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Yang Z, Lu J, Yan T, Ibrahim M, Wang Q, Tan L, Wang Q, Mu Y, Gao Y. Construction of a Titanium-Magnesium Composite Internal Fixation System for Repairing Bone Defects. ACS Biomater Sci Eng 2024. [PMID: 39163588 DOI: 10.1021/acsbiomaterials.4c00949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2024]
Abstract
The repair and regeneration of maxillofacial bone defects are major clinical challenges. Titanium (Ti)-magnesium (Mg) composites are a new generation of revolutionary internal fixation materials encompassing the mechanical strength and bioactive advantages of Ti and Mg alloys, respectively. This study was aimed to construct a Ti-Mg composite internal plate/screw fixation system to fix and repair bone defects. Further, the effects of different internal fixation systems on bone repair were analyzed through radiological and histological analyses. Notably, Ti6Al4V with rolled Mg foil was used as the experimental group, and a bone defect model of transverse complete amputation of the ulna in rabbits similar to the clinical condition was established. The internal fixation system with the highest osteogenic efficiency was selected based on in vivo results, and the direct and indirect bone repair abilities of the selected materials were evaluated in vitro. Notably, the thin Mg foil-Ti6Al4V internal fixation system exhibited the best fixation effect in the bone defect model and promoted the formation of new bone and early healing of bone defect areas. In vitro, the thin Mg foil-Ti6Al4V composite enhanced the activity of MC3T3-E1 cells; promoted the proliferation, adhesion, extension, and osteogenic differentiation of MC3T3-E1 cells; and regulated new bone formation. Further, it also promoted the polarization of RAW264.7 cells to M2 macrophages, induced the osteogenic immune microenvironment, and indirectly regulated the bone repair process. Therefore, a internal fixation system holds a promising potential for the internal fixation of maxillofacial bone defects. Our findings provide a theoretical and scientific basis for the design and clinical application of Ti-Mg internal fixation systems.
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Affiliation(s)
- Zhongheng Yang
- The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning 121001, China
| | - Jiarui Lu
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang 110001, China
| | - Tao Yan
- Department of Orthopedics and Sports Medicine and Joint Surgery, The People's Hospital of China Medical University, Shenyang, Liaoning 110016, China
| | - Muhammad Ibrahim
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
- School of Materials Science and Engineering, University of Science and Technology of China, Shenyang 110016, China
| | - Qingchuan Wang
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| | - Lili Tan
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016, China
| | - Qiang Wang
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang 110001, China
| | - Yabing Mu
- Department of Medical Bioscience, Building 6M, Umeå University, SE 90185 Umeå, Sweden
| | - Yuzhong Gao
- The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning 121001, China
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Liu Y, Wang W, Zeng Y, Zeng H. Transcriptome analysis of hydrogen inhibits osteoclastogenesis of mouse bone marrow mononuclear cells. Exp Ther Med 2023; 26:436. [PMID: 37614423 PMCID: PMC10443061 DOI: 10.3892/etm.2023.12135] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 09/01/2022] [Indexed: 08/25/2023] Open
Abstract
Hydrogen (H2) is a major biodegradation product of implanted magnesium (Mg) alloys that are commonly used in the healing of bone fractures. Our earlier study showed that H2 can inhibit mouse bone marrow mononuclear cell (BMMC) osteoclastogenesis during the differentiation of these cells into osteoclasts, thereby facilitating fracture healing. However, the way by which H2 inhibits osteoclastogenesis remains to be elucidated. The present study used RNA-sequencing to study the transcriptome of H2-exposed BMMCs in an osteoclast-induced environment and identified the target genes and signaling pathways through which H2 exerts its biological effects. Several upregulated genes were identified: Fos, Dusp1, Cxcl1, Reln, Itga2b, Plin2, Lif, Thbs1, Vegfa and Gadd45a. Several downregulated genes were also revealed: Hspa1b, Gm4951, F830016B08Rik, Fads2, Hspa1a, Slc27a6, Cacna1b, Scd2, Lama3 and Col4a5. These differentially expressed genes were mainly involved in osteoclast differentiation cascades, as well as PI3K-AKT, Forkhead box O (FoxO), MAPK, peroxisome proliferator-activated receptor (PPAR), TNF, TGF-β, JAK-STAT, RAS, VEGF, hypoxia-inducible factor (HIF-1) and AMPK signaling pathways. In summary, the present study revealed the key genes and signaling pathways involved in the H2-mediated inhibition of osteoclastogenesis, thereby providing a theoretical basis for the significance of H2 and an experimental basis for the application of Mg alloys in the treatment of osteoporosis.
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Affiliation(s)
- Yong Liu
- Department of Orthopedics, Chengdu Second People's Hospital, Chengdu, Sichuan 610017, P.R. China
| | - Wei Wang
- Department of Human Anatomy and Histoembryology, Zhuhai Campus of Zunyi Medical University, Zhuhai, Guangdong 519041, P.R. China
| | - Yong Zeng
- Department of Orthopedics, Chengdu Second People's Hospital, Chengdu, Sichuan 610017, P.R. China
| | - Hui Zeng
- Department of Bone and Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
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[Clinical study of a new biodegradable magnesium internal fixation screw in treatment of osteonecrosis of the femoral head]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2022; 36:1343-1350. [PMID: 36382450 PMCID: PMC9681592 DOI: 10.7507/1002-1892.202206055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate the safety and efficacy of a new biodegradable magnesium internal fixation screw for vascularized iliac bone flap grafting in treatment of osteonecrosis of the femoral head (ONFH). METHODS Patients with ONFH admitted between July 2020 and February 2021 were selected as the research objects, and 20 patients (20 hips) met the selection criteria and were included in the study. The patients were divided into two groups ( n=10) by central random method. The iliac bone flap was fixed with a new biodegradable magnesium internal fixation screw in the trial group, and the iliac bone flap was wedged directly in the control group. There was no significant difference ( P>0.05) in gender, age, and side, type, Association Research Circulation Osseous (ARCO) stage, and disease duration of ONFH between the two groups. The operation time and intraoperative blood loss of the two groups were recorded. Laboratory tests were performed at each time point before and after operation, including white blood cell (WBC), electrolytes (K, Ca, P, Mg), blood urea nitrogen (BUN), serum creatinine (Scr), glomerular filtration rate (eGFR), lymphocyte ratio (CD4/CD8), immunoglobulin G (IgG), IgM, alanine transaminase (ALT), aspartate aminotransferase (AST). After operation, Harris score was used to evaluate the hip joint function. CT of the hip joint and X-ray films in anteroposterior and frog positions of the pelvis were used to review the iliac bone flap position, fusion, and screw biodegradation in the trial group. RESULTS The vital signs of the two groups were stable, the incisions healed by first intention, and no adverse events occurred after operation. One patient in the control group refused to return to the hospital for follow-up at 3 months after operation, and 1 patient in the trial group refused to return to the hospital for follow-up at 1 year after operation. The rest of the patients completed the follow-up at 2 weeks, 3 months, 6 months, and 1 year after operation. Laboratory tests showed that there was no significant difference in WBC, electrolytes (K, Ca, P, Mg), BUN, Scr, eGFR, CD4/CD8, IgG, IgM, ALT, and AST between the two groups at each time point before and after operation ( P>0.05). The operation time and intraoperative blood loss of the trial group were significantly less than those of the control group ( P<0.05). The Harris scores of the two groups at 1 year significantly increased when compared with the values before operation and at 6 months after operation ( P<0.05). There was no significant difference in Harris score between the two groups at each time point ( P>0.05). Postoperative CT of hip joint and X-ray films of pelvis showed that the iliac bone flap reached osseous fusion with the fenestration of the head and neck junction of femoral head in the two groups at 1 year after operation, and no loosening or shedding of iliac bone flap was observed during follow-up. In the trial group, there were signs of dissolution and absorption of the new biodegradable magnesium internal fixation screws after operation, and the diameter of the screws gradually decreased ( P<0.05); no screw breakage or detachment occurred during follow-up. CONCLUSION In the treatment of ONFH with vascularized iliac bone flap grafting, the new biodegradable magnesium internal fixation screws can fix the iliac bone flap firmly. Compared with the traditional iliac bone flap wedging directly, it has a shorter operation time, less intraoperative blood loss, and can obtain similar joint function.
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Shan Z, Xie X, Wu X, Zhuang S, Zhang C. Development of degradable magnesium-based metal implants and their function in promoting bone metabolism (A review). J Orthop Translat 2022; 36:184-193. [PMID: 36263386 PMCID: PMC9552026 DOI: 10.1016/j.jot.2022.09.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/05/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022] Open
Abstract
Background Use of degradable magnesium (Mg)-based metal implants in orthopaedic surgeries can avoid drawbacks associated with subsequent removal of the non-degradable metallic implants, reducing cost and trauma of patients. Although Mg has been applied in the clinic for orthopaedic treatment, the use of Mg-based metal implants is largely in the research phase. But its application is potentially beneficial in this context as it has been shown that Mg can promote osteogenesis and inhibit osteoclast activity. Methods A systematic literature search about “degradable magnesium (Mg)-based metal implants” was performed in PubMed and Web of Science. Meanwhile, relevant findings have been reviewed and quoted. Results In this review, we summarize the latest developments in Mg-based metal implants and their role in bone regeneration. We also review the various molecular mechanisms by which Mg ions regulate bone metabolic processes, including osteogenesis, osteoclast activity, angiogenesis, immunity, and neurology. Finally, we discuss the remaining research challenges and opportunities for Mg-based implants and their applications. Conclusion Currently, establishment of the in vitro and in vivo biological evaluation systems and phenotypic modification improvement of Mg-based implants are still needed. Clarifying the functions of Mg-based metal implants in promoting bone metabolism is beneficial for their clinical application. The Translational potential of this article All current reviews on Mg-based implants are mainly concerned with the improvement of Mg alloy properties or the progress of applications. However, there are few reviews that provides a systematic narrative on the effect of Mg on bone metabolism. This review summarized the latest developments in Mg-based metal implants and various molecular mechanisms of Mg ions regulating bone metabolism, which is beneficial to further promote the translation of Mg based implants in the clinic and is able to provide a strong basis for the clinical application of Mg based implants.
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Affiliation(s)
- Zhengming Shan
- School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China
| | - Xinhui Xie
- School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China
- The Department of Orthopaedics, ZhongDa Hospital, Nanjing, Jiangsu, 210009, China
- Corresponding author. The Department of Orthopaedics, ZhongDa hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China.
| | - Xiaotao Wu
- School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China
- The Department of Orthopaedics, ZhongDa Hospital, Nanjing, Jiangsu, 210009, China
- Corresponding author. The Department of Orthopaedics, ZhongDa hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China.
| | - Suyang Zhuang
- School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China
- The Department of Orthopaedics, ZhongDa Hospital, Nanjing, Jiangsu, 210009, China
| | - Cong Zhang
- School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China
- The Department of Orthopaedics, ZhongDa Hospital, Nanjing, Jiangsu, 210009, China
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Guo X, Wang Q. Magnesium-based biodegradable metal materials: past, present and future. BIOMATERIALS TRANSLATIONAL 2021; 2:175-176. [PMID: 35836653 PMCID: PMC9255804 DOI: 10.12336/biomatertransl.2021.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Xiaodong Guo
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China,Corresponding authors: Xiaodong Guo, ; Qian Wang,
| | - Qian Wang
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA,Corresponding authors: Xiaodong Guo, ; Qian Wang,
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