Shape and site dependent in vivo degradation of Mg-Zn pins in rabbit femoral condyle

In vitro and in vivo degradation behavior of Mg-0.45Zn-0.45Ca (ZX00) screws for orthopedic applications

Magnesium (Mg) alloys have become a potential material for orthopedic implants due to their unnecessary implant removal, biocompatibility, and mechanical integrity until fracture healing. This study examined the in vitro and in vivo degradation of an Mg fixation screw composed of Mg-0.45Zn-0.45Ca (ZX00, in wt.%). With ZX00 human-sized implants, in vitro immersion tests up to 28 days under physiological conditions, along with electrochemical measurements were performed for the first time. In addition, ZX00 screws were implanted in the diaphysis of sheep for 6, 12, and 24 weeks to assess the degradation and biocompatibility of the screws in vivo. Using scanning electron microscopy (SEM) coupled with energy dispersive X-ray spectroscopy (EDX), micro-computed tomography (μCT), X-ray photoelectron spectroscopy (XPS), and histology, the surface and cross-sectional morphologies of the corrosion layers formed, as well as the bone-corrosion-layer-implant interfaces, were analyzed. Our findings from in vivo testing demonstrated that ZX00 alloy promotes bone healing and the formation of new bone in direct contact with the corrosion products. In addition, the same elemental composition of corrosion products was observed for in vitro and in vivo experiments; however, their elemental distribution and thicknesses differ depending on the implant location. Our findings suggest that the corrosion resistance was microstructure-dependent. The head zone was the least corrosion-resistant, indicating that the production procedure could impact the corrosion performance of the implant. In spite of this, the formation of new bone and no adverse effects on the surrounding tissues demonstrated that the ZX00 is a suitable Mg-based alloy for temporary bone implants.

Finite Element Analysis of the Non-Uniform Degradation of Biodegradable Vascular Stents

Most of the studies on the finite element analysis (FEA) of biodegradable vascular stents (BVSs) during the degradation process have limited the accuracy of the simulation results due to the application of the uniform degradation model. This paper aims to establish an FEA model for the non-uniform degradation of BVSs by considering factors such as the dynamic changes of the corrosion properties and material properties of the element, as well as the pitting corrosion and stress corrosion. The results revealed that adjusting the corrosion rate according to the number of exposed surfaces of the element and reducing the stress threshold according to the corrosion status accelerates the degradation time of BVSs by 26% and 25%, respectively, compared with the uniform degradation model. The addition of the pitting model reduces the service life of the BVSs by up to 12%. The effective support of the stent to the vessel could reach at least 60% of the treatment effect before the vessel collapsed. These data indicate that the proposed non-uniform degradation model of BVSs with multiple factors produces different phenomena compared with the commonly used models and make the numerical simulation results more consistent with the real degradation scenario.

Mg-, Zn-, and Fe-Based Alloys With Antibacterial Properties as Orthopedic Implant Materials

Implant-associated infection (IAI) is one of the major challenges in orthopedic surgery. The development of implants with inherent antibacterial properties is an effective strategy to resolve this issue. In recent years, biodegradable alloy materials have received considerable attention because of their superior comprehensive performance in the field of orthopedic implants. Studies on biodegradable alloy orthopedic implants with antibacterial properties have gradually increased. This review summarizes the recent advances in biodegradable magnesium- (Mg-), iron- (Fe-), and zinc- (Zn-) based alloys with antibacterial properties as orthopedic implant materials. The antibacterial mechanisms of these alloy materials are also outlined, thus providing more basis and insights on the design and application of biodegradable alloys with antibacterial properties as orthopedic implants.

Corrosion Behavior in Magnesium-Based Alloys for Biomedical Applications

Magnesium alloys exhibit superior biocompatibility and biodegradability, which makes them an excellent candidate for artificial implants. However, these materials also suffer from lower corrosion resistance, which limits their clinical applicability. The corrosion mechanism of Mg alloys is complicated since the spontaneous occurrence is determined by means of loss of aspects, e.g., the basic feature of materials and various corrosive environments. As such, this study provides a review of the general degradation/precipitation process multifactorial corrosion behavior and proposes a reasonable method for modeling and preventing corrosion in metals. In addition, the composition design, the structural treatment, and the surface processing technique are involved as potential methods to control the degradation rate and improve the biological properties of Mg alloys. This systematic representation of corrosive mechanisms and the comprehensive discussion of various technologies for applications could lead to improved designs for Mg-based biomedical devices in the future.

A multi-dimensional non-uniform corrosion model for bioabsorbable metallic vascular stents

Bioabsorbable metallic vascular stents (BMVSs) are an innovative technological advancement in the medical engineering field of vascular implants. BMVSs have great potential to revolutionize vascular intervention, but the lack of understanding of the construction material's natural corrosion within the body inhibits the use in clinical medicine. In this study, a corrosion function concept for in vivo implants was created to develop a multi-dimensional, non-uniform corrosion model with a larger goal of simulating the mechanical integrity of BMVSs. This proposed corrosion model simulates the corrosion rate and its effects on magnesium (Mg) alloy AZ31 based on continuum damage mechanics. The model was calibrated using three degradation experiments on Mg alloy specimens. These experiments focused on multi-dimensional corrosion, mass loss rate, and mechanical integrity during the corrosion process. Lastly, to verify the applicability of the proposed model, the resulting corrosion behaviors and mechanical characteristics of the BMVSs were implemented into a finite element framework to produce an overarching simulation of the BMVS's degradation in vivo. The results of the experiments and simulations revealed a proportional link between the corrosion of BMVSs and the number of exposed surfaces. A non-linear decline in mechanical integrity with increasing mass loss was also discovered through experimentation and modeling. Furthermore, the model and simulation can provide some details about changes in morphology and mechanics during BMVS corrosion. This work gives new insights into accurately modeling for BMVS degradation and can be used to optimize product development of BMVSs. STATEMENT OF SIGNIFICANCE: Bioabsorbable metallic vascular stents (BMVSs) are an innovative technological advancement in the medical engineering field of vascular implants. Despite BMVSs have great potential to revolutionize vascular intervention, the lack of understanding of the construction material's natural corrosion within the body inhibits their use in clinical medicine. In this study, a novel multi-dimensional non-uniform corrosion model was proposed to unveil the mechanisms during the in vivo degradation of bioabsorbable metallic implants, which can accurately capture the overlooked changes in morphology and mechanics during BMVS corrosion. This work provides a technical solution to enhance the modeling accuracy in BMVS degradation and can be further used to optimize the design of BMVSs in the future.

In Vitro and In Vivo Testing of Zinc as a Biodegradable Material for Stents Fabricated by Photo-Chemical Etching

There is an increasing interest in biodegradable metal implants made from magnesium (Mg), iron (Fe), zinc (Zn) and their alloys because they are well tolerated in vivo and have mechanical properties that approach those of non-degradable metals. In particular, Zn and its alloys show the potential to be the next generation of biodegradable materials for medical implants. However, Zn has not been as well-studied as Mg, especially for stent applications. Manufacturing stents by laser cutting has become an industry standard. Nevertheless, the use of this approach with Zn faces some challenges, such as generating thermal stress, dross sticking on the device, surface oxidation, and the need for expensive thin-walled Zn tubing and post-treatment. All of these challenges motivated us to employ photo-chemical etching for fabricating different designs of Zn (99.95% pure) stents. The stents were constructed with different strut patterns, made by photo-chemical etching, and mechanically tested to evaluate radial forces. Stents with rhombus design patterns showed a promising 0.167N/mm radial force, which was comparable to Mg-based stents. In vitro studies were conducted with uncoated Zn stents as control and Parylene C-coated Zn stents to determine corrosion rates. The Parylene C coating reduced the corrosion rate by 50% compared to uncoated stents. In vivo studies were carried out by implanting photo-chemically etched, uncoated Zn stent segments subcutaneously in a C57BL/6 mice model. Histological analyses provided favorable data about the surrounding tissue status, as well as nerve and blood vessel responses near the implant, providing insights into the in vivo degradation of the metal struts. All of these experiments confirmed that Zn has the potential for use in biodegradable stent applications.

Quantifying the degradation of degradable implants and bone formation in the femoral condyle using micro-CT 3D reconstruction

Degradation limits the application of magnesium alloys, and evaluation methods for non-traumatic in vivo quantification of implant degradation and bone formation are imperfect. In the present study, a micro-arc-oxidized AZ31 magnesium alloy was used to evaluate the degradation of implants and new bone formation in 60 male New Zealand white rabbits. Degradation was monitored by weighing the implants prior to and following implantation, and by performing micro-computed tomography (CT) scans and histological analysis after 1, 4, 12, 24, 36, and 48 weeks of implantation. The results indicated that the implants underwent slow degradation in the first 4 weeks, with negligible degradation in the first week, followed by significantly increased degradation during weeks 12–24 (P<0.05), and continued degradation until the end of the 48-week experimental period. The magnesium content decreased as the implant degraded (P<0.05); however, the density of the material exhibited almost no change. Micro-CT results also demonstrated that pin volume, pin mineral density, mean ‘pin thickness’, bone surface/bone volume and trabecular separation decreased over time (P<0.05), and that the pin surface area/pin volume, bone volume fraction, trabecular thickness, trabecular number and tissue mineral density increased over time (P<0.05), indicating that the number of bones and density of new bone increased as magnesium degraded. These results support the positive effect of magnesium on osteogenesis. However, from the maximum inner diameter of the new bone loop and diameter of the pin in the same position, the magnesium alloy was not capable of creating sufficient bridges between the bones and biomaterials when there were preexisting gaps. Histological analyses indicated that there were no inflammatory responses around the implants. The results of the present study indicate that a micro-arc-oxidized AZ31 magnesium alloy is safe in vivo and efficiently degraded. Furthermore, the novel bone formation increased as the implant degraded. The findings concluded that micro-CT, which is useful for providing non-traumatic, in vivo, quantitative and precise data, has great value for exploring the degradation of implants and novel bone formation.

Magnesium alloys: A stony pathway from intensive research to clinical reality. Different test methods and approval-related considerations

The first degradable implant made of a magnesium alloy, a compression screw, was launched to the clinical market in March 2013. Many different complex considerations are required for the marketing authorization of degradable implant materials. This review gives an overview of existing and proposed standards for implant testing for marketing approval. Furthermore, different common in vitro and in vivo testing methods are discussed. In some cases, animal tests are inevitable to investigate the biological safety of a novel medical material. The choice of an appropriate animal model is as important as subsequent histological examination. Furthermore, this review focuses on the results of various mechanical tests to investigate the stability of implants for temporary use. All the above aspects are examined in the context of development and testing of magnesium-based biomaterials and their progress them from bench to bedside. A brief history of the first market launch of a magnesium-based degradable implant is given. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 329-347, 2017.

In vitro and in vivo studies on the degradation of high-purity Mg (99.99wt.%) screw with femoral intracondylar fractured rabbit model

High-purity magnesium (HP Mg) takes advantage in no alloying toxic elements and slower degradation rate in lack of second phases and micro-galvanic corrosion. In this study, as rolled HP Mg was fabricated into screws and went through in vitro immersion tests, cytotoxicity test and bioactive analysis. The HP Mg screws performed uniform corrosion behavior in vitro, and its extraction promoted cell viability, bone alkaline phosphatase (ALP) activity, and mRNA expression of osteogenic differentiation related gene, i.e. ALP, osteopontin (OPN) and RUNX2 of human bone marrow mesenchymal stem cells (hBMSCs). Then HP Mg screws were implanted in vivo as load-bearing implant to fix bone fracture and subsequently gross observation, range of motion (ROM), X-ray scanning, qualitative micro-computed tomography (μCT) analysis, histological analysis, bending-force test and SEM morphology of retrieved screws were performed respectively at 4, 8, 16 and 24 weeks. As a result, the retrieved HP Mg screws in fixation of rabbit femoral intracondylar fracture showed uniform degradation morphology and enough bending force. However, part of PLLA screws was broken in bolt, although its screw thread was still intact. Good osseointegration was revealed surrounding HP Mg screws and increased bone volume and bone mineral density were detected at fracture gap, indicating the rigid fixation and enhanced fracture healing process provided by HP Mg screws. Consequently, the HP Mg showed great potential as internal fixation devices in intra-articular fracture operation.