1
|
Wang L, Huang H, Yuan H, Yao Y, Park JH, Liu J, Geng X, Zhang K, Hollister SJ, Fan Y. In vitro fatigue behavior and in vivo osseointegration of the auxetic porous bone screw. Acta Biomater 2023; 170:185-201. [PMID: 37634835 DOI: 10.1016/j.actbio.2023.08.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/28/2023] [Accepted: 08/21/2023] [Indexed: 08/29/2023]
Abstract
The incidence of screw loosening, migration, and pullout caused by the insufficient screw-bone fixation stability is relatively high in clinical practice. To solve this issue, the auxetic unit-based porous bone screw (AS) has been put forward in our previous work. Its favorable auxetic effect can improve the primary screw-bone fixation stability after implantation. However, porous structure affected the fatigue behavior and in vivo longevity of bone screw. In this study, in vitro fatigue behaviors and in vivo osseointegration performance of the re-entrant unit-based titanium auxetic bone screw were studied. The tensile-tensile fatigue behaviors of AS and nonauxetic bone screw (NS) with the same porosity (51%) were compared via fatigue experiments, fracture analysis, and numerical simulation. The in vivo osseointegration of AS and NS were compared via animal experiment and biomechanical analysis. Additionally, the effects of in vivo dynamic tensile loading on the osseointegration of AS and NS were investigated and analyzed. The fatigue strength of AS was approximately 43% lower while its osseointegration performance was better than NS. Under in vivo dynamic tensile loading, the osseointegration of AS and NS both improved significantly, with the maximum increase of approximately 15%. Preferrable osseointegration of AS might compensate for the shortage of fatigue resistance, ensuring its long-term stability in vivo. Adequate auxetic effect and long-term stability of the AS was supposed to provide enough screw-bone fixation stability to overcome the shortages of the solid bone screw, developing the success of surgery and showing significant clinical application prospects in orthopedic surgery. STATEMENT OF SIGNIFICANCE: This research investigated the high-cycle fatigue behavior of re-entrant unit-based auxetic bone screw under tensile-tensile cyclic loading and its osseointegration performance, which has not been focused on in existing studies. The fatigue strength of auxetic bone screw was lower while the osseointegration was better than non-auxetic bone screw, especially under in vivo tensile loading. Favorable osseointegration of auxetic bone screw might compensate for the shortage of fatigue resistance, ensuring its long-term stability and longevity in vivo. This suggested that with adequate auxetic effect and long-term stability, the auxetic bone screw had significant application prospects in orthopedic surgery. Findings of this study will provide a theoretical guidance for design optimization and clinical application of the auxetic bone screw.
Collapse
Affiliation(s)
- Lizhen Wang
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, No. 37 Xueyuan Road, Haidian District, Beijing 100083, China
| | - Huiwen Huang
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, No. 37 Xueyuan Road, Haidian District, Beijing 100083, China
| | - Hao Yuan
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, No. 37 Xueyuan Road, Haidian District, Beijing 100083, China
| | - Yan Yao
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, No. 37 Xueyuan Road, Haidian District, Beijing 100083, China
| | - Jeong Hun Park
- Wallace H. Coulter Department of Biomedical Engineering and Center for 3D Medical Fabrication, Georgia Institute of Technology and Emory University, 313 Ferst Drive, Atlanta, GA 30332, USA
| | - Jinglong Liu
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, No. 37 Xueyuan Road, Haidian District, Beijing 100083, China
| | - Xuezheng Geng
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, No. 37 Xueyuan Road, Haidian District, Beijing 100083, China
| | - Kuo Zhang
- Laboratory Animal Science Center, Peking University Health Science Center, Beijing 100083, China
| | - Scott J Hollister
- Wallace H. Coulter Department of Biomedical Engineering and Center for 3D Medical Fabrication, Georgia Institute of Technology and Emory University, 313 Ferst Drive, Atlanta, GA 30332, USA
| | - Yubo Fan
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, No. 37 Xueyuan Road, Haidian District, Beijing 100083, China.
| |
Collapse
|
2
|
Calazans Neto JV, Reis ACD, Valente MLDC. Osseointegration in additive-manufactured titanium implants: A systematic review of animal studies on the need for surface treatment. Heliyon 2023; 9:e17105. [PMID: 37484223 PMCID: PMC10361303 DOI: 10.1016/j.heliyon.2023.e17105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 05/22/2023] [Accepted: 06/07/2023] [Indexed: 07/25/2023] Open
Abstract
The objective of the systematic review is to find an answer to a question: "Do surface treatments on titanium implants produced by additive manufacturing improve osseointegration, compared to untreated surfaces?". This review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA 2020) and was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42022321351). Searches were performed in PubMed, Scopus, Science Direct, Embase, and Google Scholar databases on March 22nd, 2022. Articles were chosen in 2 steps by 2 blinded reviewers based on previously selected inclusion criteria: articles in animals that addressed the influence of surface treatments on osseointegration in implants produced by additive manufacturing. Articles were excluded that (1) did not use titanium surface, 2) that did not evaluate surface treatments, 3) that did not described osseointegration, 4) Studies with only in vitro analyses, clinical studies, systematic reviews, book chapters, short communications, conference abstracts, case reports and personal opinions.). 1003 articles were found and, after applying the eligibility criteria, 17 were used for the construction of this review. All included studies found positive osseointegration results from performing surface treatments on titanium. The risk of bias was analyzed using the SYRCLE assessment tool. Surface treatments are proposed to promote changes in the microstructure and composition of the implant surface to favor the adhesion of bone cells responsible for osseointegration. It is observed that despite the benefits generated by the additive manufacturing process in the microstructure of the implant surface, surface treatments are still indispensable, as they can promote more suitable characteristics for bone-implant integration. It can be concluded that the surface treatments evaluated in this systematic review, performed on implants produced by additive manufacturing, optimize osseointegration, as it allows the creation of a micro-nano-textured structure that makes the surface more hydrophilic and allows better contact bone-implant.
Collapse
Affiliation(s)
| | | | - Mariana Lima da Costa Valente
- Corresponding author. Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, FORP-USP. Av. Do Café, s/n, 14040Ribeirão Preto, Brazil.
| |
Collapse
|
3
|
Wang Y, Ren C, Bi F, Li P, Tian K. The hydroxyapatite modified 3D printed poly L-lactic acid porous screw in reconstruction of anterior cruciate ligament of rabbit knee joint: a histological and biomechanical study. BMC Musculoskelet Disord 2023; 24:151. [PMID: 36849968 PMCID: PMC9969685 DOI: 10.1186/s12891-023-06245-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/15/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND 3D printing technology has become a research hotspot in the field of scientific research because of its personalized customization, maneuverability and the ability to achieve multiple material fabrications. The focus of this study is to use 3D printing technology to customize personalized poly L-lactic acid (PLLA) porous screws in orthopedic plants and to explore its effect on tendon-bone healing after anterior cruciate ligament (ACL) reconstruction. METHODS Preparation of PLLA porous screws with good orthogonal pore structure by 3D printer. The hydroxyapatite (HA) was adsorbed on porous screws by electrostatic layer-by-layer self-assembly (ELSA) technology, and PLLA-HA porous screws were prepared. The surface and spatial morphology of the modified screws were observed by scanning electron microscopy (SEM). The porosity of porous screw was measured by liquid displacement method. Thirty New Zealand male white rabbits were divided into two groups according to simple randomization. Autologous tendon was used for right ACL reconstruction, and porous screws were inserted into the femoral tunnel to fix the transplanted tendon. PLLA group was fixed with porous screws, PLLA-HA group was fixed with HA modified porous screws. At 6 weeks and 12 weeks after surgery, 5 animals in each group were sacrificed randomly for histological examination. The remaining 5 animals in each group underwent Micro-CT and biomechanical tests. RESULTS The pores of PLLA porous screws prepared by 3D printer were uniformly distributed and connected with each other, which meet the experimental requirements. HA was evenly distributed in the porous screw by ELSA technique. Histology showed that compared with PLLA group, mature bone trabeculae were integrated with grafted tendons in PLLA-HA group. Micro-CT showed that the bone formation index of PLLA-HA group was better than that of PLLA group. The new bone was uniformly distributed in the bone tunnel along the screw channel. Biomechanical experiments showed that the failure load and stiffness of PLLA-HA group were significantly higher than those of PLLA group. CONCLUSIONS The 3D printed PLLA porous screw modified by HA can not only fix the grafted tendons, but also increase the inductivity of bone, promote bone growth in the bone tunnel and promote bone integration at the tendon-bone interface. The PLLA-HA porous screw is likely to be used in clinic in the future.
Collapse
Affiliation(s)
- Yafei Wang
- Department of Orthopedic Surgery, the First Affiliated Hospital of Zhengzhou University, NO.1 Jianshe East Road, Zhengzhou, China
| | - Chengzhen Ren
- Department of Orthopedic Surgery, the First Affiliated Hospital of Zhengzhou University, NO.1 Jianshe East Road, Zhengzhou, China
| | - Fanggang Bi
- Department of Orthopedic Surgery, the First Affiliated Hospital of Zhengzhou University, NO.1 Jianshe East Road, Zhengzhou, China
| | - Pengju Li
- Department of Orthopedic Surgery, the Honghui Hospital of Xi'an, No. 76 Nanguo road, Nan Xiaomen, Xi'an, 710054, China
| | - Ke Tian
- Department of Orthopedic Surgery, the First Affiliated Hospital of Zhengzhou University, NO.1 Jianshe East Road, Zhengzhou, China.
| |
Collapse
|
4
|
Wei B, Ji M, Lin Y, Geng R, Wang Q, Lu J. Investigation of the medium-term effect of osteoprotegerin/bone morphogenetic protein 2 combining with collagen sponges on tendon-bone healing in a rabbit. J Orthop Surg (Hong Kong) 2023; 31:10225536231163467. [PMID: 36893748 DOI: 10.1177/10225536231163467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Osteoprotegerin (OPG) and bone morphogenetic protein-2 (BMP-2) could be administered sequentially to promote tendon-bone healing. There remain several unresolved issues in our previously published study: a) the release kinetics of OPG/BMP-2 from the OPG/BMP-2/collagen sponge (CS) combination in vitro remained unclear; b) the medium-term effect of the OPG/BMP-2/CS combination was not analyzed. Hence, we design this study to address the issues mentioned above. METHODS 30 rabbits undergoing anterior cruciate ligament reconstruction (ACLR) with an Achilles tendon autograft randomly received one of the 3 delivery at the femoral and tibial tunnels: OPG/BMP-2, OPG/BMP-2/CS combination, and nothing (blank control). At 8 and 24 weeks post-surgery, the biomechanical tests and histologic analysis were used to evaluate the tendon-bone healing. RESULTS In mechanical tests, the OPG/BMP-2/CS group showed a higher final failure load and stiffness than the other groups at 8 and 24 weeks. Additionally, the maximum stretching distance showed a decreasing trend. The mechanical failure pattern of samples shifted from a tunnel pull-away to a graft midsubstance rupture after OPG/BMP-2/CS-treated. From histological analysis, the OPG/BMP-2/CS treatment increased the amount of collagen fibers (collagen I and II) and promoted fibrocartilage attachment. CONCLUSION CS as a carrier promotes the medium-term effect of OPG and BMP-2 on tendon-bone healing at the tendon-bone interface in a rabbit ACLR model. OPG, BMP-2 and CS were already applied in several clinical practice, but a further study of clinic use of OPG/BMP-2/CS is still needed.
Collapse
Affiliation(s)
- Bing Wei
- School of Medicine, 66334Southeast University, Nanjing, China.,Department of Orthopaedic Surgery/Joint and Sports Medicine Center, Zhongda Hospital, School of Medicine, 162752Southeast University, Nanjing, China
| | - Mingliang Ji
- School of Medicine, 66334Southeast University, Nanjing, China.,Department of Orthopaedic Surgery/Joint and Sports Medicine Center, Zhongda Hospital, School of Medicine, 162752Southeast University, Nanjing, China
| | - Yucheng Lin
- School of Medicine, 66334Southeast University, Nanjing, China.,Department of Orthopaedic Surgery/Joint and Sports Medicine Center, Zhongda Hospital, School of Medicine, 162752Southeast University, Nanjing, China
| | - Rui Geng
- School of Medicine, 66334Southeast University, Nanjing, China.,Department of Orthopaedic Surgery/Joint and Sports Medicine Center, Zhongda Hospital, School of Medicine, 162752Southeast University, Nanjing, China
| | - Qing Wang
- Department of Orthopaedic Surgery, The First People's Hospital of Yongkang Affiliated to Hangzhou Medical College, Jinhua, China
| | - Jun Lu
- School of Medicine, 66334Southeast University, Nanjing, China.,Department of Orthopaedic Surgery/Joint and Sports Medicine Center, Zhongda Hospital, School of Medicine, 162752Southeast University, Nanjing, China
| |
Collapse
|
5
|
Rouf S, Malik A, Raina A, Irfan Ul Haq M, Naveed N, Zolfagharian A, Bodaghi M. Functionally graded additive manufacturing for orthopedic applications. J Orthop 2022; 33:70-80. [PMID: 35874041 PMCID: PMC9304666 DOI: 10.1016/j.jor.2022.06.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/22/2022] [Accepted: 06/27/2022] [Indexed: 11/20/2022] Open
Abstract
Background Additive Manufacturing due to its benefits in developing parts with complex geometries and shapes, has evolved as an alternate manufacturing process to develop implants with desired properties. The structure of human bones being anisotropic in nature is biologically functionally graded i,e. The structure possesses different properties in different directions. Therefore, various orthopedic implants such as knee, hip and other bone plates, if functionally graded can perform better. In this context, the development of functionally graded (FG) parts for orthopedic application with tailored anisotropic properties has become easier through the use of additive manufacturing (AM). Objectives and Rationale: The current paper aims to study the various aspects of additively manufactured FG parts for orthopedic applications. It presents the details of various orthopedic implants such as knee, hip and other bone plates in a structured manner. A systematic literature review is conducted to study the various material and functional aspects of functionally graded parts for orthopedic applications. A section is also dedicated to discuss the mechanical properties of functionally graded parts. Conclusion The literature revealed that additive manufacturing can provide lot of opportunities for development of functionally graded orthopedic implants with improved properties and durability. Further, the effect of various FG parameters on the mechanical behavior of these implants needs to be studied in detail. Also, with the advent of various AM technologies, the functional grading can be achieved by various means e.g. density, porosity, microstructure, composition, etc. By varying the AM parameters. However, the current limitations of cost and material biocompatibility prevent the widespread exploitation of AM technologies for various orthopedic applications.
Collapse
Affiliation(s)
- Saquib Rouf
- School of Mechanical Engineering, Shri Mata Vaishno Devi University, J&K, India
| | - Abrar Malik
- School of Mechanical Engineering, Shri Mata Vaishno Devi University, J&K, India
| | - Ankush Raina
- School of Mechanical Engineering, Shri Mata Vaishno Devi University, J&K, India
| | - Mir Irfan Ul Haq
- School of Mechanical Engineering, Shri Mata Vaishno Devi University, J&K, India
| | - Nida Naveed
- Faculty of Technology, University of Sunderland, UK
| | | | - Mahdi Bodaghi
- School of Science and Technology, Nottingham Trent University, UK
| |
Collapse
|
6
|
Wu XD, Kang L, Tian J, Wu Y, Huang Y, Liu J, Wang H, Qiu G, Wu Z. Exosomes derived from magnetically actuated bone mesenchymal stem cells promote tendon-bone healing through the miR-21-5p/SMAD7 pathway. Mater Today Bio 2022; 15:100319. [PMID: 35757032 PMCID: PMC9218580 DOI: 10.1016/j.mtbio.2022.100319] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/05/2022] [Accepted: 06/06/2022] [Indexed: 12/15/2022] Open
Abstract
Graft healing after anterior cruciate ligament reconstruction (ACLR) involves slow biological processes, and various types of biological modulations have been explored to promote tendon-to-bone integration. Exosomes have been extensively studied as a promising new cell-free strategy for tissue regeneration, but few studies have reported their potential in tendon-to-bone healing. In this study, a novel type of exosome derived from magnetically actuated (iron oxide nanoparticles (IONPs) combined with a magnetic field) bone mesenchymal stem cells (BMSCs) (IONP-Exos) was developed, and the primary purpose of this study was to determine whether IONP-Exos exert more significant effects on tendon-to-bone healing than normal BMSC-derived exosomes (BMSC-Exos). Here, we isolated and characterized the two types of exosomes, conducted in vitro experiments to measure their effects on fibroblasts (NIH3T3), and performed in vivo experiments to compare the effects on tendon-to-bone integration. Moreover, functional exploration of exosomal miRNAs was further performed by utilizing a series of gain- and loss-of-function experiments. Experimental results showed that both BMSC-Exos and IONP-Exos could be shuttled intercellularly into NIH3T3 fibroblasts and enhanced fibroblast activity, including proliferation, migration, and fibrogenesis. In vivo, we found that IONP-Exos significantly prevented peri-tunnel bone loss, promoted more osseous ingrowth into the tendon graft, increased fibrocartilage formation at the tendon-bone tunnel interface, and induced a higher maximum load to failure than BMSC-Exos. Furthermore, overexpression of miR-21-5p remarkably enhanced fibrogenesis in vitro, and SMAD7 was shown to be involved in the promotive effect of IONP-Exos on tendon-to-bone healing. Our findings may provide new insights into the regulatory roles of IONPs in IONP-Exos communication via stimulating exosomal miR-21-5p secretion and the SMAD7 signaling pathway in the fibrogenic process of tendon-to-bone integration. This work could provide a new strategy to promote tendon-to-bone healing for tissue engineering in the future.
Collapse
Affiliation(s)
- Xiang-Dong Wu
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Lin Kang
- Medical Science Research Center (MRC), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Jingjing Tian
- Medical Science Research Center (MRC), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Yuanhao Wu
- Medical Science Research Center (MRC), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Yue Huang
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Jieying Liu
- Medical Science Research Center (MRC), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Hai Wang
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Guixing Qiu
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Zhihong Wu
- Medical Science Research Center (MRC), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Beijing Key Laboratory for Genetic Research of Skeletal Deformity, Beijing, 100730, China
| |
Collapse
|
7
|
Raheem AA, Hameed P, Whenish R, Elsen RS, G A, Jaiswal AK, Prashanth KG, Manivasagam G. A Review on Development of Bio-Inspired Implants Using 3D Printing. Biomimetics (Basel) 2021; 6:65. [PMID: 34842628 PMCID: PMC8628669 DOI: 10.3390/biomimetics6040065] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/08/2021] [Accepted: 11/15/2021] [Indexed: 01/15/2023] Open
Abstract
Biomimetics is an emerging field of science that adapts the working principles from nature to fine-tune the engineering design aspects to mimic biological structure and functions. The application mainly focuses on the development of medical implants for hard and soft tissue replacements. Additive manufacturing or 3D printing is an established processing norm with a superior resolution and control over process parameters than conventional methods and has allowed the incessant amalgamation of biomimetics into material manufacturing, thereby improving the adaptation of biomaterials and implants into the human body. The conventional manufacturing practices had design restrictions that prevented mimicking the natural architecture of human tissues into material manufacturing. However, with additive manufacturing, the material construction happens layer-by-layer over multiple axes simultaneously, thus enabling finer control over material placement, thereby overcoming the design challenge that prevented developing complex human architectures. This review substantiates the dexterity of additive manufacturing in utilizing biomimetics to 3D print ceramic, polymer, and metal implants with excellent resemblance to natural tissue. It also cites some clinical references of experimental and commercial approaches employing biomimetic 3D printing of implants.
Collapse
Affiliation(s)
- Ansheed A. Raheem
- Centre for Biomaterials, Cellular and Molecular Theranostics, Vellore Institute of Technology, Vellore 632014, India; (A.A.R.); (P.H.); (R.W.); (A.K.J.); (G.M.)
| | - Pearlin Hameed
- Centre for Biomaterials, Cellular and Molecular Theranostics, Vellore Institute of Technology, Vellore 632014, India; (A.A.R.); (P.H.); (R.W.); (A.K.J.); (G.M.)
| | - Ruban Whenish
- Centre for Biomaterials, Cellular and Molecular Theranostics, Vellore Institute of Technology, Vellore 632014, India; (A.A.R.); (P.H.); (R.W.); (A.K.J.); (G.M.)
| | - Renold S. Elsen
- School of Mechanical Engineering, Vellore Institute of Technology, Vellore 632014, India;
| | - Aswin G
- School of Advanced Sciences, Vellore Institute of Technology, Vellore 632014, India;
| | - Amit Kumar Jaiswal
- Centre for Biomaterials, Cellular and Molecular Theranostics, Vellore Institute of Technology, Vellore 632014, India; (A.A.R.); (P.H.); (R.W.); (A.K.J.); (G.M.)
| | - Konda Gokuldoss Prashanth
- Centre for Biomaterials, Cellular and Molecular Theranostics, Vellore Institute of Technology, Vellore 632014, India; (A.A.R.); (P.H.); (R.W.); (A.K.J.); (G.M.)
- Department of Mechanical and Industrial Engineering, Tallinn University of Technology, Ehitajate tee 5, 19086 Tallinn, Estonia
- Erich Schmid Institute of Materials Science, Austrian Academy of Science, Jahnstrasse 12, 8700 Leoben, Austria
| | - Geetha Manivasagam
- Centre for Biomaterials, Cellular and Molecular Theranostics, Vellore Institute of Technology, Vellore 632014, India; (A.A.R.); (P.H.); (R.W.); (A.K.J.); (G.M.)
| |
Collapse
|
8
|
Sultana A, Zare M, Luo H, Ramakrishna S. Surface Engineering Strategies to Enhance the In Situ Performance of Medical Devices Including Atomic Scale Engineering. Int J Mol Sci 2021; 22:11788. [PMID: 34769219 PMCID: PMC8583812 DOI: 10.3390/ijms222111788] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/14/2021] [Accepted: 10/26/2021] [Indexed: 12/13/2022] Open
Abstract
Decades of intense scientific research investigations clearly suggest that only a subset of a large number of metals, ceramics, polymers, composites, and nanomaterials are suitable as biomaterials for a growing number of biomedical devices and biomedical uses. However, biomaterials are prone to microbial infection due to Escherichia coli (E. coli), Staphylococcus aureus (S. aureus), Staphylococcus epidermidis (S. epidermidis), hepatitis, tuberculosis, human immunodeficiency virus (HIV), and many more. Hence, a range of surface engineering strategies are devised in order to achieve desired biocompatibility and antimicrobial performance in situ. Surface engineering strategies are a group of techniques that alter or modify the surface properties of the material in order to obtain a product with desired functionalities. There are two categories of surface engineering methods: conventional surface engineering methods (such as coating, bioactive coating, plasma spray coating, hydrothermal, lithography, shot peening, and electrophoretic deposition) and emerging surface engineering methods (laser treatment, robot laser treatment, electrospinning, electrospray, additive manufacturing, and radio frequency magnetron sputtering technique). Atomic-scale engineering, such as chemical vapor deposition, atomic layer etching, plasma immersion ion deposition, and atomic layer deposition, is a subsection of emerging technology that has demonstrated improved control and flexibility at finer length scales than compared to the conventional methods. With the advancements in technologies and the demand for even better control of biomaterial surfaces, research efforts in recent years are aimed at the atomic scale and molecular scale while incorporating functional agents in order to elicit optimal in situ performance. The functional agents include synthetic materials (monolithic ZnO, quaternary ammonium salts, silver nano-clusters, titanium dioxide, and graphene) and natural materials (chitosan, totarol, botanical extracts, and nisin). This review highlights the various strategies of surface engineering of biomaterial including their functional mechanism, applications, and shortcomings. Additionally, this review article emphasizes atomic scale engineering of biomaterials for fabricating antimicrobial biomaterials and explores their challenges.
Collapse
Affiliation(s)
- Afreen Sultana
- Center for Nanotechnology & Sustainability, Department of Mechanical Engineering, National University of Singapore, Singapore 117581, Singapore; (A.S.); (S.R.)
| | - Mina Zare
- Center for Nanotechnology & Sustainability, Department of Mechanical Engineering, National University of Singapore, Singapore 117581, Singapore; (A.S.); (S.R.)
| | - Hongrong Luo
- Engineering Research Center in Biomaterials, Sichuan University, Chengdu 610064, China
| | - Seeram Ramakrishna
- Center for Nanotechnology & Sustainability, Department of Mechanical Engineering, National University of Singapore, Singapore 117581, Singapore; (A.S.); (S.R.)
| |
Collapse
|
9
|
Wang Z, Agrawal P, Zhang YS. Nanotechnologies and Nanomaterials in 3D (Bio)printing toward Bone Regeneration. ADVANCED NANOBIOMED RESEARCH 2021. [DOI: 10.1002/anbr.202100035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Zongliang Wang
- Division of Engineering in Medicine Department of Medicine Brigham and Women's Hospital Harvard Medical School Cambridge MA 02139 USA
| | - Prajwal Agrawal
- Division of Engineering in Medicine Department of Medicine Brigham and Women's Hospital Harvard Medical School Cambridge MA 02139 USA
| | - Yu Shrike Zhang
- Division of Engineering in Medicine Department of Medicine Brigham and Women's Hospital Harvard Medical School Cambridge MA 02139 USA
| |
Collapse
|
10
|
Cleemput S, Huys SEF, Cleymaet R, Cools W, Mommaerts MY. Additively manufactured titanium scaffolds and osteointegration - meta-analyses and moderator-analyses of in vivo biomechanical testing. Biomater Res 2021; 25:18. [PMID: 34112248 PMCID: PMC8191027 DOI: 10.1186/s40824-021-00216-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 04/15/2021] [Indexed: 12/18/2022] Open
Abstract
Introduction Maximizing osteointegration potential of three-dimensionally-printed porous titanium (3DPPT) is an ongoing focus in biomaterial research. Many strategies are proposed and tested but there is no weighted comparison of results. Methods We systematically searched Pubmed and Embase to obtain two pools of 3DPPT studies that performed mechanical implant-removal testing in animal models and whose characteristics were sufficiently similar to compare the outcomes in meta-analyses (MAs). We expanded these MAs to multivariable meta-regressions (moderator analysis) to verify whether statistical models including reported scaffold features (e.g., “pore-size”, “porosity”, “type of unit cell”) or post-printing treatments (e.g., surface treatments, adding agents) could explain the observed differences in treatment effects (expressed as shear strength of bone-titanium interface). Results “Animal type” (species of animal in which the 3DPPT was implanted) and “type of post-treatment” (treatment performed after 3D printing) were moderators providing statistically significant models for differences in mechanical removal strength. An interaction model with covariables “pore-size” and “porosity” in a rabbit subgroup analysis (the most reported animal model) was also significant. Impact of other moderators (including “time” and “location of implant”) was not statistically significant. Discussion/conclusion Our findings suggest a stronger effect from porosity in a rat than in a sheep model. Additionally, adding a calcium-containing layer does not improve removal strength but the other post-treatments do. Our results provide overview and new insights, but little narrowing of existing value ranges. Consequent reporting of 3DPPT characteristics, standardized comparison, and expression of porosity in terms of surface roughness could help tackle these existing dilemmas. Graphical abstract ![]()
Collapse
Affiliation(s)
- Simon Cleemput
- Doctoral School of Life Sciences and Medicine, Vrije Universiteit Brussel, 1090, Brussels, Belgium. .,European Face Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 1090, Brussels, Belgium.
| | - Stijn E F Huys
- Engineering Science, Department of Mechanical Engineering, Section of Biomechanics, Catholic University of Leuven, 3000, Leuven, Belgium
| | - Robbert Cleymaet
- European Face Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 1090, Brussels, Belgium
| | - Wilfried Cools
- Interfaculty Center Data processing and Statistics, Vrije Universiteit Brussel, 1090, Brussels, Belgium
| | - Maurice Y Mommaerts
- European Face Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 1090, Brussels, Belgium
| |
Collapse
|
11
|
Tamayo JA, Riascos M, Vargas CA, Baena LM. Additive manufacturing of Ti6Al4V alloy via electron beam melting for the development of implants for the biomedical industry. Heliyon 2021; 7:e06892. [PMID: 34027149 PMCID: PMC8120950 DOI: 10.1016/j.heliyon.2021.e06892] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/27/2021] [Accepted: 04/21/2021] [Indexed: 11/18/2022] Open
Abstract
Additive Manufacturing (AM) or rapid prototyping technologies are presented as one of the best options to produce customized prostheses and implants with high-level requirements in terms of complex geometries, mechanical properties, and short production times. The AM method that has been more investigated to obtain metallic implants for medical and biomedical use is Electron Beam Melting (EBM), which is based on the powder bed fusion technique. One of the most common metals employed to manufacture medical implants is titanium. Although discovered in 1790, titanium and its alloys only started to be used as engineering materials for biomedical prostheses after the 1950s. In the biomedical field, these materials have been mainly employed to facilitate bone adhesion and fixation, as well as for joint replacement surgeries, thanks to their good chemical, mechanical, and biocompatibility properties. Therefore, this study aims to collect relevant and up-to-date information from an exhaustive literature review on EBM and its applications in the medical and biomedical fields. This AM method has become increasingly popular in the manufacturing sector due to its great versatility and geometry control.
Collapse
Affiliation(s)
- José A. Tamayo
- Grupo Calidad, Metrología y Producción, Instituto Tecnológico Metropolitano (ITM), Medellín, Colombia
| | - Mateo Riascos
- Grupo Calidad, Metrología y Producción, Instituto Tecnológico Metropolitano (ITM), Medellín, Colombia
| | - Carlos A. Vargas
- Grupo Materiales Avanzados y Energía (Matyer), Instituto Tecnológico Metropolitano (ITM), Medellín, Colombia
| | - Libia M. Baena
- Grupo de Química Básica, Aplicada y Ambiente (Alquimia), Instituto Tecnológico Metropolitano (ITM), Medellín, Colombia
| |
Collapse
|