Antibacterial PLA/Mg composite with enhanced mechanical and biological performance for biodegradable orthopedic implants

PLLA-PEG/mPEG Copolymer with Improved Hydrophilicity, Crystallinity, and Biocompatibility: An In-Depth Study on the Crystallization Kinetics

Poly(lactic acid) (PLA) possesses excellent biocompatibility and biodegradability for the construction of biomaterials. However, its limited crystallinity largely restricts practical application. In this study, four poly(l-lactic acid) (PLLA) copolymers were synthesized by incorporating two different molecular weights of PEG/mPEG (1K and 2K) chains with l-lactide via ring-opening polymerization (ROP). The impact of PEG/mPEG chains on the hydrophilicity and mechanical properties of the resulting copolymers, their crystallization kinetics, and activation energy was also examined. The results demonstrate that introducing PEG/mPEG chains could significantly improve the hydrophilicity, crystallinity, and crystallization rate and reduce the maximum crystallization temperature of the copolymer materials. Among the PLLA copolymers, PLLA-mPEG (2K) exhibits the most remarkable improvements in polymer crystallinity, crystallization rate, and reduction of the maximum crystallization temperature. The advancements in copolymer material properties were anticipated to significantly expand the potential applications for PLLA-based polymer materials, which also greatly improved the applicability as sustainable and controllable biopolymer materials.

Effect of Annealing on the Mechanical Properties of Composites of PLA Mixed with Mg and with HA

Polylactic acid (PLA) is a bioresorbable and biocompatible material and is a promising alternative to the current materials used for permanent implants as it has osteosynthesis properties. However, this material has some drawbacks due to its low mechanical and thermal resistance after 3D printing. Extensive research has been conducted to improve the properties of this material, for example, with the addition of other compounds, such as magnesium (Mg) or Hydroxyapatite (HA). These reinforced materials have been shown to reduce the internal stress of the matrix of PLA, improving the thermal, optical and structural properties of the material, even though the performance achieved is lower than needed to be implanted. In addition, although it is known that the addition of Mg or HA affects the mechanical performance of the material, mechanical properties have not been studied in the literature. Thus, the aim of this study is to research the effect of thermal post-processing based on annealing of composites made of PLA with Mg and PLA with HA, manufactured by fused filament fabrication, with the goal of finding an improvement in the mechanical properties of these materials. As a result, different designs of annealing processes have been studied with different reinforced materials and their mechanical properties have been compared, studying axial traction and compression, radial compression as well as flexibility, among others. The comparative results achieved show the relevance of the design of the annealing process for the improvement of the mechanical properties of these materials.

Oxygen-generating and antibacterial xanthan gum/PLA aerogels loaded with dexamethasone for potential wound healing

Chronic wounds do not heal within a reasonable time frame due to hypoxia and bacterial inflammation, creating an urgent need for advanced biomaterials to address these challenges. In this study, oxygen-generating, antibacterial xanthan gum-polylactic acid (XA/PLA) aerogels loaded with dexamethasone were developed for the first time for potential wound healing applications. The aerogels contained sodium percarbonate and calcium peroxide as oxygen-releasing agents, providing sustained oxygen release for up to 48 h. The aerogels had a highly porous structure with a high specific surface area (up to 396 ± 8 m2/g) and revealed high liquid absorption capacity in simulated body fluid, absorbing up to 67 times their original weight and remaining stable for 72 h. The in vitro release tests showed controlled profiles of dexamethasone over 24 h. The antibacterial tests demonstrated strong antibacterial activity against Escherichia coli (an up to 15.92 mm inhibition zone diameter) and Staphylococcus aureus (up to a 31.07 mm inhibition zone diameter). The in vitro biocompatibility assays revealed good cytocompatibility with mouse fibroblast cells (NIH/3T3), with a cell viability of >90%. Hemocompatibility tests showed no hemolytic activity with human blood (lysis rate <2%). Overall, these results emphasise the versatility of the XA/PLA aerogels and their potential for the treatment of chronic wounds.

Evaluation of the interface of metallic-coated biodegradable polymeric stents with prokaryotic and eukaryotic cells

Polymeric coronary stents, like the ABSORB™, are commonly used to treat atherosclerosis due to their bioresorbable and cell-compatible polymer structure. However, they face challenges such as high strut thickness, high elastic recoil, and lack of radiopacity. This study aims to address these limitations by modifying degradable stents produced by additive manufacturing with poly(lactic acid) (PLA) and poly(ε-caprolactone) (PCL) with degradable metallic coatings, specifically zinc (Zn) and magnesium (Mg), deposited via radiofrequency (rf) magnetron sputtering. The characterisation included the evaluation of the degradation of the coatings, antibacterial, anti-thrombogenicity, radiopacity, and mechanical properties. The results showed that the metallic coatings inhibited bacterial growth, though Mg exhibited a high degradation rate. Thrombogenicity studies showed that Zn-coated stents had anticoagulant properties, while Mg-coated and controls were thrombogenic. Zn coatings significantly improved radiopacity, enhancing contrast by 43 %. Mechanical testing revealed that metallic coatings reduced yield strength and, thus, diminished elastic recoil after stent expansion. Zn-coated stents improved cyclic compression resistance by 270 % for PCL stents, with PLA-based stents showing smaller improvements. The coatings also enhanced crush resistance, particularly for Zn-coated PCL stents. Overall, Zn-coated polymers have emerged as the premier prototype due to their superior biological and mechanical performance, appropriate degradation during the stent life, and ability to provide the appropriate radiopacity to medical devices.

Controlling Plasma-Functionalized Fillers for Enhanced Properties of PLA/ZnO Biocomposites: Effects of Excess l-Lactic Acid and Biomedical Implications

Plasma surface treatment of ceramic particles has emerged as a promising approach for developing biocomposites intended for use in tissue engineering applications. Introducing functional groups on particle surfaces promotes changes in material surface properties, enhancing adhesion, biocompatibility, and reactivity. It can also mitigate degradation during the processing of polymer matrices in composite materials. Therefore, carefully choosing the functionalizing agent responsible for generating the functional groups and selecting appropriate functionalization parameters are significant steps in the plasma surface treatment process. However, in a tissue engineering context, an excess of the functionalizing agent can be harmful, increasing cell toxicity and inhibiting the stimulation of cell growth, consequently delaying or even hindering tissue regeneration. This article examines how the functionalizing agent excess of l-lactic acid (LA) applied in the plasma surface treatment of the filler affects the thermal, rheological, biological, and wettability properties of poly(lactic acid) (PLA) and zinc oxide (ZnO) biocomposites. The investigation reveals that the surface treatment effectively mitigated the catalytic effects of ZnO on PLA degradation during melt processing, regardless of the excess functionalizing agent. There was minimal impact on the material's rheological, thermal, and wettability characteristics, but the LA residue significantly influenced cell proliferation and the biological response. These findings show the importance of removing excess functionalizing agents to obtain biocomposites suitable for tissue engineering applications.

External Stimuli-Responsive Strategies for Surface Modification of Orthopedic Implants: Killing Bacteria and Enhancing Osteogenesis

Bacterial infection and insufficient osteogenic activity are the main causes of orthopedic implant failure. Conventional surface modification methods are difficult to meet the requirements for long-term implant placement. In order to better regulate the function of implant surfaces, especially to improve both the antibacterial and osteogenic activity, external stimuli-responsive (ESR) strategies have been employed for the surface modification of orthopedic implants. External stimuli act as "smart switches" to regulate the surface interactions with bacteria and cells. The balance between antibacterial and osteogenic capabilities of implant surfaces can be achieved through these specific ESR manifestations, including temperature changes, reactive oxygen species production, controlled release of bioactive molecules, controlled release of functional ions, etc. This Review summarizes the recent progress on different ESR strategies (based on light, ultrasound, electric, and magnetic fields) that can effectively balance antibacterial performance and osteogenic capability of orthopedic implants. Furthermore, the current limitations and challenges of ESR strategies for surface modification of orthopedic implants as well as future development direction are also discussed.

Dual-Layer Nanoengineered Urinary Catheters for Enhanced Antimicrobial Efficacy and Reduced Cytotoxicity

Catheter-associated urinary tract infection (CAUTI) is the most common healthcare-associated infection; however, current therapeutic strategies remain insufficient for standard clinical application. A novel urinary catheter featuring a dual-layer nanoengineering approach using zinc (Zn) and silver nanoparticles (AgNPs) is successfully fabricated. This design targets microbial resistance, minimizes cytotoxicity, and maintains long-term efficacy. The inner AgNPs layer provides immediate antibacterial effects against the UTI pathogens, while the outer porous Zn layer controls zero-order Ag release and generates reactive oxygen species, thus enhancing long-term bactericidal performance. Enhanced antibacterial properties of Zn/AgNPs-coated catheters are observed, resulting in 99.9% of E. coli and 99.7% of S. aureus reduction, respectively. The Zn/AgNPs-coated catheter significantly suppresses biofilm with sludge formation compared to AgNP-coated and uncoated catheters (all, p < 0.05). The Zn/AgNP-coated catheter in a rabbit model demonstrated a durable, effective barrier against bacterial colonization, maintaining antimicrobial properties during the catheter indwelling period with significantly reduced inflammation and epithelial disruption compared with AgNP and uncoated groups. This innovation has the potential to revolutionize the design of antimicrobial medical devices, particularly for applications requiring long-term implantation. Although further preclinical studies are required to verify its efficacy and safety, this strategy seems to be a promising approach to preventing CAUTI-related complications.

Biodegradable magnesium and zinc composite microspheres with synergistic osteogenic effect for enhanced bone regeneration

Biodegradable polymer microspheres in bone tissue engineering have become appealing as their non-invasive advantages in irregular damage bone repair. However, current microspheres used in BTE still lack sufficient osteogenic capacity to induce effective bone regeneration. In this study, we developed osteogenic composite microspheres concurrently loaded with magnesium oxide (MgO) and zinc oxide (ZnO), both of which are osteogenic active substances, using a facile and scalable emulsification method. The osteogenic composite microspheres exhibited a sequential yet complementary release profile characterized by a rapid release of Mg2+ and a gradual release of Zn2+ in a physiological environment, thereby maintaining the concentration of bioactive ions at a sustained high level. As a result, the combination of Mg2+ and Zn2+ in the composite microspheres led to a synergistic enhancement in biomimetic mineralization and the upregulation in the expression of osteogenic-related genes and proteins at the cellular level. Through a critical-sized calvarial rate defect model, the osteogenic composite microspheres were demonstrated to have strong osteogenic ability to promote new bone formation via ultrasonic imaging, histological and immunohistochemical evaluations. In sum, these osteogenic composite microspheres as microcarriers of Mg2+ and Zn2+ have great potential in the delivery of therapeutic ions for treating bone defects.

Extracellular Matrix-Surrogate Advanced Functional Composite Biomaterials for Tissue Repair and Regeneration

Native tissues, comprising multiple cell types and extracellular matrix components, are inherently composites. Mimicking the intricate structure, functionality, and dynamic properties of native composite tissues represents a significant frontier in biomaterials science and tissue engineering research. Biomimetic composite biomaterials combine the benefits of different components, such as polymers, ceramics, metals, and biomolecules, to create tissue-template materials that closely simulate the structure and functionality of native tissues. While the design of composite biomaterials and their in vitro testing are frequently reviewed, there is a considerable gap in whole animal studies that provides insight into the progress toward clinical translation. Herein, we provide an insightful critical review of advanced composite biomaterials applicable in several tissues. The incorporation of bioactive cues and signaling molecules into composite biomaterials to mimic the native microenvironment is discussed. Strategies for the spatiotemporal release of growth factors, cytokines, and extracellular matrix proteins are elucidated, highlighting their role in guiding cellular behavior, promoting tissue regeneration, and modulating immune responses. Advanced composite biomaterials design challenges, such as achieving optimal mechanical properties, improving long-term stability, and integrating multifunctionality into composite biomaterials and future directions, are discussed. We believe that this manuscript provides the reader with a timely perspective on composite biomaterials.

Structure-function integrated biodegradable Mg/polymer composites: Design, manufacturing, properties, and biomedical applications

Mg is a typical biodegradable metal widely used for biomedical applications due to its considerable mechanical properties and bioactivity. Biodegradable polymers have attracted great interest owing to their favorable processability and inclusiveness. However, it is challenging for the degradation rates of Mg or polymers to precisely match tissue repair processes, and the significant changes in local pH during degradation hinder tissue repair. The concept of combining Mg with polymers is proposed to overcome the shortcomings of materials, aiming to meet repair needs from various aspects such as mechanics and biology. Therefore, it is essential to systematically understand the behavior of biodegradable Mg/polymer composite (BMPC) from the design, manufacturing, mechanical properties, degradation, and biological effects. In this review, we elaborate on the design concepts and manufacturing strategies of high-strength BMPC, the "structure-function" relationship between the microstructures and mechanical properties of composites, the variation in the degradation rate due to endogenous and exogenous factors, and the establishment of advanced degradation research platform. Additionally, the interplay among composite components during degradation and the biological function of composites under non-responsive/stimuli-responsive platforms are also discussed. Finally, we hope that this review will benefit future clinical applications of "structure-function" integrated biomaterials.

Bioinspired Nanotopography for Combinatory Osseointegration and Antibacterial Therapy

The ongoing global health has highlighted the critical issue of secondary infections, particularly antibiotic-resistant bacterial infections, which have been significant contributors to mortality rates. Orthopedic implants, while essential for trauma and orthopedic surgeries, are particularly susceptible to these infections, leading to severe complications and economic burdens. The traditional use of antibiotics in treating these infections poses further challenges including the risk of developing antibiotic-resistant bacteria. This study introduces a novel approach to combat this issue by developing nanostructured surfaces for orthopedic implants using target ion-induced plasma sputtering. Inspired by the natural design of dragonfly wings, these surfaces aim to prevent bacterial adhesion while promoting preosteoblast activity, offering a dual-function solution to the problems of bacterial infection and implant integration without relying on antibiotics. The in vitro results demonstrate the effectiveness of these bioinspired surfaces in eradicating bacteria and supporting cell proliferation and differentiation, presenting a promising alternative for the development of biomedical implants.

A Biocompatible Nanofibers Modified by Plasma for Osteoblast Growth Differentiation

This work employs nitrogen plasma immersion ion implantation (PIII) to modify electrospinning polylactic acid membranes and immobilizes basic fibroblast growth factors (bFGF) by forming crosslinking bonds. The study investigates the modified membranes' surface characteristics and the stimulatory effects of crosslinked bFGF polylactic acid membranes on osteoblast and fibroblast proliferation. The PIII process occurs under low vacuum conditions and is controlled by processing time and power pulse width. The experimental results indicate that, within a 400-second N2-PIII treatment, the spun fibers remain undamaged, demonstrating an increase in hydrophilicity (from 117° to 38°/36°) and nitrogen content (from 0% to 7.54%/8.05%). X-ray photoelectron spectroscopy analysis suggests the formation of a C-N-C=O crosslinked bond. Cell culture and activity assessments indicate that the PIII-treated and crosslinked bFGF film exhibits significantly higher cell growth activity (p < 0.05) than the untreated group. These intergroup differences are attributed to the surface crosslinking bond content. In osteogenic induction, the results for each day show that the treated group performs better. However, the intergroup disparities within the crosslinked bFGF group disappear with prolonged culture time due to the rapid osteogenesis prompted by bFGF. The findings suggest that PIII treatment of electrospinning polylactic acid membranes holds promise in promoting osteogenesis in bone tissue scaffolds.

A strategy for enhancing bioactivity and osseointegration with antibacterial effect by incorporating magnesium in polylactic acid based biodegradable orthopedic implant

Biodegradable orthopedic implants are essential for restoring the physiological structure and function of bone tissue while ensuring complete degradation after recovery. Polylactic acid (PLA), a biodegradable polymer, is considered a promising material due to its considerable mechanical properties and biocompatibility. However, further improvements are necessary to enhance the mechanical strength and bioactivity of PLA for reliable load-bearing orthopedic applications. In this study, a multifunctional PLA-based composite was fabricated by incorporating tricalcium phosphate (TCP) microspheres and magnesium (Mg) particles homogenously at a volume fraction of 40 %. This approach aims to enhance mechanical strength, accelerate pore generation, and improve biological and antibacterial performance. Mg content was incorporated into the composite at varying values of 1, 3, and 5 vol% (referred to as PLA/TCP-1 Mg, PLA/TCP-3 Mg, and PLA/TCP-5 Mg, respectively). The compressive strength and stiffness were significantly enhanced in all composites, reaching 87.7, 85.9, and 84.1 MPa, and 2.7, 3.0, and 3.1 GPa, respectively. The degradation test indicated faster elimination of the reinforcers as the Mg content increased, resulting in accelerated pore generation to induce enhanced osseointegration. Because PLA/TCP-3 Mg and PLA/TCP-5 Mg exhibited cracks in the PLA matrix due to rapid corrosion of Mg forming corrosion byproducts, to optimize the Mg particle content, PLA/TCP-1 Mg was selected for further evaluation. As determined by in vitro biological and antibacterial testing, PLA/TCP-1 Mg showed enhanced bioactivity with pre-osteoblast cells and exhibited antibacterial properties by suppressing bacterial colonization. Overall, the multifunctional PLA/TCP-Mg composite showed improved mechanobiological performance, making it a promising material for biodegradable orthopedic implants.

Bioabsorbable Composites Based on Polymeric Matrix (PLA and PCL) Reinforced with Magnesium (Mg) for Use in Bone Regeneration Therapy: Physicochemical Properties and Biological Evaluation

Improvements in Tissue Engineering and Regenerative Medicine (TERM)-type technologies have allowed the development of specific materials that, together with a better understanding of bone tissue structure, have provided new pathways to obtain biomaterials for bone tissue regeneration. In this manuscript, bioabsorbable materials are presented as emerging materials in tissue engineering therapies related to bone lesions because of their ability to degrade in physiological environments while the regeneration process is completed. This comprehensive review aims to explore the studies, published since its inception (2010s) to the present, on bioabsorbable composite materials based on PLA and PCL polymeric matrix reinforced with Mg, which is also bioabsorbable and has recognized osteoinductive capacity. The research collected in the literature reveals studies based on different manufacturing and dispersion processes of the reinforcement as well as the physicochemical analysis and corresponding biological evaluation to know the osteoinductive capacity of the proposed PLA/Mg and PCL/Mg composites. In short, this review shows the potential of these composite materials and serves as a guide for those interested in bioabsorbable materials applied in bone tissue engineering.