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Pourmasoumi P, Moghaddam A, Nemati Mahand S, Heidari F, Salehi Moghaddam Z, Arjmand M, Kühnert I, Kruppke B, Wiesmann HP, Khonakdar HA. A review on the recent progress, opportunities, and challenges of 4D printing and bioprinting in regenerative medicine. JOURNAL OF BIOMATERIALS SCIENCE. POLYMER EDITION 2023; 34:108-146. [PMID: 35924585 DOI: 10.1080/09205063.2022.2110480] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Four-dimensional (4 D) printing is a novel emerging technology, which can be defined as the ability of 3 D printed materials to change their form and functions. The term 'time' is added to 3 D printing as the fourth dimension, in which materials can respond to a stimulus after finishing the manufacturing process. 4 D printing provides more versatility in terms of size, shape, and structure after printing the construct. Complex material programmability, multi-material printing, and precise structure design are the essential requirements of 4 D printing systems. The utilization of stimuli-responsive polymers has increasingly taken the place of cell traction force-dependent methods and manual folding, offering a more advanced technique to affect a construct's adjusted shape transformation. The present review highlights the concept of 4 D printing and the responsive bioinks used in 4 D printing, such as water-responsive, pH-responsive, thermo-responsive, and light-responsive materials used in tissue regeneration. Cell traction force methods are described as well. Finally, this paper aims to introduce the limitations and future trends of 4 D printing in biomedical applications based on selected key references from the last decade.
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Affiliation(s)
| | | | | | - Fatemeh Heidari
- Iran Polymer and Petrochemical Institute (IPPI), Tehran, Iran
| | - Zahra Salehi Moghaddam
- Department of Microbial Biotechnology, School of Biology, College of Science, University of Tehran, Tehran, Iran
| | - Mohammad Arjmand
- Nanomaterials and Polymer Nanocomposites Laboratory, School of Engineering, University of British Columbia, Kelowna, BC, Canada
| | - Ines Kühnert
- Leibniz Institute of Polymer Research Dresden, Dresden, Germany
| | - Benjamin Kruppke
- Max Bergmann Center of Biomaterials and Institute of Materials Science, Technische Universität Dresden, Dresden, Germany
| | - Hans-Peter Wiesmann
- Max Bergmann Center of Biomaterials and Institute of Materials Science, Technische Universität Dresden, Dresden, Germany
| | - Hossein Ali Khonakdar
- Iran Polymer and Petrochemical Institute (IPPI), Tehran, Iran.,Leibniz Institute of Polymer Research Dresden, Dresden, Germany
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Liu C, Yang C, Liu J, Tang Y, Lin Z, Li L, Liang H, Lu W, Wang L. Medical high-entropy alloy: Outstanding mechanical properties and superb biological compatibility. Front Bioeng Biotechnol 2022; 10:952536. [PMID: 36032713 PMCID: PMC9403318 DOI: 10.3389/fbioe.2022.952536] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/20/2022] [Indexed: 12/03/2022] Open
Abstract
Medical metal implants are required to have excellent mechanical properties and high biocompatibility to handle the complex human environment, which is a challenge that has always existed for traditional medical metal materials. Compared to traditional medical alloys, high entropy alloys (HEAs) have a higher design freedom to allow them to carry more medical abilities to suit the human service environment, such as low elastic modulus, high biocompatible elements, potential shape memory capability. In recent years, many studies have pointed out that bio-HEAs, as an emerging medical alloy, has reached or even surpassed traditional medical alloys in various medical properties. In this review, we summarized the recent reports on novel bio-HEAs for medical implants and divide them into two groups according the properties, namely mechanical properties and biocompatibility. These new bio-HEAs are considered hallmarks of a historic shift representative of a new medical revolution.
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Affiliation(s)
- Changxi Liu
- State Key Laboratory of Metal Matrix Composites, School of Material Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
- National Center for Translational Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chengliang Yang
- National Center for Translational Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Orthopaedics, Affiliated Hospital of Youjiang Medical University for Nationalities, Guangxi Key Laboratory of Basic and Translational Research of Bone and Joint Degenerative Diseases, Baise, China
| | - Jia Liu
- National Center for Translational Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Orthopaedics, Affiliated Hospital of Youjiang Medical University for Nationalities, Guangxi Key Laboratory of Basic and Translational Research of Bone and Joint Degenerative Diseases, Baise, China
- *Correspondence: Jia Liu, ; Yujin Tang, ; Liqiang Wang,
| | - Yujin Tang
- National Center for Translational Medicine, Shanghai Jiao Tong University, Shanghai, China
- Department of Orthopaedics, Affiliated Hospital of Youjiang Medical University for Nationalities, Guangxi Key Laboratory of Basic and Translational Research of Bone and Joint Degenerative Diseases, Baise, China
- *Correspondence: Jia Liu, ; Yujin Tang, ; Liqiang Wang,
| | - Zhengjie Lin
- 3D Printing Clinical Translational and Regenerative Medicine Center, Shenzhen Shekou People’s Hospital, Shenzhen, China
| | - Long Li
- Department of Stomatology, Shenzhen Shekou People’s Hospital, Shenzhen, China
| | - Hai Liang
- Department of Stomatology, Shenzhen Shekou People’s Hospital, Shenzhen, China
| | - Weijie Lu
- State Key Laboratory of Metal Matrix Composites, School of Material Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
- National Center for Translational Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Liqiang Wang
- State Key Laboratory of Metal Matrix Composites, School of Material Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
- National Center for Translational Medicine, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Jia Liu, ; Yujin Tang, ; Liqiang Wang,
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Xia D, Zhang Y, Ou T, Wang Y, Hao Z, Zhou P, Xu S. Combination of mini locking plate and nitinol arched shape-memory connector for purely lateral malleolus fractures: technique and clinical results. ANNALS OF TRANSLATIONAL MEDICINE 2021; 8:1573. [PMID: 33437772 PMCID: PMC7791235 DOI: 10.21037/atm-20-4055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Lateral malleolus fractures occur frequently. The common techniques for fixing purely lateral malleolus fractures are often challenging, owing to the extent of soft tissue damage and fracture non-union. Herein, we report a new treatment that entails minimally invasive insertion and continuous compression of the broken ends as a novel technique, and evaluate its clinical results. Methods This study enrolled 21 patients (13 males and 8 females; mean age 32.06±3.45 years, range 23–69 years) with purely lateral malleolus fractures. Each patient underwent open reduction treatment with a mini locking plate for internal fixation and compression of the fracture end with an Arched Shape-Memory Connector (ASC). The clinical assessments were made using the American Orthopedic Foot and Ankle Society (AOFAS) scores, which were recorded at the final follow-up visit. Results The patients were followed for an average of 14.7±1.2 months (range, 12–18 months). None of the patients showed surgical failure, and all of the purely lateral malleolus fractures healed in an average of 12.6±1.5 weeks (range, 10–16 weeks). The mean AOFAS score was 88.94 (range, 83–90). Conclusions The new treatment had beneficial outcomes for purely lateral malleolus fractures. Mini locking plates are minimally invasive for surgical intervention, and combined with continuous concentrated compression with an ASC to accelerate osseous healing, they aid in restoration of function and enable early rehabilitation with a low incidence of postoperative complications.
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Affiliation(s)
- Demeng Xia
- Department of Emergency, Changhai Hospital, Naval Medical University, Shanghai, China.,Department of Orthopaedics, The Naval Hospital of Eastern Theater Command of PLA, Zhoushan, China
| | - Yuntong Zhang
- Department of Emergency, Changhai Hospital, Naval Medical University, Shanghai, China.,Department of Orthopedics, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Tianle Ou
- Department of Clinical Medicine, The Naval Medical University, Shanghai, China
| | - Yang Wang
- Department of Emergency, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Zichen Hao
- Department of Emergency, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Panyu Zhou
- Department of Emergency, Changhai Hospital, Naval Medical University, Shanghai, China.,Department of Orthopedics, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Shuogui Xu
- Department of Emergency, Changhai Hospital, Naval Medical University, Shanghai, China.,Department of Orthopedics, Changhai Hospital, Naval Medical University, Shanghai, China
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Sarvari R, Keyhanvar P, Agbolaghi S, Gholami Farashah MS, Sadrhaghighi A, Nouri M, Roshangar L. Shape-memory materials and their clinical applications. INT J POLYM MATER PO 2020. [DOI: 10.1080/00914037.2020.1833010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Raana Sarvari
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Stem Cell And Regenerative Medicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Peyman Keyhanvar
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Medical Nanotechnology, School of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Convergence of Knowledge, Technology and Society Network (CKTSN), Universal Scientific Education and Research Network (USERN), Tabriz, Iran
- ARTAN110 Startup Accelerator, Tabriz, Iran
| | - Samira Agbolaghi
- Chemical Engineering Department, Faculty of Engineering, Azarbaijan Shahid Madani University, Tabriz, Iran
| | | | - Amirhouman Sadrhaghighi
- Department of Orthodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Nouri
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, University of Medical Sciences, Tabriz, Iran
| | - Laila Roshangar
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Xia D, Zhou P, Li L, Xia Y, Hao Z, Zhang Y, Xu S. Application of a novel shape-memory alloy concentrator in displaced olecranon fractures: a report of the technique and mid-term clinical results. J Orthop Surg Res 2020; 15:453. [PMID: 33008473 PMCID: PMC7531136 DOI: 10.1186/s13018-020-01982-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 09/23/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose Olecranon fracture is a common upper limb fracture, and several surgical approaches have been advocated for its fixation. To overcome the complications associated with common techniques, we present a novel shape-memory alloy concentrator, an alternative for tension band compression, to fix olecranon fracture. Methods Fifty-seven patients (26 men and 31 women) with olecranon fracture, with a mean age of 45 years, were included in this study. Each patient had undergone open reduction and internal fixation using the Nitinol (Ni-Ti) arched shape-memory connector (ASC). The clinical assessments were performed using the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire and the Mayo Elbow Performance (MEP) score, which were both recorded at the final follow-up visit. Results The patients were followed up for 44 months on average (range, 31 to 56 months). No patients were lost to follow-up, and all of the olecranon fractures healed in an average of 15 weeks (range, 10 to 34 weeks). The mean DASH score was 8.6 (range, 0 to 32.4), and the mean MEP score was 92.5 (range, 74 to 100). Nine patients showed postoperative complications: prominent hardware (2), infection (1), loss of the range of functional motion (5), and heterotopic ossification (1). Conclusion The ASC may serve as a favorable device for multi-fragmented and comminuted fractures with rare hardware irritation and may also provide continuous concentrative compression to accelerate osseous healing, thereby aiding the restoration and permitting an early rehabilitation with a low incidence of postoperative complications.
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Affiliation(s)
- Demeng Xia
- Department of Emergency, Changhai Hospital, the Naval Medical University, No.168, Changhai St, Shanghai, 200433, People's Republic of China.,Department of Orthopaedics, Eastern Theater Naval Hospital, No. 98, Wenhua St, Zhoushan, Zhejiang, 316000, People's Republic of China
| | - Panyu Zhou
- Department of Emergency, Changhai Hospital, the Naval Medical University, No.168, Changhai St, Shanghai, 200433, People's Republic of China
| | - Lei Li
- Department of Emergency, Changhai Hospital, the Naval Medical University, No.168, Changhai St, Shanghai, 200433, People's Republic of China
| | - Yan Xia
- Department of Emergency, Changhai Hospital, the Naval Medical University, No.168, Changhai St, Shanghai, 200433, People's Republic of China
| | - Zichen Hao
- Department of Emergency, Changhai Hospital, the Naval Medical University, No.168, Changhai St, Shanghai, 200433, People's Republic of China
| | - Yuntong Zhang
- Department of Emergency, Changhai Hospital, the Naval Medical University, No.168, Changhai St, Shanghai, 200433, People's Republic of China.
| | - Shuogui Xu
- Department of Emergency, Changhai Hospital, the Naval Medical University, No.168, Changhai St, Shanghai, 200433, People's Republic of China.
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A Novel Shape Memory Plate Osteosynthesis for Noninvasive Modulation of Fixation Stiffness in a Rabbit Tibia Osteotomy Model. BIOMED RESEARCH INTERNATIONAL 2015; 2015:652940. [PMID: 26167493 PMCID: PMC4475735 DOI: 10.1155/2015/652940] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 05/30/2015] [Indexed: 01/09/2023]
Abstract
Nickel-titanium shape memory alloy (NiTi-SMA) implants might allow modulating fracture healing, changing their stiffness through alteration of both elastic modulus and cross-sectional shape by employing the shape memory effect (SME). Hypotheses: a novel NiTi-SMA plate stabilizes tibia osteotomies in rabbits. After noninvasive electromagnetic induction heating the alloy exhibits the SME and the plate changes towards higher stiffness (inverse dynamization) resulting in increased fixation stiffness and equal or better bony healing. In 14 rabbits, 1.0 mm tibia osteotomies were fixed with our experimental plate. Animals were randomised for control or induction heating at three weeks postoperatively. Repetitive X-ray imaging and in vivo measurements of bending stiffness were performed. After sacrifice at 8 weeks, macroscopic evaluation, µCT, and post mortem bending tests of the tibiae were carried out. One death and one early implant dislocation occurred. Following electromagnetic induction heating, radiographic and macroscopic changes of the implant proved successful SME activation. All osteotomies healed. In the treatment group, bending stiffness increased over time. Differences between groups were not significant. In conclusion, we demonstrated successful healing of rabbit tibia osteotomies using our novel NiTi-SMA plate. We demonstrated shape-changing SME in-vivo through transcutaneous electromagnetic induction heating. Thus, future orthopaedic implants could be modified without additional surgery.
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Zbar AP, Nir Y, Weizman A, Rabau M, Senagore A. Compression anastomoses in colorectal surgery: a review. Tech Coloproctol 2012; 16:187-99. [PMID: 22534832 DOI: 10.1007/s10151-012-0825-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Accepted: 02/28/2012] [Indexed: 12/15/2022]
Abstract
The main serious risks of anastomotic construction in the colon and rectum include dehiscence and stricture formation. There is a resurgence of interest in sutureless anastomoses formed by compression elements since the introduction of shape memory alloy (SMA) systems, which evoke minimal early inflammatory response whilst maintaining anastomotic integrity. Currently, the most commonly used SMA is the nickel-titanium (NiTi) alloy that is highly biocompatible, returning to its pre-deformed stable (austenite) shape under different mechanical and thermal loads for use in humans. Pre-clinical data for shape memory alloy systems in colorectal anastomoses are limited, but it appears to be safe in porcine and canine models with limited leakage and reduced stricture formation. There does not appear to be any difference in tissue biochemistry of inflammatory markers when compared with conventional stapled techniques, although the few studies available show a markedly reduced early inflammatory response at the anastomotic site with the NiTi device. The majority of the clinical data concerning compression anastomoses are derived from the biofragmentable anastomotic ring device. This device has fallen out of use because of reported leaks, instrumental failure and problems with device expulsion. A novel SMA device, the NiTi anastomotic ring, permits construction of a low rectal anastomosis construction during open or laparoscopic procedures. The preliminary data demonstrate a safety comparable to conventional staple technology. This device also provides the potential of benefit of reduced anastomotic inflammation, because the compression ring results in direct serosa-to-serosa (or alternatively serosa-to-muscularis propria) apposition without the persistence of residual foreign material. This type of construction could lead to a reduced incidence of early anastomotic leakage and/or the development of anastomotic stenosis. Randomized clinical trials employing a NiTi arm for elective, emergency and high-risk colorectal anastomoses are required to determine its indications and clinical profile as well as to assess whether such technology may selectively obviate the need for proximal diversion in low colorectal anastomoses.
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Affiliation(s)
- A P Zbar
- Department of Surgery and Transplantation, Chaim Sheba Medical Center, Sackler Medical School, Tel Aviv University, Tel Aviv, Israel.
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Snoeren RM, Söderman M, Kroon JN, Roijers RB, de With PHN, Babic D. High-resolution 3D X-ray imaging of intracranial nitinol stents. Neuroradiology 2012; 54:155-62. [PMID: 21331601 PMCID: PMC3261414 DOI: 10.1007/s00234-011-0839-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Accepted: 01/26/2011] [Indexed: 11/17/2022]
Abstract
INTRODUCTION To assess an optimized 3D imaging protocol for intracranial nitinol stents in 3D C-arm flat detector imaging. For this purpose, an image quality simulation and an in vitro study was carried out. METHODS Nitinol stents of various brands were placed inside an anthropomorphic head phantom, using iodine contrast. Experiments with objects were preceded by image quality and dose simulations. We varied X-ray imaging parameters in a commercially interventional X-ray system to set 3D image quality in the contrast-noise-sharpness space. Beam quality was varied to evaluate contrast of the stents while keeping absorbed dose below recommended values. Two detector formats were used, paired with an appropriate pixel size and X-ray focus size. Zoomed reconstructions were carried out and snapshot images acquired. High contrast spatial resolution was assessed with a CT phantom. RESULTS We found an optimal protocol for imaging intracranial nitinol stents. Contrast resolution was optimized for nickel-titanium-containing stents. A high spatial resolution larger than 2.1 lp/mm allows struts to be visualized. We obtained images of stents of various brands and a representative set of images is shown. Independent of the make, struts can be imaged with virtually continuous strokes. Measured absorbed doses are shown to be lower than 50 mGy Computed Tomography Dose Index (CTDI). CONCLUSION By balancing the modulation transfer of the imaging components and tuning the high-contrast imaging capabilities, we have shown that thin nitinol stent wires can be reconstructed with high contrast-to-noise ratio and good detail, while keeping radiation doses within recommended values. Experimental results compare well with imaging simulations.
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Affiliation(s)
- Rudolph M Snoeren
- Faculty Electrical Engineering, Signal Processing Systems group (SPS), Eindhoven University of Technology (TU/e), Laplace Building 028, Postbox 513, 5600MB, Eindhoven, The Netherlands.
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Abstract
Shape memory alloys, and in particular NiTi alloys, are characterized by two unique behaviors,
thermally or mechanically activated: the shape memory effect and pseudo-elastic effect. These
behaviors, due to the peculiar crystallographic structure of the alloys, assure the recovery of the original shape even after large deformations and the maintenance of a constant applied force in correspondence of significant displacements. These properties, joined with good corrosion and bending resistance, biological and magnetic resonance compatibility, explain the large diffusion, in the last 20 years, of SMA in the production of biomedical devices, in particular for mini-invasive techniques. In this paper a detailed review of the main applications of NiTi alloys in dental, orthopedics, vascular, neurological, and surgical fields is presented. In particular for each device the main characteristics and the advantages of using SMA are discussed. Moreover, the paper underlines the opportunities and the room for new ideas able to enlarge the range of SMA applications. However, it is fundamental to remember that the complexity of the material and application requires a strict collaboration between clinicians, engineers, physicists and chemists for defining accurately the problem, finding the best solution in terms of device design and accordingly optimizing the NiTi alloy properties.
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