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Degradation behavior of ZE21C magnesium alloy suture anchors and their effect on ligament-bone junction repair. Bioact Mater 2023; 26:128-141. [PMID: 36891259 PMCID: PMC9986500 DOI: 10.1016/j.bioactmat.2023.02.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 02/18/2023] [Accepted: 02/18/2023] [Indexed: 03/04/2023] Open
Abstract
Current materials comprising suture anchors used to reconstruct ligament-bone junctions still have limitation in biocompatibility, degradability or mechanical properties. Magnesium alloys are potential bone implant materials, and Mg2+ has been shown to promote ligament-bone healing. Here, we used Mg-2 wt.% Zn-0.5 wt.% Y-1 wt.% Nd-0.5 wt.% Zr (ZE21C) alloy and Ti6Al4V (TC4) alloy to prepare suture anchors to reconstruct the patellar ligament-tibia in SD rats. We studied the degradation behavior of the ZE21C suture anchor via in vitro and in vivo experiments and assessed its reparative effect on the ligament-bone junction. In vitro, the ZE21C suture anchor degraded gradually, and calcium and phosphorus products accumulated on its surface during degradation. In vivo, the ZE21C suture anchor could maintain its mechanical integrity within 12 weeks of implantation in rats. The tail of the ZE21C suture anchor in high stress concentration degraded rapidly during the early implantation stage (0-4weeks), while bone healing accelerated the degradation of the anchor head in the late implantation stage (4-12weeks). Radiological, histological, and biomechanical assays indicated that the ZE21C suture anchor promoted bone healing above the suture anchor and fibrocartilaginous interface regeneration in the ligament-bone junction, leading to better biomechanical strength than the TC4 group. Hence, this study provides a basis for further research on the clinical application of degradable magnesium alloy suture anchors.
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Siegler S, Taghvaei M, Zegarski R, Palmese G, Mathew R, Schayes J, Schaer T, Najafi A. A porous swelling copolymeric material for improved implant fixation to bone. J Biomed Mater Res B Appl Biomater 2023; 111:1342-1350. [PMID: 36815442 DOI: 10.1002/jbm.b.35238] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 02/10/2023] [Indexed: 02/24/2023]
Abstract
Most metallic commercial bone anchors, such as screws and suture anchors achieve their fixation to bone through shear of the bone located between the threads. They have several deficiencies, potentially leading to failure, which are particularly evident in low-density bone. These include stress-shielding resulting from mechanical properties mismatch; lack of mechanically induced remodeling and osteointegration; and when the pullout force on the anchor, during functional activities, exceeds their pullout strength, catastrophic failure occurs leaving behind large bone defects that may be hard to repair. To overcome these deficiencies, we introduced in this study a porous swelling co-polymeric material and studied its swelling and compressive mechanical characteristics as bone anchor under different configurations. Porosity was achieved by adding a non-dissolvable agent (NaCl) during the process of polymerization, which was later dissolved in water, leaving behind a porous structure with adequate porosity for osteointegration. Three different groups of cylindrical samples of the swelling co-polymer were investigated. Solid, fully porous, and partially porous with a solid core and a porous outer layer. The results of the swelling and simple compression study show that the partially porous swelling co-polymer maintains excellent mechanical properties matching those of cancellous bone, quick swelling response, and an adequate porous outer layer for mechanically induced osteointegration. These suggest that this material may present an effective alternative to conventional bone anchors particularly in low-density bone.
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Affiliation(s)
- Sorin Siegler
- Department of Mechanical Engineering, Drexel University, Philadelphia, Pennsylvania, USA
| | - Moein Taghvaei
- Department of Mechanical Engineering, Drexel University, Philadelphia, Pennsylvania, USA
| | - Ryan Zegarski
- Department of Mechanical Engineering, Drexel University, Philadelphia, Pennsylvania, USA
| | - Giuseppe Palmese
- College of Engineering, Rowan University, Glassboro, New Jersey, USA
| | - Rena Mathew
- Department of Mechanical Engineering, Drexel University, Philadelphia, Pennsylvania, USA
| | - Julia Schayes
- School of Veterniary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Thomas Schaer
- School of Veterniary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ahmad Najafi
- Department of Mechanical Engineering, Drexel University, Philadelphia, Pennsylvania, USA
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Biocompatibility and Biological Performance of Additive-Manufactured Bioabsorbable Iron-Based Porous Interference Screws in a Rabbit Model: A 1-Year Observational Study. Int J Mol Sci 2022; 23:ijms232314626. [PMID: 36498952 PMCID: PMC9740248 DOI: 10.3390/ijms232314626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/20/2022] [Accepted: 11/20/2022] [Indexed: 11/24/2022] Open
Abstract
This study evaluated the mid-term (12-month) biomechanical, biocompatibility, and biological performance of additive-manufactured bioabsorbable iron-based interference screws (ISs). Two bioabsorbable iron IS types-manufactured using pure iron powder (iron_IS) and using pure iron powder with 0.2 wt% tricalcium phosphate (TCP_IS)-were compared with conventional metallic IS (control) using in vitro biocompatibility and degradation analyses and an in vivo animal study. The in vitro ultimate failure strength was significantly higher for iron_IS and TCP_IS than for control ISs at 3 months post-operatively; however, the difference between groups were nonsignificant thereafter. Moreover, at 3 months after implantation, iron_IS and TCP_IS increased bone volume fraction, bone surface area fraction, and percent intersection surface; the changes thereafter were nonsignificant. Iron_IS and TCP_IS demonstrated degradation over time with increased implant surface, decreased implant volume, and structure thickness; nevertheless, the analyses of visceral organs and biochemistry demonstrated normal results, except for time-dependent iron deposition in the spleen. Therefore, compared with conventional ISs, bioabsorbable iron-based ISs exhibit higher initial mechanical strength. Although iron-based ISs demonstrate high biocompatibility 12 months after implantation, their corrosive iron products may accumulate in the spleen. Because they demonstrate mechanical superiority along with considerable absorption capability after implantation, iron-based ISs may have potential applications in implantable medical-device development in the future.
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Liu WC, Chang CH, Chen CH, Lu CK, Ma CH, Huang SI, Fan WL, Shen HH, Tsai PI, Yang KY, Fu YC. 3D-Printed Double-Helical Biodegradable Iron Suture Anchor: A Rabbit Rotator Cuff Tear Model. MATERIALS 2022; 15:ma15082801. [PMID: 35454494 PMCID: PMC9027822 DOI: 10.3390/ma15082801] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/07/2022] [Accepted: 04/07/2022] [Indexed: 12/16/2022]
Abstract
Suture anchors are extensively used in rotator cuff tear surgery. With the advancement of three-dimensional printing technology, biodegradable metal has been developed for orthopedic applications. This study adopted three-dimensional-printed biodegradable Fe suture anchors with double-helical threads and commercialized non-vented screw-type Ti suture anchors with a tapered tip in the experimental and control groups, respectively. The in vitro study showed that the Fe and Ti suture anchors exhibited a similar ultimate failure load in 20-pound-per-cubic-foot polyurethane foam blocks and rabbit bone. In static immersion tests, the corrosion rate of Fe suture anchors was 0.049 ± 0.002 mm/year. The in vivo study was performed on New Zealand white rabbits and SAs were employed to reattach the ruptured supraspinatus tendon. The in vivo ultimate failure load of the Fe suture anchors was superior to that of the Ti suture anchors at 6 weeks. Micro-computed tomography showed that the bone volume fraction and bone surface density in the Fe suture anchors group 2 and 6 weeks after surgery were superior, and the histology confirmed that the increased bone volume around the anchor was attributable to mineralized osteocytes. The three-dimensional-printed Fe suture anchors outperformed the currently used Ti suture anchors.
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Affiliation(s)
- Wen-Chih Liu
- Ph.D. Program in Biomedical Engineering, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan; (W.-C.L.); (C.-H.C.)
- Department Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Regeneration Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Orthopedic Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Chih-Hau Chang
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan;
| | - Chung-Hwan Chen
- Ph.D. Program in Biomedical Engineering, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan; (W.-C.L.); (C.-H.C.)
- Department Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Regeneration Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Orthopedic Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Graduate Institute of Animal Vaccine Technology, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung 912301, Taiwan
- Department of Orthopedic Surgery, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Orthopedics, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung 80420, Taiwan
| | - Chun-Kuan Lu
- Department of Orthopedic Surgery, Park One International Hospital, Kaohsiung 81367, Taiwan;
| | - Chun-Hsien Ma
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu 31057, Taiwan; (C.-H.M.); (S.-I.H.); (W.-L.F.); (H.-H.S.); (P.-I.T.)
| | - Shin-I Huang
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu 31057, Taiwan; (C.-H.M.); (S.-I.H.); (W.-L.F.); (H.-H.S.); (P.-I.T.)
| | - Wei-Lun Fan
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu 31057, Taiwan; (C.-H.M.); (S.-I.H.); (W.-L.F.); (H.-H.S.); (P.-I.T.)
| | - Hsin-Hsin Shen
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu 31057, Taiwan; (C.-H.M.); (S.-I.H.); (W.-L.F.); (H.-H.S.); (P.-I.T.)
| | - Pei-I Tsai
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu 31057, Taiwan; (C.-H.M.); (S.-I.H.); (W.-L.F.); (H.-H.S.); (P.-I.T.)
| | - Kuo-Yi Yang
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu 31057, Taiwan; (C.-H.M.); (S.-I.H.); (W.-L.F.); (H.-H.S.); (P.-I.T.)
- Correspondence: (K.-Y.Y.); (Y.-C.F.)
| | - Yin-Chih Fu
- Ph.D. Program in Biomedical Engineering, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan; (W.-C.L.); (C.-H.C.)
- Department Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Regeneration Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Orthopedic Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan;
- Department of Orthopedics, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Correspondence: (K.-Y.Y.); (Y.-C.F.)
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