Nickel-free austenitic stainless steels for medical applications

The combination of allicin with domiphen is effective against microbial biofilm formation

Background

Microorganisms in biofilms are particularly difficult to control because of their increased survival and antibiotic resistance. Allicin and domiphen were employed to inhibit the microbial growth and biofilm formation of Staphylococcus aureus, Escherichia coli, and Candida albicans strains.

Methods

Broth microdilution method and checkerboard assay were conducted to determine the efficacy of allicin combined with domiphen against S. aureus, E. coli, and C. albicans. Microbial biofilm formation was measured using the crystal violet staining method and fluorescence microscopy. And the total viable count of the biofilm cells on material surface after the treatment with antimicrobial reagents was calculated with the plate count technique.

Results

The two drugs showed synergistic effects against the pathogens with a fractional bactericidal concentration of less than 0.38. The combination of 64 μg/mL allicin with 1 μg/mL domiphen dispersed over 50% of the biofilm mass of S. aureus, E. coli, and C. albicans. In addition, the drug combination reduced the total viable counts of E. coli and C. albicans biofilm cells on stainless steel and polyethylene surfaces by more than 102 CFU/mL.

Conclusion

The combination of allicin and domiphen is an effective strategy for efficiently decreasing biofilms formation on various industrial materials surfaces.

The Role of Vasculature and Angiogenic Strategies in Bone Regeneration

Bone regeneration is a complex process that involves various growth factors, cell types, and extracellular matrix components. A crucial aspect of this process is the formation of a vascular network, which provides essential nutrients and oxygen and promotes osteogenesis by interacting with bone tissue. This review provides a comprehensive discussion of the critical role of vasculature in bone regeneration and the applications of angiogenic strategies, from conventional to cutting-edge methodologies. Recent research has shifted towards innovative bone tissue engineering strategies that integrate vascularized bone complexes, recognizing the significant role of vasculature in bone regeneration. The article begins by examining the role of angiogenesis in bone regeneration. It then introduces various in vitro and in vivo applications that have achieved accelerated bone regeneration through angiogenesis to highlight recent advances in bone tissue engineering. This review also identifies remaining challenges and outlines future directions for research in vascularized bone regeneration.

Alloplastic temporomandibular joint replacement - past, present, and future: "Learn from the past, prepare for the future, live in the present." Thomas S. Monson

Based on evidence from the orthopaedic, biomedical engineering, and oral and maxillofacial surgical literature, this paper discusses reported successes and failures of past alloplastic temporomandibular joint (TMJ) devices that have led to the development of present total temporomandibular joint replacement (TMJR) devices. The paper concludes with discussion of the ongoing research that will lead to future embodiment (materials, designs, and manufacture) advances in TMJR management of severe and debilitating end-stage TMJ disease, further improving patients' mandibular function, form, and overall quality of life.

Characterization of nickel levels considering seasonal and intra-individual variation using three biological matrices

Nickel compounds are classified as group 1 carcinogens by the International Agency for Research on Cancer. However, only a few exposure assessment studies have been conducted on such compounds to date. In this study, we investigated the distribution of nickel in three biological types of samples (blood, serum, and urine) and its temporal variability through repeated measurements. From 2020 to 2021, blood and urine samples were collected for four times from 50 healthy participants. Nickel concentrations were determined using inductively coupled plasma mass spectrometry, and inter-individual correlation was calculated from linear mixed model. The overall geometric mean of nickel was 1.028 μg/L in blood, 0.687 μg/L in serum, and 1.464 μg/L in urine. Blood nickel was the highest in November (blood: 1.197 μg/L), and the geometric mean of nickel concentrations in the serum and urine were the highest in March (serum: 1.146 μg/L; urine: 1.893 μg/L). This matched seasonal trends for fine particulate matter concentrations from 2020 to 2021. Thus, seasonal effects significantly affect nickel levels in blood, serum, and urine. The inter-individual correlations were low as 0.081 for blood and 0.064 for urine. In addition, the correlation of nickel levels between each biological sample was low. It was also found that age, gender, commuting time, and different matrices affect concentrations. Blood and serum nickel levels were high in this study compared to other nationwide data, with urinary nickel ranking the second highest among the six countries examined. Therefore, biomonitoring study in the general population should be conducted, and finding a suitable matrix that can reflect nickel exposure to set exposure guideline levels is imperative.

Bioactivity, Cytotoxicity, and Tribological Studies of Nickel-Free Austenitic Stainless Steel Obtained via Powder Metallurgy Route

In the present study, the bioactivity, cytotoxicity, and tribological properties of a nickel-free austenitic stainless steel produced via the mechanical alloying of elemental iron, chromium, and manganese nitride powders following by hot isostatic pressing was investigated. Powders after 90 h of mechanical alloying were consolidated via hot isostatic pressing at 1150 °C (1425 K) and heat treated at 1175 °C (1448 K) for 1 h in a vacuum with furnace cooling. Tribological tests were performed to determine the resistance of the as-received nickel-free steel. It was noticed that applying heat treatment after hot isostatic pressing decreases the average friction coefficient and wear rate of the austenitic steel. An immersion test in a simulated body fluid for 28 days at 37 ± 1 °C has been used to determine the biocompatibility of the tested material. The SEM-EDS analysis allowed us to characterise the morphology of the films and the elements of the steel on the thin-film layer. Elements typical of apatite (calcium and phosphorus) were detected on the surface of the sample. Cellular toxicity tests showed no significant toxic side effects for Saos-2 human osteosarcoma cells and the number of Saos-2 human osteosarcoma cells on the nickel-free steel was greater than on the 316LV grade steel.

Additive manufacturing of vascular stents

With the advancement of additive manufacturing (AM), customized vascular stents can now be fabricated to fit the curvatures and sizes of a narrowed or blocked blood vessel, thereby reducing the possibility of thrombosis and restenosis. More importantly, AM enables the design and fabrication of complex and functional stent unit cells that would otherwise be impossible to realize with conventional manufacturing techniques. Additionally, AM makes fast design iterations possible while also shortening the development time of vascular stents. This has led to the emergence of a new treatment paradigm in which custom and on-demand-fabricated stents will be used for just-in-time treatments. This review is focused on the recent advances in AM vascular stents aimed at meeting the mechanical and biological requirements. First, the biomaterials suitable for AM vascular stents are listed and briefly described. Second, we review the AM technologies that have been so far used to fabricate vascular stents as well as the performances they have achieved. Subsequently, the design criteria for the clinical application of AM vascular stents are discussed considering the currently encountered limitations in materials and AM techniques. Finally, the remaining challenges are highlighted and some future research directions are proposed to realize clinically-viable AM vascular stents. STATEMENT OF SIGNIFICANCE: Vascular stents have been widely used for the treatment of vascular disease. The recent progress in additive manufacturing (AM) has provided unprecedented opportunities for revolutionizing traditional vascular stents. In this manuscript, we review the applications of AM to the design and fabrication of vascular stents. This is an interdisciplinary subject area that has not been previously covered in the published review articles. Our objective is to not only present the state-of-the-art of AM biomaterials and technologies but to also critically assess the limitations and challenges that need to be overcome to speed up the clinical adoption of AM vascular stents with both anatomical superiority and mechanical and biological functionalities that exceed those of the currently available mass-produced devices.

Development of Multifunctional Commercial Pure Titanium-Polyethylene Glycol Drug-Eluting Substrates with Enhanced Optical and Antithrombotic Properties

PURPOSE

Development of multifunctional advanced stent implants (metal/polymer composite)-drug-eluting stents with superior material and optical properties is still a challenge. In this research work, multifunctional metal-polymer composite drug-eluting substrates (DES) for stent application were developed by using commercially pure titanium (cpTi) and polyethylene glycol (PEG).

METHODS

Surface modifications on titanium substrates were carried out by sodium hydroxide under various concentrations; 5M (6 and 24 h) and 10M (6 and 24 h). It induces a nanoporous structure which facilitates the larger area for encapsulation of the drug, Aspirin (ASA) via intermolecular forces followed by polymer coating of PEG (MW-20,000) by physical adsorption process, which is structured as layer-by-layer gathering.

RESULTS

The developed cpTi-PEG DES were characterized using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), optical energy bandgap, static contact angle measurement, antithrombotic and drug release studies. The development of sodium titanate oxide prompted surface nano-features revealed by SEM and XRD. Moreover, FTIR confirms the presence of ASA and PEG functional groups over the cpTi surface. Drug release studies fitted with Ritger-Peppas kinetic model (≤ 60%), which indicates the super case II transport mechanisms (n > 1). Further UV-visible absorbance spectrum was quantified by the Tauc plot, which shows the broadening of the energy bandgap (E_g). In addition, the shrink in blood clots was more around the Tib2/ASA/PEG.Please confirm the inserted city name in affiliations [1,2] are correct and amend if necessary.Yes, city name "Rourkela" is correct.

CONCLUSION

Developed cpTi-PEG DES has improved optical properties and prevent thrombus formation which suggesting it a potential substrate to overcome prime clinical challenges.

Biomimetic calcium phosphate coating on medical grade stainless steel improves surface properties and serves as a drug carrier for orthodontic applications

OBJECTIVE

Recently, stainless steel (SSL) miniscrew implants have been used in orthodontic clinics as temporary anchorage devices. Although they have excellent physical properties, their biocompatibility is relatively poor. Previously, our group developed a two-phase biomimetic calcium phosphate (BioCaP) coating that can significantly improve the biocompatibility of medical devices. This study aimed to improve the biocompatibility of SSL by coating SSL surface with the BioCaP coating.

METHODS

Titanium (Ti) discs and SSL discs (diameter: 5 mm, thickness: 1 mm) were used in this study. To form an amorphous layer, the Ti discs were immersed in a biomimetic modified Tyrode solution (BMT) for 24 h. The SSL discs were immersed in the same solution for 0 h, 12 h, 24 h, 36 h and 48 h. To form a crystalline layer, the discs were then immersed in a supersaturated calcium phosphate solution (CPS) for 48 h. The surface properties of the BioCaP coatings were analysed. In addition, bovine serum albumin (BSA) was incorporated into the crystalline layer during biomimetic mineralisation as a model protein.

RESULTS

The morphology, chemical composition and drug loading capacity of the BioCaP coating on smooth SSL were confirmed. This coating improved roughness and wettability of SSL surface. In vitro, with the extension of BMT coating period, the cell seeding efficiency, cell spreading area and cell proliferation on the BioCaP coating were increased.

SIGNIFICANCE

These in vitro results show that the BioCaP coating can improve surface properties of smooth medical grade SSL and serve as a carrier system for bioactive agents.

3D Printing Technologies in Personalized Medicine, Nanomedicines, and Biopharmaceuticals

3D printing technologies enable medicine customization adapted to patients' needs. There are several 3D printing techniques available, but majority of dosage forms and medical devices are printed using nozzle-based extrusion, laser-writing systems, and powder binder jetting. 3D printing has been demonstrated for a broad range of applications in development and targeting solid, semi-solid, and locally applied or implanted medicines. 3D-printed solid dosage forms allow the combination of one or more drugs within the same solid dosage form to improve patient compliance, facilitate deglutition, tailor the release profile, or fabricate new medicines for which no dosage form is available. Sustained-release 3D-printed implants, stents, and medical devices have been used mainly for joint replacement therapies, medical prostheses, and cardiovascular applications. Locally applied medicines, such as wound dressing, microneedles, and medicated contact lenses, have also been manufactured using 3D printing techniques. The challenge is to select the 3D printing technique most suitable for each application and the type of pharmaceutical ink that should be developed that possesses the required physicochemical and biological performance. The integration of biopharmaceuticals and nanotechnology-based drugs along with 3D printing ("nanoprinting") brings printed personalized nanomedicines within the most innovative perspectives for the coming years. Continuous manufacturing through the use of 3D-printed microfluidic chips facilitates their translation into clinical practice.

Superior Comprehensive Mechanical Properties of a Low-Carbon Medium Manganese Steel for Replacing AISI 4330 Steel in the Oil and Gas Industry

A low-carbon medium manganese steel (0.12C-3.13Mn) containing Cr, Ni, Mo, V, and Cu elements was designed to replace the AISI 4330 steel applied in the oil and gas industry. The mechanical properties, microstructures, and fatigue crack growth rate were comparatively analyzed using uniaxial tension tests, microstructure characterization, and compact tension with fatigue crack growth characterization. The results showed that the ductility and -40 °C impact energy of 0.12C-3.13Mn steel were better than AISI 4330 steel (from 115 J to 179 J), while the yield strength of 957 MPa of the former was lower than the latter of 1060 MPa after being subjected to the same tempering process. The microstructure of 0.12C-3.13Mn steel was composed of a mixture of tempered martensite, reversed austenite, and nanosized precipitation particles, while the microstructure of S4330 steel contained ferrite and large-size Fe₃C with lath and near-spherical morphologies. Compared to Cr-rich Fe₃C, (V, Mo)C and Cu-rich particles have smaller sizes and, thus, provide more strengthening increment, leading to a higher yield ratio. The impressive fatigue-resistance property was obtained in 0.12C-3.13Mn steel because the threshold value was 5.23 MPa*m^1/2 compared to the value of 4.88 MPa*m^1/2 for S4330 steel. Even if the fatigue crack grew, the stress intensity factor range of 0.12C-3.13Mn steel was obviously wider than that of AISI 4330 steel due to the presence of reversed austenite and secondary cracks. Overall, the AISI 4330 steel could be replaced with the designed 0.12C-3.13Mn steel due to the similar strength and better ductility, low-temperature toughness, and fatigue-resistance property.

Evaluation of Biocompatibility of 316 L Stainless Steels Coated with TiN, TiCN, and Ti-DLC Films

In this study, TiN, TiCN, and Ti-diamond-like carbon (Ti-DLC) films were coated on 316 L stainless steel (AISI 316 L) substrate surface by physical vapor deposition. The biocompatibility of the three films (TiN, TiCN, and Ti-DLC) and three metals (AISI 316 L, Ti, and Cu) was compared on the basis of the differences in the surface morphology, water contact angle measurements, CCK-8 experiment results, and flow cytometry test findings. The biocompatibility of the TiN and TiCN films is similar to that of AISI 316 L, which has good biocompatibility. However, the biocompatibility of the Ti-DLC films is relatively poor, which is mainly due to the inferior hydrophobicity and large amount of sp2 phases. The presence of TiC nanoclusters on the surface of the Ti-DLC film aggravates the inferior biocompatibility. Compared to the positive Cu control group, the Ti-DLC film had a higher cell proliferation rate and lower cell apoptosis rate. Although the Ti-DLC film inhibited cell survival to a certain extent, it did not show obvious cytotoxicity. TiN and TiCN displayed excellent performance in promoting cell proliferation and reducing cytotoxicity; thus, TiN and TiCN can be considered good orthodontic materials, whereas Ti-DLC films require further improvement.

Alloplastic temporomandibular joint replacement: present status and future perspectives of the elements of embodiment

Medical device embodiment involves the following elements: materials, design, and manufacturing. Failure of any one of these elements can result in failure of the device, despite the others being satisfactory. The abundance of clinical and basic science literature published since 1986, demonstrates the safety and efficacy of alloplastic temporomandibular joint replacement (TMJR). Currently, there are 19 countries producing 41 TMJR devices. More than 75% are custom designed, and 27% are additively manufactured. In light of the increasing number of TMJR devices being designed and manufactured around the world, this paper will discuss TMJR embodiment so that clinicians understand their present status as well as the prospects for the future of new and/or improved TMJR devices, to ensure that these devices continue to be safe and effective long-term surgical options for the management of end-stage TMJ pathologies.

Nickel-free high-nitrogen austenitic steel outperforms CoCrMo alloy regarding tribocorrosion in simulated inflammatory synovial fluids

CoCrMo alloys are well-established biomaterials used for orthopedic joint replacement implants. However, such alloys have been associated with clinical problems related to wear and corrosion. A new generation of austenitic high-nitrogen steels (AHNSs) has been developed for biomedical applications. Here, we have addressed influences of hyaluronic acid, combined with inflammatory (oxidizing) conditions, on tribocorrosion of the high-nitrogen FeCrMnMoN_0.9 steel (DIN/EN X13CrMnMoN18-14-3, 1.4452), and of the low carbon CoCrMo_0.03 alloy (ISO 5832-12). We aimed to elucidate critical and clinically relevant conditions affecting the implant's performance in certain orthopedic applications. Tribocorrosion tests were conducted in triplicate, with discs under reciprocating sliding wear against a ceramic ball. Different lubricants were prepared from standardized bovine serum solution (ISO 14242-1), with variable additions of hyaluronic acid (HA) and hydrogen peroxide (H₂ O₂ ). Test conditions were: 37°C, 86,400 cycles, 37 N load (20-40 MPa after run-in phase). Volumetric wear was quantified; surfaces were evaluated by electrochemical parameters and microscopy/spectroscopy analyses (SEM/EDS). Factorial analysis of variance tests was conducted to examine the effects of HA, H₂ O₂ , and test material on wear- and corrosion-related dependent variables. Tribocorrosion performances of CoCrMo_0.03 and FeCrMnMoN_0.9 were comparable in fluids without H₂ O₂ . With higher H₂ O₂ concentrations, tribocorrosion increased for CoCrMo_0.03 , while this was not the case for FeCrMnMoN_0.9 . HA significantly enhanced wear of CoCrMo_0.03 in the absence of H₂ O₂ , while it mitigated the tribocorrosive action of 3 mM H₂ O₂ ; HA had no impact on FeCrMnMoN_0.9 . These results indicate a favorable performance of FeCrMnMoN_0.9 compared to CoCrMo_0.03 , and encourage further research on AHNS for certain orthopedic applications.

Using scaffolds as drug delivery systems to treat bone tumor

Surgery is the principal strategy to treat osteosarcoma and other types of bone tumors, but it causes bone defects that cannot be healed spontaneously. After surgery, patients still need to receive radiotherapy and/or chemotherapy to prevent tumor recurrence and metastasis, which leads to systemic side effects. Bone scaffolds exhibit the potentials to load cargos (drugs or growth factors) and act as drug delivery systems (DDSs) in the osteosarcoma postoperative treatment. This review introduces current types of bone scaffolds and highlights representative works using scaffolds as DDSs to treat osteosarcomas. Challenges and perspectives in the scaffold-based DDSs are also discussed. This review may provide references to develop effective and safe strategies for osteosarcoma postoperative treatment.

Biocompatible Materials in Otorhinolaryngology and Their Antibacterial Properties

For decades, biomaterials have been commonly used in medicine for the replacement of human body tissue, precise drug-delivery systems, or as parts of medical devices that are essential for some treatment methods. Due to rapid progress in the field of new materials, updates on the state of knowledge about biomaterials are frequently needed. This article describes the clinical application of different types of biomaterials in the field of otorhinolaryngology, i.e., head and neck surgery, focusing on their antimicrobial properties. The variety of their applications includes cochlear implants, middle ear prostheses, voice prostheses, materials for osteosynthesis, and nasal packing after nasal/paranasal sinuses surgery. Ceramics, such as as hydroxyapatite, zirconia, or metals and metal alloys, still have applications in the head and neck region. Tissue engineering scaffolds and drug-eluting materials, such as polymers and polymer-based composites, are becoming more common. The restoration of life tissue and the ability to prevent microbial colonization should be taken into consideration when designing the materials to be used for implant production. The authors of this paper have reviewed publications available in PubMed from the last five years about the recent progress in this topic but also establish the state of knowledge of the most common application of biomaterials over the last few decades.

Microstructure-dependent crevice corrosion damage of implant materials CoCr28Mo6, TiAl6V4 and REX 734 under severe inflammatory conditions

Fretting corrosion is associated with increased risk of premature implant failure. In this complex in vivo corrosion system, the contribution of static crevice corrosion of the joined metal alloys is still unknown. The aim of this study was to develop a methodology for testing crevice corrosion behavior that simulates the physiological conditions of modular taper junctions and to identify critical factors on corrosion susceptibility. Samples of medical grade CoCr28Mo6 cast and wrought alloy, TiAl6V4 wrought alloy and REX 734 stainless steel were prepared metallographically and the microstructure was investigated using scanning electron microscopy (SEM). Crevice formers that mimic typical geometries of taper junctions were developed. Crevice corrosion immersion tests were performed in different physiological fluids (bovine serum or phosphate buffered saline with additives of 30 mM H₂ O₂ at pH = 1) for 4 weeks at 37°C. SEM with energy dispersive X-ray spectroscopy as well as focused ion beam were used to characterize the surface morphology, investigate present damages and identify the chemical composition of residues. Macroscopic inspection showed increased crevice corrosion susceptibility of TiAl6V4 and REX 734 under severe simulated inflammatory conditions. CoCr28Mo6 cast alloy exhibited degraded areas next to Cr- and Mo-rich precipitations that were located within the opposed crevices. The results indicate that aggressive electrolyte composition and crevice heights of 50-500 μm are critical influencing factors on crevice corrosion of biomedical alloys. Furthermore, manufacturing-related microstructure of common implant alloys determines the deterioration of corrosion resistance. The developed method should be used to enhance the corrosion resistance of common implant biomaterials by an adapted microstructure.

Investigation of mechanical behaviors and improved design of V-shaped braid stents

V-shaped braid stents (VBSs), as highly retrievable and flexible nitinol stents, are extensively applied in endovascular diseases. They also cause less damage to vessel wall compared to tube-cutting stents. However, poor performance of VBS or suboptimal operation can give rise to unwanted clinical situations such as thrombosis and intimal hyperplasia. Therefore, research on designing factors affecting the performance of these devices is of great significance. Furthermore, simulation of stenting process can help designers understand the interactions of stents and vessel wall to reduce time to market. Thus, finite element analysis (FEA) and bench test are performed taking into account both designing factors and stenting process of VBS, including development of parametric modeling tool, research on the relationships among structural parameters and radial force, exploration of the interactions of VBS and vessel wall and pulsating load effect. This research was performed using a commercial solver Abaqus/standard with a user material subroutine (UMAT/nitinol). Structural parameters of VBS, unit-cell height and wire diameter have significant impacts on radial force, unit-cell number has slight influence on radial force, and arc diameter has almost negligible impact on radial force. Without pulsatile load, maximum stress and strain always occur in arc position; however, in pulsatile load, maximum stress and strain are gradually transformed to strut position. The stress created near vessel wall and VBS interface is higher than interaction stress due to pulsating load. The obtained result provided valuable information on the structural design of stents as well as the effects of stent on vessel wall and that vessel wall on stent deformation.Graphical abstract[Formula: see text].

A comprehensive review on metallic implant biomaterials and their subtractive manufacturing

There is a tremendous increase in the demand for converting biomaterials into high-quality industrially manufactured human body parts, also known as medical implants. Drug delivery systems, bone plates, screws, cranial, and dental devices are the popular examples of these implants - the potential alternatives for human life survival. However, the processing techniques of an engineered implant largely determine its preciseness, surface characteristics, and interactive ability with the adjacent tissue(s) in a particular biological environment. Moreover, the high cost-effective manufacturing of an implant under tight tolerances remains a challenge. In this regard, several subtractive or additive manufacturing techniques are employed to manufacture patient-specific implants, depending primarily on the required biocompatibility, bioactivity, surface integrity, and fatigue strength. The present paper reviews numerous non-degradable and degradable metallic implant biomaterials such as stainless steel (SS), titanium (Ti)-based, cobalt (Co)-based, nickel-titanium (NiTi), and magnesium (Mg)-based alloys, followed by their processing via traditional turning, drilling, and milling including the high-speed multi-axis CNC machining, and non-traditional  abrasive water jet machining (AWJM), laser beam machining (LBM), ultrasonic machining (USM), and electric discharge machining (EDM) types of subtractive manufacturing techniques. However, the review further funnels down its primary focus on Mg, NiTi, and Ti-based alloys on the basis of the increasing trend of their implant applications in the last decade due to some of their outstanding properties. In the recent years, the incorporation of cryogenic coolant-assisted traditional subtraction of biomaterials has gained researchers' attention due to its sustainability, environment-friendly nature, performance, and superior biocompatible and functional outcomes fitting for medical applications. However, some of the latest studies reported that the medical implant manufacturing requirements could be more remarkably met using the non-traditional subtractive manufacturing approaches. Altogether, cryogenic  machining among the traditional routes and EDM among the non-traditional means along with their variants, were identified as some of the most effective subtractive manufacturing techniques for achieving the dimensionally accurate and biocompatible metallic medical implants with significantly modified surfaces.

Machine Learning-Driven Biomaterials Evolution

Biomaterials is an exciting and dynamic field, which uses a collection of diverse materials to achieve desired biological responses. While there is constant evolution and innovation in materials with time, biomaterials research has been hampered by the relatively long development period required. In recent years, driven by the need to accelerate materials development, the applications of machine learning in materials science has progressed in leaps and bounds. The combination of machine learning with high-throughput theoretical predictions and high-throughput experiments (HTE) has shifted the traditional Edisonian (trial and error) paradigm to a data-driven paradigm. In this review, each type of biomaterial and their key properties and use cases are systematically discussed, followed by how machine learning can be applied in the development and design process. The discussions are classified according to various types of materials used including polymers, metals, ceramics, and nanomaterials, and implants using additive manufacturing. Last, the current gaps and potential of machine learning to further aid biomaterials discovery and application are also discussed.

Biomedical Alloys and Physical Surface Modifications: A Mini-Review

Biomedical alloys are essential parts of modern biomedical applications. However, they cannot satisfy the increasing requirements for large-scale production owing to the degradation of metals. Physical surface modification could be an effective way to enhance their biofunctionality. The main goal of this review is to emphasize the importance of the physical surface modification of biomedical alloys. In this review, we compare the properties of several common biomedical alloys, including stainless steel, Co-Cr, and Ti alloys. Then, we introduce the principle and applications of some popular physical surface modifications, such as thermal spraying, glow discharge plasma, ion implantation, ultrasonic nanocrystal surface modification, and physical vapor deposition. The importance of physical surface modifications in improving the biofunctionality of biomedical alloys is revealed. Future studies could focus on the development of novel coating materials and the integration of various approaches.

Nickel hypersensitivity and skin patch testing in total hip replacement surgery: a systematic review

Approximately 60,000 cemented femoral stems are implanted in the UK each year with the majority being manufactured from stainless steel containing 10–15% nickel. Nickel hypersensitivity has been reported in up to 13% of the general population and there is a concern that nickel hypersensitivity might adversely affect the outcome of total hip replacement (THR). We reviewed the current literature on the potential link between nickel hypersensitivity and THR complications, and the usefulness of patch testing.

We conducted a literature search in PubMed, MEDLINE and EMBASE databases. The level of evidence and the quality of the selected studies were assessed using the Oxford Centre for Evidence-Based Medicine Criteria and the Methodological Index for Non-Randomised Studies tool, respectively.

Twenty-six studies met the inclusion criteria, reporting on 1852 patients who underwent primary or revision THR. All studies detailed skin patch testing and recorded prevalence of nickel hypersensitivity from 1.5% to 33.3%. Five studies reported a rise in Nickel hypersensitivity following THR, while four reported a decreased prevalence post-operatively. Eight studies concluded that metal hypersensitivity could have developed following THR, while seven studies did not support a link between metal hypersensitivity and THR complications. Four of the studies recommended routine patch testing pre-operatively, but three others concluded that routine patch testing was not indicated.

We have not identified a link between nickel hypersensitivity and THR complications, and the role of patch testing remains unclear. Further large-scale studies would be required to investigate this relationship and to clarify the role of patch testing in facilitating implant selection.

Cite this article: EFORT Open Rev 2021;6:825-838. DOI: 10.1302/2058-5241.6.210051

High-manganese and nitrogen stabilized austenitic stainless steel (Fe-18Cr-22Mn-0.65N): a material with a bright future for orthopedic implant devices

The rationale behind the success of nickel free or with extremely low nickel austenitic high manganese and nitrogen stabilized stainless steels is adverse influences of nickel ion on human body. Replacement of nickel by nitrogen and manganese provides a stable microstructure and facilitates better biocompatibility in respect of the conventional 316L austenitic stainless steel (316L SS). In this investigation, biocompatibility of the high-manganese and nitrogen stabilized (Fe-18Cr-22Mn-0.65N) austenitic stainless steel was studied and found highly promising.In vitrocell culture and cell proliferation (MTT) assays were performed on this stainless steel and assessed in respect of the 316L SS. Both the steels exhibited similar cell growth behavior. Furthermore, an enhancement was observed in cell proliferation on the Fe-18Cr-22Mn-0.65N SS after surface modification by ultrasonic shot peening (USP). The mean percent proliferation of the MG-63 cells increased from ≈88% for Un-USP to 98% and 105% for USP 3-2 and USP 2-2 samples, respectively for 5 d of incubation. Interestingly,in vivoanimal study performed in rabbits for 3 and 6 weeks showed callus formation and sign of union without any allergic reaction.

Corrosion behavior of high nitrogen nickel-free austenitic stainless steel in the presence of artificial saliva and Streptococcus mutans

High nitrogen nickel-free austenitic stainless steels (HNSs) have great potentials to be used in dentistry owing to its exceptional mechanical properties, high corrosion resistance, and biocompatibility. In this study, HNSs with nitrogen of 0.88 wt% and 1.08 wt% displayed much lower maximum pit depths than 316L stainless steel (SS) after 21 d of immersion in abiotic artificial saliva (2.2 μm and 1.7 μm vs. 4.5 μm). Microbiologically influenced corrosion (MIC) evaluations revealed that Streptococcus mutans biofilms led to much severer corrosion of 316L SS than HNSs. Corrosion current densities of HNSs were two orders of magnitude lower than that of 316L SS after incubation of 7 d (37.5 nA/cm² and 29.9 nA/cm² vs. 5.63 μA/cm²). The pitting potentials of HNSs were at least 550 mV higher than that of 316L SS in the presence of S. mutans, confirming the better MIC resistance of HNSs. Cytotoxicity assay confirmed that HNSs were not toxic to MC3T3-E1 cells and allowed better sessile cell growth on them than on 316L SS. It can be concluded that HNSs are more suitable dental materials than the conventional 316L SS.

Analysis of the Crystallization Kinetics and Thermal Stability of the Amorphous Mg72Zn24Ca4 Alloy

The aim of this study was to analyze the crystallization of the Mg₇₂Zn₂₄Ca₄ metallic glass alloy. The crystallization process of metallic glass Mg₇₂Zn₂₄Ca₄ was investigated by means of the differential scanning calorimetry. The glass-forming ability and crystallization are both strongly dependent on the heating rate. The crystallization kinetics, during the isothermal annealing, were modelled by the Johnson–Mehl–Avrami equation. Avrami exponents were from 2.7 to 3.51, which indicates diffusion-controlled grain growth. Local exponents of the Johnson–Mehl–Avrami equation were also calculated. In addition, the Mg phase—being the isothermal crystallization product—was found, and the diagram of the time–temperature phase transformation was developed. This diagram enables the reading of the start and end times of the crystallization process, occurring in amorphous ribbons of the Mg₇₂Zn₂₄Ca₄ alloy on the isothermal annealing temperature. The research showed high stability of the amorphous structure of Mg₇₂Zn₂₄Ca₄ alloy at human body temperature.

Synthesis, Surface Nitriding and Characterization of Ti-Nb Modified 316L Stainless Steel Alloy Using Powder Metallurgy

The powder metallurgy (PM) technique has been widely used for producing different alloy compositions by the addition of suitable reinforcements. PM is also capable of producing desireable mechanical and physical properties of the material by varying process parameters. This research investigates the addition of titanium and niobium in a 316L stainless steel matrix for potential use in the biomedical field. The increase of sintering dwell time resulted in simultaneous sintering and surface nitriding of compositions, using nitrogen as the sintering atmosphere. The developed alloy compositions were characterized using OM, FESEM, XRD and XPS techniques for quantification of the surface nitride layer and the nitrogen absorbed during sintering. The corrosion resistance and cytotoxicity assessments of the developed compositions were carried out in artificial saliva solution and human oral fibroblast cell culture, respectively. The results indicated that the nitride layer produced during sintering increased the corrosion resistance of the alloy and the developed compositions are non-cytotoxic. This newly developed alloy composition and processing technique is expected to provide a low-cost solution to implant manufacturing.

Effects of Titanium-Implanted Dose on the Tribological Properties of 316L Stainless Steel

The effects of titanium (Ti) ion-implanted doses on the chemical composition, surface roughness, mechanical properties, as well as tribological properties of 316L austenitic stainless steel are investigated in this paper. The Ti ion implantations were carried out at an energy of 40 kV and at 2 mA for different doses of 3.0 × 10¹⁶, 1.0 × 10¹⁷, 1.0 × 10¹⁸, and 1.7 × 10¹⁸ ions/cm². The results showed that a new phase (Cr₂Ti) was detected, and the concentrations of Ti and C increased obviously when the dose exceeded 1.0 × 10¹⁷ ions/cm². The surface roughness can be significantly reduced after Ti ion implantation. The nano-hardness increased from 3.44 to 5.21 GPa at a Ti ion-implanted dose increase up to 1.0 × 10¹⁸ ions/cm². The friction coefficient decreased from 0.78 for un-implanted samples to 0.68 for a sample at the dose of 1.7 × 10¹⁸ ions/cm². The wear rate was slightly improved when the sample implanted Ti ion at a dose of 1.0 × 10¹⁸ ions/cm². Adhesive wear and oxidation wear are the main wear mechanisms, and a slightly abrasive wear is observed during sliding. Oxidation wear was improved significantly as the implantation dose increased.

Structure-Phase Transformations in the Course of Solid-State Mechanical Alloying of High-Nitrogen Chromium-Manganese Steels

The solid-state mechanical alloying (MA) of high-nitrogen chromium-manganese austenite steel—MA in a planetary ball mill, —was studied by methods of Mössbauer spectroscopy and transmission electron microscopy (TEM). In the capacity of a material for the alloying we used mixtures of the binary Fe–Mn and Fe–Cr alloys with the nitrides CrN (Cr2N) and Mn2N. It is shown that ball milling of the mixtures has led to the occurrence of the α → γ transitions being accompanied by the (i) formation of the solid solutions supersaturated with nitrogen and by (ii) their decomposition with the formation of secondary nitrides. The austenite formed by the ball milling and subsequent annealing at 700–800 °C, was a submicrocrystalline one that contained secondary nano-sized crystalline CrN (Cr2N) nitrides. It has been established that using the nitride Mn2N as nitrogen-containing addition is more preferable for the formation and stabilization of austenite—in the course of the MA and subsequent annealing—because of the formation of the concentration-inhomogeneous regions of γ phase enriched with austenite-forming low-mobile manganese.

Corrosion resistance of the nickel-free high-nitrogen steel FeCrMnMoN0.9 under simulated inflammatory conditions

Nickel-free, high-nitrogen austenitic steels (AHNS) have been introduced for biomedical applications, with encouraging results in terms of mechanical and corrosion properties. Here, we tested the corrosion resistance of a nickel-free high nitrogen steel (FeCrMnMoN0.9) in bovine serum solutions containing 0 or 3 g/L hyaluronic acid (HA), and 0, 3, or 30 mM hydrogen peroxide (H₂ O₂ ) simulating no, moderate, or strong inflammatory conditions, respectively. Nondestructive electrochemical measurements (open circuit potential [OCP], linear polarization resistance "R_P ", and electrochemical impedance spectroscopy) were run in triplicate over 10 hr. The presence of HA had no significant effect either on the stabilized OCP values, or on the corrosion resistance of FeCrMnMoN0.9. Increasing H₂ O₂ concentrations shifted the OCP to more electropositive values; the corrosion resistance decreased only at a 30 mM H₂ O₂ . Final R_P values at 0, 3, and 30 mM H₂ O₂ resulted in 1598 ± 276, 1746 ± 308, and 439 ± 47 kΩ cm² , respectively. These values were 4-14 times higher, than the R_P values measured on LC-CoCrMo in our previous study, conducted under identical conditions. While these findings are encouraging, future studies need to focus on tribocorrosive properties of the AHNS to evaluate its applicability in joint replacement.

Surface Characteristics and Cell Adhesion Behaviors of the Anodized Biomedical Stainless Steel

In this study, an electrochemical anodizing method was applied as surface modification of the 316L biomedical stainless steel (BSS). The surface properties, microstructural characteristics, and biocompatibility responses of the anodized 316L BSS specimens were elucidated through scanning electron microscopy, X-ray photoelectron spectroscopy, X-ray diffractometry, transmission electron microscopy, and in vitro cell culture assay. Analytical results revealed that the oxide layer of dichromium trioxide (Cr2O3) was formed on the modified 316L BSS specimens after the different anodization modifications. Moreover, a dual porous (micro/nanoporous) topography can also be discovered on the surface of the modified 316L BSS specimens. The microstructure of the anodized oxide layer was composed of amorphous austenite phase and nano-Cr2O3. Furthermore, in vitro cell culture assay also demonstrated that the osteoblast-like cells (MG-63) on the anodized 316L BSS specimens were completely adhered and covered as compared with the unmodified 316L BSS specimen. As a result, the anodized 316L BSS with a dual porous (micro/nanoporous) oxide layer has great potential to induce cell adhesion and promote bone formation.

Complex Corrosion Properties of AISI 316L Steel Prepared by 3D Printing Technology for Possible Implant Applications

This paper deals with the investigation of complex corrosion properties of 3D printed AISI 316L steel and the influence of additional heat treatment on the resulting corrosion and mechanical parameters. There was an isotonic solution used for the simulation of the human body and a diluted sulfuric acid solution for the study of intergranular corrosion damage of the tested samples. There were significant microstructural changes found for each type of heat treatment at 650 and 1050 °C, which resulted in different corrosion properties of the tested samples. There were changes of corrosion potential, corrosion rate and polarization resistance found by the potentiodynamic polarization method. With regard to these results, the most appropriate heat treatment can be applied to applications with intended use in medicine.

Optimization of Sintering Parameters of 316L Stainless Steel for In-Situ Nitrogen Absorption and Surface Nitriding Using Response Surface Methodology

This research investigates the simultaneous sintering and surface nitriding of 316L stainless steel alloy using powder metallurgy method. The influence of sintering temperature and dwell time are investigated for maximum nitrogen absorption, densification and increased microhardness using response surface methodology (RSM). In this study, 316L stainless steel powder was compacted at 800 MPa and sintered at two different temperatures of 1150 and 1200 °C with varying dwell times of 1, 3, 5 and 8 h in nitrogen atmosphere. The sintered compacts were then characterized for their microstructure, densification, microhardness and nitrogen absorption. The results revealed that increased dwell time assisted nitrogen to diffuse into stainless steel matrix along with the creation of nitride layer onto the sample surface. The microhardness and density also increased with increasing dwell time. A densification of 7.575 g/cm3 and microhardness of 235 HV were obtained for the samples sintered at 1200 °C temperature with 8 h dwell time. The simultaneous sintering and surface nitriding technique developed in this research work can help in improving corrosion resistance of this material and controlling leaching of metal ions for its potential use in biomedical applications.

Austenitic Stainless Steel Powders with Increased Nitrogen Content for Laser Additive Manufacturing

Nitrogen is used as an alloying element, substituting the expensive and allergenic element nickel, in austenitic stainless steels to improve their mechanical properties and corrosion resistance. The development of austenitic stainless steel powders with increased nitrogen content for laser additive manufacturing has recently received great interest. To increase nitrogen content in the austenitic steel powders (for example AISI 316L), two measures are taken in this study: (1) melting the steel under a nitrogen atmosphere, and (2) adding manganese to increase the solubility of nitrogen in the steel. The steel melt is then atomized by means of gas atomization (with either nitrogen or argon). The resulting powders are examined and characterized with regard to nitrogen content, particle size distribution, particle shape, microstructure, and flowability. It shows that about 0.2–0.3 mass % nitrogen can be added to the austenitic stainless steel 316L by adding manganese and melting the steel under nitrogen atmosphere. The particles are spherical in shape and very few satellite particles are observed. The steel powders show good flowability and packing density, therefore they can be successfully processed by means of laser powder bed fusion (L-PBF).

Microstructure, Mechanical, and Corrosion Properties of Ni-Free Austenitic Stainless Steel Prepared by Mechanical Alloying and HIPping

An influence of the powder metallurgy route on the phase structure, mechanical properties, and corrosion resistance of Fe–18%Cr–12%Mn–N nickel-free austenitic stainless steel as a potential material for medical applications were studied. The powder was mechanically alloyed in a high purity nitrogen atmosphere for 90 h followed by Hot Isostatic Pressing at 1150 °C (1423 K) and heat treatment at 1175 °C (1423 K) for 1 h in a vacuum with furnace cooling and water quenching. More than 96% of theoretical density was obtained for the samples after Hot Isostatic Pressing that had a direct influence on the tensile strength of the tested samples (Ultimate Tensile Strength is 935 MPa) with the total elongation of 0.5%. Heat treatment did not affect the tensile strength of the tested material, however, an elongation was improved by up to 3.5%. Corrosion properties of the tested austenitic stainless steel in various stages of the manufacturing process were evaluated applying the anodic polarization measurements and compared with the austenitic 316LV stainless steel. In general, the heat treatment applied after Hot Isostatic Pressing improved the corrosion resistance. The Hot Isostatic Pressing sample shows dissolution, while heat treatment causes a passivity range, the noblest corrosion potential, and lower current density of this sample.

An Efficient Approach for Nitrogen Diffusion and Surface Nitriding of Boron-Titanium Modified Stainless Steel Alloy for Biomedical Applications

Austenitic 316L stainless steel has been the most widely acceptable biomaterial for producing implants. The downside of this material includes the leaching of nickel ions from the matrix that limits its’ usage in implant manufacturing. In this research, production of stainless steel alloy modified with boron and titanium is investigated. The sintering of the alloy systems is carried out in nitrogen atmosphere for a dwell time of 8 h. The X-Ray diffraction (XRD) analysis reveals that dwell time and alloy composition leads to the formation of strong nitrides and borides. The X-Ray Photoelectron Spectroscopy (XPS) results show the presence of nitrogen on to the surface of sintered specimens. The nitride layer on the surface of the specimens is helpful in the retention of nickel ions in the stainless steel matrix, as indicated in the weight loss measurements. The cytotoxicity assessment indicates that the developed alloys are biocompatible and can be used as implant materials.

On the Evaluation of Surface Fatigue Strength of a Stainless-Steel Aeronautical Component

In this paper, a novel method for the evaluation of the surface fatigue strength of a stainless-steel component is proposed. The use of stainless steel is necessary indeed, whenever a component has to work in a particularly aggressive environment that may cause an oxidation of the component itself. One of the major problems that affect stainless-steel components is the possible wear of the antioxidant film that reduces the antioxidant properties of the component itself. One of the main causes that can lead to wear is related to the surface corrosion that occurs every time two evolving bodies are forced to work against each other. If the antioxidant film is affected by surface fatigue problems, such as pitting or spalling, the antioxidant capacities of this type of steel may be lost. In this context, it is, therefore, necessary to verify, at least, by calculation that no corrosion problems exist. The method proposed in this activity is a hybrid method, numerical-theoretical, which allows to estimate the surface fatigue strength in a very short time without having to resort to finite element models that often are so complex to be in contrast with industrial purposes.

Nanoglass-based balloon expandable stents

Here, a prototypical metallic nanoglass is proposed as a new alloy for balloon expandable stents. Traditionally, the stainless steel SS 316L alloy has been used as a preferred material for this application due to its proper combination of mechanical properties, corrosion resistance, and biocompatibility. Recently, metallic glasses (MGs) have been considered as promising materials for biodevice applications. MGs often display outstanding mechanical properties superior to those of conventional metallic alloys and overcome some of the weaknesses of SS 316L, such as radiopacity, stainless steel allergy, and thrombosis-induced restenosis. However, commonly used monolithic MGs, which have an amorphous homogeneous microstructure, suffer from lack of ductility that is necessary for deployment of balloon expandable stents. In contrast, nanoglasses, that is, amorphous alloys with heterogeneous microstructure, exhibit enhanced ductility which makes them promising materials for balloon expandable stents. We evaluate the feasibility of a prototypical Zr₆₄ Cu₃₆ nanoglass with a grain size of 5 nm for balloon expandable stents by performing finite element method modeling of the stent deployment process in a coronary artery. We consider the BX-Velocity stent design and the nanoglass mechanical properties calculated from atomistic simulations. The results suggest that nanoglasses are suitable materials for balloon expandable stent applications. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 108B:73-79, 2020.

Corrosion of Metallic Biomaterials: A Review

Metallic biomaterials are used in medical devices in humans more than any other family of materials. The corrosion resistance of an implant material affects its functionality and durability and is a prime factor governing biocompatibility. The fundamental paradigm of metallic biomaterials, except biodegradable metals, has been "the more corrosion resistant, the more biocompatible." The body environment is harsh and raises several challenges with respect to corrosion control. In this invited review paper, the body environment is analysed in detail and the possible effects of the corrosion of different biomaterials on biocompatibility are discussed. Then, the kinetics of corrosion, passivity, its breakdown and regeneration in vivo are conferred. Next, the mostly used metallic biomaterials and their corrosion performance are reviewed. These biomaterials include stainless steels, cobalt-chromium alloys, titanium and its alloys, Nitinol shape memory alloy, dental amalgams, gold, metallic glasses and biodegradable metals. Then, the principles of implant failure, retrieval and failure analysis are highlighted, followed by description of the most common corrosion processes in vivo. Finally, approaches to control the corrosion of metallic biomaterials are highlighted.

Effect of chromium content on the corrosion resistance of ferritic stainless steels in sulfuric acid solution

Due to recent increases in the price of Ni, steel use is currently undergoing a global shift from austenitic stainless steels to ferritic stainless steels. In this study, the corrosion behavior of four types ferritic stainless steels with different Cr contents was investigated to study the effect of Cr content on the corrosion resistance in a sulfuric acid solution. The polarization curves of the ferritic stainless steel with the highest Cr content indicated the best corrosion resistance. No corrosion was observed for the stainless steel with 24 mass% Cr after a potential sweep based on ex-situ SEM images. Corrosion resistivity was improved for high Cr content (>24 mass%) stainless steel because it is considered to form a stable passivation layer.

Effects of metal ions on caspase-1 activation and interleukin-1β release in murine bone marrow-derived macrophages

Ions released from metal implants have been associated with adverse tissue reactions and are therefore a major concern. Studies with macrophages have shown that cobalt, chromium, and nickel ions can activate the NLRP3 inflammasome, a multiprotein complex responsible for the activation of caspase-1 (a proteolytic enzyme converting pro-interleukin [IL]-1β to mature IL-1β). However, the mechanism(s) of inflammasome activation by metal ions remain largely unknown. The objectives of the present study were to determine if, in macrophages: 1. caspase-1 activation and IL-1β release induced by metal ions are oxidative stress-dependent; and 2. IL-1β release induced by metal ions is NF-κB signaling pathway-dependent. Lipopolysaccharide (LPS)-primed murine bone marrow-derived macrophages (BMDM) were exposed to Co2+ (6-48 ppm), Cr3+ (100-500 ppm), or Ni2+ (12-96 ppm), in the presence or absence of a caspase-1 inhibitor (Z-WEHD-FMK), an antioxidant (L-ascorbic acid [L-AA]), or an NF-κB inhibitor (JSH-23). Culture supernatants were analyzed for caspase-1 by western blotting and/or IL-1β release by ELISA. Immunoblotting revealed the presence of caspase-1 (p20 subunit) in supernatants of BMDM incubated with Cr3+, but not with Ni2+ or Co2+. When L-AA (2 mM) was present with Cr3+, the caspase-1 p20 subunit was undetectable and IL-1β release decreased down to the level of the negative control, thereby demonstrating that caspase-1 activation and IL-1β release induced by Cr3+ was oxidative stress-dependent. ELISA demonstrated that Cr3+ induced the highest release of IL-1β, while Co2+ had no or limited effects. In the presence of Ni2+, the addition of L-AA (2 mM) also decreased IL-1β release, below the level of the negative control, suggesting that IL-1β release induced by Ni2+ was also oxidative stress-dependent. Finally, when present during both priming with LPS and activation with Cr3+, JSH-23 blocked IL-1β release, demonstrating NF-κB involvement. Overall, this study showed that while both Cr3+ and Ni2+ may be inducing inflammasome activation, Cr3+ is likely a more potent activator, acting through oxidative stress and the NF-κB signaling pathway.

Electroplating for Decorative Applications: Recent Trends in Research and Development

Electroplating processes are widely employed in industrial environments for a large variety of metallic coatings, ranging from technological to decorative applications. Even if the galvanic electrodeposition is certainly a mature technology, new concepts, novel applications, environmental legislation and the new material requirements for next-generation devices make the scientific research in this field still very active. This review focuses mostly at the decorative and wearable applications, and aims to create a bridge between the past knowledge and the future direction that this process, i.e., electrodeposition, is taking. Both the theoretical fundamentals as well as some of the most widespread practical applications—limited to metallic and alloy coatings—are explored. As an integral part of the industrial process, we take a look at the main techniques thought which the quality control of deposits and surfaces is carried out. Finally, global industrial performance and research directions towards sustainable solutions are highlighted.

Microstructure and Properties of Porous High-N Ni-Free Austenitic Stainless Steel Fabricated by Powder Metallurgical Route

Porous high-N Ni-free austenitic stainless steel was fabricated by a powder metallurgical route. The microstructure and properties of the prepared porous austenitic stainless steel were studied. Results reveal that the duplex stainless steel transforms into austenitic stainless steel after nitridation sintering for 2 h. The prepared high-N stainless steel consists of γ-Fe matrix and FCC structured CrN. Worm-shaped and granular-shaped CrN precipitates were observed in the prepared materials. The orientation relationship between CrN and austenite matrix is [011]_CrN//[011]_γ and (-1-11)_CrN//(1-11)_γ. Results show that the as-fabricated porous high-nitrogen austenitic stainless steel features a higher mechanical property than common stainless steel foam. Both compressive strength and Young’s modulus decrease with an increase in porosity. The 3D morphology of the prepared porous materials presents good pore connectivity. The prepared porous high-N Ni-free austenitic stainless steel has superior pore connectivity, a good combination of compressive strength and ductility, and low elastic modulus, which makes this porous high-N Ni-free austenitic stainless steel very attractive for metal foam applications.

A combination of interdisciplinary analytical tools for evaluation of multi-layered coatings on medical grade stainless steel for biomedical applications

In this comprehensive study several analytical techniques were used in order to evaluate multi-layered biomedical surface coatings composed of a drug (diclofenac) and a polymer (chitosan). Such a thorough examination is of paramount importance in order to assure safety and prove efficiency of potential biomedical materials already at the in vitro level, hence leading to their potentially faster introduction to clinical trials. For the first time a novel technique based on thermal diffusivity and conductivity measurements (photothermal beam deflection spectroscopy - BDS) was employed in order to analyse in a non-destructive way the thickness of respective layers, together with their thermal diffusivity and conductivity. In addition to attenuated total reflection Fourier-transform infrared spectroscopy (ATR-FTIR), BDS confirmed successive surface layers of the prepared coatings. Scanning electron microscopy and atomic force microscopy were used to examine structural information on the macro- and micro/nano-scale, respectively. Surface hydrophobicity was measured with the contact angle analysis, which clearly showed differences in hydrophobicity between coated and non-coated samples. Considering the targeted application of the prepared coatings (as implant in orthopaedic treatments), the in vitro drug release was analysed spectrophotometrically to examine the coatings potential for a controlled drug release. Furthermore, the material was also tested by electrochemical impedance spectroscopy and cyclic polarisation techniques, which were able to detect even minor differences between the performance of the coated and non-coated materials. As the final test, the biocompatibility of the coatings with human osteoblasts was determined.

A Critical Review on Metallic Glasses as Structural Materials for Cardiovascular Stent Applications

Functional and mechanical properties of novel biomaterials must be carefully evaluated to guarantee long-term biocompatibility and structural integrity of implantable medical devices. Owing to the combination of metallic bonding and amorphous structure, metallic glasses (MGs) exhibit extraordinary properties superior to conventional crystalline metallic alloys, placing them at the frontier of biomaterials research. MGs have potential to improve corrosion resistance, biocompatibility, strength, and longevity of biomedical implants, and hence are promising materials for cardiovascular stent applications. Nevertheless, while functional properties and biocompatibility of MGs have been widely investigated and validated, a solid understanding of their mechanical performance during different stages in stent applications is still scarce. In this review, we provide a brief, yet comprehensive account on the general aspects of MGs regarding their formation, processing, structure, mechanical, and chemical properties. More specifically, we focus on the additive manufacturing (AM) of MGs, their outstanding high strength and resilience, and their fatigue properties. The interconnection between processing, structure and mechanical behaviour of MGs is highlighted. We further review the main categories of cardiovascular stents, the required mechanical properties of each category, and the conventional materials have been using to address these requirements. Then, we bridge between the mechanical requirements of stents, structural properties of MGs, and the corresponding stent design caveats. In particular, we discuss our recent findings on the feasibility of using MGs in self-expandable stents where our results show that a metallic glass based aortic stent can be crimped without mechanical failure. We further justify the safe deployment of this stent in human descending aorta. It is our intent with this review to inspire biodevice developers toward the realization of MG-based stents.