Advances in functionalized polymer coatings on biodegradable magnesium alloys - A review

A fucoidan-loaded hydrogel coating for enhancing corrosion resistance, hemocompatibility and endothelial cell growth of magnesium alloy for cardiovascular stents

Although magnesium alloy has received tremendous attention in biodegradable cardiovascular stents, the poor in vivo corrosion resistance and limited endothelialization are still the bottlenecks for its application in cardiovascular stents. Fabrication of the multifunctional bioactive coating with excellent anti-corrosion on the surface is beneficial for rapid re-endothelialization and the normal physiological function recovery of blood vessels. In the present study, a bioactive hydrogel coating was established on the surface of magnesium alloy by copolymerization of sulfobetaine methacrylate (SBMA) and acrylamide (AM) via ultraviolet (UV) polymerization, followed by the immobilization of fucoidan (Fu). The results showed that the as-prepared multifunctional hydrogel coating could enhance the corrosion resistance and the surface wettability of the magnesium alloy surface, endowing it with the ability of selective albumin adsorption; meanwhile, it could augment biocompatibility. The following introduction of fucoidan on the surface could further improve the hemocompatibility characterized by reducing protein adsorption, minimizing hemolysis, and preventing platelet aggregation and activation. Additionally, the immobilized fucoidan promoted endothelial cell (EC) growth, as well as up-regulated the expression of vascular endothelial growth factor (VEGF) and nitric oxide (NO) in endothelial cells (ECs). Consequently, this research paves a novel approach to developing a versatile bioactive coating for magnesium alloy surfaces and lays a foundation in cardiovascular biomaterials.

Adapting to the acidic environment of the NP: RADA16-PLGA (TGF-β3) induces chondrogenic differentiation of BMSCs

Aim: RADA16-PLGA composite scaffolds constructed with simultaneous loading of BMSCs and TGF-β3 and explored their ability for chondrogenic differentiation in vitro.Methods: The performance of the composite scaffolds is assessed by rheometer assay, electron microscopic structural observation and ELISA release assay. The biosafety of the composite scaffolds is assessed by cytocompatibility assay and cell migration ability. The chondrogenic differentiation ability of composite scaffolds is evaluated by Alisin blue staining, PCR and immunofluorescence staining.Results: The composite scaffold has a good ECM-like structure, the ability to control the release of TGF-β3 and good biocompatibility. More importantly, the composite scaffolds can induce the differentiation of BMSCs to chondrocytes.Conclusion: Composite scaffolds are expected to enhance the endogenous NP repair process.

In Vitro Corrosion of Polyester-Coated Magnesium Alloy under pH-Static Conditions

The resorption rate of bioresorbable implants requires tuning to match the desired field of application. The use of Mg as implant material is highly advantageous, as it provides sufficient mechanical strength combined with its biodegradability. Consequently, the implant vanishes after it has served its intended purpose, allowing the complete restoration of natural tissue and organ function. However, a biodegradable Mg implant requires a biodegradable coating to slow the rate of Mg corrosion, as a permanent coating would negate the benefits of using Mg as an implant material. Therefore, degradable polymers are the materials of choice, especially polyester-based coatings, such as PLLA, as they have been proven in clinical practice over the long term. Within this work, the degradation retarding effect of a physical barrier in form of four clinically relevant polyester-based coatings, poly-l-lactide (PLLA), poly-l-lactide-co-glycolide (PLGA), poly(l-lactide-co-PEG) triblock copolymer (PLLA-co-PEG), and polydioxanone (PDO), is investigated in vitro under pH-static conditions using CO2 gas to compensate pH changes due to Mg corrosion. Coating thicknesses of 7.5 to 8.3 μm were comparable to commercially available stent systems. Quantitative analysis of magnesium concentration in buffered test medium by a photometric assay allows real-time monitoring. Shielding effect of different polyesters through polymer coating and formation of a protective passivation layer beneath the polymer coating was observed and characterized using SEM and EDX techniques. Our finding was that even imperfect polymer layers provide a considerable protective effect, and the used in vitro setup matches reported in vivo observations regarding elemental composition of corrosion products.

Biocompatibility and corrosion resistance of drug coatings with different polymers for magnesium alloy cardiovascular stents

Recently, advances in enhancing corrosion properties through various techniques, and the clinical application of biodegradable cardiovascular stents made from magnesium (Mg) alloys face challenges to corrosion resistance, blood compatibility, and biocompatibility. Drug-eluting stents (DES) offer a solution to enhance the corrosion resistance of Mg alloys while simultaneously reducing the occurrence of restenosis. In this study, WE43 Mg alloy was pretreated using electropolishing technology, and different polymers (PEG and PLLA) were used as drug-polymer coatings for the Mg alloy. At the same time, PTX, an anticoagulant, was incorporated to achieve drug coating of different polymers on WE43 Mg alloy. The corrosion resistance of different polymer-drug coatings was assessed using a plasma solution. Furthermore, in vitro and in vivo tests were used to evaluate the blood biocompatibility of these coatings. The results indicated the PTX-PEG-coated WE43 Mg alloy exhibited the highest corrosion resistance and the most stable drug release profile among the tested coatings. Its hemolysis rate of 0.6 % was within the clinical requirements (<5 %). The incorporation of PEG prevents non-specific protein adsorption and nanoparticle aggregation, enhancing the surface hemocompatibility of WE43 Mg alloy. Therefore, the PTX-PEG coating shows promising potential for application in the development of drug-coated Mg alloy.

Biodegradable magnesium based metal materials inhibit the growth of cervical cancer cells

Traditional chemotherapy drugs for cervical cancer often cause significant toxic side effects and drug resistance problems, highlighting the urgent need for more innovative and effective treatment strategies. Magnesium alloy is known to be degradable and biocompatible. The release of degradation products Mg2+, OH-, and H2 from magnesium alloy can alter the tumor microenvironment, providing potential anti-tumor properties. We explored the innovative use of magnesium alloy biomaterials in the treatment of cervical cancer, investigating how various concentrations of Mg2+ on the proliferation and cell death of cervical cancer cells. The results revealed that varying concentrations of Mg2+ significantly inhibited cervical cancer by arresting the cell cycle in the G0/G1 phase and inducing apoptosis in SiHa cells, effectively reducing tumor cell proliferation. In vivo experiments demonstrated that 20 mM Mg2+ group had the smallest tumor volume, exhibiting a potent inhibitory effect on the biological characteristics of cervical cancer. This enhances the therapeutic potential of this biomaterial as a local anti-tumor therapy and lays a theoretical foundation for the potential application of magnesium in the treatment of cervical cancer.

Constructing sodium alginate/carboxymethyl chitosan coating capable of catalytically releasing NO or CO for improving the hemocompatibility and endothelialization of magnesium alloys

Although significant progress in developing biodegradable magnesium alloy materials in cardiovascular stents has been achieved recently, they still face challenges such as rapid in vivo corrosion degradation, inferior blood compatibility, and limited re-endothelialization after the implantation. Hydrogel coating that can catalyze the liberation of gas signal molecules offers a good solution to alleviate the corrosion rate and enhance the biocompatibility of magnesium and its alloys. In this study, based on alkaline heat treatment and construction of polydopamine coating on the surface of magnesium alloy, sodium alginate/carboxymethyl chitosan (SA/CMCS) gel was simultaneously covalently grafted onto the surface to build a natural polymer hydrogel coating, and selenocystamine (SeCA) and CO release molecules (CORM-401) were respectively immobilized on the surface of the hydrogel coating to ameliorate the anticoagulant performance and accelerate endothelial cells (ECs) growth by catalyzing the release of endogenous gas signal molecules (NO or CO). The findings verified that the as-prepared hydrogel coating can catalyze the liberation of CO or NO and significantly improve the corrosion resistance of magnesium alloy. At the same time, owing to the excellent hydrophilicity of the hydrogel coating, the good anticoagulant property of sodium alginate, and the ability of CMCS to promote the ECs growth, the modified magnesium alloy could significantly improve the albumin adsorption while preventing the adsorption of fibrinogen, hence significantly augmenting the anticoagulant properties and promoting the ECs growth. Under the catalytic release of NO or CO, the released gas molecules further enhanced hemocompatibility and promoted endothelial cell (EC) growth and the expression of vascular endothelial growth factor (VEGF) and NO of ECs. Therefore, the bioactive coatings that can catalyze the release of NO or CO have potential applications in constructing surface bioactive coatings for magnesium alloy materials used for intravascular stents.

Beyond hype: unveiling the Real challenges in clinical translation of 3D printed bone scaffolds and the fresh prospects of bioprinted organoids

Bone defects pose significant challenges in healthcare, with over 2 million bone repair surgeries performed globally each year. As a burgeoning force in the field of bone tissue engineering, 3D printing offers novel solutions to traditional bone transplantation procedures. However, current 3D-printed bone scaffolds still face three critical challenges in material selection, printing methods, cellular self-organization and co-culture, significantly impeding their clinical application. In this comprehensive review, we delve into the performance criteria that ideal bone scaffolds should possess, with a particular focus on the three core challenges faced by 3D printing technology during clinical translation. We summarize the latest advancements in non-traditional materials and advanced printing techniques, emphasizing the importance of integrating organ-like technologies with bioprinting. This combined approach enables more precise simulation of natural tissue structure and function. Our aim in writing this review is to propose effective strategies to address these challenges and promote the clinical translation of 3D-printed scaffolds for bone defect treatment.

Influence of the activation time of magnesium surfaces on the concentration of active hydroxyl groups and corrosion resistance

Magnesium alloys have been extensively studied as degradable biomaterials for clinical applications due to their biocompatibility and mechanical properties. However, their poor corrosion resistance can lead to issues such as osteolysis and the release of gaseous hydrogen. This study investigated the influence of the activation time of magnesium surfaces in a sodium hydroxide (NaOH) solution on the concentration of active hydroxyl groups and corrosion resistance. The results indicated that immersion time significantly influences the formation of a corrosion-resistant film and the distribution of surface hydroxyl groups. Specifically, specimens treated for 7.5 h exhibited the highest concentration of hydroxyl groups and the most uniform oxide film distribution. Electrochemical tests demonstrated capacitive behavior and passive surface formation for all evaluated times, with the 7.5-h immersion in NaOH yielding superior corrosion resistance, lower current density, and a more efficient and thicker protective film. SEM and EDS analyses confirmed increased formation of Mg(OH)₂ for samples treated for 5 and 7.5 h, while a 10-h treatment resulted in a brittle, porous layer prone to degradation. Statistical analysis using ANOVA and Fisher's LSD test corroborated these findings. The optimal 7.5-h alkali treatment enhanced magnesium's corrosion resistance and surface properties, making it a promising candidate for orthopedic implants. However, further studies are necessary to assess biocompatibility and physiological responses before clinical implementation.

Surface engineering of pure magnesium in medical implant applications

This review comprehensively surveys the latest advancements in surface modification of pure magnesium (Mg) in recent years, with a focus on various cost-effective procedures, comparative analyses, and assessments of outcomes, addressing the merits and drawbacks of pure Mg and its alloys. Diverse economically feasible methods for surface modification, such as hydrothermal processes and ultrasonic micro-arc oxidation (UMAO), are discussed, emphasizing their exceptional performance in enhancing surface properties. The attention is directed towards the biocompatibility and corrosion resistance of pure Mg, underscoring the remarkable efficacy of techniques such as Ca-deficientca-deficient hydroxyapatite (CDHA)/MgF2 bi-layer coating and UMAO coating in electrochemical processes. These methods open up novel avenues for the application of pure Mg in medical implants. Emphasis is placed on the significance of adhering to the principles of reinforcing the foundation and addressing the source. The advocacy is for a judicious approach to corrosion protection on high-purity Mg surfaces, aiming to optimize the overall mechanical performance. Lastly, a call is made for future in-depth investigations into areas such as composite coatings and the biodegradation mechanisms of pure Mg surfaces, aiming to propel the field towards more sustainable and innovative developments.

A CO-releasing coating based on carboxymethyl chitosan-functionalized graphene oxide for improving the anticorrosion and biocompatibility of magnesium alloy stent materials

Due to its biofunctions similar to NO, the CO gas signaling molecule has gradually shown great potential in cardiovascular biomaterials for regulating the in vivo performances after the implantation and has received increasing attention. To construct a bioactive surface with CO-releasing properties on the surface of magnesium-based alloy to augment the anticorrosion and biocompatibility, graphene oxide (GO) was firstly modified using carboxymethyl chitosan (CS), and then CO-releasing molecules (CORM401) were introduced to synthesize a novel biocompatible nanomaterial (GOCS-CO) that can release CO in the physiological environments. The GOCS-CO was further immobilized on the magnesium alloy surface modified by polydopamine coating with Zn2+ (PDA/Zn) to create a bioactive surface capable of releasing CO in the physiological environment. The outcomes showed that the CO-releasing coating can not only significantly enhance the anticorrosion and abate the corrosion degradation rate of the magnesium alloy in a simulated physiological environment, but also endow it with good hydrophilicity and a certain ability to adsorb albumin selectively. Owing to the significant enhancement of anticorrosion and hydrophilicity, coupled with the bioactivity of GOCS, the modified sample not only showed excellent ability to prevent platelet adhesion and activation and reduce hemolysis rate but also can promote endothelial cell (EC) adhesion, proliferation as well as the expression of nitric oxide (NO) and vascular endothelial growth factor (VEGF). In the case of CO release, the hemocompatibility and EC growth behaviors were further significantly improved, suggesting that CO molecules released from the surface can significantly improve the hemocompatibility and EC growth. Consequently, the present study provides a novel surface modification method that can simultaneously augment the anticorrosion and biocompatibility of magnesium-based alloys, which will strongly promote the research and application of CO-releasing bioactive coatings for surface functionalization of cardiovascular biomaterials and devices.

Innovative Developments in Lumbar Interbody Cage Materials and Design: A Comprehensive Narrative Review

This review comprehensively examines the evolution and current state of interbody cage technology for lumbar interbody fusion (LIF). This review highlights the biomechanical and clinical implications of the transition from traditional static cage designs to advanced expandable variants for spinal surgery. The review begins by exploring the early developments in cage materials, highlighting the roles of titanium and polyetheretherketone in the advancement of LIF techniques. This review also discusses the strengths and limitations of these materials, leading to innovations in surface modifications and the introduction of novel materials, such as tantalum, as alternative materials. Advancements in three-dimensional printing and surface modification technologies form a significant part of this review, emphasizing the role of these technologies in enhancing the biomechanical compatibility and osseointegration of interbody cages. In addition, this review explores the increase in biodegradable and composite materials such as polylactic acid and polycaprolactone, addressing their potential to mitigate long-term implant-related complications. A critical evaluation of static and expandable cages is presented, including their respective clinical and radiological outcomes. While static cages have been a mainstay of LIF, expandable cages are noted for their adaptability to the patient's anatomy, reducing complications such as cage subsidence. However, this review highlights the ongoing debate and the lack of conclusive evidence regarding the superiority of either cage type in terms of clinical outcomes. Finally, this review proposes future directions for cage technology, focusing on the integration of bioactive substances and multifunctional coatings and the development of patient-specific implants. These advancements aim to further enhance the efficacy, safety, and personalized approach of spinal fusion surgeries. Moreover, this review offers a nuanced understanding of the evolving landscape of cage technology in LIF and provides insights into current practices and future possibilities in spinal surgery.

Layered Double Hydroxides: Recent Progress and Promising Perspectives Toward Biomedical Applications

Layered double hydroxides (LDHs) have been widely studied for biomedical applications due to their excellent properties, such as good biocompatibility, degradability, interlayer ion exchangeability, high loading capacity, pH-responsive release, and large specific surface area. Furthermore, the flexibility in the structural composition and ease of surface modification of LDHs makes it possible to develop specifically functionalized LDHs to meet the needs of different applications. In this review, the recent advances of LDHs for biomedical applications, which include LDH-based drug delivery systems, LDHs for cancer diagnosis and therapy, tissue engineering, coatings, functional membranes, and biosensors, are comprehensively discussed. From these various biomedical research fields, it can be seen that there is great potential and possibility for the use of LDHs in biomedical applications. However, at the same time, it must be recognized that the actual clinical translation of LDHs is still very limited. Therefore, the current limitations of related research on LDHs are discussed by combining limited examples of actual clinical translation with requirements for clinical translation of biomaterials. Finally, an outlook on future research related to LDHs is provided.

Preparation of biocompatibility coating on magnesium alloy surface by sodium alginate and carboxymethyl chitosan hydrogel

Magnesium alloy is an excellent material for biodegradable cerebrovascular stents. However, the rapid degradation rate of magnesium alloy will make stent unstable. To improve the biocompatibility of magnesium alloy, in this study, biodegradable sodium alginate and carboxymethyl chitosan (SA/CMCS) was used to coat onto hydrothermally treated the surface of magnesium alloy by a dipping coating method. The results show that the SA/CMCS coating facilitates the growth, proliferation, and migration of endothelial cells and promotes neovascularization. Moreover, the SA/CMCS coating suppresses macrophage activation while promoting their transformation into M2 type macrophages. Overall, the SA/CMCS coating demonstrates positive effects on the safety and biocompatibility of magnesium alloy after implantation, and provide a promising therapy for the treatment of intracranial atherosclerotic stenosis in the future.

An oxidized dextran-composite self-healing coated magnesium scaffold reduces apoptosis to induce bone regeneration

Self-healing coatings have shown promise in controlling the degradation of scaffolds and addressing coating detachment issues. However, developing a self-healing coating for magnesium (Mg) possessing multiple biological functions in infectious environments remains a significant challenge. In this study, a self-healing coating was developed for magnesium scaffolds using oxidized dextran (OD), 3-aminopropyltriethoxysilane (APTES), and nano-hydroxyapatite (nHA) doped micro-arc oxidation (MHA), named OD-MHA/Mg. The results demonstrated that the OD-MHA coating effectively addresses coating detachment issues and controls the degradation of Mg in an infectious environment through self-healing mechanisms. Furthermore, the OD-MHA/Mg scaffold exhibits antibacterial, antioxidant, and anti-apoptotic properties, it also promotes bone repair by upregulating the expression of osteogenesis genes and proteins. The findings of this study indicate that the OD-MHA coated Mg scaffold possessing multiple biological functions presents a promising approach for addressing infectious bone defects. Additionally, the study showcases the potential of polysaccharides with multiple biological functions in facilitating tissue healing even in challenging environments.

Mg-based implants with a sandwiched composite coating simultaneously facilitate antibacterial and osteogenic properties

Insufficient antibacterial effects and over-fast degradation are the main limitations of magnesium (Mg)-based orthopedic implants. In this study, a sandwiched composite coating containing a triclosan (TCS)-loaded poly(lactic acid) (PLA) layer inside and brushite (DCPD) layer outside was prepared on the surface of the Mg-Nd-Zn-Zr (denoted as JDBM) implant. In vitro degradation tests revealed a remarkable improvement in the corrosion resistance and moderate degradation rate. The drug release profile demonstrated a controllable and sustained TCS release for at least two weeks in vitro. The antibacterial rates of the implant were all over 99.8% for S. aureus, S. epidermidis, and E. coli, demonstrating superior antibacterial effects. Additionally, this coated JDBM implant exhibited no cytotoxicity but improved cell adhesion and proliferation, indicating excellent cytocompatibility. In vivo assays were conducted by implant-related femur osteomyelitis and osseointegration models in rats. Few bacteria were attached to the implant surface and the surrounding bone tissue. Furthermore, the coated JDBM implant exhibited more new bone formation than other groups due to the synergistic biological effects of released TCS and Mg2+, revealing excellent osteogenic ability. In summary, the JDBM implant with the sandwiched composite coating could significantly enhance the antibacterial activities and osteogenic properties simultaneously by the controllable release of TCS and Mg2+, presenting great potential for clinical transformation.

Development and Future Trends of Protective Strategies for Magnesium Alloy Vascular Stents

Magnesium alloy stents have been extensively studied in the field of biodegradable metal stents due to their exceptional biocompatibility, biodegradability and excellent biomechanical properties. Nevertheless, the specific in vivo service environment causes magnesium alloy stents to degrade rapidly and fail to provide sufficient support for a certain time. Compared to previous reviews, this paper focuses on presenting an overview of the development history, the key issues, mechanistic analysis, traditional protection strategies and new directions and protection strategies for magnesium alloy stents. Alloying, optimizing stent design and preparing coatings have improved the corrosion resistance of magnesium alloy stents. Based on the corrosion mechanism of magnesium alloy stents, as well as their deformation during use and environmental characteristics, we present some novel strategies aimed at reducing the degradation rate of magnesium alloys and enhancing the comprehensive performance of magnesium alloy stents. These strategies include adapting coatings for the deformation of the stents, preparing rapid endothelialization coatings to enhance the service environment of the stents, and constructing coatings with self-healing functions. It is hoped that this review can help readers understand the development of magnesium alloy cardiovascular stents and solve the problems related to magnesium alloy stents in clinical applications at the early implantation stage.

Comprehensive review of materials, applications, and future innovations in biodegradable esophageal stents

Esophageal stricture (ES) results from benign and malignant conditions, such as uncontrolled gastroesophageal reflux disease (GERD) and esophageal neoplasms. Upper gastrointestinal endoscopy is the preferred diagnostic approach for ES and its underlying causes. Stent insertion using an endoscope is a prevalent method for alleviating or treating ES. Nevertheless, the widely used self-expandable metal stents (SEMS) and self-expandable plastic stents (SEPS) can result in complications such as migration and restenosis. Furthermore, they necessitate secondary extraction in cases of benign esophageal stricture (BES), rendering them unsatisfactory for clinical requirements. Over the past 3 decades, significant attention has been devoted to biodegradable materials, including synthetic polyester polymers and magnesium-based alloys, owing to their exceptional biocompatibility and biodegradability while addressing the challenges associated with recurring procedures after BES resolves. Novel esophageal stents have been developed and are undergoing experimental and clinical trials. Drug-eluting stents (DES) with drug-loading and drug-releasing capabilities are currently a research focal point, offering more efficient and precise ES treatments. Functional innovations have been investigated to optimize stent performance, including unidirectional drug-release and anti-migration features. Emerging manufacturing technologies such as three-dimensional (3D) printing and new biodegradable materials such as hydrogels have also contributed to the innovation of esophageal stents. The ultimate objective of the research and development of these materials is their clinical application in the treatment of ES and other benign conditions and the palliative treatment of malignant esophageal stricture (MES). This review aimed to offer a comprehensive overview of current biodegradable esophageal stent materials and their applications, highlight current research limitations and innovations, and offer insights into future development priorities and directions.

Fucoidan- and Ciprofloxacin-Doped Plasma-Activated Polymer Coatings on Biodegradable Zinc: Hemocompatibility and Drug Release

Blood-contacting medical devices such as biodegradable metallic bone implant materials are expected to show excellent hemocompatibility both in vitro and in vivo. Different approaches are being studied and used to modify biomaterial surfaces for enhanced biocompatibility and hemocompatibility. However, the composition of degradable biomaterial must address several drawbacks at once. Iron-reinforced zinc material was used as a metallic substrate with improved mechanical properties when compared with those of pure zinc. Poly(lactic) acid (PLA) or polyethylenimine (PEI) was selected as a polymeric matrix for further doping with antibiotic ciprofloxacin (CPR) and marine-sourced polysaccharide fucoidan (FU), which are known for their antibacterial and potential anticoagulant properties, respectively. Radiofrequency air plasma was employed to induce metallic/polymer-coated surface activation before further modification with FU/CPR. Sample surface morphology and composition were studied and evaluated (contact angle measurements, AFM, SEM, and FT-IR) along with the hemolysis ratio and platelet adhesion test. Successful doping of the polymer layer by FU/CRP was confirmed. While PEI induced severe hemolysis over 12%, the PLA-coated samples exhibited even lower hemolysis (∼2%) than uncoated samples while the uncoated samples showed the lowest platelet adhesion. Moreover, gradual antibiotic release from PLA determined by the electrochemical methods using screen-printed carbon electrodes was observed after 24, 48, and 72 h, making the PLA-coated zinc-based material an attractive candidate for biodegradable material design.

Supramolecular Self-Healing Antifouling Coating for Dental Materials

In orthodontic treatment, orthodontic appliances are prone to bacterial infections, which pose a risk to oral health. Surface modification of orthodontic appliances has been explored to improve their antifouling properties and impart antibacterial capabilities, inhibiting initial bacterial adhesion and biofilm formation. However, coatings are susceptible to damage in the complex oral environment, leading to a loss of functionality. Here, we have prepared an antifouling self-healing coating based on supramolecular bonding by employing a simple spin coating method. The presence of the hydrophilic zwitterionic trimethylamine N-oxide (TMAO) and the hydrophobic antimicrobial moieties triclosan acrylate (TCSA) imparts to the polymers an amphiphilic structure and enhances the interaction with bacteria, resulting in excellent antimicrobial activity and surface antifouling properties. The multiple hydrogen bonds of ureido-pyrimidinone methacrylate (UPyMA) and ionic interactions contained in the polymers not only increased the adhesion of the coating to the material substrate (approximately 3 times) but also endowed the coating with the intrinsic self-healing ability to restore the antibiofouling properties at oral temperature and humidity. Finally, the polymer coating is biologically safe both in vitro and in vivo, showing no cytotoxic effects on cells and tissues. This research offers a promising avenue for improving the performance of orthodontic appliances and contributes to the maintenance and treatment of oral health.

Evolution from Bioinert to Bioresorbable: In Vivo Comparative Study of Additively Manufactured Metal Bone Scaffolds

Additively manufactured scaffolds offer significant potential for treating bone defects, owing to their porous, customizable architecture and functionalization capabilities. Although various biomaterials have been investigated, metals - the most successful orthopedic material - have yet to yield satisfactory results. Conventional bio-inert metals, such as titanium (Ti) and its alloys, are widely used for fixation devices and reconstructive implants, but their non-bioresorbable nature and the mechanical property mismatch with human bones limit their application as porous scaffolds for bone regeneration. Advancements in additive manufacturing have facilitated the use of bioresorbable metals, including magnesium (Mg), zinc (Zn), and their alloys, as porous scaffolds via Laser Powder Bed Fusion (L-PBF) technology. This in vivo study presents a comprehensive, side-by-side comparative analysis of the interactions between bone regeneration and additively manufactured bio-inert/bioresorbable metal scaffolds, as well as their therapeutic outcomes. The research offers an in-depth understanding of the metal scaffold-assisted bone healing process, illustrating that Mg and Zn scaffolds contribute to the bone healing process in distinct ways, but ultimately deliver superior therapeutic outcomes compared to Ti scaffolds. These findings suggest that bioresorbable metal scaffolds hold considerable promise for the clinical treatment of bone defects in the near future.

Liquid Metal-Based Flexible Bioelectrodes for Management of In-Stent-Restenosis: Potential Application

Although vascular stents have been widely used in clinical practice, there is still a risk of in-stent restenosis after their implantation. Combining conventional vascular stents with liquid metal-based electrodes with impedance detection, irreversible electroporation, and blood pressure detection provides a new direction to completely solve the restenosis problem. Compared with conventional rigid electrodes, liquid metal-based electrodes combine high conductivity and stretchability, and are more compliant with the implantation process of vascular stents and remain in the vasculature for a long period of time. This perspective reviews the types and development of conventional vascular stents and proposes a novel stent that integrates liquid metal-based electrodes on conventional vascular stents. This vascular stent has three major functions of prediction, detection and treatment, and is expected to be a new generation of cardiovascular implant with intelligent sensing and real-time monitoring.

New N-Methylimidazole-Functionalized Chitosan Derivatives: Hemocompatibility and Antibacterial Properties

Novel imidazole derivatives of the low molecular weight chitosan N-(2-hydroxypropyl)-1H-1,2,3-triazol-4-yl)methyl)-1-methyl-1H-imidazol-3-ium chitosan chloride (NMIC) were synthesized using copper-catalyzed azide-alkyne cycloaddition (CuAAC). The degrees of substitution (DSs) for the new derivatives were 18-76%. All chitosan derivatives (2000 µg/mL) were completely soluble in water. The antimicrobial activity of the new compounds against E. coli and S. epidermidis was studied. The effect of chitosan derivatives on blood and its components was studied. NMIC samples (DS 34-76%) at a concentration <10 μg/mL had no effect on blood and plasma coagulation. Chitosan derivatives (DS 18-76%) at concentrations of ≥83 μg/mL in blood and ≥116.3 μg/mL in plasma resulted in a prolongation of the clotting time of blood and plasma, positively related to the DS. At concentrations up to 9.1 μg/mL, NMIC did not independently provoke platelet aggregation. The degree of erythrocyte hemolysis upon contact with NMIC samples (2.5-2500 μg/mL) was below 4%. The inhibition of blood/plasma coagulation indicates the promising use of the studied samples to modify the surface of medical materials in order to achieve thromboresistance.

Polymeric Coatings for Magnesium Alloys for Biodegradable Implant Application: A Review

Magnesium (Mg) alloys are a very attractive material of construction for biodegradable temporary implants. However, Mg alloys suffer unacceptably rapid corrosion rates in aqueous environments, including physiological fluid, that may cause premature mechanical failure of the implant. This necessitates a biodegradable surface barrier coating that should delay the corrosion of the implant until the fractured/damaged bone has healed. This review takes a brief account of the merits and demerits of various existing coating methodologies for the mitigation of Mg alloy corrosion. Since among the different coating approaches investigated, no single coating recipe seems to address the degradation control and functionality entirely, this review argues the need for polymer-based and biodegradable composite coatings.

Electrophoretic Deposition, Microstructure, and Selected Properties of Poly(lactic-co-glycolic) Acid-Based Antibacterial Coatings on Mg Substrate

There is an urgent need to develop biodegradable implants that can degrade once they have fulfilled their function. Commercially pure magnesium (Mg) and its alloys have the potential to surpass traditional orthopedic implants due to their good biocompatibility and mechanical properties, and most critically, biodegradability. The present work focuses on the synthesis and characterization (microstructural, antibacterial, surface, and biological properties) of poly(lactic-co-glycolic) acid (PLGA)/henna (Lawsonia inermis)/Cu-doped mesoporous bioactive glass nanoparticles (Cu-MBGNs) composite coatings deposited via electrophoretic deposition (EPD) on Mg substrates. PLGA/henna/Cu-MBGNs composite coatings were robustly deposited on Mg substrates using EPD, and their adhesive strength, bioactivity, antibacterial activity, corrosion resistance, and biodegradability were thoroughly investigated. Scanning electron microscopy and Fourier transform infrared spectroscopy studies confirmed the uniformity of the coatings' morphology and the presence of functional groups that were attributable to PLGA, henna, and Cu-MBGNs, respectively. The composites exhibited good hydrophilicity with an average roughness of 2.6 μm, indicating desirable properties for bone forming cell attachment, proliferation, and growth. Crosshatch and bend tests confirmed that the adhesion of the coatings to Mg substrates and their deformability were adequate. Electrochemical Tafel polarization tests revealed that the composite coating adjusted the degradation rate of Mg substrate in a human physiological environment. Incorporating henna into PLGA/Cu-MBGNs composite coatings resulted in antibacterial activity against Escherichia coli and Staphylococcus aureus. The coatings stimulated the proliferation and growth of osteosarcoma MG-63 cells during the initial incubation period of 48 h (determined by the WST-8 assay).

Polymer bilayer-Micro arc oxidation surface coating on pure magnesium for bone implantation

Background

Pure magnesium-based ortho-implants have a number of advantages. However, vital parameters like degradation rate and biocompatibility still call for significant improvement.

Methods

In this study, poly (1,3-trimethylene carbonate) (PTMC) and polydopamine (PDA) bilayer and micro arc oxidation composite coatings were prepared successively on magnesium surface by immersion method and microarc oxidation. Its corrosion resistance and biocompatibility were evaluated by in vitro corrosion tests, cellular compatibility experiments, and in vivo animal experiments.

Results

In vitro experiments demonstrated that the composite coating provides excellent corrosion protection and biocompatibility. Animal studies demonstrated that the composite coating slowed the degradation of the implant and was not toxic to animal viscera.

Conclusion

In conclusion, the inorganic-organic composite coating proposed in this study provided good corrosion resistance and enhanced biocompatibility for pure magnesium implants.

The translational potential of this article

The translational potential of this article is to develop an anti-corrosion composite coating on a pure magnesium surface and to verify the viability of its use in animal models. It is hoped to open up a new approach to the design of new degradable orthopedic magnesium-based implants.

Current Strategies for Engineered Vascular Grafts and Vascularized Tissue Engineering

Blood vessels not only transport oxygen and nutrients to each organ, but also play an important role in the regulation of tissue regeneration. Impaired or occluded vessels can result in ischemia, tissue necrosis, or even life-threatening events. Bioengineered vascular grafts have become a promising alternative treatment for damaged or occlusive vessels. Large-scale tubular grafts, which can match arteries, arterioles, and venules, as well as meso- and microscale vasculature to alleviate ischemia or prevascularized engineered tissues, have been developed. In this review, materials and techniques for engineering tubular scaffolds and vasculature at all levels are discussed. Examples of vascularized tissue engineering in bone, peripheral nerves, and the heart are also provided. Finally, the current challenges are discussed and the perspectives on future developments in biofunctional engineered vessels are delineated.

Preparation and evaluation of injectable microsphere formulation for longer sustained release of donepezil

In this study, donepezil-loaded PLGA and PLA microspheres (Dp-PLGA-M/Dp-PLA-M) and Dp-PLA-M wrapped in a polyethylene glycol-b-polycaprolactone (PC) hydrogel (Dp-PLA-M/PC) were prepared to reduce the dosing frequency of injections to treat Alzheimer's disease patients. Dp-PLGA-M and Dp-PLA-M with a uniform particle size distribution were repeatably fabricated in nearly quantitative yield and with high encapsulated Dp yields using an ultrasonic atomizer. The injectability and in vitro and in vivo Dp release, biodegradation, and inflammatory response elicited by the Dp-PLGA-M, Dp-PLA-M, and Dp-PLA-M/PC formulations were then compared. All injectable formulations showed good injectability with ease of injection, even flow, and no clogging using a syringe needle under 21-G. The injections required a force of <1 N. According to the biodegradation rate of micro-CT, GPC and NMR analyses, the biodegradation of Dp-PLA-M was slower than that of Dp-PLGA-M, and the biodegradation rate of Dp-PLA-M/PC was also slower. In the Dp release experiment, Dp-PLA-M sustained Dp for longer compared with Dp-PLGA-M. Dp-PLA-M/PC exhibited a longer sustained release pattern of two months. In vivo bioavailability of Dp-PLA-M/PC was almost 1.4 times higher than that of Dp-PLA-M and 1.9 times higher than that of Dp-PLGA-M. The variations in the Dp release patterns of Dp-PLGA-M and Dp-PLA-M were explained by differences in the degradation rates of PLGA and PLA. The sustained release of Dp by Dp-PLA-M/PC was attributed to the fact that the PC hydrogel served as a wrapping matrix for Dp-PLA-M, which could slow down the biodegradation of PLA-M, thus delaying the release of Dp from Dp-PLA-M. Dp-PLGA-M induced a higher inflammatory response compared to Dp-PLA-M/PC, suggesting that the rapid degradation of PLGA triggered a strong inflammatory response. In conclusion, Dp-PLA-M/PC is a promising injectable Dp formulation that could be used to reduce the dosing frequency of Dp injections.

Predicting localised corrosion and mechanical performance of a PEO surface modified rare earth magnesium alloy for implant use through in-silico modelling

In this study, the influence of a plasma electrolytic oxidation (PEO) surface treatment on a medical-grade WE43-based magnesium alloy is examined through an experimental and computational framework that considers the effects of localised corrosion features and mechanical properties throughout the corrosion process. First, a comprehensive in-vitro immersion study was performed on WE43-based tensile specimens with and without PEO surface modification, which included fully automated spatial reconstruction of the phenomenological features of corrosion through micro-CT scanning, followed by uniaxial tensile testing. Then the experimental data of both unmodified and PEO-modified groups were used to calibrate parameters of a finite element-based surface corrosion model. In-vitro, it was found that the WE43-PEO modified group had a significantly lower corrosion rate and maintained significantly higher mechanical properties than the unmodified. While corrosion rates were ∼50% lower in the WE43-PEO modified specimens, the local geometric features of corroding surfaces remained similar to the unmodified WE43 group, however evolving after almost the double amount of time. We were also able to quantitatively demonstrate that the PEO surface treatment on magnesium continued to protect samples from corrosion throughout the entire period tested, and not just in the early stages of corrosion. Using the results from the testing framework, the model parameters of the surface-based corrosion model were identified for both groups. This enabled, for the first time, in-silico prediction of the physical features of corrosion and the mechanical performance of both unmodified and PEO modified magnesium specimens. This simulation framework can enable future in-silico design and optimisation of bioabsorbable magnesium devices for load-bearing medical applications.

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Examination of corrosion morphology and mechanics of PEO modified WE43.

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Automated phenomenological tracking of corrosion features by PitScan.

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Corrosion model of unmodified WE43 and WE43 PEO modified.

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Calibration through geometrical features and mechanical parameters followed.

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PEO treatment does not influence the severity of localised corrosion.

A Superior Corrosion Protection of Mg Alloy via Smart Nontoxic Hybrid Inhibitor-Containing Coatings

The increase of corrosion resistance of magnesium and its alloys by forming the smart self-healing hybrid coatings was achieved in this work in two steps. In the first step, using the plasma electrolytic oxidation (PEO) treatment, a ceramic-like bioactive coating was synthesized on the surface of biodegradable MA8 magnesium alloy. During the second step, the formed porous PEO layer was impregnated with a corrosion inhibitor 8-hydroxyquinoline (8-HQ) and bioresorbable polymer polycaprolactone (PCL) in different variations to enhance the protective properties of the coating. The composition, anticorrosion, and antifriction properties of the formed coatings were studied. 8-HQ allows controlling the rate of material degradation due to the self-healing effect of the smart coating. PCL treatment of the inhibitor-containing layer significantly improves the corrosion and wear resistance and retains an inhibitor in the pores of the PEO layer. It was revealed that the corrosion inhibitor incorporation method (including the number of steps, impregnation, and the type of solvent) significantly matters to the self-healing mechanism. The hybrid coatings obtained by a 1-step treatment in a dichloromethane solution containing 6 wt.% polycaprolactone and 15 g/L of 8-HQ are characterized by the best corrosion resistance. This coating demonstrates the lowest value of corrosion current density (3.02 × 10−7 A cm−2). The formation of the hybrid coating results in the corrosion rate decrease by 18 times (0.007 mm year−1) as compared to the blank PEO layer (0.128 mm year−1). An inhibitor efficiency was established to be 83.9%. The mechanism of corrosion protection of Mg alloy via smart hybrid coating was revealed.

Recent research advances on corrosion mechanism and protection, and novel coating materials of magnesium alloys: a review

Magnesium alloys have achieved a good balance between biocompatibility and mechanical properties, and have great potential for clinical application, and their performance as implant materials has been continuously improved in recent years. However, a high degradation rate of Mg alloys in a physiological environment remains a major limitation before clinical application. In this review, according to the human body's intake of elements, the current mainstream implanted magnesium alloy system is classified and discussed, and the corrosion mechanism of magnesium alloy in vivo and in vitro is described, including general corrosion, localized corrosion, pitting corrosion, and degradation of body fluid environment impact etc. The introduction of methods to improve the mechanical properties and biocorrosion resistance of magnesium alloys is divided into two parts: the alloying part mainly discusses the strengthening mechanisms of alloying elements, including grain refinement strengthening, solid solution strengthening, dislocation strengthening and precipitation strengthening etc.; the surface modification part introduces the ideas and applications of novel materials with excellent properties such as graphene and biomimetic materials in the development of functional coatings. Finally, the existing problems are summarized, and the future development direction is prospected.

MWCNTs-TiO2 Incorporated-Mg Composites to Improve the Mechanical, Corrosion and Biological Characteristics for Use in Biomedical Fields

This study attempts to synthesize MgZn/TiO₂-MWCNTs composites with varying TiO₂-MWCNT concentrations using mechanical alloying and a semi-powder metallurgy process coupled with spark plasma sintering. It also aims to investigate the mechanical, corrosion, and antibacterial properties of these composites. When compared to the MgZn composite, the microhardness and compressive strength of the MgZn/TiO₂-MWCNTs composites were enhanced to 79 HV and 269 MPa, respectively. The results of cell culture and viability experiments revealed that incorporating TiO₂-MWCNTs increased osteoblast proliferation and attachment and enhanced the biocompatibility of the TiO₂-MWCNTs nanocomposite. It was observed that the corrosion resistance of the Mg-based composite was improved and the corrosion rate was reduced to about 2.1 mm/y with the addition of 10 wt% TiO₂-1 wt% MWCNTs. In vitro testing for up to 14 days revealed a reduced degradation rate following the incorporation of TiO₂-MWCNTs reinforcement into a MgZn matrix alloy. Antibacterial evaluations revealed that the composite had antibacterial activity, with an inhibition zone of 3.7 mm against Staphylococcus aureus. The MgZn/TiO₂-MWCNTs composite structure has great potential for use in orthopedic fracture fixation devices.

A "built-up" composite film with synergistic functionalities on Mg-2Zn-1Mn bioresorbable stents improves corrosion control effects and biocompatibility

Control of premature corrosion of magnesium (Mg) alloy bioresorbable stents (BRS) is frequently achieved by the addition of rare earth elements. However, limited long-term experience with these elements causes concerns for clinical application and alternative methods of corrosion control are sought after. Herein, we report a "built-up" composite film consisting of a bottom layer of MgF₂ conversion coating, a sandwich layer of a poly (1, 3-trimethylene carbonate) (PTMC) and 3-aminopropyl triethoxysilane (APTES) co-spray coating (PA) and on top a layer of poly (lactic-co-glycolic acid) (PLGA) ultrasonic spray coating to decorate the rare earth element-free Mg-2Zn-1Mn (ZM21) BRS for tailoring both corrosion resistance and biological functions. The developed "built-up" composite film shows synergistic functionalities, allowing the compression and expansion of the coated ZM21 BRS on an angioplasty balloon without cracking or peeling. Of special importance is that the synergistic corrosion control effects of the "built-up" composite film allow for maintaining the mechanical integrity of stents for up to 3 months, where complete biodegradation and no foreign matter residue were observed about half a year after implantation in rabbit iliac arteries. Moreover, the functionalized ZM21 BRS accomplished re-endothelialization within one month.

PCL-nHAC/Mg-Ca alloy composite and preliminary study of its osteogenesis property

Owing to their excellent properties, magnesium alloys are widely used in bone tissue engineering. However, considerable work has been conducted to control the degradation rate and improve the cytocompatibility of magnesium alloys. In this study, low-cost production introduced a new bone repair composite (PCL-nHAC/Mg-Ca), which was composed of nano-hydroxylapatite-collagen (nHAC), polycaprolactone (PCL) and Mg-Ca alloy substrate treated by micro- arc oxidation (MAO). The experimental results showed that compared with the Mg-Ca alloy treated by MAO alone, the PCL-nHAC/Mg-Ca composite has a porous structure and a slower degradation rate. Cell experiments showed that the PCL-nHAC/Mg-Ca composite had good biocompatibility and significantly enhanced the proliferation of the MC3T3-E1 cells. The rabbit skull defect model further proved that the PCL-nHAC/Mg-Ca composite could regulate the degradation rate of the Mg-Ca alloy and promote the formation of bone tissue. Histological analyses showed that the PCL-nHAC/Mg-Ca composite had good stability in vivo and could better accelerate bone formation.

Bioactive fluorcanasite reinforced magnesium alloy-based porous bio-nanocomposite scaffolds with tunable mechanical properties

Magnesium (Mg) alloy-based porous bio-nanocomposite bone scaffolds were developed by powder metallurgy route. Selective alloying elements such as calcium (Ca), zinc (Zn) and strontium (Sr) were incorporated to tune the mechanical integrity while, bioactive fluorcanasite nano-particulates were introduced within the alloy system to enhance the bone tissue regeneration. Green compacts containing carbamide were fabricated and sintered using two-stage heat treatment process to achieve the targeted porosities. The microstructure of these fabricated magnesium alloy-based bio-nanocomposites was examined by Field emission scanning electron microscope (FE-SEM) and x-ray micro computed tomography (x-ray μCT), which revealed gradient porosities and distribution of alloying elements. X-ray diffraction (XRD) studies confirmed the presence of major crystalline phases in the fabricated samples and the evolution of the various combinations of intermetallic phases of Ca, Mg, Zn and Sr which were anticipated to enhance the mechanical properties. Further, XRD studies revealed the presence of apatite phase for the immersed samples, a conducive environment for bone regeneration. The fabricated samples were evaluated for their mechanical performance against uniaxial compression load. The tunability of compressive strengths and modulus values could be established with variation in porosities of fabricated samples. The retained compressive strength and Young's modulus of the samples following immersion in phosphate buffered saline (PBS) solution was found to be in line with that of natural human cancellous bone, thereby establishing the potential of the fabricated magnesium-alloy-based nanocomposite as a promising scaffold candidate for bone tissue engineering.

Progress in bioactive surface coatings on biodegradable Mg alloys: A critical review towards clinical translation

Mg and its alloys evince strong candidature for biodegradable bone implants, cardiovascular stents, and wound closing devices. However, their rapid degradation rate causes premature implant failure, constraining clinical applications. Bio-functional surface coatings have emerged as the most competent strategy to fulfill the diverse clinical requirements, besides yielding effective corrosion resistance. This article reviews the progress of biodegradable and advanced surface coatings on Mg alloys investigated in recent years, aiming to build up a comprehensive knowledge framework of coating techniques, processing parameters, performance measures in terms of corrosion resistance, adhesion strength, and biocompatibility. Recently developed conversion and deposition type surface coatings are thoroughly discussed by reporting their essential therapeutic responses like osteogenesis, angiogenesis, cytocompatibility, hemocompatibility, anti-bacterial, and controlled drug release towards in-vitro and in-vivo study models. The challenges associated with metallic, ceramic and polymeric coatings along with merits and demerits of various coatings have been illustrated. The use of multilayered hybrid coating comprising a unique combination of organic and inorganic components has been emphasized with future perspectives to obtain diverse bio-functionalities in a facile single coating system for orthopedic implant applications.

In Vitro Degradation and Photoactivated Antibacterial Activity of a Hemin-CaP Microsphere-Loaded Coating on Pure Magnesium

Photoactivated sterilization has received more attention in dealing with implant-associated infections due to its advantages of rapid and effective bacteriostasis and broad-spectrum antibacterial activity. Herein, a micro-arc oxidation (MAO)/polymethyltrimethoxysilane (PMTMS)@hemin-induced calcium-bearing phosphate microsphere (Hemin-CaP) coating was prepared on pure magnesium (Mg) via MAO processing and dipping treatments. The morphology and composition of the coating were characterized via scanning electron microscopy, Fourier transform infrared spectrometer, X-ray diffractometer and X-ray photoelectron spectrometer. Corrosion behavior was evaluated through electrochemical and hydrogen evolution tests. The release of Fe³⁺ ions at different immersion times was measured with an atomic absorption spectrophotometer. Antibacterial performance and cytotoxicity were assessed using the spread plate method, MTT assay and live/dead staining experiment. The results showed that the corrosion current density of the MAO/PMTMS@(Hemin-CaP) coating (4.41 × 10^-8 A·cm^-2) was decreased by two orders of magnitude compared to that of pure Mg (3.12 × 10^-6 A·cm^-2). Photoactivated antibacterial efficiencies of the Hemin-CaP microspheres and MAO/PMTMS@(Hemin-CaP) coating reached about 99% and 92%, respectively, which we attributed to the photothermal and photodynamic properties of hemin with a porphyrin ring. Moreover, based on the release of Fe³⁺ ions, the MC3T3-E1 pre-osteoblasts' viability reached up to 125% after a 72 h culture, indicating a positive effect of the coating in promoting cell growth. Thus, this novel composite coating holds a promising application as bone implants.

Polydopamine-modified decellularized intestinal scaffolds loaded with adipose-derived stem cells promote intestinal regeneration

Regeneration of gastrointestinal tissues remains a great challenge due to their unique microenvironment. Functional composite decellularized scaffolds have shown great potential in gastrointestinal repair and inducing gastrointestinal tissue-specific proliferation. In this study, polydopamine (PDA)-mediated surface modification of decellularized intestinal scaffolds (DIS), combined with adipose tissue-derived stem cells (ADSC), was used to promote intestinal wound healing while avoiding intestinal resection. The results showed that DIS had good biocompatibility and could maintain the growth and proliferation of ADSC. Moreover, PDA-coated DIS not only had anti-infection ability but could also further promote the secretory activity for the paracrine effects of ADSC. ADSC cultured on PDA-DIS produced significantly higher levels of anti-inflammatory and proangiogenic cytokines than those cultured on plastic plates or DIS. In vivo, ADSC-PDA-DIS significantly promoted intestinal wound closure in rat intestinal defect models. Moreover, ADSC-PDA-DIS was able to induce more neovascularization at 4 weeks postoperatively and promoted macrophage recruitment to accelerate wound healing. Taken together, the results showed that PDA-modified DIS could significantly improve the efficacy of stem cell therapy, and ADSC-PDA-DIS could improve the wound healing process with anti-infection effects, enhancing neovascularization and immunoregulation, which may be of great clinical significance for gastrointestinal regeneration.

Natural Coatings and Surface Modifications on Magnesium Alloys for Biomedical Applications

Magnesium (Mg) alloys have great potential in biomedical applications due to their incomparable properties regarding other metals, such as stainless steels, Co-Cr alloys, and titanium (Ti) alloys. However, when Mg engages with body fluids, its degradation rate increases, inhibiting the complete healing of bone tissue. For this reason, it has been necessary to implement protective coatings to control the rate of degradation. This review focuses on natural biopolymer coatings used on Mg alloys for resorbable biomedical applications, as well as some modification techniques implemented before applying natural polymer coatings to improve their performance. Issues such as improving the corrosion resistance, cell adhesion, proliferation, and biodegradability of natural biopolymers are discussed through their basic comparison with inorganic-type coatings. Emphasis is placed on the expected biological behavior of each natural polymer described, to provide basic information as a reference on this topic.

A hydrophobic layer prepared by cyclic grafting of polydimethylsiloxane on magnesium: improved corrosion resistance and biocompatibility

Magnesium and its alloys have been widely studied as absorbable coronary stent materials. However, the rapid corrosion rate in the intravascular environment inhibits the application of magnesium-based stents. In order to endow magnesium-based stent with appropriate degradation rate and biocompatibility, a hydrophobic layer was constructed by in situ cyclic grafting 4,4'-diphenylmethane diisocyanate and aminopropyl-terminated polydimethylsiloxane on pure magnesium. SEM-EDS, X-ray photoelectron spectroscopy and water contact angle were detected to analyze the chemical composition of the layer. The amino groups were confirmed to be introduced on the surface which provide a platform for subsequent modification. The contact angle value of the modified surface is 132.1°, indicating a hydrophilic surface. The electrochemical measurements and immersion tests demonstrated that the hydrophobic layer significantly improved the anti-corrosion ability of the substrate. Besides, the biocompatibility of the hydrophobic surface was examined by platelet adhesion, cytocompatibility in vitro and subcutaneous implantation in vivo. Immunological and histological results indicated that the hydrophobic layer had excellent biocompatibility. Therefore, the presented study might be a promising method for the surface modification of biomedical magnesium-based stent.

Progress of laser surface treatment on magnesium alloy

Magnesium (Mg) metals have been widely used in various fields as one of the most promising lightweight structural materials. However, the low corrosion resistance and poor mechanical properties restrict its applications. Surface treatments are common approach to enhance the mechanical strength and corrosion resistance of Mg metals. Among them, laser surface treatment generates novel tissues and structures in situ on the sample surface, thereby improving properties of mechanical strength and corrosion resistance. We briefly describe the changes in surface organization that arise after laser treatment of Mg surfaces, as well as the creation of structures such as streaks, particles, holes, craters, etc., and provide an overview of the reasons for the alterations. The effect of laser processing on wettability, hardness, friction wear, degradation, biocompatibility and mechanical properties were reviewed. At last, the limitations and development trend of laser treatment on Mg metals research were further pointed out.

Comparison of 2D and 3D Plasma Electrolytic Oxidation (PEO)-Based Coating Porosity Data Obtained by X-ray Tomography Rendering and a Classical Metallographic Approach

In this work, the porosity of plasma electrolytic oxidation (PEO)-based coatings on Al- and Mg-based substrates was studied by two imaging techniques-namely, SEM and computer microtomography. Two approaches for porosity determination were chosen; relatively simple and fast SEM surface and cross-sectional imaging was compared with X-ray micro computed tomography (microCT) rendering. Differences between 2D and 3D porosity were demonstrated and explained. A more compact PEO coating was found on the Al substrate, with a lower porosity compared to Mg substrates under the same processing parameters. Furthermore, huge pore clusters were detected with microCT. Overall, 2D surface porosity calculations did not show sufficient accuracy for them to become the recommended method for the exact evaluation of the porosity of PEO coatings; microCT is a more appropriate method for porosity evaluation compared to SEM imaging. Moreover, the advantage of 3D microCT images clearly lies in the detection of closed and open porosity, which are important for coating properties.

Controlled magnesium ion delivery system for in situ bone tissue engineering

Magnesium cation (Mg²⁺) has been an emerging therapeutic agent for inducing vascularized bone regeneration. However, the therapeutic effects of current magnesium (Mg) -containing biomaterials are controversial due to the concentration- and stage-dependent behavior of Mg²⁺. Here, we first provide an overview of biochemical mechanism of Mg²⁺ in various concentrations and suggest that 2-10 mM Mg²⁺in vitro may be optimized. This review systematically summarizes and discusses several types of controlled Mg²⁺ delivery systems based on polymer-Mg composite scaffolds and Mg-containing hydrogels, as well as their design philosophy and several parameters that regulate Mg²⁺ release. Given that the continuous supply of Mg²⁺ may prevent biomineral deposition in the later stage of bone regeneration and maturation, we highlight the controlled delivery of Mg²⁺ based dual- or multi-ions system, especially for the hierarchical therapeutic ion release system, which shows enhanced biomineralization. Finally, the remaining challenges and perspectives of Mg-containing biomaterials for future in situ bone tissue engineering are discussed as well.

Mapping knowledge structure and themes trends of biodegradable Mg-based alloy for orthopedic application: A comprehensive bibliometric analysis

Background: Since Lambotte and Payr first studied Mg-based alloys for orthopedics in 1900, the research of this field has finally ushered in vigorous development in the 21st century. From the perspective of quantitative analysis, this paper clearly demonstrated the global research trend from 2005 to 2021 by using bibliometrics and scientometric analysis.

Methods: We obtained the publications from the Web of Science Core Collection (WoSCC) database. The bibliometric and scientometric analysis was conducted by using R software, CiteSpace software, VOSviewer software, Pajek software and Microsoft Excel program.

Results: In total, 1921 publications were retrieved. It can be found that the number of publications is gradually increasing year by year. We can find that the most prolific countrie, institution and researcher are China, Chinese Academy of Sciences and Zheng Yufeng, respectively. The most influential journals in this field are Acta Biomaterialia and Biomaterials, with 16,511 and 12,314 total citations, respectively. By conducting the co-cited documents-based clustering analysis, 16 research hotspots and their representative studies have been identified. Besides, by conducting analysis of keywords, we divided the keyword citation bursts representing the development of the field into three stages.

Conclusion: The number of researches on the biodegradable Mg-based alloys increased sharply all over the world in the 21st century. China has made significant progress in biodegradable Mg-based alloy research. More focus will be placed on osteogenic differentiation, fabrication, graphene oxide, antibacterial property, bioactive glass and nanocomposite, which may be the next popular topics in the field.

Biodegradable interbody cages for lumbar spine fusion: Current concepts and future directions

Lumbar fusion often remains the last treatment option for various acute and chronic spinal conditions, including infectious and degenerative diseases. Placement of a cage in the intervertebral space has become a routine clinical treatment for spinal fusion surgery to provide sufficient biomechanical stability, which is required to achieve bony ingrowth of the implant. Routinely used cages for clinical application are made of titanium (Ti) or polyetheretherketone (PEEK). Ti has been used since the 1980s; however, its shortcomings, such as impaired radiographical opacity and higher elastic modulus compared to bone, have led to the development of PEEK cages, which are associated with reduced stress shielding as well as no radiographical artefacts. Since PEEK is bioinert, its osteointegration capacity is limited, which in turn enhances fibrotic tissue formation and peri-implant infections. To address shortcomings of both of these biomaterials, interdisciplinary teams have developed biodegradable cages. Rooted in promising preclinical large animal studies, a hollow cylindrical cage (Hydrosorb™) made of 70:30 poly-l-lactide-co-d, l-lactide acid (PLDLLA) was clinically studied. However, reduced bony integration and unfavourable long-term clinical outcomes prohibited its routine clinical application. More recently, scaffold-guided bone regeneration (SGBR) with application of highly porous biodegradable constructs is emerging. Advancements in additive manufacturing technology now allow the cage designs that match requirements, such as stiffness of surrounding tissues, while providing long-term biomechanical stability. A favourable clinical outcome has been observed in the treatment of various bone defects, particularly for 3D-printed composite scaffolds made of medical-grade polycaprolactone (mPCL) in combination with a ceramic filler material. Therefore, advanced cage design made of mPCL and ceramic may also carry initial high spinal forces up to the time of bony fusion and subsequently resorb without clinical side effects. Furthermore, surface modification of implants is an effective approach to simultaneously reduce microbial infection and improve tissue integration. We present a design concept for a scaffold surface which result in osteoconductive and antimicrobial properties that have the potential to achieve higher rates of fusion and less clinical complications. In this review, we explore the preclinical and clinical studies which used bioresorbable cages. Furthermore, we critically discuss the need for a cutting-edge research program that includes comprehensive preclinical in vitro and in vivo studies to enable successful translation from bench to bedside. We develop such a conceptual framework by examining the state-of-the-art literature and posing the questions that will guide this field in the coming years.

Additive Manufacturing of Biomaterials-Design Principles and Their Implementation

Additive manufacturing (AM, also known as 3D printing) is an advanced manufacturing technique that has enabled progress in the design and fabrication of customised or patient-specific (meta-)biomaterials and biomedical devices (e.g., implants, prosthetics, and orthotics) with complex internal microstructures and tuneable properties. In the past few decades, several design guidelines have been proposed for creating porous lattice structures, particularly for biomedical applications. Meanwhile, the capabilities of AM to fabricate a wide range of biomaterials, including metals and their alloys, polymers, and ceramics, have been exploited, offering unprecedented benefits to medical professionals and patients alike. In this review article, we provide an overview of the design principles that have been developed and used for the AM of biomaterials as well as those dealing with three major categories of biomaterials, i.e., metals (and their alloys), polymers, and ceramics. The design strategies can be categorised as: library-based design, topology optimisation, bio-inspired design, and meta-biomaterials. Recent developments related to the biomedical applications and fabrication methods of AM aimed at enhancing the quality of final 3D-printed biomaterials and improving their physical, mechanical, and biological characteristics are also highlighted. Finally, examples of 3D-printed biomaterials with tuned properties and functionalities are presented.

Surface Modification of WE43 Magnesium Alloys with Dopamine Hydrochloride Modified GelMA Coatings

As biodegradable medical implants, magnesium alloys have attracted great concerns due to their desirable biological and mechanical performances. Nevertheless, the overfast degradation rate of magnesium alloys makes it difficult to make full use of their potential in medical sciences. Therefore, it is a hot issue to control the degradation rate and functionalize the magnesium alloys via surface modifications. Herein, methacrylate gelatin (GelMA) hydrogel was adopted as coatings on the surface of WE43 magnesium alloys to control the degradation behaviors of magnesium alloys. Inspired by mussels, dopamine (DOPA) hydrochloride was adopted to modify GelMA to further functionalize the coatings. The compositions, swelling properties, degradation behaviors, and morphologies of samples were characterized by UV-Vis spectrophotometer, nuclear magnetic resonance (NMR), Fourier transform infrared spectroscopy (FTIR), scanning electron microscope (SEM), and immersion test. It was shown that GelMA-DOPA composites could be obtained and the swelling and degradation behaviors of magnesium alloys could be controlled by adjusting the compositions of GelMA and DOPA. Furthermore, the GelMA-DOPA hydrogel coatings can be tightly bonded to the Mg alloys.