1
|
Deichsel A, Glasbrenner J, Raschke MJ, Klimek M, Peez C, Briese T, Herbst E, Kittl C. Interference screws manufactured from magnesium display similar primary stability for soft tissue anterior cruciate ligament graft fixation compared to a biocomposite material - a biomechanical study. J Exp Orthop 2023; 10:103. [PMID: 37815666 PMCID: PMC10564698 DOI: 10.1186/s40634-023-00663-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 09/20/2023] [Indexed: 10/11/2023] Open
Abstract
PURPOSE Biodegradable interference screws (IFS) can be manufactured from different biomaterials. Magnesium was previously shown to possess osteoinductive properties, making it a promising material to promote graft-bone healing in anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to compare IFS made from magnesium to a contemporary biocomposite IFS. METHODS In a porcine model of ACL reconstruction, deep porcine flexor tendons were trimmed to a diameter of 8 mm, sutured in Krackow technique, and fixed with either 8 × 30 mm biocomposite IFS (Bc-IFS) or 8 × 30 mm magnesium IFS (Mg-IFS) in an 8 mm diameter bone tunnel in porcine tibiae. Cyclic loading for 1000 cycles from 0 to 250 N was applied, followed by load to failure testing. Elongation, load to failure and stiffness of the tested constructs was determined. RESULTS After 1000 cycles at 250 N, elongation was 4.8 mm ± 1.5 in the Bc-IFS group, and 4.9 mm ± 1.5 in the Mg-IFS group. Load to failure was 649.5 N ± 174.3 in the Bc-IFS group, and 683.8 N ± 116.5 in the Mg-IFS group. Stiffness was 125.3 N/mm ± 21.9 in the Bc-IFS group, and 122.5 N/mm ± 20.3 in the Mg-IFS group. No significant differences regarding elongation, load to failure and stiffness between Bc-IFS and Mg-IFS were observed. CONCLUSION Magnesium IFS show comparable biomechanical primary stability in comparison to biocomposite IFS and may therefore be an alternative to contemporary biodegradable IFS.
Collapse
Affiliation(s)
- Adrian Deichsel
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - Johannes Glasbrenner
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - Michael J Raschke
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - Matthias Klimek
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - Christian Peez
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - Thorben Briese
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - Elmar Herbst
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany
| | - Christoph Kittl
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus, Building W1, 48149, Münster, Germany.
| |
Collapse
|
2
|
Söntgen S, Keilig L, Kabir K, Weber A, Reimann S, Welle K, Bourauel C. Mechanical and numerical investigations of biodegradable magnesium alloy screws for fracture treatment. J Biomed Mater Res B Appl Biomater 2023; 111:7-15. [PMID: 35796311 DOI: 10.1002/jbm.b.35127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 11/11/2022]
Abstract
Small fracture treatment includes the use of so-called "Herbert screws". In the past years, novel resorbable materials were introduced as an alternative to the classical titanium implants. The purpose of this study was to evaluate the influence of ongoing resorption/corrosion processes on the mechanical stability screws made from the magnesium alloy MgYREZr®. Our samples consisted of two partly resorbed screws, explanted due to medical reasons after 6 and 12 weeks, respectively, and five unused reference screws. We performed three-point bending tests to determine the stability of all screws. Additionally, with FE-models of the screws based on μCT-scans, we investigated whether any differences in the bending behavior of the screws can be attributed to the reduction of the material volume due to resorption alone. Both partly resorbed screws failed at a lower force than the reference screws (178.6 ± 5.5 N for the reference screws, 72.5 N and 74.5 N for the screw explanted after 6 and 12 weeks, respectively). FE simulations performed with the three different geometries and original material parameters (Young's modulus Enew = 45 GPa, yield limit σnew = 235 MPa) showed that the early fracture could not be attributed to the changed geometry alone. Material parameters for the partly resorbed screws were determined by fitting the numerical to the experimental force-displacement curves (E6week = 15 GPa, σ6week = 135 MPa and E12week = 8 GPa, σ12week = 135 MPa, respectively). Our results showed that both geometry of the screws and different material properties contribute to the overall stability. Understanding and controlling these two factors throughout the resorption process could enhance treatment options.
Collapse
Affiliation(s)
- Sabrina Söntgen
- Oral Technology, Medical Faculty, University of Bonn, Bonn, Germany
| | - Ludger Keilig
- Department of Prosthetic Dentistry, Preclinical Education and Materials Science, Medical Faculty, University of Bonn, Bonn, Germany
| | - Koroush Kabir
- Department of Orthopedic and Trauma Surgery, Medical Faculty, University of Bonn, Bonn, Germany
| | - Anna Weber
- Oral Technology, Medical Faculty, University of Bonn, Bonn, Germany
| | - Susanne Reimann
- Oral Technology, Medical Faculty, University of Bonn, Bonn, Germany
| | - Kristian Welle
- Department of Orthopedic and Trauma Surgery, Medical Faculty, University of Bonn, Bonn, Germany
| | | |
Collapse
|
3
|
Degradable Pure Magnesium Used as a Barrier Film for Oral Bone Regeneration. J Funct Biomater 2022; 13:jfb13040298. [PMID: 36547558 PMCID: PMC9781112 DOI: 10.3390/jfb13040298] [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: 11/04/2022] [Revised: 12/08/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
The barrier membrane plays an extremely critical role in guided bone regeneration (GBR), which determines the success or failure of GBR technology. In order to obtain barrier membranes with high mechanical strength and degradability, some researchers have focused on degradable magnesium alloys. However, the degradation rate of pure Mg-based materials in body fluids is rather fast, thus posing an urgent problem to be solved in oral clinics. In this study, a novel micro-arc oxidation (MAO) surface-treated pure Mg membrane was prepared. Electrochemical tests, immersion experiments and in vivo experiments were carried out to investigate its potential use as a barrier membrane. The experimental results showed that the corrosion resistance of a pure Mg membrane treated by MAO is better than that of the uncoated pure Mg. The results of cell experiments showed no obvious cytotoxicity, which suggests the enhanced differentiation of osteoblasts. At the same time, the MAO-Mg membrane showed better biological activity than the pure Ti membrane in the early stage of implantation, exhibiting relatively good bone regeneration ability. Consequently, the MAO membrane has been proven to possess good application prospects for guided bone regeneration.
Collapse
|
4
|
Mechanical Analysis and Corrosion Analysis of Zinc Alloys for Bioabsorbable Implants for Osteosynthesis. MATERIALS 2022; 15:ma15020421. [PMID: 35057136 PMCID: PMC8781263 DOI: 10.3390/ma15020421] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/18/2021] [Accepted: 12/29/2021] [Indexed: 01/27/2023]
Abstract
Zinc alloys have recently been researched intensely for their great properties as bioabsorbable implants for osteosynthesis. Pure zinc (Zn) itself has relatively poor strength, which makes it insufficient for most clinical use. Research has already proven that the mechanical strength of zinc can be enhanced significantly by alloying it with silver. This study evaluated zinc silver alloys (ZnAg) as well as novel zinc silver titanium alloys (ZnAgTi) regarding their mechanical properties for the use as bioabsorbable implants. Compared to pure zinc the mechanical strength was enhanced significantly for all tested zinc alloys. The elastic properties were only enhanced significantly for the zinc silver alloys ZnAg6 and ZnAg9. Regarding target values for orthopedic implants proposed in literature, the best mechanical properties were measured for the ZnAg3Ti1 alloy with an ultimate tensile strength of 262 MPa and an elongation at fracture of 16%. Besides the mechanical properties, the corrosion rates are important for bioabsorbable implants. This study tested the corrosion rates of zinc alloys in PBS solution (phosphate buffered solution) with electrochemical corrosion measurement. Zinc and its alloys showed favorable corrosion rates, especially in comparison to magnesium, which has a much lower degradation rate and no buildup of hydrogen gas pockets during the process. Altogether, this makes zinc alloys highly favorable for use as material for bioabsorbable implants for osteosynthesis.
Collapse
|
5
|
Zainal Abidin NA, Abdul Wahab AH, Abdul Rahim RA, Abdul Kadir MR, Ramlee MH. Biomechanical analysis of three different types of fixators for anterior cruciate ligament reconstruction via finite element method: a patient-specific study. Med Biol Eng Comput 2021; 59:1945-1960. [PMID: 34392448 DOI: 10.1007/s11517-021-02419-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/26/2021] [Indexed: 01/11/2023]
Abstract
Complication rates of anterior cruciate ligament reconstruction (ACL-R) were reported to be around 15% although it is a common arthroscopic procedure with good outcomes. Breakage and migration of fixators are still possible even months after surgery. A fixator with optimum stability can minimise those two complications. Factors that affect the stability of a fixator are its configuration, material, and design. Thus, this paper aims to analyse the biomechanical effects of different types of fixators (cross-pin, interference screw, and cortical button) towards the stability of the knee joint after ACL-R. In this study, finite element modelling and analyses of a knee joint attached with double semitendinosus graft and fixators were carried out. Mimics and 3-Matic softwares were used in the development of the knee joint models. Meanwhile, the graft and fixators were designed by using SolidWorks software. Once the meshes of all models were finished in 3-Matic, simulation of the configurations was done using MSC Marc Mentat software. A 100-N anterior tibial load was applied onto the tibia to simulate the anterior drawer test. Based on the findings, cross-pin was found to have optimum stability in terms of stress and strain at the femoral fixation site for better treatment of ACL-R.
Collapse
Affiliation(s)
- Nur Afikah Zainal Abidin
- Medical Devices & Technology Centre (MEDiTEC), Institute of Human Centered Engineering (iHumEn), Universiti Teknologi Malaysia, 81310, Johor Bahru, Johor, Malaysia.,Bioinspired Devices and Tissue Engineering (BIOINSPIRA) Group, School of Biomedical Engineering and Health Sciences, Faculty of Engineering, Universiti Teknologi Malaysia, 81310, Johor Bahru, Johor, Malaysia
| | - Abdul Hadi Abdul Wahab
- Centre for Multimodal Signal Processing, Faculty of Engineering and Technology, Tunku Abdul Rahman Universiti College, Jalan Genting Kelang, 53300, Setapak, Kuala Lumpur, Malaysia.,Department of Electrical and Electronics Engineering, Faculty of Engineering and Technology, Tunku Abdul Rahman Universiti College, Jalan Genting Kelang, 53300, Setapak, Kuala Lumpur, Malaysia
| | - Rabiatul Adibah Abdul Rahim
- Medical Devices & Technology Centre (MEDiTEC), Institute of Human Centered Engineering (iHumEn), Universiti Teknologi Malaysia, 81310, Johor Bahru, Johor, Malaysia
| | - Mohammed Rafiq Abdul Kadir
- Bioinspired Devices and Tissue Engineering (BIOINSPIRA) Group, School of Biomedical Engineering and Health Sciences, Faculty of Engineering, Universiti Teknologi Malaysia, 81310, Johor Bahru, Johor, Malaysia.,Sports Innovation and Technology Centre (SITC), Institute of Human Centered Engineering (iHumEn), Universiti Teknologi Malaysia, UTM, 81310, Johor Bahru, Johor, Malaysia
| | - Muhammad Hanif Ramlee
- Medical Devices & Technology Centre (MEDiTEC), Institute of Human Centered Engineering (iHumEn), Universiti Teknologi Malaysia, 81310, Johor Bahru, Johor, Malaysia. .,Bioinspired Devices and Tissue Engineering (BIOINSPIRA) Group, School of Biomedical Engineering and Health Sciences, Faculty of Engineering, Universiti Teknologi Malaysia, 81310, Johor Bahru, Johor, Malaysia.
| |
Collapse
|
6
|
Herber V, Okutan B, Antonoglou G, Sommer NG, Payer M. Bioresorbable Magnesium-Based Alloys as Novel Biomaterials in Oral Bone Regeneration: General Review and Clinical Perspectives. J Clin Med 2021; 10:jcm10091842. [PMID: 33922759 PMCID: PMC8123017 DOI: 10.3390/jcm10091842] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 02/07/2023] Open
Abstract
Bone preservation and primary regeneration is a daily challenge in the field of dental medicine. In recent years, bioresorbable metals based on magnesium (Mg) have been widely investigated due to their bone-like modulus of elasticity, their high biocompatibility, antimicrobial, and osteoconductive properties. Synthetic Mg-based biomaterials are promising candidates for bone regeneration in comparison with other currently available pure synthetic materials. Different alloys based on Mg were developed to fit clinical requirements. In parallel, advances in additive manufacturing offer the possibility to fabricate experimentally bioresorbable metallic porous scaffolds. This review describes the promising clinical results of resorbable Mg-based biomaterials for bone repair in osteosynthetic application and discusses the perspectives of use in oral bone regeneration.
Collapse
Affiliation(s)
- Valentin Herber
- Department of Dentistry and Oral Health, Division of Oral Surgery and Orthodontics, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria; (G.A.); (M.P.)
- Department of Orthopaedics and Traumatology, Medical University of Graz, Auenbruggerplatz 5/6, 8036 Graz, Austria; (B.O.); (N.G.S.)
- Correspondence:
| | - Begüm Okutan
- Department of Orthopaedics and Traumatology, Medical University of Graz, Auenbruggerplatz 5/6, 8036 Graz, Austria; (B.O.); (N.G.S.)
| | - Georgios Antonoglou
- Department of Dentistry and Oral Health, Division of Oral Surgery and Orthodontics, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria; (G.A.); (M.P.)
| | - Nicole G. Sommer
- Department of Orthopaedics and Traumatology, Medical University of Graz, Auenbruggerplatz 5/6, 8036 Graz, Austria; (B.O.); (N.G.S.)
| | - Michael Payer
- Department of Dentistry and Oral Health, Division of Oral Surgery and Orthodontics, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria; (G.A.); (M.P.)
| |
Collapse
|
7
|
ABIDIN NURAFIKAHZAINAL, KADIR MOHAMMEDRAFIQABDUL, RAMLEE MUHAMMADHANIF. BIOMECHANICAL EFFECTS OF DIFFERENT LENGTHS OF CROSS-PINS IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A FINITE ELEMENT ANALYSIS. J MECH MED BIOL 2020. [DOI: 10.1142/s0219519420500475] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Complication rates of anterior cruciate ligament reconstruction (ACL-R) were reported to be around 15%. Although it is a very common arthroscopic surgery with good outcomes, breakage and migration of fixators are still possible to occur due to stability issue. One of the factors that affects the mechanical stability of fixators is its length. Therefore, the aim of this paper is to analyze the biomechanical effects of different lengths of fixators (cross-pin technique) towards the stabilities of the knee joint after ACL-R. Finite element analyses of knee joint with DST grafts and fixators were carried out. Mimics and 3-Matic were used in the development of knee joint models, while the grafts and fixators were designed by using SolidWorks software. All models were remeshed in the 3-Matic and numerical analysis was performed via MSC.Marc Mentat software. A 100 N anterior tibial load was applied onto the tibia to simulate the anterior drawer test after the surgery and proximal femur was fixed at all degrees of freedom. Based on the findings, cross-pin with 40[Formula: see text]mm in length provided the most favorable option for better treatment of ACL-R, where it could promote osseointegration and preventing fracture.
Collapse
Affiliation(s)
- NUR AFIKAH ZAINAL ABIDIN
- Medical Devices & Technology Centre (MEDiTEC), Institute of Human Centered Engineering (iHumEn), Universiti Teknologi Malaysia, 81310 UTM Johor Bahru, Johor, Malaysia
- Bioinspired Devices and Tissue Engineering Group (BIOINSPIRA), Faculty of Engineering, School of Biomedical Engineering and Health Sciences, Universiti Teknologi Malaysia, 81310 UTM Johor Bahru, Johor, Malaysia
| | - MOHAMMED RAFIQ ABDUL KADIR
- Bioinspired Devices and Tissue Engineering Group (BIOINSPIRA), Faculty of Engineering, School of Biomedical Engineering and Health Sciences, Universiti Teknologi Malaysia, 81310 UTM Johor Bahru, Johor, Malaysia
- Sports Innovation and Technology Centre (SITC), Institute of Human Centered Engineering (iHumEn), Universiti Teknologi Malaysia, 81310 UTM Johor Bahru, Johor, Malaysia
| | - MUHAMMAD HANIF RAMLEE
- Medical Devices & Technology Centre (MEDiTEC), Institute of Human Centered Engineering (iHumEn), Universiti Teknologi Malaysia, 81310 UTM Johor Bahru, Johor, Malaysia
- Bioinspired Devices and Tissue Engineering Group (BIOINSPIRA), Faculty of Engineering, School of Biomedical Engineering and Health Sciences, Universiti Teknologi Malaysia, 81310 UTM Johor Bahru, Johor, Malaysia
| |
Collapse
|
8
|
Advances and Challenges of Biodegradable Implant Materials with a Focus on Magnesium-Alloys and Bacterial Infections. METALS 2018. [DOI: 10.3390/met8070532] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
9
|
|