Corrosion behavior of a welded stainless-steel orthopedic implant

Recent developments in nanomaterials for upgrading treatment of orthopedics diseases

Nanotechnology has changed science in the last three decades. Recent applications of nanotechnology in the disciplines of medicine and biology have enhanced medical diagnostics, manufacturing, and drug delivery. The latest studies have demonstrated this modern technology's potential for developing novel methods of disease detection and treatment, particularly in orthopedics. According to recent developments in bone tissue engineering, implantable substances, diagnostics and treatment, and surface adhesives, nanomedicine has revolutionized orthopedics. Numerous nanomaterials with distinctive chemical, physical, and biological properties have been engineered to generate innovative medication delivery methods for the local, sustained, and targeted delivery of drugs with enhanced therapeutic efficacy and minimal or no toxicity, indicating a very promising strategy for effectively controlling illnesses. Extensive study has been carried out on the applications of nanotechnology, particularly in orthopedics. Nanotechnology can revolutionize orthopedics cure, diagnosis, and research. Drug delivery precision employing nanotechnology using gold and liposome nanoparticles has shown especially encouraging results. Moreover, the delivery of drugs and biologics for osteosarcoma is actively investigated. Different kind of biosensors and nanoparticles has been used in the diagnosis of bone disorders, for example, renal osteodystrophy, Paget's disease, and osteoporosis. The major hurdles to the commercialization of nanotechnology-based composite are eventually examined, thus helping in eliminating the limits in connection to some pre-existing biomaterials for orthopedics, important variables like implant life, quality, cure cost, and pain and relief from pain. The potential for nanotechnology in orthopedics is tremendous, and most of it looks to remain unexplored, but not without challenges. This review aims to highlight the up tp date developments in nanotechnology for boosting the treatment modalities for orthopedic ailments. Moreover, we also highlighted unmet requirements and present barriers to the practical adoption of biomimetic nanotechnology-based orthopedic treatments.

Recent Advances and Perspective of Nanotechnology-Based Implants for Orthopedic Applications

Bioimplant engineering strives to provide biological replacements for regenerating, retaining, or modifying injured tissues and/or organ function. Modern advanced material technology breakthroughs have aided in diversifying ingredients used in orthopaedic implant applications. As such, nanoparticles may mimic the surface features of real tissues, particularly in terms of wettability, topography, chemistry, and energy. Additionally, the new features of nanoparticles support their usage in enhancing the development of various tissues. The current study establishes the groundwork for nanotechnology-driven biomaterials by elucidating key design issues that affect the success or failure of an orthopaedic implant, its antibacterial/antimicrobial activity, response to cell attachment propagation, and differentiation. The possible use of nanoparticles (in the form of nanosized surface or a usable nanocoating applied to the implant’s surface) can solve a number of problems (i.e., bacterial adhesion and corrosion resilience) associated with conventional metallic or non-metallic implants, particularly when implant techniques are optimised. Orthopaedic biomaterials’ prospects (i.e., pores architectures, 3D implants, and smart biomaterials) are intriguing in achieving desired implant characteristics and structure exhibiting stimuli-responsive attitude. The primary barriers to commercialization of nanotechnology-based composites are ultimately discussed, therefore assisting in overcoming the constraints in relation to certain pre-existing orthopaedic biomaterials, critical factors such as quality, implant life, treatment cost, and pain alleviation.

The determining role of nanoscale mechanical twinning on cellular functions of nanostructured materials

Considering that micromotions generated at the bone-implant interface under physiological loading introduce mechanical strain on the tissue and surface of the implant and that strain can be introduced during processing of the biomedical device, we elucidate here the interplay between mechanically-induced nanoscale twinning in austenitic stainless steel on osteoblast functions. Mechanically-induced nanoscale twinning significantly impacted cell attachment, cell-substrate interactions, proliferation, and subsequent synthesis of prominent proteins (fibronectin, actin, and vinculin). Twinning was beneficial in favorably modulating cellular activity and contributed to small differences in hydrophilicity and nanoscale roughness in relation to the untwinned surface.

Corrosion Protection of Al/Au/ZnO Anode for Hybrid Cell Application

Effective protection of power sources from corrosion is critical in the development of abiotic fuel cells, biofuel cells, hybrid cells and biobateries for implantable bioelectronics. Corrosion of these bioelectronic devices result in device inability to generate bioelectricity. In this paper Al/Au/ZnO was considered as a possible anodic substrate for the development of a hybrid cell. The protective abilities of corrosive resistant aluminum hydroxide and zinc phosphite composite films formed on the surface of Al/Au/ZnO anode in various electrolyte environments were examined by electrochemical methods. The presence of phosphate buffer and physiological saline (NaCl) buffer allows for the formation of aluminum hyrdroxide and zinc phosphite composite films on the surface of the Al/Au/ZnO anode that prevent further corrosion of the anode. The highly protective films formed on the Al/Au/ZnO anode during energy harvesting in a physiological saline environment resulted in 98.5% corrosion protective efficiency, thereby demonstrating that the formation of aluminum hydroxide and zinc phosphite composite films are effective in the prevention of anode corrosion during energy harvesting. A cell assembly consisting of the Al/Au/ZnO anode and platinum cathode resulted in an open circuit voltage of 1.03 V. A maximum power density of 955.3 mW/ cm² in physiological saline buffer at a cell voltage and current density of 345 mV and 2.89 mA/ cm², respectively.

Reduced graphene oxide growth on 316L stainless steel for medical applications

We report a new method for the growth of reduced graphene oxide (rGO) on the 316L alloy of stainless steel (SS) and its relevance for biomedical applications. We demonstrate that electrochemical etching increases the concentration of metallic species on the surface and enables the growth of rGO. This result is supported through a combination of Raman spectroscopy, X-ray photoelectron spectroscopy (XPS), atomic force microscopy (AFM), scanning electron microscopy (SEM), density functional theory (DFT) calculations and static water contact angle measurements. Raman spectroscopy identifies the G and D bands for oxidized species of graphene at 1595 cm(-1) and 1350 cm(-1), respectively, and gives an ID/IG ratio of 1.2, indicating a moderate degree of oxidation. XPS shows -OH and -COOH groups in the rGO stoichiometry and static contact angle measurements confirm the wettability of rGO. SEM and AFM measurements were performed on different substrates before and after coronene treatment to confirm rGO growth. Cell viability studies reveal that these rGO coatings do not have toxic effects on mammalian cells, making this material suitable for biomedical and biotechnological applications.

Understanding the impact of grain structure in austenitic stainless steel from a nanograined regime to a coarse-grained regime on osteoblast functions using a novel metal deformation-annealing sequence

Metallic biomedical devices with nanometer-sized grains (NGs) provide surfaces that are different from their coarse-grained (CG) (tens of micrometer) counterparts in terms of increased fraction of grain boundaries (NG>50%; CG<2-3%). The novel concept of 'phase-reversion' involving a controlled deformation-annealing sequence is used to obtain a wide range of grain structures, starting from the NG regime to the CG regime, to demonstrate that the grain structure significantly impacts cellular interactions and osteoblast functions. The uniqueness of this concept is the ability to address the critical aspect of cellular activity in nanostructured materials, because a range of grain sizes from NG to CG are obtained in a single material using an identical set of parameters. This is in addition to a high strength/weight ratio and superior wear and corrosion resistance. These multiple attributes are important for the long-term stability of biomedical devices. Experiments on the interplay between grain structure from the NG regime to CG in austenitic stainless steel on osteoblast functions indicated that cell attachment, proliferation, viability, morphology and spread varied with grain size and were favorably modulated on the NG and ultrafine-grain structure. Furthermore, immunofluorescence studies demonstrated stronger vinculin signals associated with actin stress fibers in the outer regions of the cells and cellular extensions on the NG surface. The differences in the cellular response with change in grain structure are attributed to grain structure and degree of hydrophilicity. The study lays the foundation for a new branch of nanostructured materials for biomedical applications.

Development and biocompatibility of a novel corrodible fluoride-coated magnesium-calcium alloy with improved degradation kinetics and adequate mechanical properties for cardiovascular applications

Recently, corrodible magnesium-based alloys have been introduced for use as cardiovascular stents and orthopedic implants. However, rapid corrosion rates have raised questions about their biocompatibility. Therefore, we developed a binary fluoride-coated magnesium-calcium alloy with improved degradation kinetics. Biocompatibility of the alloys was evaluated with metabolic assays (colorimetric WST-1 test). Furthermore, five different probes of magnesium-calcium alloys (MgCa 0.4, 0.6, 0.8, 1.2, and 2.0 wt %) were cocultivated with human smooth muscle cells and endothelial cells. To investigate the decomposition kinetics in a physiological environment the alloys were used untreated and fluoride coated (MgF(2)). Mg and Ca decreased the metabolic activity in vascular cells dose-dependently, with cytotoxic effects only at unphysiological concentrations. Uncoated magnesium alloys showed signs of decomposition after a short incubation time of 24 h in contrast to MgF(2) coated alloys. After 10 days smooth muscle and endothelial cells around the alloys were still alive, whereas colonization of the surfaces was only observed for smooth muscle cells. The fluoride-coated MgCa alloys exhibited good results concerning mechanical properties, degradation kinetics, and biocompatibility in vitro. We conclude that a binary fluoride magnesium-calcium alloy is a promising candidate for the production of cardiovascular stents.

The generation of wear-resistant antimicrobial stainless steel surfaces by active screen plasma alloying with N and nanocrystalline Ag

Hospital-acquired infections (HAIs), a large proportion of which are derived from contact transmission, represent a massive global challenge. In this study a novel active screen plasma (ASP) alloying technology has been developed to generate highly durable antimicrobial surfaces by combining a wear-resistant S-phase with nanocrystalline silver for medical grade stainless steel. The phase constituent, microstructure, composition and surface roughness of the alloyed surfaces were fully characterized, and the surface hardness, wear resistance and antimicrobial efficiency of the treated surfaces were evaluated. Experimental results showed that the surface hardness and sliding wear resistance of medical grade 316LVM stainless steel can be effectively improved by the ASP alloying treatment; furthermore, the Ag alloyed S-phase can achieve 93% reduction in Escherichia coli (E. coli) after 6 h contact time. Therefore, the novel ASP alloying treatment can not only improve wear resistance but also confer antibacterial activity to stainless steel surfaces.

Influence of Fe(II) and Fe(III) on the expression of genes related to cholesterol- and fatty acid metabolism in human vascular smooth muscle cells

Iron is the major alloy component for a large variety of cardiovascular devices such as stents. In recent studies it has been shown that biodegradable iron or iron based stents exhibit good mechanical features with no pronounced neointimal proliferation. Whole genome gene profiling using DNA chip technology revealed that genes involved in cholesterol and fatty acid metabolism (low-density lipoprotein receptor, LDL-R; 3-hydroxy-3-methylglutaryl-Coenzyme A synthase 1 (HMGCS1) and fatty acid desaturase 1 (FADS1) are up-regulated after exposure of vascular smooth muscle cells with soluble ferrous iron. To analyze the effects of iron on these genes in detail we co-incubated human vascular smooth muscle cells for 12 and 24 h with different concentrations of ferrous (soluble iron(II)-gluconate) and ferric iron (soluble iron(III)-chloride), Ferrlecit, a commercially available drug (ferric iron-gluconate complex) and solid iron coils. The expression of LDL-R, HMGCS1 and FADS1 was analyzed using TaqMan Real-time PCR. After 24 h, all forms of iron led to a significant up-regulation of the examined genes. At high concentrations the expression rates declined, probably as a result of reduced metabolic activity. The most prominent effects were observed after co-incubation with Ferrlecit, probably caused by an increased bioavailability of the iron gluconate complex. We postulate that both, bi- and trivalent forms of iron induce the expression of LDL-R, HMGCS1 and FADS1 by generation of highly reactive oxygen species. Further animal experiments using tissues from iron-stented vessels may lead to a more profound insight into iron induced expression of cholesterol- and fatty acid metabolism related genes.

Stability of passivated 316L stainless steel oxide films for cardiovascular stents

Passivated 316L stainless steel is used extensively in cardiovascular stents. The degree of chloride ion attack might increase as the oxide film on the implant degrades from exposure to physiological fluid. Stability of 316L stainless steel stent is a function of the concentration of hydrated and hydrolyated oxide concentration inside the passivated film. A high concentration of hydrated and hydrolyated oxide inside the passivated oxide film is required to maintain the integrity of the passivated oxide film, reduce the chance of chloride ion attack, and prevent any possible leaching of positively charged ions into the surrounding tissue that accelerate the inflammatory process. Leaching of metallic ions from corroded implant surface into surrounding tissue was confirmed by the X-ray mapping technique. The degree of thrombi weight percentage [W(ao): (2.1 +/- 0.9)%; W(ep): (12.5 +/- 4.9)%, p < 0.01] between the amorphous oxide (AO) and the electropolishing (EP) treatment groups was statistically significant in ex-vivo extracorporeal thrombosis experiment of mongrel dog. The thickness of neointima (T(ao): 100 +/- 20 microm; T(ep): 500 +/- 150 microm, p < 0.01) and the area ratio of intimal response at 4 weeks (AR(ao): 0.62 +/- 0.22; AR(ep): 1.15 +/- 0.42, p < 0.001) on the implanted iliac stents of New Zealand rabbit could be a function of the oxide properties.

Long-term biocompatibility of a corrodible peripheral iron stent in the porcine descending aorta

Currently there are no biodegradable stents available for treatment of vascular obstructions in patients with congenital heart defects. This study was performed to evaluate the safety of a corrodible stent produced from pure iron in a peripheral stent design (6-12mm diameter) in a slotted tube design similar to a commercially available 316-L stent which served as control. Both stents were implanted into the descending aorta of 29 minipigs with an overstretch injury without technical problems. Two animals died after the implantation not related to the iron stent. The remaining 27 minipigs were followed for 1-360 days. Histomorphometry and quantitative angiography showed no difference with regard to the amount of neointimal proliferation between 316-L and iron stents. Histopathological examination of heart, lung, spleen, liver, kidney and para-aortic lymphatic nodes demonstrated no signs of iron overload or iron-related organ toxicity. Adjacent to the iron stent struts, there was no evidence for local toxicity due to corrosion products. We conclude that iron is a suitable metal for the production of a large-size degradable stent with no local or systemic toxicity. A faster degradation rate, however, is desirable and further studies have to focus on the modification of the composition and design of the stent to expedite the degradation process.

The study of lifetime of polymer and composite bone joint screws under cyclical loads and in vitro conditions

The "strain-life time" method has been adapted for life-time prediction of polymer and composite bone joint screws. Mechanical and fatigue properties of screws made of biostable (polysulfone), biosorbable (poly(lactide-co-glycolide) and short carbon fibre reinforced polymer composite materials have been examined in this study. The lifetime predictions under in vitro conditions were calculated for polymer and composite implants. The forecasting of joint screws stability under conditions close to natural body environment is shown to be feasible based on equations describing lifetime of the examined joint screws.