The Effect of Magnesium Ions on Bone Bonding to Hydroxyapatite Coating on Titanium Alloy Implants

Optimization of the clinically approved mg-Zn alloy system through the addition of ca

Background

Although several studies on the Mg-Zn-Ca system have focused on alloy compositions that are restricted to solid solutions, the influence of the solid solution component of Ca on Mg-Zn alloys is unknown. Therefore, to broaden its utility in orthopedic applications, studies on the influence of the addition of Ca on the microstructural, mechanical, and corrosion properties of Mg-Zn alloys should be conducted. In this study, an in-depth investigation of the effect of Ca on the mechanical and bio-corrosion characteristics of the Mg-Zn alloy was performed for the optimization of a clinically approved Mg alloy system comprising Ca and Zn.

Methods

The Mg alloy was fabricated by gravitational melting of high purity Mg, Ca, and Zn metal grains under an Ar gas environment. The surface and cross-section were observed using scanning electron microscopy (SEM) and transmission electron microscopy (TEM) to analyze their crystallographic structures. Electrochemical and immersion tests in Hank’s balanced salt solution were used to analyze their corrosion resistance. Tensile testing was performed with universal testing equipment to investigate the impact of Ca addition. The examination of cytotoxicity for biometric determination was in line with the ISO10993 standard.

Results

In this study, the 0.1% Ca alloy had significantly retarded grain growth due to the formation of the tiny and well-dispersed Ca₂Mg₆Zn₃ phase. In addition, the yield strength and elongation of the 0.1% Ca alloy were more than 50% greater than the 2% Zn alloy. The limited cell viability of the 0.3% Ca alloy could be attributed to its high corrosion rate, whereas the 0.1% Ca alloy demonstrated cell viability of greater than 80% during the entire experimental period.

Conclusion

The effect of the addition of Ca on the microstructure, mechanical, and corrosion characteristics of Mg-Zn alloys was analyzed in this work. The findings imply that the Mg-Zn alloy system could be optimized by adding a small amount of Ca, improving mechanical properties while maintaining corrosion rate, thus opening the door to a wide range of applications in orthopedic surgery.

Electroless Deposits of ZnO and Hybrid ZnO/Ag Nanoparticles on Mg-Ca0.3 Alloy Surface: Multiscale Characterization

ZnO and hybrid of ZnO/Ag structures in the nanometer size were electroless deposited on the Mg-Ca0.3 alloy surface, achieved from aqueous solutions (10−3 M at 21 °C) of ZnO (suspension), Zn(NO3)2 and AgNO3. The surface characterization of the deposits was carried out by Scanning Electron Microscopy-Energy Dispersive Spectroscopy (SEM-EDS), X-Ray Photoelectron Spectroscopy (XPS), Fourier transform infrared (FTIR), UV-Visible and Raman spectroscopy. The nanoparticles (NPs) area size distribution analysis revealed that the average of ZnO-NPs was ~85 nm. Likewise, the Ag-NPs of electroless deposits had an average area size of ~100 nm and nucleated in the vicinity of ZnO-NPs as Ag+ ions have been attracted by the negatively charged O2− atoms of the Zn-O dipole. The ZnO-NPs had the wurtzite structure, as indicated by Raman spectroscopy analysis and XRD complementary analysis. The UV-Visible spectroscopy analysis gave a peak at ~320 nm associated with the decrease in the imaginary part (k) of the refractive index of Ag-NPs. On the Mg-Ca0.3 surface, MgO, Mg(OH)2 and MgCO3 are present due to the Mg-matrix. XRD spectra of Ag-NPs indicated the presence of planes arranged with the FCC hexagonal structure. The reported hybrid ZnO/Ag electroless deposits of NPs are of interest for temporary implant devices, providing antibacterial properties to Mg-Ca0.3 surface, a widely used biodegradable material.

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.

Effect of pore size on tissue ingrowth and osteoconductivity in biodegradable Mg alloy scaffolds

Magnesium has mechanical properties similar to those of bone and is being considered as a potential bone substitute. In the present study, two different pore sized scaffolds of the Mg alloy LAE442, coated with magnesium fluoride, were compared. The scaffolds had interconnecting pores of either 400 (p400) or 500 µm (p500). ß-TCP served as control. Ten scaffolds per time group (6, 12, 24, 36 weeks) were implanted in the trochanter major of rabbits. Histological analyses, µCT scans, and SEM/EDX were performed. The scaffolds showed slow volume decreases (week 36 p400: 9.9%; p500: 7.5%), which were accompanied by uncritical gas releases. In contrast, ß-TCP showed accelerated resorption (78.5%) and significantly more new bone inside (18.19 ± 1.47 mm³). Bone fragments grew into p400 (0.17 ± 0.19 mm³) and p500 (0.36 ± 0.26 mm³), reaching the centrally located pores within p500 more frequently. In particular, p400 displayed a more uneven and progressively larger surface area (week 36 p400: 253.22 ± 19.44; p500: 219.19 ± 4.76 mm²). A better osseointegration of p500 was indicated by significantly more trabecular contacts and a 200 µm wide bone matrix being in the process of mineralization and in permanent contact with the scaffold. The number of macrophages and foreign body giant cells were at an acceptable level concerning resorbable biomaterials. In terms of ingrown bone and integrative properties, LAE442 scaffolds could not achieve the results of ß-TCP. In this long-term study, p500 appears to be a biocompatible and more osteoconductive pore size for the Mg alloy LAE442.

In vivo investigation of open-pored magnesium scaffolds LAE442 with different coatings in an open wedge defect

The magnesium alloy LAE442 showed promising results as a bone substitute in numerous studies in non-weight bearing bone defects. This study aimed to investigate the in vivo behavior of wedge-shaped open-pored LAE442 scaffolds modified with two different coatings (magnesium fluoride (MgF₂, group 1)) or magnesium fluoride/calcium phosphate (MgF₂/CaP, group 2)) in a partial weight-bearing rabbit tibia defect model. The implantation of the scaffolds was performed as an open wedge corrective osteotomy in the tibia of 40 rabbits and followed for observation periods of 6, 12, 24, and 36 weeks. Radiological and microcomputed tomographic examinations were performed in vivo. X-ray microscopic, histological, histomorphometric, and SEM/EDS analyses were performed at the end of each time period. µCT measurements and X-ray microscopy showed a slight decrease in volume and density of the scaffolds of both coatings. Histologically, endosteal and periosteal callus formation with good bridging and stabilization of the osteotomy gap and ingrowth of bone into the scaffold was seen. The MgF₂ coating favored better bridging of the osteotomy gap and more bone-scaffold contacts, especially at later examination time points. Overall, the scaffolds of both coatings met the requirement to withstand the loads after an open wedge corrective osteotomy of the proximal rabbit tibia. However, in addition to the inhomogeneous degradation behavior of individual scaffolds, an accumulation of gas appeared, so the scaffold material should be revised again regarding size dimension and composition.

In vitro degradation, haemolysis and cytotoxicity study of Mg-0.4Ce/ZnO2 nanocomposites

Magnesium is an ideal candidate for biodegradable implants, but the major concern is its uncontrollable degradation for application as a biomaterial. The in vitro corrosion and cytotoxicity of Mg‐0.4Ce/ZnO₂ (magnesium nanocomposites) were studied to determine its suitability as a biodegradable material. The polycrystalline nature of Mg‐0.4Ce/ZnO₂ was assessed using an optical microscope. The hydrophobic nature of Mg‐0.4Ce/ZnO₂ was determined by contact angle measurements. The corrosion resistance of magnesium nanocomposites was tested in phosphate buffer solution (PBS) and it was improved by the gradual deposition of a protective layer on its surface after 48 h. The cytotoxicity of Mg‐0.4Ce/ZnO₂ was evaluated by 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide (MTT) assay and calcium deposition by Alizarin red staining using sarcoma osteogenic (Saos2) cells. The haemocompatibility test of Mg‐0.4Ce/ZnO₂ showed 30% haemolysis, which is higher than the safe value for biomaterials, and cell viability was reduced after 24 h in comparison with control groups. The calcium deposition by sarcoma osteogenic cells showed a brick red colour deposition in both the control group and Mg‐0.4Ce/ZnO₂ after 24 h. The preliminary degradation results of Mg‐0.4Ce/ZnO₂ showed good corrosion resistance; however further improvement is needed in haemolysis and cytotoxicity studies for its use as a biodegradable material for orthopaedic applications.

Effect of Laser Parameters on Processing of Biodegradable Magnesium Alloy WE43 via Selective Laser Melting Method

The global aim of the theme of magnesium alloy processing by the selective laser melting technology is to enable printing of replacements into the human body. By combining the advantages of WE43 magnesium alloy and additive manufacturing, it is possible to print support structures that have very similar properties to human bones. However, printing magnesium alloy parts is very difficult, and the printing strategies are still under development. Knowledge of weld deposit behaviour is needed to design a complex printing strategy and still missing. The main aim of the manuscript is the find a stable process window and identify the dependence of the weld deposit shape and properties on the laser power and scanning speed. The range of the tested parameters was 100–400 W and 100–800 mm/s for laser power and scanning speed. The profilometry and light microscopy were used to verify the continuity and shape evaluation. The microhardness and EDX analysis were used for the detailed view of the weld deposit. The manuscript specifies the weld deposit dimensions, their changes depending on laser power and scanning speed, and the continuity of the weld tracks. The stable weld deposits are made by the energy density of 5.5–12 J/mm². Thin walls were also created by layering welds to determine the surface roughness scattering (Ra 35–60) for various settings of laser power and scanning speed.

Development of magnesium implants by application of conjoint-based quality function deployment

Biodegradable magnesium-based implants are the subject of a great deal of research for different orthopedic and vascular applications. The targeted design and properties depend on the specific medical function and location in the body. Development of the biomaterial requires a comprehensive understanding of the biological interaction between the implant and the host tissue, as well as of the behavior in the physiological environment in vivo. Research into and the development of innovative magnesium implants entails interdisciplinary research efforts and communication between materials science, bioscience, and medical experts. The present study provides a transparent planning and communication tool for market-oriented implant development processes. The objective was to identify medical needs at an early stage of the development process and to quantify the importance of the engineering characteristics of different research fields that cater to specific implant requirements. The method is demonstrated by the performance of a survey-based conjoint analysis, which was integrated into a quality function deployment approach. Twenty-seven medical professionals and 29 biomaterial scientists assessed the importance of identified medical requirements, whereby the control of mechanical integrity and degradation along with nontoxicity and nonimmunogenicity showed the highest number of preferences. The evaluation of implant options by 31 experts indicated that the engineering characteristic with the highest importance was the condition and sterilization of the surface. These values can be used to set priorities in strategic decisions. Research trials can be aligned to medical preferences, ensuring high product quality and an effective development process. This is the first paper to report on the application of conjoint-based quality function deployment in biomaterial research.

Hallux valgus correction utilising a modified short scarf osteotomy with a magnesium biodegradable or titanium compression screws - a comparative study of clinical outcomes

BACKGROUND

Biodegradable implants reduce the likelihood of further surgery for hardware removal and reduce the risks of associated infection and allergy. The purpose of this study is to evaluate the clinical efficacy and determine the comparability of biodegradable magnesium alloy MgYREZr (MAGNEZIX® CS) compression screw fixation compared with standard titanium screw fixation in the surgical treatment of hallux valgus deformity.

METHODS

Eleven patients undergoing corrective surgery for hallux valgus utilising biodegradable magnesium screws and a control group of 25 patients undergoing corrective hallux valgus surgery with standard titanium screws were reviewed at a median of 19 months (range 12-30 months). PROM scores (Manchester-Oxford Foot Questionnaire (MOXFQ), Foot and Ankle Outcomes Instrument (FAOI) and the EQ-5D-3 L) were recorded preoperatively and at latest follow-up.

RESULTS

The results between the two groups were broadly similar, with the Magnesium and Titanium patients showing similar patterns in the various domains in the MOXFQ, the FAOI and the EQ-5D-3 L. Most patients reported a near full shoe comfort score, and EQ-5D-3 L scores were significantly improved in both patient groups (with most patients reporting a full score). Foot pain and foot function improved irrespective of the scoring systems and patients in both groups demonstrated significantly improved scores following the surgery (p < 0.05). Notably, there were no significant differences when comparing the post-operative scores between the groups for any individual scoring parameter. No impairment to quality of life was recorded. There were no intra or post-operative complications. There were no problems encountered through the use of the bioabsorbable screws.

CONCLUSION

Biodegradable magnesium-based compression screws appeared to be safe in this study and are an effective fixation device in the treatment of hallux valgus deformity with clinical outcomes similar to standard titanium screw fixation.

Development of a synthetic tissue engineered three-dimensional printed bioceramic-based bone graft with homogenously distributed osteoblasts and mineralizing bone matrix in vitro

Over the last decade there have been increasing efforts to develop three-dimensional (3D) scaffolds for bone tissue engineering from bioactive ceramics with 3D printing emerging as a promising technology. The overall objective of the present study was to generate a tissue engineered synthetic bone graft with homogenously distributed osteoblasts and mineralizing bone matrix in vitro, thereby mimicking the advantageous properties of autogenous bone grafts and facilitating usage for reconstructing segmental discontinuity defects in vivo. To this end, 3D scaffolds were developed from a silica-containing calcium alkali orthophosphate, using, first, a replica technique - the Schwartzwalder-Somers method - and, second, 3D printing, (i.e. rapid prototyping). The mechanical and physical scaffold properties and their potential to facilitate homogenous colonization by osteogenic cells and extracellular bone matrix formation throughout the porous scaffold architecture were examined. Osteoblastic cells were dynamically cultured for 7 days on both scaffold types with two different concentrations of 1.5 and 3 × 10⁹ cells/l. The amount of cells and bone matrix formed and osteogenic marker expression were evaluated using hard tissue histology, immunohistochemical and histomorphometric analysis. 3D-printed scaffolds (RPS) exhibited more micropores, greater compressive strength and silica release. RPS seeded with 3 × 10⁹ cells/l displayed greatest cell and extracellular matrix formation, mineralization and osteocalcin expression. In conclusion, RPS displayed superior mechanical and biological properties and facilitated generating a tissue engineered synthetic bone graft in vitro, which mimics the advantageous properties of autogenous bone grafts, by containing homogenously distributed terminally differentiated osteoblasts and mineralizing bone matrix and therefore is suitable for subsequent in vivo implantation for regenerating segmental discontinuity bone defects. Copyright © 2016 John Wiley & Sons, Ltd.

Combined effect of magnesia and zirconia on the bioactivity of calcium silicate ceramics at C\S ratio less than unity

This paper describes the effect of magnesia in the presence of zirconia on the bioactivity, microstructure and physico-mechanical properties of calcium silicate composition adjusted at calcia/silica ratio(C/S) of 0.5. A mixture from calcium carbonate and silica was conducted at C/S of 0.5. 20wt.% of magnesia and 5-25wt.% of ZrO₂ were added. Each mixture was mixed with ethanol in a planetary ball mill, dried, formed and fired at a temperature of 1325±5°C. Phase composition, FE-SEM, and physico-mechanical properties of the fired specimens were determined and explained. The in vitro bioactivities of these specimens were investigated by analysis of their abilities to form apatite in the simulated body fluid (SBF) for a short time (7days) using SEM-EDS. The findings indicated that the surface of the specimens containing 5 and 15wt.% ZrO₂ were completely covered by single and multilayered hydroxyapatite (HA) precipitate typical to "cauliflower" morphology, respectively. The surface of the specimen containing 25wt.% ZrO₂ did not cover, but there are some scattered HA precipitate. The differences among the results were rationalized based on the phase composition. Vickers hardness and fracture toughness of the specimens of highly promised bioactivity were 2.32-2.57GPa and 1.80-1.50MPa. m^1/2, respectively. The properties of these specimens are similar to the properties of human cortical bone. Consequently, these composites might be used as bone implant materials.

A preliminary study for novel use of two Mg alloys (WE43 and Mg3Gd)

In this study, two types of magnesium alloys (WE43 and Mg3Gd) were compared with Heal-All membrane (a biodegradable membrane used in guided bone regeneration) in vitro to determine whether the alloys could be used as biodegradable membranes. Degradation behavior was assessed using immersion testing with simulated body fluid (SBF). Microstructural characteristics before and after immersion were evaluated through scanning electron microscopy, and degradation products were analyzed with energy dispersive spectrometry (EDS). To evaluate the biocompatibility of the three types of materials, we performed cytotoxicity, adhesion, and mineralization tests using human osteoblast-like MG63 cells. Immersion testing results showed no significant difference in degradation rate between WE43 and Mg3Gd alloys. However, both Mg alloys corroded faster than the Heal-All membrane, with pitting corrosion as the main corrosion mode for the alloys. Degradation products mainly included P- and Ca-containing apatites on the surface of WE43 and Mg3Gd, whereas these apatites were rarely detected on the surface of the Heal-All membrane. All three type of materials exhibited good biocompatibility. In the mineralization experiment, the alkaline phosphatase (ALP) activity of 10 % Mg3Gd extract was significantly higher than the extracts of the two other materials and the negative control. This study highlighted the potential of these Mg-REE alloys for uses in bone regeneration and further studies and refinements are obviously required.

Conversion of titania (TiO2) into conductive titanium (Ti) nanotube arrays for combined drug-delivery and electrical stimulation therapy

The conversion of titania (TiO₂) nanotubes into titanium (Ti), while preserving their nanotubular structures is demonstrated for proposed application as bone implants and electrodes for combined local drug delivery and electrical stimulation therapy.

Effects of alloying elements on the corrosion behavior and biocompatibility of biodegradable magnesium alloys: a review

This review elaborates the effects of alloying elements on the microstructure, mechanical properties, corrosion and biocompatibility of biodegradable magnesium alloys.

Long-term in vivo degradation behaviour and biocompatibility of the magnesium alloy ZEK100 for use as a biodegradable bone implant

Magnesium alloys are the focus of research as resorbable materials for osteosynthesis, as they provide sufficient stability and would make surgery to remove implants unnecessary. The new degradable magnesium alloy ZEK100 was developed to improve the stability and corrosion resistance by alloying with zinc, rare earth metals and zirconium. As the implants were degraded to only a limited extent after 6 months implantation in a previous in vivo study the present study was conducted to evaluate the long-term degradation behaviour and biocompatibility in the same animal model over 9 and 12 months. Five rabbits each with intramedullary tibia implants were examined over 9 and 12 months. Three legs were left without an implant to serve as negative controls. Numerous examinations were performed in the follow-up (clinical examinations, serum analysis, and radiographic and in vivo micro-CT investigations) and after death (ex vivo micro-CT, histology, and implant analysis) to assess the in vivo degradation and biocompatibility. It could be shown that favourable in vivo degradation behaviour is not necessarily associated with good biocompatibility. Although ZEK100 provided a very high initial stability and positive biodegradation, it must be excluded from further biomedical testing as it showed pathological effects on the host tissue following complete degradation.

Assessment of Cellular Reactions to Magnesium as Implant Material in Comparison to Titanium and to Glyconate Using the Mouse Tail Model

Purpose

Nowadays, research in magnesium alloys as a biodegradable implant material has increased. The aim of this study was to examine osteoinductive properties and tissue responses to pure magnesium in comparison to conventional permanent (titanium) and to degradable (glyconate) implant materials.

Methods

Magnesium wires (0.4 mm in diameter, 10 mm length) were implanted into tail veins of mice and examined after 2, 4, 8, 16 and 32 weeks. Titanium and glyconate as controls were assessed after 2, 4, 8 and 24 weeks. μ-computed tompgraphy, histology and SEM examinations were performed.

Results

Magnesium implants showed increasing structural losses over time with fragmentation after an observation period of 32 weeks. Glyconate was fully degraded and titanium remained almost unaffected after 24 weeks. In contrast to some titanium and glyconate implants, first calcium and phosphate precipitations could be observed around magnesium implants after two weeks. However, ossification could not be observed even after 32 weeks, whereas enchondral ossification was found partially in the sourrounding of glyconate and titanium implants after eight weeks. Nevertheless, magnesium implants showed less inflammatory responses and fibrosing properties than the conventional implant materials.

Conclusions

Although the assumed osteoinductive properties could not be detected, magnesium appears to be a promising degradable implant material because of the low sensitizing and inflammatory potential.

In vivo degradation performance of micro-arc-oxidized magnesium implants: a micro-CT study in rats

Biodegradable Mg alloys are of great interest for osteosynthetic applications because they do not require surgical removal after they have served their purpose. In this study, fast-degrading ZX50 Mg-based implants were surface-treated by micro-arc oxidation (MAO), to alter the initial degradation, and implanted along with untreated ZX50 controls in the femoral legs of 20 male Sprague-Dawley rats. Their degradation was monitored by microfocus computed tomography (μCT) over a total observation period of 24weeks, and histological analysis was performed after 4, 12 and 24weeks. While the MAO-treated samples showed almost no corrosion in the first week, they revealed an accelerated degradation rate after the third week, even faster than that of the untreated ZX50 implants. This increase in degradation rate can be explained by an increase in the surface-area-to-volume ratio of MAO-treated implants, which degrade inhomogeneously via localized corrosion attacks. The histological analyses show that the initially improved corrosion resistance of the MAO implants has a positive effect on bone and tissue response: The reduced hydrogen evolution (due to reduced corrosion) makes possible increased osteoblast apposition from the very beginning, thus generating a stable bone-implant interface. As such, MAO treatment appears to be very interesting for osteosynthetic implant applications, as it delays implant degradation immediately after implantation, enhances fracture stabilization, minimizes the burden on the postoperatively irritated surrounding tissue and generates good bone-implant connections, followed by accelerated degradation in the later stage of bone healing.

In vivo testing of a bioabsorbable magnesium alloy serving as total ossicular replacement prostheses

Magnesium alloys have been investigated in different fields of medicine and represent a promising biomaterial for implants due to characteristics like bioabsorbability and osteoinduction. The objective of this study was to evaluate the usability of magnesium as implant material in middle ear surgery. Magnesium implants were placed into the right middle ear of eighteen New Zealand White rabbits. Nine animals were euthanized after four weeks and nine animals after three month. The petrous bones were removed and embedded in epoxy resin. The specimens were then polished, stained and evaluated with the aid of a light microscope. The histological examination revealed a good biocompatibility. After four weeks, a beginning corrosion of the implant’s surface and low amount of trabecular bone formation in the area of the stapes base plate was observed. A considerable degradation of implants and obvious bone formation was found three month after implantation. The magnesium alloy used in the present study partly corroded too fast, so that a complete bone reconstruction could not be established in time. The increased osteoinduction on the stapes base plate resulted in a tight bone-implant bonding. Thus, a promising application of magnesium could be a coating of biomaterials in order to improve the bony integration of implants.

In vivo assessment of the host reactions to the biodegradation of the two novel magnesium alloys ZEK100 and AX30 in an animal model

BACKGROUND

Most studies on biodegradable magnesium implants published recently use magnesium-calcium-alloys or magnesium-aluminum-rare earth-alloys.However, since rare earths are a mixture of elements and their toxicity is unclear, a reduced content of rare earths is favorable. The present study assesses the in vivo biocompatibility of two new magnesium alloys which have a reduced content (ZEK100) or contain no rare earths at all (AX30).

METHODS

24 rabbits were randomized into 4 groups (AX30 or ZEK100, 3 or 6 months, respectively) and cylindrical pins were inserted in their tibiae. To assess the biodegradation μCT scans and histological examinations were performed.

RESULTS

The μCT scans showed that until month three ZEK100 degrades faster than AX30, but this difference is leveled out after 6 months. Histology revealed that both materials induce adverse host reactions and high numbers of osteoclasts in the recipient bone. The mineral apposition rates of both materials groups were high.

CONCLUSIONS

Both alloys display favorable degradation characteristics, but they induce adverse host reactions, namely an osteoclast-driven resorption of bone and a subsequent periosteal formation of new bone. Therefore, the biocompatibility of ZEK100 and AX30 is questionable and further studies, which should focus on the interactions on cellular level, are needed.

Biomechanical characterisation of a degradable magnesium-based (MgCa0.8) screw

Magnesium alloys have been in the focus of research in recent years as degradable biomaterial. The purpose of this study was the biomechanical characterisation of MgCa0.8-screws. The maximum pull out force of screws was determined in a synthetic bone without corrosion and after fixed intervals of corrosion: 24, 48, 72 and 96 h. This in vitro study has been carried out with Hank's solution with a flow rate corresponding to the blood flow in natural bone. A maximum pull out force (F(max)) of 201.5 ± 9.3 N was measured without corrosion. The biomechanical parameter decreased by 30% after 96 h in corrosive medium compared to the non-corrosion group. A maximum load capacity of 28 ± 7.6 N/h was determined. Our biomechanical data suggests that this biodegradable screw provides a promising bone-screw-fixation and has great potential for medical application.

Biodegradable Behaviors of Mg-6%Zn-5%Hydroxyapatite Biomaterial

The Mg-6%Zn-5%Hydroxyapatite (HA) biomaterial had been prepared through powder metallurgy method in this investigation. The mechanical properties and biodegradable behaviors of the Mg-Zn-HAcomposite in simulated body fluid were studied. The Mg-Zn-HA specimens obtained appropriate density, adjustable elastic modulus and compatible strength to natural bones. Immersion corrosion experiments revealed that 5wt% addition of HA in Mg-6%Zn alloy exhibited acceptable corrosion rates in simulated body fluid. The Mg matrix, Mg7Zn3phase and HA are identified in the experimental composite. The Mg(OH)2and Hydroxyapatite were found on the corrosion products in the simulated body fluid.

Bone-implant interface strength and osseointegration: Biodegradable magnesium alloy versus standard titanium control

Previous research on the feasibility of using biodegradable magnesium alloys for bone implant applications mainly focused on biocompatibility and corrosion resistance. However, successful clinical employment of endosseous implants is largely dependent on biological fixation and anchorage in host bone to withstand functional loading. In the present study, we therefore aimed to investigate whether bone-implant interface strength and osseointegration of a novel biodegradable magnesium alloy (Mg-Y-Nd-HRE, based on WE43) is comparable to that of a titanium control (Ti-6Al-7Nb) currently in clinical use. Biomechanical push-out testing, microfocus computed tomography and scanning electron microscopy were performed in 72 Sprague-Dawley rats 4, 12 and 24 weeks after implantation to address this question. Additionally, blood smears were obtained from each rat at sacrifice to detect potential systemic inflammatory reactions. Push-out testing revealed highly significantly greater maximum push-out force, ultimate shear strength and energy absorption to failure in magnesium alloy rods than in titanium controls after each implantation period. Microfocus computed tomography showed significantly higher bone-implant contact and bone volume per tissue volume in magnesium alloy implants as well. Direct bone-implant contact was verified by histological examination. In addition, no systemic inflammatory reactions were observed in any of the animals. We conclude that the tested biodegradable implant is superior to the titanium control with respect to both bone-implant interface strength and osseointegration. These results suggest that the investigated biodegradable magnesium alloy not only achieves enhanced bone response but also excellent interfacial strength and thus fulfils two critical requirements for bone implant applications.

Ceramic Coatings of Magnesium Alloy for Biomaterial Applications

Ceramic coatings were produced on magnesium (Mg) alloy of AZ91D for biomaterial applications by micro-arc oxidation (MAO) and electrodeposition methods. The morphology, microstructure, phase composition and corrosion properties of the prepared coatings were investigated by scanning electron microscopy (SEM), X-ray diffraction (XRD) and potentiodynamic polarization tester, etc. The results indicated that a porous oxide layer was grown on the Mg alloy sheets after MAO process and the compositions of oxides were mainly Mg2SiO4 and MgO. After further electrodeposition and alkaline treatment, a flake-like structure diverging from centre to periphery was grown on the MAO coating and the coating was mainly made up of hydroxyapatite (HA). Moreover, the corrosion resistance of the Mg alloy after being treated with MAO and electrodeposition technique increases obviously, which was evaluated in stimulated body fluid (SBF).

Preparation and in vitro evaluation of plasma-sprayed Mg(2)SiO(4) coating on titanium alloy

In this paper, chemically synthesized Mg(2)SiO(4) (MS) powder was plasma-sprayed onto a titanium alloy substrate to evaluate its application potentials in biomedicine. The phase composition and surface morphology of the MS coating were analyzed. Results showed that the MS coating was composed mainly of Mg(2)SiO(4) phase, with a small amount of MgO and glass phases. Mechanical testing showed that the coating exhibited good adhesion strength to the substrate due to the close thermal expansion coefficient between the MS ceramic and the titanium alloy substrate. The measured bonding strength was as high as 41.5+/-5.3MPa, which is much higher than the traditional HA coating. In vitro cytocompatibility evaluation of the MS coating was performed using canine bone marrow stem cells (MSCs). The MSCs exhibited good adhesion, proliferation and differentiation behavior on the MS coating surface, which can be explained by the high protein adsorption capability of the MS coating, as well as the stimulatory effects of Mg and Si ions released from the coating. The proliferation rate of the MSCs on MS coating was very close to that on the hydroxylapatite (HA) coating. Alkaline phosphatase (ALP) activity analysis demonstrated that the ALP level of the MSCs on the MS coating remained high even after 21days, implying that the surface characteristics of the coating are beneficial for the differentiation of MSCs. In summary, our results suggest that MS coating might be a new approach to prepare bone implants.

Influence of aggressive ions on the degradation behavior of biomedical magnesium alloy in physiological environment

Various electrochemical approaches, including potentiodynamic polarization, open circuit potential evolution and electrochemical impedance spectroscopy (EIS), are employed to investigate the degradation behavior of biomedical magnesium alloy under the influence of aggressive ions, such as chloride, phosphate, carbonate and sulfate, in a physiological environment. The synergetic effects and mutual influence of these ions on the degradation behavior of Mg are revealed. Our results demonstrate that chloride ions can induce porous pitting corrosion. In the presence of phosphates, the corrosion rate decreases and the formation of pitting corrosion is significantly delayed due to precipitation of magnesium phosphate. Hydrogen carbonate ions are observed to stimulate the corrosion of magnesium alloy during the early immersion stage but they can also induce rapid passivation on the surface. This surface passivation behavior mainly results from the fast precipitation of magnesium carbonate in the corrosion product layer that can subsequently inhibit pitting corrosion completely. Sulfate ions are also found to stimulate magnesium dissolution. These results improve our understanding on the degradation mechanism of surgical magnesium in the physiological environment.

The effects of magnesium particles in posterolateral spinal fusion: an experimental in vivo study in a sheep model

Object

Magnesium has recently become a material of interest as a biocompatible and biodegradable implant metal. Authors of several reports have noted the potential bone-cell activating or bone-healing effect of high Mg ion concentrations. The classic method for achieving intertransverse process fusion involves using an autologous iliac crest bone graft. Several studies have been performed to investigate enhancement of this type of autograft fusion. To the authors’ knowledge, no research has been conducted in which the efficacy of pure Mg particles in posterolateral spinal fusion has been investigated. The objective of this study was to determine whether Mg particles enhance the effectiveness of intertransverse process lumbar fusion in a sheep model.

Methods

Sixteen skeletally mature female sheep were subjected to intertransverse process spinal fusions with pedicle screw fixation at L2–3 and L5–6. Each animal was given a 5-cm3 bone autograft at one fusion level, and a combined 5-cm3 bone autograft with the addition of 1 cm3 Mg at the other level. Six months after surgery, bone formation was evaluated by gross inspection and palpation, and by radiological, histological, scanning electron microscopic, and x-ray diffraction analyses. Radiological results were graded from 0 to 4 according to the status of the bridging bone, which was determined by evaluating both x-ray films and computed tomography scans. The quality of the spinal fusion was assigned a histological score of 0 to 7, in which a score of 0 represented an empty cleft and a score of 7 represented complete bridging of bone between the transverse processes. The trabecular bone formation at each fusion level and the Ca hydroxyapatite crystalline structure in core biopsy specimens were evaluated using scanning electron microscopy and x-ray diffraction analyses, respectively.

The rate of rigid bone fusion, according to both palpation and radiological assessment, in the combined Mg and autologous bone treatment group was higher (81.25%) than in the autograft bone treatment group (62.5%), but this difference was not statistically significant. The quality of bone fusion, according to the histological grading system and scanning electron microscopy inspection, was higher in the bone fusion segments of the Mg and autologous graft combined group than in the group with autograft-only arthrodesis, and this difference was statistically significant. The x-ray diffraction analyses further confirmed the effect of Mg in promoting the formation of the crystalline portion of the bone (hydroxyapatite).

Conclusions

Based on the results of this study, adding Mg particles to autologous corticocancellous bone in a posterolateral intertransverse process fusion enhances the quality of bone formation. However, radiological findings did not reveal a statistically significant effect of Mg on the rate of solid bone fusion formation between the two transverse processes.

Magnesium and its alloys as orthopedic biomaterials: A review

As a lightweight metal with mechanical properties similar to natural bone, a natural ionic presence with significant functional roles in biological systems, and in vivo degradation via corrosion in the electrolytic environment of the body, magnesium-based implants have the potential to serve as biocompatible, osteoconductive, degradable implants for load-bearing applications. This review explores the properties, biological performance, challenges and future directions of magnesium-based biomaterials.