Extrusion-based 3D printed biodegradable porous iron

Mechanical Strengthening and Degradation Regulation of Iron Foam-Polycaprolactone Interpenetrating Composite Scaffolds

Porous materials, owing to their unique pore networks, are expected to positively influence the enhancement of mechanical properties and modulation of degradation behavior. Herein, composite scaffolds were fabricated by a combination of triply periodic minimal surfaces (TPMS) design, selective laser sintering (SLS), and hot-pressing technology, in which iron foam (FFe) and polycaprolactone (PCL) were the reinforcing phase and matrix, respectively. Mechanical strengthening was achieved by forming an interpenetrating structure between the continuously porous FFe and TPMS structure PCL. Regarding degradation regulation, a catalytic degradation microcirculation system (CDMS) was constructed through acid-base neutralization reactions between FFe and PCL degradation products. The results indicated that the compressive and tensile moduli of composite scaffolds were increased by an astonishing 1758.8% and 466.0% compared with the PCL scaffold, which is attributed to the synergistic load sharing and stress transmission efficiency of the interpenetrating structures. In addition, the weight loss of the composite scaffold was 3.6 times higher than that of the PCL scaffold, indicating that the constructed CDMS is expected to achieve degradation regulation. Encouragingly, the composite scaffold also exhibited a good apatite induction ability during in vitro culture. Therefore, the constructed composite scaffold realizes the regulation of mechanical and degradation properties, so that it has potential applications in bone tissue engineering.

In Vitro Degradation and Cytocompatibility Study of Biodegradable Porous Zinc Scaffolds Fabricated by Fused Deposition Modeling Based Rapid Tooling Method

An integrative study is conducted on the static biodegradation behavior and cytocompatibility of organized porous network structured (OPNS) zinc scaffolds fabricated via the Fused Deposition Modeling based Rapid Tooling (FDM-RT) method. The degradation study investigates the corrosion mechanism over immersion time in simulated body fluid (SBF), whereas the cytocompatibility study incorporates MTT assay and direct cell counting tests. The results indicate that the scaffold morphology, including scaffold struts, interconnectivity, or porosity, along with the immersion period, significantly influence the degradation behavior. The static corrosion rates are determined to be 0.27 ± 0.006, 0.79 ± 0.01, and 1.35 ± 0.05 mm y-1 for bulk and porous zinc samples after 28 days. The higher corrosion rate of porous zinc alloys is mainly due to their higher surface area, which enhances exposure to the solution. Over time, protective layers form on both porous and bulk samples, leading to a gradual decrease in corrosion rate. The XRD results reveal that the corrosion protective layer is primarily composed of ZnO, Ca3(PO4)2, Zn (OH)2, and Zn3(PO4)2·4H2O. Moreover, MTT assay and direct cell counting of mouse fibroblast 3T3 cells on bulk and porous zinc samples suggest that the prepared zinc samples have potential for tissue engineering applications.

Advances in growth factor-containing 3D printed scaffolds in orthopedics

Currently, bone tissue engineering is a research hotspot in the treatment of orthopedic diseases, and many problems in orthopedics can be solved through bone tissue engineering, which can be used to treat fractures, bone defects, arthritis, etc. More importantly, it can provide an alternative to traditional bone grafting and solve the problems of insufficient autologous bone grafting, poor histocompatibility of grafts, and insufficient induced bone regeneration. Growth factors are key factors in bone tissue engineering by promoting osteoblast proliferation and differentiation, which in turn increases the efficiency of osteogenesis and bone regeneration. 3D printing technology can provide carriers with better pore structure for growth factors to improve the stability of growth factors and precisely control their release. Studies have shown that 3D-printed scaffolds containing growth factors provide a better choice for personalized treatment, bone defect repair, and bone regeneration in orthopedics, which are important for the treatment of orthopedic diseases and have potential research value in orthopedic applications. This paper aims to summarize the research progress of 3D printed scaffolds containing growth factors in orthopedics in recent years and summarize the use of different growth factors in 3D scaffolds, including bone morphogenetic proteins, platelet-derived growth factors, transforming growth factors, vascular endothelial growth factors, etc. Optimization of material selection and the way of combining growth factors with scaffolds are also discussed.

Development of Tailored Porous Ti6Al4V Materials by Extrusion 3D Printing

Nowadays, metallic bone replacement is in high demand due to different issues, like sicknesses and accidents. Thus, bone implants are fabricated with tailored properties and microstructure for long-term use in the human body. To improve such implants, 3D printing is the most promising technique. Therefore, this work aims to evaluate the fabrication of porous materials by extrusion 3D printing of Ti6Al4V. Cylindrical samples were fabricated from pellets for metal injection molding of Ti6Al4V powders, creating hexagonal channels with three different sizes. The densification kinetics was evaluated by dilatometry tests, which enabled following the densification of the samples during the sintering cycle. Subsequently, the samples were characterized by scanning electron microscopy and X-ray computed tomography to analyze their microstructure. Compression tests evaluated the mechanical strength of sintered samples. It was found that the hexagonal shape during printing is better defined as the channel size increases. The results show similar behavior for each of the channel sizes during sintering; however, greater densification is obtained as the channel size decreases. Additionally, microporosity is obtained at the particle level, which is completely interconnected, ensuring the passage of fluids through the entire sample. On the other hand, as the channel size increases, Young's modulus and yield strength are considerably reduced. The main conclusion is that parts with two scales of porosity can be designed by the 3D printing extrusion process.

A Systematic Review of the Contribution of Additive Manufacturing toward Orthopedic Applications

Human bone holds an inherent capacity for repairing itself from trauma and damage, but concerning the severity of the defect, the choice of implant placement is a must. Additive manufacturing has become an elite option due to its various specifications such as patient-specific custom development of implants and its easy fabrication rather than the conventional methods used over the years. Additive manufacturing allows customization of the pore size, porosity, various mechanical properties, and complex structure design and formulation. Selective laser melting, powder bed fusion, electron beam melting, and fused deposition modeling are the various AM methods used extensively for implant fabrication. Metals, polymers, biocrystals, composites, and bio-HEA materials are used for implant fabrication for various applications. A wide variety of polymer implants are fabricated using additive manufacturing for nonload-bearing applications, and β-tricalcium phosphate, hydroxyapatite, bioactive glass, etc. are mainly used as ceramic materials in additive manufacturing due to the biological properties that could be imparted by the latter. For decades metals have played a major role in implant fabrication, and additive manufacturing of metals provides an easy approach to implant fabrication with augmented qualities. Various challenges and setbacks faced in the fabrication need postprocessing such as sintering, coating, surface polishing, etc. The emergence of bio-HEA materials, printing of shape memory implants, and five-dimensional printing are the trends of the era in additive manufacturing.

Tetracalcium phosphate/porous iron synergistically improved the mechanical, degradation and biological properties of polylactic acid scaffolds

Synergistically improving the mechanical and degradable properties of polylactic acid (PLA) scaffolds and endowing them with bioactivity are urgent problems to be solved in deepening their application in tissue engineering. In this work, tetracalcium phosphate (TTCP) and porous iron (pFe) were compounded by stirring and vacuum negative pressure, and then they were blended with polylactic acid and a porous scaffold (named TTCP@pFe/PLA) was prepared by selective laser sintering. On the one hand, molten polylactic acid penetrates the pores of porous iron to form an interlocking network, thereby achieving mechanical strengthening. On the other hand, the alkaline environment generated by the dissolution of tetracalcium phosphate can effectively catalyze the hydrolysis of polylactic acid to accelerate the degradation. Meanwhile, the dissolution of tetracalcium phosphate forms a local calcium-rich microenvironment, which rapidly induces apatite formation, that is, confers bioactivity on scaffolds. As a result, the TTCP@pFe/PLA scaffold exhibited a notable enhancement in mechanical strength, being 2.2 times stronger compared to the polylactic acid scaffold. More importantly, MC3T3E1 cells exhibit good adhesion, stretching, and proliferation on the composite scaffold, demonstrating good cytocompatibility. All these good properties of the TTCP@pFe/PLA scaffold indicate that it has potential applications as a novel alternative in bone tissue regeneration.

Orthopedic meta-implants

Meta-biomaterials, engineered materials with distinctive combinations of mechanical, physical, and biological properties stemming from their micro-architecture, have emerged as a promising domain within biomedical engineering. Correspondingly, meta-implants, which serve as the device counterparts of meta-biomaterials, offer exceptional functionalities, holding great potential for addressing complex skeletal diseases. This paper presents a comprehensive overview of the various types of meta-implants, including hybrid, shape-morphing, metallic clay, and deployable meta-implants, highlighting their unprecedented properties and recent achievement in the field. This paper also delves into the potential future developments of meta-implants, addressing the exploration of multi-functionalities in meta-biomaterials and their applications in diverse biomedical fields.

Recent advances in Fe-based bioresorbable stents: Materials design and biosafety

Fe-based materials have received more and more interests in recent years as candidates to fabricate bioresorbable stents due to their appropriate mechanical properties and biocompatibility. However, the low degradation rate of Fe is a serious limitation for such application. To overcome this critical issue, many efforts have been devoted to accelerate the corrosion rate of Fe-based stents, through the structural and surface modification of Fe matrix. As stents are implantable devices, the released corrosion products (Fe2+ ions) in vessels may alter the metabolism, by generating reactive oxygen species (ROS), which might in turn impact the biosafety of Fe-based stents. These considerations emphasize the importance of combining knowledge in both materials and biological science for the development of efficient and safe Fe-based stents, although there are still only limited numbers of reviews regarding this interdisciplinary field. This review aims to provide a concise overview of the main strategies developed so far to design Fe-based stents with accelerated degradation, highlighting the fundamental mechanisms of corrosion and the methods to study them as well as the reported approaches to accelerate the corrosion rates. These approaches will be divided into four main sections, focusing on (i) increased active surface areas, (ii) tailored microstructures, (iii) creation of galvanic reactions (by alloying, ion implantation or surface coating of noble metals) and (iv) decreased local pH induced by degradable surface organic layers. Recent advances in the evaluation of the in vitro biocompatibility of the final materials and ongoing in vivo tests are also provided.

3D/4D printing of cellulose nanocrystals-based biomaterials: Additives for sustainable applications

Cellulose nanocrystals (CNCs) have gained significant attraction from both industrial and academic sectors, thanks to their biodegradability, non-toxicity, and renewability with remarkable mechanical characteristics. Desirable mechanical characteristics of CNCs include high stiffness, high strength, excellent flexibility, and large surface-to-volume ratio. Additionally, the mechanical properties of CNCs can be tailored through chemical modifications for high-end applications including tissue engineering, actuating, and biomedical. Modern manufacturing methods including 3D/4D printing are highly advantageous for developing sophisticated and intricate geometries. This review highlights the major developments of additive manufactured CNCs, which promote sustainable solutions across a wide range of applications. Additionally, this contribution also presents current challenges and future research directions of CNC-based composites developed through 3D/4D printing techniques for myriad engineering sectors including tissue engineering, wound healing, wearable electronics, robotics, and anti-counterfeiting applications. Overall, this review will greatly help research scientists from chemistry, materials, biomedicine, and other disciplines to comprehend the underlying principles, mechanical properties, and applications of additively manufactured CNC-based structures.

Physiomimetic biocompatibility evaluation of directly printed degradable porous iron implants using various cell types

Additively manufactured (AM) degradable porous metallic biomaterials offer unique opportunities for satisfying the design requirements of an ideal bone substitute. Among the currently available biodegradable metals, iron has the highest elastic modulus, meaning that it would benefit the most from porous design. Given the successful preclinical applications of such biomaterials for the treatment of cardiovascular diseases, the moderate compatibility of AM porous iron with osteoblast-like cells, reported in earlier studies, has been surprising. This may be because, as opposed to static in vitro conditions, the biodegradation products of iron in vivo are transported away and excreted. To better mimic the in situ situations of biodegradable biomaterials after implantation, we compared the biodegradation behavior and cytocompatibility of AM porous iron under static conditions to the conditions with dynamic in situ-like fluid flow perfusion in a bioreactor. Furthermore, the compatibility of these scaffolds with four different cell types was evaluated to better understand the implications of these implants for the complex process of natural wound healing. These included endothelial cells, L929 fibroblasts, RAW264.7 macrophage-like cells, and osteoblastic MG-63 cells. The biodegradation rate of the scaffolds was significantly increased in the perfusion bioreactor as compared to static immersion. Under either condition, the compatibility with L929 cells was the best. Moreover, the compatibility with all the cell types was much enhanced under physiomimetic dynamic flow conditions as compared to static biodegradation. Our study highlights the importance of physiomimetic culture conditions and cell type selection when evaluating the cytocompatibility of degradable biomaterials in vitro. STATEMENT OF SIGNIFICANCE: Additively manufactured (AM) degradable porous metals offer unique opportunities for the treatment of large bony defects. Despite the successful preclinical applications of biodegradable iron in the cardiovascular field, the moderate compatibility of AM porous iron with osteoblast-like cells was reported. To better mimic the in vivo condition, we compared the biodegradation behavior and cytocompatibility of AM porous iron under static condition to dynamic perfusion. Furthermore, the compatibility of these scaffolds with various cell types was evaluated to better simulate the process of natural wound healing. Our study suggests that AM porous iron holds great promise for orthopedic applications, while also highlighting the importance of physio-mimetic culture conditions and cell type selection when evaluating the cytocompatibility of degradable biomaterials in vitro.

Recent advances in 3D printing of biodegradable metals for orthopaedic applications

The use of biodegradable polymers for treating bone-related diseases has become a focal point in the field of biomedicine. Recent advancements in material technology have expanded the range of materials suitable for orthopaedic implants. Three-dimensional (3D) printing technology has become prevalent in healthcare, and while organ printing is still in its early stages and faces ethical and technical hurdles, 3D printing is capable of creating 3D structures that are supportive and controllable. The technique has shown promise in fields such as tissue engineering and regenerative medicine, and new innovations in cell and bio-printing and printing materials have expanded its possibilities. In clinical settings, 3D printing of biodegradable metals is mainly used in orthopedics and stomatology. 3D-printed patient-specific osteotomy instruments, orthopedic implants, and dental implants have been approved by the US FDA for clinical use. Metals are often used to provide support for hard tissue and prevent complications. Currently, 70-80% of clinically used implants are made from niobium, tantalum, nitinol, titanium alloys, cobalt-chromium alloys, and stainless steels. However, there has been increasing interest in biodegradable metals such as magnesium, calcium, zinc, and iron, with numerous recent findings. The advantages of 3D printing, such as low manufacturing costs, complex geometry capabilities, and short fabrication periods, have led to widespread adoption in academia and industry. 3D printing of metals with controllable structures represents a cutting-edge technology for developing metallic implants for biomedical applications. This review explores existing biomaterials used in 3D printing-based orthopedics as well as biodegradable metals and their applications in developing metallic medical implants and devices. The challenges and future directions of this technology are also discussed.

Extrusion-based 3D printing of biodegradable, osteogenic, paramagnetic, and porous FeMn-akermanite bone substitutes

The development of biodegradable Fe-based bone implants has rapidly progressed in recent years. Most of the challenges encountered in developing such implants have been tackled individually or in combination using additive manufacturing technologies. Yet not all the challenges have been overcome. Herein, we present porous FeMn-akermanite composite scaffolds fabricated by extrusion-based 3D printing to address the unmet clinical needs associated with Fe-based biomaterials for bone regeneration, including low biodegradation rate, MRI-incompatibility, mechanical properties, and limited bioactivity. In this research, we developed inks containing Fe, 35 wt% Mn, and 20 or 30 vol% akermanite powder mixtures. 3D printing was optimized together with the debinding and sintering steps to obtain scaffolds with interconnected porosity of 69%. The Fe-matrix in the composites contained the γ-FeMn phase as well as nesosilicate phases. The former made the composites paramagnetic and, thus, MRI-friendly. The in vitro biodegradation rates of the composites with 20 and 30 vol% akermanite were respectively 0.24 and 0.27 mm/y, falling within the ideal range of biodegradation rates for bone substitution. The yield strengths of the porous composites stayed within the range of the values of the trabecular bone, despite in vitro biodegradation for 28 d. All the composite scaffolds favored the adhesion, proliferation, and osteogenic differentiation of preosteoblasts, as revealed by Runx2 assay. Moreover, osteopontin was detected in the extracellular matrix of cells on the scaffolds. Altogether, these results demonstrate the remarkable potential of these composites in fulfilling the requirements of porous biodegradable bone substitutes, motivating future in vivo research. STATEMENT OF SIGNIFICANCE: We developed FeMn-akermanite composite scaffolds by taking advantage of the multi-material capacity of extrusion-based 3D printing. Our results demonstrated that the FeMn-akermanite scaffolds showed an exceptional performance in fulfilling all the requirements for bone substitution in vitro, i.e., a sufficient biodegradation rate, having mechanical properties in the range of trabecular bone even after 4 weeks biodegradation, paramagnetic, cytocompatible and most importantly osteogenic. Our results encourage further research on Fe-based bone implants in in vivo.

Biocompatibility and Biological Performance of Additive-Manufactured Bioabsorbable Iron-Based Porous Interference Screws in a Rabbit Model: A 1-Year Observational Study

This study evaluated the mid-term (12-month) biomechanical, biocompatibility, and biological performance of additive-manufactured bioabsorbable iron-based interference screws (ISs). Two bioabsorbable iron IS types-manufactured using pure iron powder (iron_IS) and using pure iron powder with 0.2 wt% tricalcium phosphate (TCP_IS)-were compared with conventional metallic IS (control) using in vitro biocompatibility and degradation analyses and an in vivo animal study. The in vitro ultimate failure strength was significantly higher for iron_IS and TCP_IS than for control ISs at 3 months post-operatively; however, the difference between groups were nonsignificant thereafter. Moreover, at 3 months after implantation, iron_IS and TCP_IS increased bone volume fraction, bone surface area fraction, and percent intersection surface; the changes thereafter were nonsignificant. Iron_IS and TCP_IS demonstrated degradation over time with increased implant surface, decreased implant volume, and structure thickness; nevertheless, the analyses of visceral organs and biochemistry demonstrated normal results, except for time-dependent iron deposition in the spleen. Therefore, compared with conventional ISs, bioabsorbable iron-based ISs exhibit higher initial mechanical strength. Although iron-based ISs demonstrate high biocompatibility 12 months after implantation, their corrosive iron products may accumulate in the spleen. Because they demonstrate mechanical superiority along with considerable absorption capability after implantation, iron-based ISs may have potential applications in implantable medical-device development in the future.

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.

Preparation and Properties of Iron Nanoparticle-Based Macroporous Scaffolds for Biodegradable Implants

Fe-based scaffolds are of particular interest in the technology of biodegradable implants due to their high mechanical properties and biocompatibility. In the present work, using an electroexplosive Fe nanopowder and NaCl particles 100-200 µm in size as a porogen, scaffolds with a porosity of about 70 ± 0.8% were obtained. The effect of the sintering temperature on the structure, composition, and mechanical characteristics of the scaffolds was considered. The optimum parameters of the sintering process were determined, allowing us to obtain samples characterized by plastic deformation and a yield strength of up to 16.2 MPa. The degradation of the scaffolds sintered at 1000 and 1100 °C in 0.9 wt.% NaCl solution for 28 days resulted in a decrease in their strength by 23% and 17%, respectively.

Fabrication and characterization of biodegradable Zn scaffold by vacuum heating-press sintering for bone repair

Bone repair materials with excellent mechanical properties are highly desirable, especially in load-bearing sits. However, the currently used ceramic- and polymer-based ones mainly show poor mechanical properties. Recently, biodegradable metals have attracted extensive attention due to their reliable mechanical strength and degradability. As biodegradable metals, zinc-based materials are promising due to their suitable degradation rate and good biocompatibility. Here, we fabricated biodegradable porous Zn scaffolds with relatively high mechanical properties by vacuum heating-press sintering using NaCl particles as space holders. The microstructure, actual porosity, compressive mechanical properties, in vitro degradation behavior and the vitality of osteoblasts of porous Zn scaffolds were tested and investigated. The results show the porosities of the prepared porous Zn scaffolds are ranging from 11.3 % to 63.3 %, and the pore sizes are similar to the size range of the screened NaCl particles (200-500 μm). Compressive yield strength of 14.2-73.7 MPa and compressive elastic modulus of 1.9-6.7 GPa are shown on porous Zn scaffolds, some of which approach to that of cancellous bone (2-12 MPa and 0.1-5 GPa). Compared to bulk Zn, although the porous structures cause a partial loss of strength, the reliable mechanical properties are still retained. In addition, the porous structures not only greatly increase the degradation rate, but also promote the proliferation of osteoblasts. Based on these results, biodegradable porous Zn scaffolds (porosity in the 40 %-50 %) fabricated by vacuum heating-press sintering method show high application potential for clinical bone repair.

A Simple Replica Method as the Way to Obtain a Morphologically and Mechanically Bone-like Iron-Based Biodegradable Material

Porous iron-based scaffolds were prepared by the simple replica method using polyurethane foam as a template and applying the sintering process in a tube furnace. Their surface morphology was characterized using scanning electron microscopy (SEM) and phase homogeneity was confirmed using X-ray diffraction (XRD). Corrosion behavior was determined using immersion and potentiodynamic polarization methods in phosphate buffered saline (PBS). The surface energy was calculated by studying the changes of enthalpy of calorimetric immersion. A preliminary biological test was also carried out and was done using the albumin adsorption procedure. Results of our work showed that in using the simple replica method it is possible to obtain iron biomaterial with morphology and mechanical properties almost identical to bones, and possessing adequate wettability, which gives the potential to use this material as biomaterial for scaffolds in orthopedics.

Additive manufacturing of bioactive and biodegradable porous iron-akermanite composites for bone regeneration

Advanced additive manufacturing techniques have been recently used to tackle the two fundamental challenges of biodegradable Fe-based bone-substituting materials, namely low rate of biodegradation and insufficient bioactivity. While additively manufactured porous iron has been somewhat successful in addressing the first challenge, the limited bioactivity of these biomaterials hinder their progress towards clinical application. Herein, we used extrusion-based 3D printing for additive manufacturing of iron-matrix composites containing silicate-based bioceramic particles (akermanite), thereby addressing both of the abovementioned challenges. We developed inks that carried iron and 5, 10, 15, or 20 vol% of akermanite powder mixtures for the 3D printing process and optimized the debinding and sintering steps to produce geometrically-ordered iron-akermanite composites with an open porosity of 69-71%. The composite scaffolds preserved the designed geometry and the original α-Fe and akermanite phases. The in vitro biodegradation rates of the composites were improved as much as 2.6 times the biodegradation rate of geometrically identical pure iron. The yield strengths and elastic moduli of the scaffolds remained within the range of the mechanical properties of the cancellous bone, even after 28 days of biodegradation. The composite scaffolds (10-20 vol% akermanite) demonstrated improved MC3T3-E1 cell adhesion and higher levels of cell proliferation. The cellular secretion of collagen type-1 and the alkaline phosphatase activity on the composite scaffolds (10-20 vol% akermanite) were, respectively higher than and comparable to Ti6Al4V in osteogenic medium. Taken together, these results clearly show the potential of 3D printed porous iron-akermanite composites for further development as promising bone substitutes. STATEMENT OF SIGNIFICANCE: : Porous iron matrix composites containing akermanite particles were produced by means of multi-material additive manufacturing to address the two fundamental challenges associated with biodegradable iron-based biomaterials, namely very low rate of biodegradation and insufficient bioactivity. Our porous iron-akermanite composites exhibited enhanced biodegradability and superior bioactivity compared to porous monolithic iron scaffolds. The murine bone cells proliferated on the composite scaffolds, and secreted the collagen type-1 matrix that stimulated bony-like mineralization. The results show the exceptional potential of the developed porous iron-based composite scaffolds for application as bone substitutes.

Additive manufacturing of Zn-Mg alloy porous scaffolds with enhanced osseointegration: In vitro and in vivo studies

Biodegradable metals (BM) and additive manufacturing (AM) are regarded revolutionary biomaterials and biofabrication technologies for bone repairing metal implants, the combination of both, namely AM of BM, is thus expected to solve the dual technical difficulties including "conventional medical metals are biologically inert and exist in the human body permanently" and "conventional manufacturing processes are inadequate to fabricate personalized implants of complicated structure". This work additively manufactured biodegradable Zn-Mg alloy porous scaffolds by laser powder bed fusion (L-PBF). By using the pre-alloyed Zn-xMg (x = 1, 2 and 5 wt.%) powder and the optimized processing conditions, high fusion quality with the relative density greater than 99.5% was confirmed for the L-PBF parts. The influence of Mg content on microstructure, mechanical properties, in vitro corrosion, cytocompatibility, in vivo degradation, biocompatibility and osteogenic effect was investigated. Fine α-Zn grains and precipitation phases including Mg₂Zn₁₁ and MgZn₂ were observed in the Zn-xMg L-PBF parts. The hardness increased, and the strength increases firstly and then decreased with increasing the Mg content. The compressive strength and elastic modulus of Zn-1Mg porous scaffolds reached the highest as 40.9 ± 0.4 MPa and 1.17 ± 0.11 GPa, respectively, equivalent to those of cancellous bone. The corrosion rate and cell viability slightly rose with increasing the Mg content. Histological analysis after 6-week and 12-week implantation in rabbit femurs showed enhanced bone formation around the Zn-1Mg porous scaffolds compared with pure Zn counterparts. In summary, Zn-1Mg porous scaffolds produced by L-PBF presented promising results to fulfill customized requirements of biodegradable bone implants. STATEMENT OF SIGNIFICANCE: Additive manufacturing of biodegradable metal porous scaffolds is expected to solve the dual challenges from customized structures and bioactive function required for bone implants. It was the first to present a systematic in vitro and in vivo investigation into the compositions, microstructure, mechanical properties, biodegradation, biocompatibility and osteogenic effect of additively manufactured Zn-Mg alloy porous scaffolds. Reliable formation quality and performance evaluation was achieved by using the pre-alloyed Zn-xMg (x = 1, 2 and 5 wt.%) powder and the optimized laser powder bed fusion process. Although the Zn-1Mg scaffolds exhibited promising mechanical strength, biocompatibility, and osteogenic effect, their degradation rate needs to be further accelerated compared with the term of bone reconstruction.

Progress in manufacturing and processing of degradable Fe-based implants: a review

Biodegradable metals have gained vast attention as befitting candidates for developing degradable metallic implants. Such implants are primarily employed for temporary applications and are expected to degrade or resorbed after the tissue is healed. Fe-based materials have generated considerable interest as one of the possible biodegradable metals. Like other biometals such as Mg and Zn, Fe exhibits good biocompatibility and biodegradability. The versatility in the mechanical behaviour of Fe-based materials makes them a better choice for load-bearing applications. However, the very low degradation rate of Fe in the physiological environment needs to be improved to make it compatible with tissue growth. Several studies on tailoring the degradation behaviour of Fe in the human body are already reported. Majority of these works include studies on the effect of manufacturing and processing techniques on biocompatibility and biodegradability. This article focuses on a comprehensive review and analysis of the various manufacturing and processing techniques so far reported for developing biodegradable iron-based orthopaedic implants. The current status of research in the field is neatly presented, and a summary of the works is included in the article for the benefit of researchers in the field to contextualise their research and effectively find the lacunae in the existing scholarship.

Stress-Induced Dual-Phase Structure to Accelerate Degradation of the Fe Implant

Fe is considered as a potential candidate for implant materials, but its application is impeded by the low degradation rate. Herein, a dual-phase Fe30Mn6Si alloy was prepared by mechanical alloying (MA). During MA, the motion of dislocations driven by the impact stress promoted the solid solution of Mn in Fe, which transformed α-ferrite into γ-austenite since Mn was an austenite-stabilizing element. Meanwhile, the incorporation of Si decreased the stacking fault energy inside austenite grains, which tangled dislocations into stacking faults and acted as nucleation sites for ε-martensite. Resultantly, Fe30Mn6Si powder had a dual-phase structure composed of 53% γ-austenite and 47% ε-martensite. Afterward, the powders were prepared into implants by selective laser melting. The Fe30Mn6Si alloy had a more negative corrosion potential of -0.76 ± 0.09 V and a higher corrosion current of 30.61 ± 0.41 μA/cm² than Fe and Fe30Mn. Besides, the long-term weight loss tests also proved that Fe30Mn6Si had the optimal degradation rate (0.25 ± 0.02 mm/year).

3D-Printed Double-Helical Biodegradable Iron Suture Anchor: A Rabbit Rotator Cuff Tear Model

Suture anchors are extensively used in rotator cuff tear surgery. With the advancement of three-dimensional printing technology, biodegradable metal has been developed for orthopedic applications. This study adopted three-dimensional-printed biodegradable Fe suture anchors with double-helical threads and commercialized non-vented screw-type Ti suture anchors with a tapered tip in the experimental and control groups, respectively. The in vitro study showed that the Fe and Ti suture anchors exhibited a similar ultimate failure load in 20-pound-per-cubic-foot polyurethane foam blocks and rabbit bone. In static immersion tests, the corrosion rate of Fe suture anchors was 0.049 ± 0.002 mm/year. The in vivo study was performed on New Zealand white rabbits and SAs were employed to reattach the ruptured supraspinatus tendon. The in vivo ultimate failure load of the Fe suture anchors was superior to that of the Ti suture anchors at 6 weeks. Micro-computed tomography showed that the bone volume fraction and bone surface density in the Fe suture anchors group 2 and 6 weeks after surgery were superior, and the histology confirmed that the increased bone volume around the anchor was attributable to mineralized osteocytes. The three-dimensional-printed Fe suture anchors outperformed the currently used Ti suture anchors.

Biodegradable iron-silicon implants produced by additive manufacturing

Due to many negative and undesirable side effects from the use of permanent implants, the development of temporary implants based on biocompatible and biodegradable materials is a promising area of modern medicine. In the presented study, we have investigated complex-shaped iron-silicon (Fe-Si) scaffolds that can be used as potential biodegradable framework structures for creating solid implants for bone grafting. Since iron and silicon are biocompatible materials, and their alloy should also have biocompatibility. It has been demonstrated that cells UC-MSC and 3T3 were attached to, spread, and proliferated on the Fe-Si scaffolds' surface. Most of UC-MSC and 3T3 remained viable, only single dead cells were observed. According to the results of biological testing, the scaffolds have shown that deposition of calcium phosphate particles occurs on day one in the scaffold at the defect site that can be used as a primary marker of osteodifferentiation. These results demonstrate that the 3D-printed porous iron-silicon (Fe-Si) alloy scaffolds are promising structures for bone grafting and regeneration.

Corrosion behavior and degradation mechanism of micro-extruded 3D printed ordered pore topological Fe scaffolds

The fabrication of ordered pore topological structures (OPTS) with an improved biodegradation profile offers unique attributes required for bone reconstruction. These attributes consisted of fully interconnected porous structure, bone-mimicking mechanical properties, and the possibility of fully regenerating bony defects. Most of the biomaterials based on magnesium were associated with the problem of too fast degradation rate. Here, the present aim was based on the fabrication of ordered pore topological Fe structures (OPTFS) using micro-extrusion-based 3D printing followed by pressureless microwave sintering. Two different kinds of pore features namely randomly distributed interconnected micropores and designed interconnected macropores were investigated. Static in vitro degradation results inferred that the H-2 mm pore size of hexagonal based ordered pore topological Fe structures (H-OPTFS) exhibited the highest degradation rate of 6.45 mg cm^-2  day^-1 on the 28th day. Electrochemical results revealed that the corrosion current density of the T-1 Fe sample with 44% porosity increased nearly by a multiple of three times as compared to dense Fe (from 16.79 to 44.63  μA cm - 2 ) _. Similarly, these results showed more significance in H-2 mm pores size (with highest 66% porosity) of H-OPTFS as compared to H-1.75 mm and H-1.5 mm pore size of H-OPTFS (≈2 times higher degradation rate than H-1.5 mm pore size). Moreover, the MG63 osteoblast cell line was adhered to and proliferated significantly throughout the surface and illustrated more than 80% cell viability of the prepared porous Fe scaffold. The analyzed results have shown the potential of fabricated OPTFS could be considered for biomedical applications.

Biodegradation behaviour of Fe-based alloys in Hanks' Balanced Salt Solutions: Part II. The evolution of local pH and dissolved oxygen concentration at metal interface

Commercially pure Fe, Fe35Mn, and (Fe35Mn)5Ag alloys were prepared by uniaxial pressing of the mixture of individual powders, followed by sintering. The influence of the alloying elements Mn and Ag on the corrosion behaviour of these Fe-based alloys was investigated in Hanks' Balanced Salt Solution (HBSS). Furthermore, the role of the components in HBSS, particularly Ca2+ ions during alloys degradation was studied. Distribution of local pH and dissolved oxygen concentration was measured 50 μm above the interface of the degrading alloys. The results revealed that 5 wt% Ag addition to Fe35Mn alloy triggered micro-galvanic corrosion, while uniform corrosion dominated in pure Fe and Fe35Mn. Fast precipitation of Ca-P-containing products on the surface of these Fe-based alloys buffered local pH at the metal interface, and blocked oxygen diffusion at the initial stages of immersion. In the (Fe35Mn)5Ag, the detachment or structural changes of Ca-P-containing products gradually diminished their barrier property. These findings provided valuable insights into the degradation mechanism of promising biodegradable Fe-based alloys.

Extrusion-based 3D printing of ex situ-alloyed highly biodegradable MRI-friendly porous iron-manganese scaffolds

Additively manufactured biodegradable porous iron has been only very recently demonstrated. Two major limitations of such a biomaterial are very low biodegradability and incompatibility with magnetic resonance imaging (MRI). Here, we present a novel biomaterial that resolves both of those limitations. We used extrusion-based 3D printing to fabricate ex situ-alloyed biodegradable iron-manganese scaffolds that are non-ferromagnetic and exhibit enhanced rates of biodegradation. We developed ink formulations containing iron and 25, 30, or 35 wt% manganese powders, and debinding and sintering process to achieve Fe-Mn scaffolds with 69% porosity. The Fe25Mn scaffolds had the ε-martensite and γ-austenite phases, while the Fe30Mn and Fe35Mn scaffolds had only the γ-austenite phase. All iron-manganese alloys exhibited weakly paramagnetic behavior, confirming their potential to be used as MRI-friendly bone substitutes. The in vitro biodegradation rates of the scaffolds were very much enhanced (i.e., 4.0 to 4.6 times higher than that of porous iron), with the Fe35Mn alloy exhibiting the highest rate of biodegradation (i.e., 0.23 mm/y). While the elastic moduli and yield strengths of the scaffolds decreased over 28 days of in vitro biodegradation, those values remained in the range of cancellous bone. The culture of preosteoblasts on the porous iron-manganese scaffolds revealed that cells could develop filopodia on the scaffolds, but their viability was reduced by the effect of biodegradation. Altogether, this research marks a major breakthrough and demonstrates the great prospects of multi-material extrusion-based 3D printing to further address the remaining issues of porous iron-based materials and, eventually, develop ideal bone substitutes. STATEMENT OF SIGNIFICANCE: 3D printed porous iron biomaterials for bone substitution still encounter limitations, such as the slow biodegradation and magnetic resonance imaging incompatibility. Aiming to solve the two fundamental issues of iron, we present ex-situ alloyed porous iron-manganese scaffolds fabricated by means of multi-material extrusion-based 3D printing. Our porous iron-manganese possessed enhanced biodegradability, non-ferromagnetic property, and bone-mimicking mechanical property throughout the in vitro biodegradation period. The results demonstrated a great prospect of multi-material extrusion-based 3D printing to further address the remaining challenges of porous iron-based biomaterials to be an ideal biodegradable bone substitutes.

Biocompatibility and Biological Performance Evaluation of Additive-Manufactured Bioabsorbable Iron-Based Porous Suture Anchor in a Rabbit Model

This study evaluated the biocompatibility and biological performance of novel additive-manufactured bioabsorbable iron-based porous suture anchors (iron_SAs). Two types of bioabsorbable iron_SAs, with double- and triple-helical structures (iron_SA_2_helix and iron_SA_3_helix, respectively), were compared with the synthetic polymer-based bioabsorbable suture anchor (polymer_SAs). An in vitro mechanical test, MTT assay, and scanning electron microscope (SEM) analysis were performed. An in vivo animal study was also performed. The three types of suture anchors were randomly implanted in the outer cortex of the lateral femoral condyle. The ultimate in vitro pullout strength of the iron_SA_3_helix group was significantly higher than the iron_SA_2_helix and polymer_SA groups. The MTT assay findings demonstrated no significant cytotoxicity, and the SEM analysis showed cells attachment on implant surface. The ultimate failure load of the iron_SA_3_helix group was significantly higher than that of the polymer_SA group. The micro-CT analysis indicated the iron_SA_3_helix group showed a higher bone volume fraction (BV/TV) after surgery. Moreover, both iron SAs underwent degradation with time. Iron_SAs with triple-helical threads and a porous structure demonstrated better mechanical strength and high biocompatibility after short-term implantation. The combined advantages of the mechanical superiority of the iron metal and the possibility of absorption after implantation make the iron_SA a suitable candidate for further development.