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Sathishkumar S, Paulraj J, Chakraborti P, Muthuraj M. Comprehensive Review on Biomaterials and Their Inherent Behaviors for Hip Repair Applications. ACS APPLIED BIO MATERIALS 2023; 6:4439-4464. [PMID: 37871169 DOI: 10.1021/acsabm.3c00327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Developing biomaterials for hip prostheses is challenging and requires dedicated attention from researchers. Hip replacement is an inevitable and remarkable orthopedic therapy for enhancing the quality of patient life for those who have arthritis as well as trauma. Generally, five types of hip replacement procedures are successfully performed in the current medical market: total hip replacements, hip resurfacing, hemiarthroplasty, bipolar, and dual mobility systems. The average life span of artificial hip joints is about 15 years, and several studies have been conducted over the last 60 years to improve the performance and thereby increase the lifespan of artificial hip joints. Present-day prosthetic hip joints are linked to the wide availability of biomaterials. Metals, ceramics, and polymers are some of the most promising types of biomaterials; nevertheless, each biomaterial has advantages and disadvantages. Metals and ceramics fail in most applications owing to stress shielding and the emission of wear debris; ongoing research is being carried out to find a remedy to these unfavorable responses. Recent research found that polymers and composites based on polymers are significant alternative materials for artificial joints. With growing research and several biomaterials, recent reviews lag in effectively addressing hip implant materials' individual mechanical, tribological, and physiological behaviors. This Review comprehensively investigates the historical evolution of artificial hip replacement procedures and related biomaterials' mechanical, tribological, and biological characteristics. In addition, the most recent advances are also discussed to stimulate and guide future researchers as they seek more effective methods and synthesis of innovative biomaterials for hip arthroplasty application.
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Biswas A, Kurtulan D, Ngeru T, Azócar Guzmán A, Hanke S, Hartmaier A. Mechanical Behavior of Austenitic Steel under Multi-Axial Cyclic Loading. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1367. [PMID: 36836997 PMCID: PMC9963949 DOI: 10.3390/ma16041367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Low-nickel austenitic steel is subjected to high-pressure torsion fatigue (HPTF) loading, where a constant axial compression is overlaid with a cyclic torsion. The focus of this work lies on investigating whether isotropic J2 plasticity or crystal plasticity can describe the mechanical behavior during HPTF loading, particularly focusing on the axial creep deformation seen in the experiment. The results indicate that a J2 plasticity model with an associated flow rule fails to describe the axial creep behavior. In contrast, a micromechanical model based on an empirical crystal plasticity law with kinematic hardening described by the Ohno-Wang rule can match the HPTF experiments quite accurately. Hence, our results confirm the versatility of crystal plasticity in combination with microstructural models to describe the mechanical behavior of materials under reversing multiaxial loading situations.
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Affiliation(s)
- Abhishek Biswas
- Interdisciplinary Centre for Advanced Materials Simulation (ICAMS), Ruhr-Universität Bochum, Universitätstraße 150, 44801 Bochum, Germany
| | - Dzhem Kurtulan
- Chair of Materials Science and Engineering, Universität Duisburg-Essen, 47057 Duisburg, Germany
| | - Timothy Ngeru
- Chair of Materials Science and Engineering, Universität Duisburg-Essen, 47057 Duisburg, Germany
| | - Abril Azócar Guzmán
- Interdisciplinary Centre for Advanced Materials Simulation (ICAMS), Ruhr-Universität Bochum, Universitätstraße 150, 44801 Bochum, Germany
| | - Stefanie Hanke
- Chair of Materials Science and Engineering, Universität Duisburg-Essen, 47057 Duisburg, Germany
| | - Alexander Hartmaier
- Interdisciplinary Centre for Advanced Materials Simulation (ICAMS), Ruhr-Universität Bochum, Universitätstraße 150, 44801 Bochum, Germany
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Wang C, Ma Z, Yuan K, Ji T. Using scaffolds as drug delivery systems to treat bone tumor. NANOTECHNOLOGY 2022; 33:212002. [PMID: 35092950 DOI: 10.1088/1361-6528/ac5017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 01/28/2022] [Indexed: 06/14/2023]
Abstract
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.
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Affiliation(s)
- Caifeng Wang
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing 100190, People's Republic of China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Zijiu Ma
- College of Materials Science and Opto-Electronic Technology, University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Kemeng Yuan
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing 100190, People's Republic of China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Tianjiao Ji
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing 100190, People's Republic of China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
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Suwardi A, Wang F, Xue K, Han MY, Teo P, Wang P, Wang S, Liu Y, Ye E, Li Z, Loh XJ. Machine Learning-Driven Biomaterials Evolution. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2102703. [PMID: 34617632 DOI: 10.1002/adma.202102703] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/09/2021] [Indexed: 06/13/2023]
Abstract
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.
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Affiliation(s)
- Ady Suwardi
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - FuKe Wang
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - Kun Xue
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - Ming-Yong Han
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - Peili Teo
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - Pei Wang
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - Shijie Wang
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - Ye Liu
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - Enyi Ye
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - Zibiao Li
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - Xian Jun Loh
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
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Kumar CS, Singh G, Poddar S, Varshney N, Mahto SK, Podder AS, Chattopadhyay K, Rastogi A, Singh V, Mahobia GS. High-manganese and nitrogen stabilized austenitic stainless steel (Fe-18Cr-22Mn-0.65N): a material with a bright future for orthopedic implant devices. Biomed Mater 2021; 16. [PMID: 34517359 DOI: 10.1088/1748-605x/ac265e] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/13/2021] [Indexed: 01/08/2023]
Abstract
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.
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Affiliation(s)
- Chandra Shekhar Kumar
- Department of Metallurgical Engineering, IIT (BHU), Varanasi, Uttar Pradesh 221005, India
| | - Gaurav Singh
- Department of Orthopaedics, Varun Arjun Medical College, Banthra, Uttar Pradesh 242307, India
| | - Suruchi Poddar
- School of Biomedical Engineering, IIT (BHU), Varanasi, Uttar Pradesh 221005, India
| | - Neelima Varshney
- School of Biomedical Engineering, IIT (BHU), Varanasi, Uttar Pradesh 221005, India
| | - Sanjeev Kumar Mahto
- School of Biomedical Engineering, IIT (BHU), Varanasi, Uttar Pradesh 221005, India
| | - Arijit Saha Podder
- Research & Development, Jindal Stainless Limited, Hisar, Haryana 125005, India
| | - Kausik Chattopadhyay
- Department of Metallurgical Engineering, IIT (BHU), Varanasi, Uttar Pradesh 221005, India
| | - Amit Rastogi
- Department of Orthopaedics, Institute of Medical Sciences (BHU), Varanasi, Uttar Pradesh 221005, India
| | - Vakil Singh
- Department of Metallurgical Engineering, IIT (BHU), Varanasi, Uttar Pradesh 221005, India
| | - Girija Shankar Mahobia
- Department of Metallurgical Engineering, IIT (BHU), Varanasi, Uttar Pradesh 221005, India
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Radice S, Impergre A, Fischer A, Wimmer MA. Corrosion resistance of the nickel-free high-nitrogen steel FeCrMnMoN0.9 under simulated inflammatory conditions. J Biomed Mater Res B Appl Biomater 2020; 109:902-910. [PMID: 33159504 DOI: 10.1002/jbm.b.34754] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 09/03/2020] [Accepted: 10/21/2020] [Indexed: 11/09/2022]
Abstract
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 "RP ", 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 RP 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 RP 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.
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Affiliation(s)
- Simona Radice
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Amandine Impergre
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Alfons Fischer
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Markus A Wimmer
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
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Alendronate release from calcium phosphate cement for bone regeneration in osteoporotic conditions. Sci Rep 2018; 8:15398. [PMID: 30337567 PMCID: PMC6194021 DOI: 10.1038/s41598-018-33692-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 10/03/2018] [Indexed: 01/14/2023] Open
Abstract
Osteoporosis represents a major health problem in terms of compromising bone strength and increasing the risk of bone fractures. It can be medically treated with bisphosphonates, which act systemically upon oral or venous administration. Further, bone regenerative treatments in osteoporotic conditions present a challenge. Here, we focused on the development of a synthetic bone substitute material with local diminishing effects on osteoporosis. Composites were created using calcium phosphate cement (CPC; 60 wt%) and polylactic-co-glycolic acid (PLGA; 40 wt%), which were loaded with alendronate (ALN). In vitro results showed that ALN-loaded CPC/PLGA composites presented clinically suitable properties, including setting times, appropriate compressive strength, and controlled release of ALN, the latter being dependent on composite degradation. Using a rat femoral condyle bone defect model in osteoporotic animals, ALN-loaded CPC/PLGA composites demonstrated stimulatory effects on bone formation both within and outside the defect region.
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Torricelli P, Fini M, Giavaresi G, Giardino R. In vitro Models to Test Orthopedic Biomaterials in View of Their Clinical Application in Osteoporotic Bone. Int J Artif Organs 2018; 27:658-63. [PMID: 15478536 DOI: 10.1177/039139880402700803] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The development of in vitro cell cultures, in association with in vivo experimentation, greatly improved the characterization of biomaterials for orthopedic devices before their clinical use. In recent years an increasing interest has arisen in the use of both pathological osteoblast cultures and animal models to perform in vitro and in vivo tests on biomaterial behavior. A growing number of prostheses, in fact, are implanted in osteoporotic patients, due to the increasing age of the population. Moreover, the presence of osteoporosis may affect bone-biomaterial osteointegration in these patients. The present paper is a literature review and, after a short description of in vitro studies for characterization of osteoblasts derived from osteoporotic bone, the results of in vitro studies on biomaterial biocompatibility and osteointegration rate in the presence of osteoporotic bone derived osteoblast cultures are reported. Pathological cell culture models are able to demonstrate the different behavior of osteoblasts in response to biomaterials, when comparing normal and pathological conditions.
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Affiliation(s)
- P Torricelli
- Department of Experimental Surgery, Research Institute Codivilla Putti, Rizzoli Orthopedic Institute, Bologna, Italy
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9
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Talha M, Behera CK, Sinha OP. Promising in vitro performances of nickel-free nitrogen containing stainless steels for orthopaedic applications. BULLETIN OF MATERIALS SCIENCE 2014; 37:1321-1330. [DOI: 10.1007/s12034-014-0078-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Talha M, Behera C, Sinha O. In-vitro long term and electrochemical corrosion resistance of cold deformed nitrogen containing austenitic stainless steels in simulated body fluid. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2014; 40:455-66. [DOI: 10.1016/j.msec.2014.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 02/18/2014] [Accepted: 04/03/2014] [Indexed: 10/25/2022]
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Effect of cold working on biocompatibility of Ni-free high nitrogen austenitic stainless steels using Dalton's Lymphoma cell line. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2014; 35:77-84. [PMID: 24411354 DOI: 10.1016/j.msec.2013.10.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 10/05/2013] [Accepted: 10/19/2013] [Indexed: 11/20/2022]
Abstract
The aims of the present work are to explore the effect of cold working on in-vitro biocompatibility of indigenized low cost Ni-free nitrogen containing austenitic stainless steels (HNSs) and to compare it with conventionally used biomedical grade, i.e. AISI 316L and 316LVM, using Dalton's Lymphoma (DL) cell line. The MTT assay [3-(4,5-dimethythiazol 2-yl)-2,5-diphenyltetrazolium bromide] was performed on DL cell line for cytotoxicity evaluation and cell adhesion test. As a result, it was observed that the HNS had higher cell proliferation and cell growth and it increases by increasing nitrogen content and degree of cold working. The surface wettability of the alloys was also investigated by water contact angle measurements. The value of contact angles was found to decrease with increase in nitrogen content and degree of cold working. This indicates that the hydrophilic character increases with increasing nitrogen content and degree of cold working which further attributed to enhance the surface free energy (SFE) which would be conducive to cell adhesion which in turn increases the cell proliferation.
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Talha M, Behera CK, Sinha OP. A review on nickel-free nitrogen containing austenitic stainless steels for biomedical applications. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2013; 33:3563-75. [PMID: 23910251 DOI: 10.1016/j.msec.2013.06.002] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2012] [Revised: 05/30/2013] [Accepted: 06/04/2013] [Indexed: 10/26/2022]
Abstract
The field of biomaterials has become a vital area, as these materials can enhance the quality and longevity of human life. Metallic materials are often used as biomaterials to replace structural components of the human body. Stainless steels, cobalt-chromium alloys, commercially pure titanium and its alloys are typical metallic biomaterials that are being used for implant devices. Stainless steels have been widely used as biomaterials because of their very low cost as compared to other metallic materials, good mechanical and corrosion resistant properties and adequate biocompatibility. However, the adverse effects of nickel ions being released into the human body have promoted the development of "nickel-free nitrogen containing austenitic stainless steels" for medical applications. Nitrogen not only replaces nickel for austenitic structure stability but also much improves steel properties. Here we review the harmful effects associated with nickel and emphatically the advantages of nitrogen in stainless steel, as well as the development of nickel-free nitrogen containing stainless steels for medical applications. By combining the benefits of stable austenitic structure, high strength, better corrosion and wear resistance and superior biocompatibility in comparison to the currently used austenitic stainless steel (e.g. 316L), the newly developed nickel-free high nitrogen austenitic stainless steel is a reliable substitute for the conventionally used medical stainless steels.
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Affiliation(s)
- Mohd Talha
- Centre of Advanced Study, Department of Metallurgical Engineering, Indian Institute of Technology (Banaras Hindu University), Varanasi 221005, Uttar Pradesh, India
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Wan P, Ren Y, Zhang B, Yang K. Effect of nitrogen on biocorrosion behavior of high nitrogen nickel-free stainless steel in different simulated body fluids. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2012. [DOI: 10.1016/j.msec.2011.12.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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14
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Fini M, Giavaresi G, Salamanna F, Veronesi F, Martini L, De Mattei M, Tschon M. Harmful lifestyles on orthopedic implantation surgery: a descriptive review on alcohol and tobacco use. J Bone Miner Metab 2011; 29:633-44. [PMID: 21898177 DOI: 10.1007/s00774-011-0309-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Accepted: 08/11/2011] [Indexed: 11/26/2022]
Abstract
Alcohol abuse and smoking habits have adverse effects on bone health and are a risk factor for osteoporosis, fractures and impaired fracture repair. Osteointegration processes around implanted biomaterials involve a coordinated cascade of complex events that are very similar to those occurring during fracture repair and require a suitable microenvironment and the coordinated action of cells and signal molecules. Therefore, diseases and harmful lifestyles that impair the normal bone healing process can reduce the success of implant surgery and may negatively influence the osteointegration of prostheses and implant devices for fracture fixation such as screws, nails and plates. Understanding the effects of harmful lifestyles on bone implant osteointegration is important for successful implant therapy, orthopedic reconstructive surgery and tissue-engineered-based therapies. However, the mechanisms by which smoking and alcoholism affect bone metabolism, bone mass and the balance of bone resorption and formation, also in the presence of an orthopedic implant, are not completely understood and remain inadequately elucidated. This review aims to analyze in vitro and in vivo studies regarding orthopedic implant integration in the presence of tobacco smoking and alcohol consumption with a focus on pathophysiology and local or systemic mechanisms of action on bone.
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Affiliation(s)
- Milena Fini
- Laboratory of Preclinical and Surgical Studies, Research Institute Codivilla-Putti, Rizzoli Orthopaedic Institute, via di Barbiano, 1/10, 40136 Bologna, Italy.
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15
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Effect of nitrogen on blood compatibility of nickel-free high nitrogen stainless steel for biomaterial. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2010. [DOI: 10.1016/j.msec.2010.06.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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16
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Yang K, Ren Y. Nickel-free austenitic stainless steels for medical applications. SCIENCE AND TECHNOLOGY OF ADVANCED MATERIALS 2010; 11:014105. [PMID: 27877320 PMCID: PMC5090547 DOI: 10.1088/1468-6996/11/1/014105] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2009] [Revised: 02/26/2010] [Accepted: 01/17/2010] [Indexed: 05/24/2023]
Abstract
The adverse effects of nickel ions being released into the human body have prompted the development of high-nitrogen nickel-free austenitic stainless steels for medical applications. Nitrogen not only replaces nickel for austenitic structure stability but also much improves steel properties. Here we review the harmful effects associated with nickel in medical stainless steels, the advantages of nitrogen in stainless steels, and emphatically, the development of high-nitrogen nickel-free stainless steels for medical applications. By combining the benefits of stable austenitic structure, high strength and good plasticity, better corrosion and wear resistances, and superior biocompatibility compared to the currently used 316L stainless steel, the newly developed high-nitrogen nickel-free stainless steel is a reliable substitute for the conventional medical stainless steels.
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Affiliation(s)
- Ke Yang
- Institute of Metal Research, Chinese Academy of Sciences, 72 Wenhua Road, Shenyang 110016, People’s Republic of China
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17
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Chronic alcohol abuse and endosseous implants: Linkage of in vitro osteoblast dysfunction to titanium osseointegration rate. Toxicology 2008; 243:138-44. [DOI: 10.1016/j.tox.2007.10.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2007] [Revised: 09/26/2007] [Accepted: 10/01/2007] [Indexed: 11/22/2022]
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18
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Tschon M, Fini M, Giavaresi G, Borsari V, Lenger H, Bernauer J, Chiesa R, Cigada A, Chiusoli L, Giardino R. Soft tissue response to a new austenitic stainless steel with a negligible nickel content. Int J Artif Organs 2006; 28:1003-11. [PMID: 16288438 DOI: 10.1177/039139880502801007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study evaluates the soft tissue response to a new austenitic stainless steel with a low nickel content (P558) in comparison with a conventional stainless steel (SSt)and a titanium alloy (Ti6Al4V). Previous findings showed its in vitro biocompatibility by culturing P558 with healthy and osteoporotic osteoblasts and its in vivo effectiveness as bone implant material. Regarding its use as a material in osteosynthesis,P558 biocompatibility when implanted in soft tissues, as subcutis and muscle, was assessed. Disks and rods of these metals were implanted in rat subcutis and in rabbit muscle, respectively. Four and twelve weeks post surgery implants with surrounding tissue were retrieved for histologic and histomorphometric analysis: fibrous capsule thickness and new vessel formation were measured. Around all implanted materials, light microscopy highlighted a reactive and fibrous capsule formation coupled with ongoing neoangiogenesis both in rats and in rabbits. Histomorphometric measurements revealed a stronger inflammatory response,in terms of capsule thickness,surrounding SSt implants (9.8% Ni content) both in rat subcutis and in rabbit muscle independently of shape and site of implantation. A progressive decrease in capsule thickness around P558 (<0.02% Ni content) and Ti6Al4V, respectively, was seen. Regarding new vessel density, the data showed a different response dependent on the site of implantation. However,in the light of the previous and present studies, P558 is a good material, instead of titanium alloys, in orthopedic research.
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Affiliation(s)
- M Tschon
- Laboratory of Experimental Surgery, Research Institute Codivilla-Putti, Rizzoli Orthopaedic Institute, Bologna--Italy
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Fini M, Giavaresi G, Torricelli P, Borsari V, Giardino R, Nicolini A, Carpi A. Osteoporosis and biomaterial osteointegration. Biomed Pharmacother 2005; 58:487-93. [PMID: 15511604 DOI: 10.1016/j.biopha.2004.08.016] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2004] [Indexed: 01/02/2023] Open
Abstract
Biomaterial osteointegration depends not only on the properties of the implanted material but also on the characteristics and regenerative capability of the host bone. For this reason, researchers involved in biomaterial evaluation now place great importance on the various pathologies often present in orthopaedic patients which can negatively affect the success of surgical implants. Osteoporosis is undoubtedly one of the most frequently encountered of such diseases. Models reproducing the osteoporotic condition can be useful to understand the influence of the pathology on cell behaviour, bone regeneration and osteointegration processes, thus increasing our basic knowledge and allowing the development of surgical techniques and implant biomaterials more suitable for use in the surgical treatment of fractures in osteoporotic patients. The present paper is a literature review and, after a short description of how the presence of osteoporosis could influence bone regenerative processes, the results of the main studies on biomaterial biocompatibility and osteointegration both in vitro and in vivo in the presence of osteoporotic condition are reported. Both cell cultures and animal models are able to demonstrate the different response of bone to biomaterials by comparing healthy and pathological conditions. The use of pathological bone-derived cells and pathological animals is therefore recommended to test candidate orthopaedic materials.
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Affiliation(s)
- M Fini
- Experimental Surgery Department, Research Institute Codivilla Putti, Rizzoli Orthopaedic Institute, Via di Barbiano, 1/10, 40136 Bologna, Italy.
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