mg and enhance its biocompatibility. For this purpose, surfaces of magnesium-calcium (MgCa1) alloys were modified with calcium phosphate (CaP) or CaP doped with zinc (Zn) or gallium (Ga) via microarc oxidation. The effects of surface modifications on physical, chemical, and mechanical properties and corrosion resistance of the alloys were studied using surface profilometry, goniometry, scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), nanoindentation, and electrochemical impedance spectroscopy (EIS). The coating thickness was about 5-8 μm, with grain sizes of 43.1 nm for CaP coating and 28.2 and 58.1 nm for Zn- and Ga-doped coatings, respectively. According to EIS measurements, the capacitive response (Y_c) decreased from 11.29 to 8.72 and 0.15 Ω^-1 cm^-2 sⁿ upon doping with Zn and Ga, respectively. The E_corr value, which was -1933 mV for CaP-coated samples, was found significantly electropositive at -275 mV for Ga-doped ones. All samples were cytocompatible according to indirect tests. In vitro culture with Saos-2 cells led to changes in the surface compositions of the alloys. The numbers of cells attached to the Zn-doped (2.6 × 10⁴ cells/cm²) and Ga-doped (6.3 × 10⁴ cells/cm²) coatings were higher than that on the surface of the undoped coating (1.0 × 10³ cells/cm²). Decreased corrosivity and enhanced cell affinity of the modified MgCa alloys (CaP coated and Zn and Ga doped, with Ga-doped ones having the greatest positive effect) make them novel and promising candidates as biodegradable metallic implant materials for the treatment of bone damages and other orthopedic applications.

In vitro evaluation of freeze-drying chitosan-mineralized collagen/Mg-Ca alloy composites for osteogenesis

Magnesium (Mg) alloy with good mechanical properties and biodegradability is considered as one of the ideal bone repair materials. However, the rapid corrosion of Mg-based metals can pose harm to the function of an implant in clinical applications. In this study, micro-arc oxidation coating was prepared on the surface of the Mg-Ca matrix, then the chitosan and mineralized collagen (nano-hydroxyapatite/collagen; nHAC) were immobilized on the surface of the MAO/Mg-Ca matrix to construct the CS-nHAC/Mg-Ca composites of different component proportions (the ratio of CS to nHAC is 2:1, 1:1, and 1:2, respectively). The corrosion resistance, osteogenic activity, and angiogenic ability were extensively investigated. The results indicated that the CS-nHAC reinforcement materials can improve the corrosion resistance of the Mg matrix significantly and promote the proliferation and adhesion of mouse embryo osteoblast precursor cells (MC3T3-E1) and human umbilical vein endothelial cells (HUVECs). In addition, the CS-nHAC/Mg-Ca composites can not only promote the alkaline phosphatase (ALP) activity and extracellular matrix mineralization of MC3T3-E1 cells but also enhance the migration motility and vascular endothelial growth factor (VEGF) expression of HUVECs. Meanwhile, the 2CS-1nHAC/Mg-Ca composite exhibited the optimum function characteristics compared with other samples. Therefore, considering the improvement of corrosion resistance and biocompatibility, the CS-nHAC/Mg-Ca composites are expected to be a promising orthopedic implant.

Designing Advanced Biomedical Biodegradable Mg Alloys: A Review

The increased demand for alloys that can serve as implantation devices with outstanding bio-properties has led to the development of numerous biomedical Mg-based alloys. These alloys have been extensively investigated for their performance in living tissue with mixed results. Hence, there are still major concerns regarding the use of magnesium alloys for such applications. Among the issues raised are elevated corrosion rates, hydrogen generation, and the maintenance of mechanical integrity for designated healing times. In addition, toxicity can arise from the addition of alloying elements that are intended to improve the mechanical integrity and corrosion resistance of Mg alloys. The current work reviews the recent advances in the development of Mg alloys for applications as bio-absorbable materials in living organic environments. In particular, it attempts to develop a roadmap of effective factors that can be utilized when designing Mg alloys. Among the factors reviewed are the effects of alloying additions and processing methods on the exhibited mechanical properties and corrosion rates in simulated bio-fluids used in biomedical applications.

Harnessing superhydrophobic coatings for enhancing the surface corrosion resistance of magnesium alloys

Clinical applications of magnesium (Mg) alloys have been severely limited by their rapid corrosion in physiological environments. Superhydrophobic coatings can prevent water from contacting the Mg alloy surface, retarding alloy corrosion. In this study, a superhydrophobic Mg alloy was prepared by depositing fluorine-modified SiO₂ nanoparticles (SiO₂-F NPs) with polydopamine (PDA). The dip-coating strategy presented is simple, green, can be undertaken without any complex equipment, has reduced power consumption, and decreased threat to human health. The as-prepared superhydrophobic Mg alloy is resistant to corrosion in simulated body fluid (SBF). The superhydrophobicity was stable after the tape, water-impact and sand-impact tests over multiple cycles. In addition, cytotoxicity investigations demonstrated that the superhydrophobic Mg alloy exhibited excellent cytocompatibility. This work opens up a new avenue in the design of superhydrophobic Mg alloys for corrosion resistance.

Biodegradable shape memory alloys: Progress and prospects

Shape memory alloys (SMAs) have a wide range of potential novel medical applications due to their superelastic properties and ability to restore and retain a 'memorised' shape. However, most SMAs are permanent and do not degrade in the body when used in implantable devices. The use of non-degrading metals may lead to the requirement for secondary removal surgery and this in turn may introduce both short and long-term health risks, or additional waste disposal requirements. Biodegradable SMAs can effectively eliminate these issues by gradually degrading inside the human body while providing the necessary support for healing purposes, therefore significantly alleviating patient discomfort and improving healing efficiency. This paper reviews the current progress in biodegradable SMAs from the perspective of biodegradability, mechanical properties, and biocompatibility. By providing insights into the status of SMAs and biodegradation mechanisms, the prospects for Mg- and Fe-based biodegradable SMAs to advance biodegradable SMA-based medical devices are explored. Finally, the remaining challenges and potential solutions in the biodegradable SMAs area are discussed, providing suggestions and research frameworks for future studies on this topic.

Microstructure, corrosion rate, and mechanical properties of unidirectionally and cross-rolled Mg-0.375Ga and Mg-0.750Ga alloys

The effect of unidirectional and cross rolling on the corrosion rate, texture, tensile properties and hemolysis of the Mg-0.375Ga and Mg-0.750Ga alloys was evaluated. Pure Mg and as-cast alloys were processed by unidirectional and cross rolling at 400°C to obtain a total thickness reduction of 50%. The corrosion rate was measured by the weight loss method in simulated body fluid. Determination of the hemolysis percentage was carried out by direct contact of specimens with diluted blood. After hot rolling, the mechanical properties of the alloys were improved. The cross-rolled Mg-0.750Ga alloy showed the highest grain refinement (55 μm) and the highest ultimate tensile strength (240 MPa), however, lower elongation (13.9%) than the rolled Mg-0.375Ga alloy. While unidirectional rolling creates a strong basal texture, cross rolling weakens considerably this texture. The Ga addition weakens the basal texture. Corrosion rate of the Mg-Ga alloys was significantly reduced (<1 mm/yr) after heat treatment and hot rolling due the homogenization of the microstructure and the presence of gallium as alloying element. The cross-rolled samples showed higher corrosion than the heat-treated and unidirectionally rolled samples. After rolling, alloys showed hemolysis percentages between 7.1 and 9.3%, values lower than those presented by pure magnesium (>22.7%) and as-cast alloys (>24.2%); however, the alloys are still hemolytic (>5%).

Clinical translation and challenges of biodegradable magnesium-based interference screws in ACL reconstruction

As one of the most promising fixators developed for anterior cruciate ligament (ACL) reconstruction, biodegradable magnesium (Mg)-based interference screws have gained increasing attention attributed to their appropriate modulus and favorable biological properties during degradation after surgical insertion. However, its fast degradation and insufficient mechanical strength have also been recognized as one of the major causes to limit their further application clinically. This review focused on the following four parts. Firstly, the advantages of Mg or its alloys over their counterparts as orthopaedic implants in the fixation of tendon grafts in ACL reconstruction were discussed. Subsequently, the underlying mechanisms behind the contributions of Mg ions to the tendon-bone healing were introduced. Thirdly, the technical challenges of Mg-based interference screws towards clinical trials were discussed, which was followed by the introduction of currently used modification methods for gaining improved corrosion resistance and mechanical properties. Finally, novel strategies including development of Mg/Titanium (Ti) hybrid fixators and Mg-based screws with innovative structure for achieving clinically customized therapies were proposed. Collectively, the advancements in the basic and translational research on the Mg-based interference screws may lay the foundation for exploring a new era in the treatment of the tendon-bone insertion (TBI) and related disorders.

The Influence of Rapid Solidification on Corrosion Behavior of Mg60Zn20Yb15.7Ca2.6Sr1.7 Alloy for Medical Applications

Biodegradable magnesium alloys with Zn, Yb, Ca and Sr additions are potential materials with increased corrosion resistance in physiological fluids that ensure a controlled resorption process in the human body. This article presents the influence of the use of a high cooling rate on the corrosion behavior of Mg₆₀Zn₂₀Yb_15.7Ca_2.6Sr_1.7 alloy proposed for medical applications. The microstructure of the alloy in a form of high-pressure die-casted plates was presented using scanning electron microscopy in the backscattered electrons (BSEs) mode with energy-dispersive X-ray spectrometer (EDX) qualitative analysis of chemical composition. The crystallization mechanism and thermal properties were described on the basis of differential scanning calorimetry (DSC) results. The corrosion behavior of Mg₆₀Zn₂₀Yb_15.7Ca_2.6Sr_1.7 alloy was analyzed by electrochemical studies with open circuit potential (E_OCP) measurements and polarization tests. Moreover, light microscopy and X-ray photoelectron spectroscopy were used to characterize the corrosion products formed on the surface of studied samples. On the basis of the results, the influence of the cooling rate on the improvement in the corrosion resistance was proved. The presented studies are novel and important from the point of view of the impact of the technology of biodegradable materials on corrosion products that come into direct contact with the tissue environment.

In vitro and in vivo degradation assessment and preventive measures of biodegradable Mg alloys for biomedical applications

Magnesium (Mg) and its alloys have been widely explored as a potential biodegradable implant material. However, the fast degradation of Mg-based alloys under physiological environment has hindered their widespread use for implant applications till date. The present review focuses on in vitro and in vivo degradation of biodegradable Mg alloys, and preventive measures for biomedical applications. Initially, the corrosion assessment approaches to predict the degradation behavior of Mg alloys are discussed along with the measures to control rapid corrosion. Furthermore, this review attempts to explore the correlation between in vitro and in vivo corrosion behavior of different Mg alloys. It was found that the corrosion depends on experimental conditions, materials and the results of different assessment procedures hardly matches with each other. It has been demonstrated the corrosion rate of magnesium can be tailored by alloying elements, surface treatments and heat treatments. Various researches also studied different biocompatible coatings such as dicalcium phosphate dihydrate (DCPD), β-tricalcium phosphate (β-TCP), hydroxyapatite (HA), polycaprolactone (PCL), polylactic acid (PLA), and so on, on Mg alloys to suppress rapid degradation and examine their influence on new bone regeneration as well. This review shows the need for a standard method of corrosion assessment to predict the in vivo corrosion rate based on in vitro data, and thus reducing the in vivo experimentation.

A review of the physiological impact of rare earth elements and their uses in biomedical Mg alloys

Magnesium (Mg) is well-tolerated by the body, displaying exceedingly low toxicity, rapid excretion, and numerous bioactive effects, including improved bone formation and protection against oxidative stresses; further, Mg alloys can be degraded in vivo to allow complete removal of an implant without surgical intervention, avoiding revision surgery and thrombosis concerns seen with permanent implants. Rare earth elements (REEs) have been of particular interest in alloying Mg alloys for nearly a century due to their unique chemical and physical properties but have attracted increasing attention in recent decades. The REEs contribute greatly to the mechanical and biological properties of metal alloys, and so are common in Mg alloys in a wide variety of applications; in particular, they represent the dominant alloying additions in current, clinically applied Mg alloys. Notably, the use of these elements may assist in the development of advanced Mg alloys for use as biodegradable orthopedic implants and cardiovascular stents. To this end, current research progress in this area, highlighting the physiological impact of REEs in Mg alloys, is reviewed. Clinical work and preclinical data of REE-containing Mg alloys are analyzed. The biological roles of REEs in cellular responses in vivo require further research in the development of biofunctional Mg alloy medical devices. STATEMENT OF SIGNIFICANCE: The presented work is a review into the biological impact and current application of rare-earth elements (REEs) in biodegradable Mg-based biomaterials. Despite their efficacy in improving corrosion, mechanical, and manufacturability properties of Mg alloys, the physiological effects of REEs remain poorly understood. Therefore, the present work was undertaken to both provide guidance in the development of new biomedical alloys, and highlight areas of existing concerns and unclear knowledge. Key findings of this review include a summary of current clinical and preclinical work, and the identification of Sc as the most promising REE with regards to physiological impact. Y, Ce, Pr, Gd, Dy, Yb, Sm, and Eu should be considered carefully before their use as alloying elements, with other REEs intermediate or insufficiently studied.

Tissue responses after implantation of biodegradable Mg alloys evaluated by multimodality 3D micro-bioimaging in vivo

The local response of tissue triggered by implantation of degradable magnesium-based implant materials was investigated in vivo in a murine model. Pins (5.0 mm length by 0.5 mm diameter) made of Mg, Mg-10Gd, and Ti were implanted in the leg muscle tissue of C57Bl/6N mice (n = 6). Implantation was generally well tolerated as documented by only a mild short term increase in a multidimensional scoring index. Lack of difference between the groups indicated that the response was systemic and surgery related rather than material dependent. Longitudinal in vivo monitoring utilizing micro-computed tomography over 42 days demonstrated the highest and most heterogeneous degradation for Mg-10Gd. Elemental imaging of the explants by micro X-ray fluorescence spectrometry showed a dense calcium-phosphate-containing degradation layer. In order to monitor resulting surgery induced and/or implant material associated local cell stress, sphingomyelin based liposomes containing indocyanine green were administered. An initial increase in fluorescent signals (3-7 days after implantation) indicating cell stress at the site of the implantation was measured by in vivo fluorescent molecular tomography. The signal decreased until the 42nd day for all materials. These findings demonstrate that Mg based implants are well tolerated causing only mild and short term adverse reactions.

Biodegradable magnesium-based biomaterials: An overview of challenges and opportunities

As promising biodegradable materials with nontoxic degradation products, magnesium (Mg) and its alloys have received more and more attention in the biomedical field very recently. Having excellent biocompatibility and unique mechanical properties, magnesium-based alloys currently cover a broad range of applications in the biomedical field. The use of Mg-based biomedical devices eliminates the need for biomaterial removal surgery after the healing process and reduces adverse effects induced by the implantation of permanent biomaterials. However, the high corrosion rate of Mg-based implants leads to unexpected degradation, structural failure, hydrogen evolution, alkalization, and cytotoxicity. To overcome these limitations, alloying Mg with suitable alloying elements and surface treatment come highly recommended. In this area, open questions remain on the behavior of Mg-based biomaterials in the human body and the effects of different factors that have resulted in these challenges. In addition to that, many techniques are yet to be verified to turn these challenges into opportunities. Accordingly, this article aims to review major challenges and opportunities for Mg-based biomaterials to minimize the challenges for the development of novel biomaterials made of Mg and its alloys.

Use of resorbable magnesium screws in children: systematic review of the literature and short-term follow-up from our series

PURPOSE

Biodegradable implants are of major interest in orthopaedics, especially in the skeletally immature population. Magnesium (Mg) implants are promising for selected surgical procedure in adults, but evidence is lacking. Thus, the aim of this study is to analyze the safety and efficacy of resorbable Mg screw in different orthopaedic procedures in skeletally immature patients. In addition, we present a systematic review of the current literature on the clinical use of Mg implants.

METHODS

From 2018 until the writing of this manuscript, consecutive orthopaedic surgical procedures involving the use of Mg screws performed at our centre in patients < 15 years of age were retrospectively reviewed. In addition, a systematic review of the literature was performed in the main databases. We included clinical studies conducted on humans, using Mg-alloy implants for orthopaedic procedures.

RESULTS

A total of 14 patients were included in this retrospective analysis. Mean age at surgery was 10.8 years (sd 2.4), mean follow-up was 13.8 months (sd 7.5). Healing was achieved in all the procedures, with no implant-related adverse reaction. No patients required any second surgical procedure. The systematic review evidenced 20 clinical studies, 19 of which conducted on an adult and one including paediatric patients.

CONCLUSION

Evidence on resorbable Mg implants is low but promising in adults and nearly absent in children. Our series included apophyseal avulsion, epiphyseal fractures, osteochondritis dissecans, displaced osteochondral fragment and tendon-to-bone fixation. Mg screws guaranteed stable fixation, without implant failure, with good clinical and radiological results and no adverse events.

LEVEL OF EVIDENCE

IV - Single cohort retrospective analysis with systematic review.

Preclinical study analysis of massive magnesium alloy graft for calcaneal fractures

The highly comminuted calcaneal fractures represent a challenge for surgeons and require bone grafts for a good clinical outcome. Postoperative results are generally associated with increased morbidity and long periods of inactivity. The biomedical community promotes the use of artificial materials for grafts in order to achieve improved results. In an era when cosmetic concerns as well as the satisfaction of patients are mandatory and the use of autologous bone grafts is not without complications, an artificial replacement appears to be a favorable option. Synthetic bone grafts are known to fail under stress shield or are associated with systemic side effects. The purpose of the present study was to investigate and determine an already commercially available magnesium (Mg) alloy whose design is most suitable for long-term use. The mechanical properties of Mg1Ca and MgYREZr compared with normal cortical and cancellous bone were assessed. Another discussed aspect was the influence of the alloy in the graft fixation. The results revealed that Mg1Ca and MgYREZr alloys had a low tensile strength of 75 and 250 MPa, respectively. For this reason, it was surmised that MgYREZr alloy could be an optimal choice with favorable corrosion resistance. Since calcaneal fractures are prone to skin necrosis and septic complications, the need for antibacterial procedures and antibiotic prophylaxis is highlighted. Thus, an in vivo attempt was also made to identify the relationship between Mg alloy products and bacterial load. However, the most important feature of the present study was the creation of a 3D model grafting, with an anti-sliding design, which can be potentially used with the preferred Mg alloy in this type of fractures. In conclusion, artificial materials are the future in medicine, replacing the body-limiting capabilities of grafts. They are safe and incur less comorbidities. This method could pave the way for reducing patient discomfort and increasing patient satisfaction. Although further testing is required, this research represents a great starting point for calcaneal fractures.

In Vitro Degradation Behavior and Biocompatibility of Bioresorbable Molybdenum

The degradation behavior and biocompatibility of pure molybdenum (Mo) were investigated. Dissolution of powder metallurgically manufactured and commercially available Mo was investigated by ion concentration measurement after immersion in modified Kokubo’s SBF (c-SBF-Ca) for 28 days at 37 °C and pH 7.4. Degradation layers and corrosion attack were examined with optical microscopy and REM/EDX analysis. Furthermore, potentiodynamic polarization measurements were conducted. Mo gradually dissolves in modified SBF releasing molybdate anions (MoO42−). The dissolution rate after 28 days is 10 µm/y for both materials and dissolution accelerates over time. A non-passivating, uniform and slowly soluble degradation product layer is observed. Additionally, apoptosis and necrosis assays with Mo ion extracts and colonization tests with human endothelial (HCAEC) and smooth muscle cell lines (HCASMC) on Mo substrates were performed. No adverse effects on cell viability were observed for concentrations expected from the dissolution of implants with typical geometries and substrates were densely colonized by both cell lines. Furthermore, Mo does not trigger thrombogenic or inflammatory responses. In combination with its favorable mechanical properties and the renal excretion of bio-available molybdate ions, Mo may be an alternative to established bioresorbable metals.

In vitro biodegradation behavior of biodegradable hydroxyapatite coated AZ31 alloy treated at various pH values

OBJECTIVES

The aim of this study is to evaluate the effect of pH treatment on the formation of hydroxyapatite (HA) coating layer and the biodegradation rate of hydroxyapatite coated AZ31 alloy for applications in biodegradable implants.

METHODS

HA was grown on the surface of AZ31 substrate at three different pH solutions of 7.5, 9.0, and 10.5 respectively by chemical solution treatment method. The coated samples were evaluated their biodegradation behavior by immersion test in the simulated body fluid (SBF) for 14 days. The biodegradation rate of the samples during immersion test was observed by Mg²⁺ ion quantification method and measuring the increase of pH of the medium.

RESULTS

HA coatings were successfully grown on the AZ31 substrate at three different pH conditions. The sample coated at pH 7.5 showed its uniform and dense coating layer resulted in highest corrosion resistance. While the highest biodegradation rate was observed for the sample coated at pH 10.5 due to many micro-cracks formed in the HA layer. After 14 days of immersion, Mg(OH)₂ and calcium phosphate were corrosion products on the surface of the specimens coated at pH 10.5 and pH 9.0 respectively. While HA almost remained on the surface of sample coated at pH 7.5.

CONCLUSION

AZ31 alloy coated with HA at pH 7.5 has lowest biodegradation rate and become suitable for applications in biodegradable implants.

Test conditions can significantly affect the results of in vitro cytotoxicity testing of degradable metallic biomaterials

In vitro cytotoxicity testing is an indispensable part of the development of new biomaterials. However, the standard ISO 10993-5 enables variability in the testing conditions, which makes the results of the test incomparable. We studied the influence of media composition on the results of the cytotoxicity test. Solutions of ZnCl₂ served as simulated extracts and we also used extracts of three types of Zn-based and Mg-based degradable metals. We incubated the cells with the solutions prepared in two types of media with two concentrations of serum (5 and 10%). We compared the toxic effect of the extracts on L929 murine fibroblast-derived cell line, which is recommended by ISO standard and on “osteoblast-like cells” U-2 OS. We also compared two methods of exposition: solutions were added either to a sub-confluent layer or to the cell suspension. We evaluated the metabolic activity of the cells using the resazurin test. We found out that in vitro cytotoxicity is dramatically influenced by the concentration of serum and by the type of the medium as well as by the type of exposition and type of cells. Therefore, when performing in vitro cytotoxicity testing of biomaterials, the authors should carefully specify the conditions of the test and comparison of different studies should be carried out with caution.

Microstructural and Corrosion Properties of Hydroxyapatite Containing PEO Coating Produced on AZ31 Mg Alloy

In this work, the composition of an electrolyte was selected and optimized to induce the formation of hydroxyapatite during Plasma electrolytic oxidation (PEO) treatment on an AZ31 alloy for application in bioabsorbable implants. In detail, the PEO process, called PEO-BIO (Plasma Electrolytic Oxidation-Biocompatible), was performed using a silicate-phosphate-based electrolyte with the addition of calcium oxide in direct-current mode using high current densities and short treatment times. For comparison, a known PEO process for producing anticorrosive coatings, called standard, was applied on the same alloy. The coatings were characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD) and XPS analyses. The corrosion performance was evaluated in simulated body fluid (SBF) at 37 °C. The coating produced on the PEO-BIO sample was porous and thicker than the standard PEO one, with zones enriched in Ca and P. The XRD analysis showed the formation of hydroxyapatite and calcium oxides in addition to magnesium-silicon oxide and magnesium oxide in the PEO-BIO sample. The corrosion resistance of PEO-BIO sample was comparable with that of a traditional PEO treated sample, and higher than that of the untreated alloy.

Superhydrophobic, superamphiphobic and SLIPS materials as anti-corrosion and anti-biofouling barriers

Multifunctional interfacial materials with special wettability including superhydrophobic, superamphiphobic, and SLIPS exhibited promising potentials for corrosion and biofouling resistance.

Biocompatible Magnesium Implant Double-Coated with Dexamethasone-Loaded Black Phosphorus and Poly(lactide-co-glycolide)

Magnesium (Mg) and its alloys have presented a paradigm for biodegradability in the field of biomedical devices. However, biodegradation of Mg and its alloys cause the formation of hydrogen gas and basic molecules in the body. Here we developed a surface modification method for Mg implants by double-coating with osteogenic dexamethasone (Dex)-loaded black phosphorus (BP) and poly(lactide-co-glycolide) (PLGA). According to electrochemical and biodegradation tests, the prepared Mg-Dex/BP/PLGA showed remarkably enhanced resistance against corrosion possibly by the neutralization of basic molecules from Mg implants with acidic molecules from BP and PLGA with increasing biodegradation. Scanning electron microscopy, cell proliferation tests, Alizarin Red staining, and alkaline phosphatase activity tests confirmed that MC3T3-E1 cells significantly proliferated and were differentiated on the Mg-Dex/BP/PLGA surface. Taken together, the facile surface modification of Mg implants could be effectively harnessed for protecting the Mg surface from corrosion and inducing the osseointegration of preosteoblasts onto the Mg implant.

Biocompatibility and Immune Response of a Newly Developed Volume-Stable Magnesium-Based Barrier Membrane in Combination with a PVD Coating for Guided Bone Regeneration (GBR)

To date, there are no bioresorbable alternatives to non-resorbable and volume-stable membranes in the field of dentistry for guided bone or tissue regeneration (GBR/GTR). Even magnesium (Mg) has been shown to constitute a favorable biomaterial for the development of stabilizing structures. However, it has been described that it is necessary to prevent premature degradation to ensure both the functionality and the biocompatibility of such Mg implants. Different coating strategies have already been developed, but most of them did not provide the desired functionality. The present study analyses a new approach based on ion implantation (II) with PVD coating for the passivation of a newly developed Mg membrane for GBR/GTR procedures. To demonstrate comprehensive biocompatibility and successful passivation of the Mg membranes, untreated Mg (MG) and coated Mg (MG-Co) were investigated in vitro and in vivo. Thereby a collagen membrane with an already shown biocompatibility was used as control material. All investigations were performed according to EN ISO 10993 regulations. The in vitro results showed that both the untreated and PVD-coated membranes were not cytocompatible. However, both membrane types fulfilled the requirements for in vivo biocompatibility. Interestingly, the PVD coating did not have an influence on the gas cavity formation compared to the uncoated membrane, but it induced lower numbers of anti-inflammatory macrophages in comparison to the pure Mg membrane and the collagen membrane. In contrast, the pure Mg membrane provoked an immune response that was fully comparable to the collagen membrane. Altogether, this study shows that pure magnesium membranes represent a promising alternative compared to the nonresorbable volume-stable materials for GBR/GTR therapy.

Analysis of vascular inflammation against bioresorbable Zn-Ag based alloys

Zinc (Zn) has emerged as a promising bioresorbable stent material due to its satisfactory corrosion behavior and excellent biocompatibility. However, for load bearing implant applications, alloying is required to boost its mechanical properties as pure Zn exhibits poor strength. Unfortunately, an increase in inflammation relative to pure Zn is a commonly observed side-effect of Zn alloys. Consequently, the development of a Zn-based alloy that can simultaneously feature improved mechanical properties and suppress inflammatory responses is a big challenge. Here, a bioresorbable, biocompatible Zn-Ag-based quinary alloy was comprehensively evaluated in vivo, in comparison to reference materials. The inflammatory and smooth muscle cellular response was characterized and correlated to metrics of neointimal growth. We found that implantation of the quinary alloy was associated with significantly improved inflammatory activities relative to the reference materials. Additionally, we found that inflammation, but not smooth muscle cell hyperplasia, significantly correlates to neointimal growth for Zn alloys. The results suggest that inflammation is the main driver of neointimal growth for Zn-based alloys and that the quinary Zn-Ag-Mn-Zr-Cu alloy may impart inflammation-resistance properties to arterial implants.