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1.
ACS Biomater Sci Eng ; 10(6): 3514-3527, 2024 06 10.
Artículo en Inglés | MEDLINE | ID: mdl-38723173

RESUMEN

The field of bone regeneration has always been a hot and difficult research area, and there is no perfect strategy at present. As a new type of biodegradable material, magnesium alloys have excellent mechanical properties and bone promoting ability. Compared with other inert metals, magnesium alloys have significant advantages and broad application prospects in the field of bone regeneration. By searching the official Web sites and databases of various funds, this paper summarizes the research status of magnesium composites in the field of bone regeneration and introduces the latest scientific research achievements and clinical transformations of scholars in various countries and regions, such as improving the corrosion resistance of magnesium alloys by adding coatings. Finally, this paper points out the current problems and challenges, aiming to provide ideas and help for the development of new strategies for the treatment of bone defects and fractures.


Asunto(s)
Regeneración Ósea , Magnesio , Regeneración Ósea/efectos de los fármacos , Magnesio/uso terapéutico , Magnesio/farmacología , Magnesio/química , Humanos , Aleaciones/química , Aleaciones/uso terapéutico , Materiales Biocompatibles/uso terapéutico , Materiales Biocompatibles/farmacología , Materiales Biocompatibles/química , Animales , Sustitutos de Huesos/uso terapéutico , Sustitutos de Huesos/química , Sustitutos de Huesos/farmacología , Corrosión
2.
Acta Biomater ; 147: 427-438, 2022 07 15.
Artículo en Inglés | MEDLINE | ID: mdl-35644328

RESUMEN

Implant removal is unnecessary for biodegradable magnesium (Mg)-based implants and, therefore, the related risk for implant-induced fractures is limited. Aging, on the other hand, is associated with low bone-turnover and decreased bone mass and density, and thus increased fracture risk. Osteoporosis is accompanied by Mg deficiency, therefore, we hypothesized that Mg-based implants may support bone formation by Mg2+ ion release in an ovariectomy-induced osteoporotic rat model. Hence, we investigated osseointegration and implant degradation of a low-alloyed, degrading Mg-Zn-Ca implant (ZX00) in ovariectomy-induced osteoporotic (Osteo), old healthy (OH), and juvenile healthy (JH) groups of female Sprague Dawley rats via in vivo micro-computed tomography (µCT). For the Osteo rats, we demonstrate diminished trabecular bone already after 8 weeks upon ovariectomy and significantly enhanced implant volume loss, with correspondingly pronounced gas formation, compared to the OH and JH groups. Sclerotic rim development was observed in about half of the osteoporotic rats, suggesting a prevention from foreign-body and osteonecrosis development. Synchrotron radiation-based µCT confirmed lower bone volume fractions in the Osteo group compared to the OH and JH groups. Qualitative histological analysis additionally visualized the enhanced implant degradation in the Osteo group. To date, ZX00 provides an interesting implant material for young and older healthy patients, but it may not be of advantage in pharmacologically untreated osteoporotic conditions. STATEMENT OF SIGNIFICANCE: Magnesium-based implants are promising candidates for treatment of osteoporotic fractures because of their biodegradable, biomechanical, anti-bacterial and bone regenerative properties. Here we investigate magnesium‒zinc‒calcium implant materials in a rat model with ovariectomy-induced osteoporosis (Osteo group) and compare the related osseointegration and implant degradation with the results obtained for old healthy (OH) and juvenile healthy (JH) rats. The work applied an appropriate disease model for osteoporosis and focused in particular on long-term implant degradation for different bone conditions. Enhanced implant degradation and sclerotic rim formation was observed in osteoporotic rats, which illustrates that the setting of different bone models generates significantly modified clinical outcome. It further illustrated that these differences must be taken into account in future biodegradable implant development.


Asunto(s)
Aleaciones , Osteoporosis , Aleaciones/uso terapéutico , Animales , Femenino , Humanos , Magnesio/farmacología , Magnesio/uso terapéutico , Oseointegración , Osteoporosis/patología , Ovariectomía , Ratas , Ratas Sprague-Dawley , Microtomografía por Rayos X , Zinc/uso terapéutico
3.
Biomaterials ; 280: 121301, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34922270

RESUMEN

The need for the development of load-bearing, absorbable wound closure devices is driving the research for novel materials that possess both good biodegradability and superior mechanical characteristics. Biodegradable metals (BMs), namely: magnesium (Mg), zinc (Zn) and iron (Fe), which are currently being investigated for absorbable vascular stent and orthopaedic implant applications, are slowly gaining research interest for the fabrication of wound closure devices. The current review presents an overview of the traditional and novel BM-based intracutaneous and transcutaneous wound closure devices, and identifies Zn as a promising substitute for the traditional materials used in the fabrication of absorbable load-bearing sutures, internal staples, and subcuticular staples. In order to further strengthen Zn to be used in highly stressed situations, nutrient elements (NEs), including calcium (Ca), Mg, Fe, and copper (Cu), are identified as promising alloying elements for the strengthening of Zn-based wound closure device material that simultaneously provide potential therapeutic benefit to the wound healing process during implant biodegradation process. The influence of NEs on the fundamental characteristics of biodegradable Zn are reviewed and critically assessed with regard to the mechanical properties and biodegradability requirements of different wound closure devices. The opportunities and challenges in the development of Zn-based wound closure device materials are presented to inspire future research on this rapidly growing field.


Asunto(s)
Aleaciones , Zinc , Implantes Absorbibles , Aleaciones/uso terapéutico , Materiales Biocompatibles/uso terapéutico , Magnesio , Ensayo de Materiales , Nutrientes
4.
Antimicrob Resist Infect Control ; 10(1): 133, 2021 09 10.
Artículo en Inglés | MEDLINE | ID: mdl-34507617

RESUMEN

OBJECTIVES/PURPOSE: High-touch surfaces are a critical reservoir in the spread of nosocomial infections. Although disinfection and infection control protocols are well developed, they lack the ability to passively reduce the pathogenic load of high-touch surfaces. Copper and its alloys have been suggested as a surface that exhibit continuous biocidal effects. Antimicrobial studies on these surfaces are prevalent, while virucidal studies are not as well explored. The goal of this study was to first determine the virucidal activity of a copper-nickel-zinc alloy and to then examine the effect of soiling and virus preparation on virucidal activity. METHODS: A baculovirus vector was used as an easily quantifiable model of an infectious enveloped animal cell virus. Droplets containing virus were deposited on surfaces and allowed to stay wet using humidity control or were dried onto the surface. Virus was then recovered from the surface and assayed for infectivity. To examine how the composition of the droplet affected the survival of the virus, 3 different soiling conditions were tested. The first two were recommended by the United States Environmental Protection Agency and the third consisted of cell debris resulting from virus amplification. RESULTS: A copper-nickel-zinc alloy was shown to have strong virucidal effects for an enveloped virus. Copper, nickel, and zinc ions were all shown to leach from the alloy surface and are the likely cause of virucidal activity by this surface. Virucidal activity was achieved under moderate soiling but lost under high soiling generated by routine virus amplification procedures. The surface was able to repeatably inactivate dried virus droplets under moderate soiling conditions, but unable to do so for virus droplets kept wet using high humidity. CONCLUSION: Ion leaching was associated with virucidal activity in both wet and dried virus conditions. Soiling protected the virus by quenching metal ions, and not by inhibiting leaching. The composition of the solution containing virus plays a critical role in evaluating the virucidal activity of surfaces and surface coatings.


Asunto(s)
Antivirales/administración & dosificación , Infección Hospitalaria/prevención & control , Infección Hospitalaria/virología , Desinfección/métodos , Virosis/prevención & control , Aleaciones/farmacología , Aleaciones/uso terapéutico , Antivirales/farmacología , Cobre/farmacología , Cobre/uso terapéutico , Medios de Cultivo Condicionados , Desinfección/normas , Humanos , Técnicas de Dilución del Indicador , Níquel/farmacología , Níquel/uso terapéutico , Virosis/virología , Zinc/farmacología , Zinc/uso terapéutico
5.
Adv Sci (Weinh) ; 8(14): e2100719, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34014040

RESUMEN

As alternatives, metallic/nonmetallic bone graft materials play significant roles in bone defect surgery to treat external trauma or bone disease. However, to date, there are rather limited long-term implantable materials owning to in situ molding incapability of metallics and poor mechanical property of nonmetallics. Here, Bi-based low melting point alloy, with unique properties of injectability, solid-liquid phase transition, mechanical capability, and biocompatibility, present obvious long-lasting bone affinity as the excellent artificial bone-substitute. It is particularly necessary to point out that the targeted injected Bi alloy remains in its original position for up to 210 days without moving, as well as, displays good osseointegration ability to resolve repeated revision trauma caused by losing bone repair material. Additionally, with outstanding electrical and thermal conductivity, an unconventional way using Bi alloy to realize very beneficial hyperthermia analgesia via non-invasive wireless energy delivery is first proposed, which avoids adverse effects on bone remodeling inflicted by traditional drugs. The significantly decreased expression of pain sensitizing factor, such as, interleukin-6, neuropeptide substance, and transient receptor potential vanilloid 1 reveals the potential mechanism of hyperthermia analgesia. The present findings suggest the combination therapy of Bi alloy in bone repair and analgesia, which owns far-reaching clinical application value.


Asunto(s)
Aleaciones/uso terapéutico , Analgesia/métodos , Materiales Biocompatibles/uso terapéutico , Huesos/lesiones , Huesos/cirugía , Prótesis e Implantes , Animales , Modelos Animales de Enfermedad , Masculino , Oseointegración/fisiología , Osteoblastos/fisiología , Ratas , Ratas Sprague-Dawley
6.
Trends Biotechnol ; 39(6): 624-640, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33199046

RESUMEN

Gallium (Ga) and Ga-based liquid metal (LM) alloys offer low toxicity, excellent electrical and thermal conductivities, and fluidity at or near room temperature. Ga-based LM particles (LMPs) synthesized from these LMs exhibit both fluidic and metallic properties and are suitable for versatile functionalization in therapeutics. Functionalized Ga-based LMPs can be actuated using physical or chemical stimuli for drug delivery, cancer treatment, bioimaging, and biosensing. However, many of the fundamentals of their unique characteristics for therapeutics remain underexplored. We present the most recent advances in Ga-based LMPs in therapeutics based on the underlying mechanisms of their design and implementation. We also highlight some future biotechnological opportunities for Ga-based LMPs based on their extraordinary advantages.


Asunto(s)
Galio , Aleaciones/química , Aleaciones/uso terapéutico , Sistemas de Liberación de Medicamentos , Galio/química , Galio/uso terapéutico
7.
J Biomed Mater Res B Appl Biomater ; 109(2): 160-179, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-32776481

RESUMEN

Bone defects and diseases are devastating, and can lead to severe functional deficits or even permanent disability. Nevertheless, orthopedic implants and scaffolds can facilitate the growth of incipient bone and help us to treat bone defects and diseases. Currently, a wide range of biomaterials with distinct biocompatibility, biodegradability, porosity, and mechanical strength is used in bone-related research. However, most orthopedic implants and scaffolds have certain limitations and diverse complications, such as limited corrosion resistance, low cell proliferation, and bacterial adhesion. With recent advancements in materials science and nanotechnology, metallic and metallic oxide nanoparticles have become the subject of significant interest as they offer an ample variety of options to resolve the existing problems in the orthopedic industry. More importantly, these nanoparticles possess unique physicochemical and mechanical properties not found in conventional materials, and can be incorporated into orthopedic implants and scaffolds to enhance their antimicrobial ability, bioactive molecular delivery, mechanical strength, osteointegration, and cell labeling and imaging. However, many metallic and metallic oxide nanoparticles can also be toxic to nearby cells and tissues. This review article will discuss the applications and functions of metallic and metallic oxide nanoparticles in orthopedic implants and bone tissue engineering.


Asunto(s)
Aleaciones/uso terapéutico , Materiales Biocompatibles/uso terapéutico , Nanopartículas del Metal/uso terapéutico , Prótesis e Implantes , Aleaciones/efectos adversos , Materiales Biocompatibles/efectos adversos , Corrosión , Humanos , Nanopartículas del Metal/efectos adversos , Óxidos/efectos adversos , Óxidos/uso terapéutico
8.
Sci Rep ; 10(1): 22280, 2020 12 17.
Artículo en Inglés | MEDLINE | ID: mdl-33335223

RESUMEN

The metal alloys used in dentistry are made mainly of nickel (Ni), titanium (Ti), and other elements such as molybdenum (Mo), zirconium (Zr), iron (Fe), tin (Sn), chrome (Cr), carbon (C), copper (Cu) and niobium (Nb) which can release metal ions in unstable environments. The aim of this work was determine the salivary pH before and during orthodontic treatment; evaluate the release of metal ions, mainly Ni and Ti, in urine and saliva using Inductively Coupled Plasma Optical Emission Spectroscopy (ICP-OES); and evaluate the corrosion using Scanning Electronic Microscopy (SEM). In this study, we selected 35 individuals under orthodontic treatment, from whom saliva and urine samples were collected in 3 stages: (a) basal, (b) at 3 and (c) 6 months after the placement of the fixed appliances. SEM analyzed the Ni-Ti (0.016″) and stainless steel (SS) (0.016 × 0.022″) archs after 1 month of being in contact with the oral cavity. Statistical analysis was performed with Stata using the ANOVA model of repeated measures with a p < 0.05. A statistically significant difference in the concentration of Ni in saliva were found between 3 and 6 months of intervention and Ti in urine was found 3 and 6 months.


Asunto(s)
Aleaciones Dentales/uso terapéutico , Níquel/uso terapéutico , Saliva/efectos de los fármacos , Titanio/uso terapéutico , Adolescente , Aleaciones/química , Aleaciones/uso terapéutico , Niño , Cobre/uso terapéutico , Cobre/orina , Aleaciones Dentales/efectos adversos , Femenino , Humanos , Iones/orina , Hierro/uso terapéutico , Hierro/orina , Masculino , Molibdeno/uso terapéutico , Molibdeno/orina , Níquel/efectos adversos , Níquel/orina , Niobio/uso terapéutico , Niobio/orina , Acero Inoxidable/química , Titanio/efectos adversos , Titanio/orina , Circonio/uso terapéutico , Circonio/orina
9.
Biomed Res Int ; 2020: 5769293, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32724803

RESUMEN

OBJECTIVE: To compare the biomechanical properties of a new memory compression alloy plate and traditional titanium plate after anterior cervical discectomy and fusion (ACDF). METHODS: A finite element model of the C3-7 segments was developed and validated. The C5-6 disc was removed, and an intervertebral cage made of peek material was implanted. Then, a new memory compression alloy plate composed of Ti-Ni memory alloy and a traditional titanium plate were integrated at the C5-6 segment. All models were subjected to a load of 73.6 N to simulate the head weight and 1 Nm of flexion-extension, lateral bending, and axial rotation. The range of segmental motion (ROM) and stress on the prostheses, adjacent discs, and endplates were analyzed. RESULTS: Compared with intact status, ACDF with the new prothesis and traditional titanium plate reduced the ROM of C5-6 in six directions by 95.2%-100% and increased that of adjacent discs (C4-5 and C6-7) by 4.8%-112.5%. Adjacent disc stress peaks were higher for the traditional titanium plate (0.7-4.2 MPa) than for the new prosthesis (0.6-4.1 MPa). Endplate stress peaks were the highest in ACDF with the new prosthesis (15.6-53.3 MPa), followed by ACDF with traditional titanium plate (5.0-29.4 MPa). Stress peaks were significantly lower for the new prothesis (12.8-52.3 MPa) than for the traditional titanium plate (397.0-666.1 MPa). CONCLUSIONS: The new prosthesis improved the immediate stability of the surgical site and had an elastic modulus that was smaller than that of traditional titanium plate, making it conducive to reducing stress shielding and the impact on the adjacent intervertebral disc.


Asunto(s)
Aleaciones/uso terapéutico , Fenómenos Biomecánicos/fisiología , Vértebras Cervicales/cirugía , Discectomía/métodos , Disco Intervertebral/cirugía , Níquel/uso terapéutico , Fusión Vertebral/métodos , Titanio/uso terapéutico , Adulto , Placas Óseas , Análisis de Elementos Finitos , Humanos , Masculino , Presión , Prótesis e Implantes , Rango del Movimiento Articular/fisiología , Rotación , Adulto Joven
10.
Int J Mol Sci ; 21(14)2020 Jul 21.
Artículo en Inglés | MEDLINE | ID: mdl-32708351

RESUMEN

Metallic alloy nanoparticles are synthesized by combining two or more different metals. Bimetallic or trimetallic nanoparticles are considered more effective than monometallic nanoparticles because of their synergistic characteristics. In this review, we outline the structure, synthesis method, properties, and biological applications of metallic alloy nanoparticles based on their plasmonic, catalytic, and magnetic characteristics.


Asunto(s)
Aleaciones/química , Aleaciones/síntesis química , Sistemas de Liberación de Medicamentos/métodos , Nanopartículas/química , Aleaciones/uso terapéutico , Catálisis , Diagnóstico por Imagen/métodos , Campos Magnéticos , Nanopartículas del Metal/química , Nanopartículas del Metal/uso terapéutico , Nanopartículas/uso terapéutico
11.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(6): 671-675, 2020 Jun 15.
Artículo en Chino | MEDLINE | ID: mdl-32538554

RESUMEN

OBJECTIVE: To evaluate the effectiveness of nitinol memory alloy two foot fixator combined with Kirschner wire in the treatment of trans-scaphoid perilunate dislocation. METHODS: Between September 2011 and October 2018, 17 patients with trans-scaphoid perilunate dislocation were treated with nitinol memory alloy two foot fixator and Kirschner wire. There were 12 males and 5 females, with an average age of 32.6 years (range, 23-52 years). The disease duration was 8 hours to 9 days, with an average of 6.5 days. The causes of injury included 6 cases of falling injury, 4 cases of traffic accident injury, 3 cases of stress injury of wrist caused by sports, 2 cases of violent injury of wrist caused by machine impact, 1 case of military training injury, and 1 case of other injury. One case was complicated with nerve injury. According to Herbert's classification, all the fractures were type B4. At 1 week before operation, 3 months, 6 months after operation and last follow-up, the wrist function was evaluated according to the Krimmer scale score. RESULTS: All the 17 patients were followed up 10.5-48 months, with an average of 18.6 months. There was no loosening or infection of the internal fixator, no necrosis of the scaphoid and lunate. The periosteal dislocations of the patients were well reduced and the scaphoid fractures all healed. The healing time was 4-18 months, with an average of 11.3 months. The Krimmer wrist scores were 37.5±4.4, 61.3±7.2, 83.3±9.3, 87.3±8.2 at 1 week before operation, 3 months, 6 months after operation and last follow-up, respectively. The Krimmer wrist score at each time point after operation was significantly improved when compared with that before operation ( P<0.05), and at 6 months after operation and last follow-up than at 3 months after operation ( P<0.05). There was no significant difference between at 6 months and last follow-up ( P>0.05). At last follow-up, the Krimmer wrist function was excellent in 13 cases, good in 2 cases, fair in 1 case, poor in 1 case, and the excellent and good rate was 88.23%. CONCLUSION: Nitinol memory alloy two foot fixator combined with Kirschner wire in the treatment of trans-scaphoid periosteal dislocation has definite effectiveness, simple operation, and good recovery of wrist function after operation.


Asunto(s)
Aleaciones , Hilos Ortopédicos , Fijación Interna de Fracturas , Fracturas Óseas , Luxaciones Articulares , Hueso Escafoides , Adulto , Aleaciones/uso terapéutico , Hilos Ortopédicos/normas , Femenino , Fijación Interna de Fracturas/normas , Fracturas Óseas/cirugía , Humanos , Luxaciones Articulares/cirugía , Masculino , Persona de Mediana Edad , Hueso Escafoides/cirugía , Resultado del Tratamiento , Adulto Joven
12.
Artículo en Inglés | MEDLINE | ID: mdl-32459075

RESUMEN

The use of pericardial tissue has been widely adopted in a range of cardiac surgery procedures involving the reconstruction of heart valves. Its use in aortic valve construction has been discussed in recent years by Ozaki et al. A key parameter in the optimal functioning of a fabricated valve is the sizing of the new cusps. This video tutorial demonstrates aortic valve construction using newly designed templates and forceps to facilitate sizing and enhance the symmetrical coaptation of the new cusps.


Asunto(s)
Aleaciones/uso terapéutico , Estenosis de la Válvula Aórtica/cirugía , Válvula Aórtica/cirugía , Pericardio/trasplante , Diseño de Prótesis/métodos , Ajuste de Prótesis/métodos , Anciano , Femenino , Prótesis Valvulares Cardíacas , Implantación de Prótesis de Válvulas Cardíacas/instrumentación , Implantación de Prótesis de Válvulas Cardíacas/métodos , Humanos , Procedimientos de Cirugía Plástica/instrumentación , Procedimientos de Cirugía Plástica/métodos , Stents , Estructuras Creadas Quirúrgicamente , Resultado del Tratamiento
13.
Eur J Vasc Endovasc Surg ; 58(5): 719-727, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31500990

RESUMEN

BACKGROUND: Percutaneous transluminal angioplasty (PTA) is a common procedure in patients with peripheral arterial disease (PAD) affecting the femoropopliteal segment (F-P). Biomimetic nitinol stents (Supera peripheral stent, SPS) and drug eluting stents (DES) were designed to improve the longevity of F-P PTA; however, their performance has not been compared in a pragmatic setting, taking atherosclerotic plaque characteristics into account. METHODS: Overall, 296 consecutive patients (mean age: 73 y, SD: 11 y, 65% male, 68% with chronic limb threatening ischaemia) who underwent F-P PTA using SPS or DES between 2013 and 2018 were identified from a prospectively maintained institutional database. Patient and plaque characteristics, including F-P plaque characterisation based on computed tomography, were collected; 121 case matched pairs were created using a propensity score based on patient and plaque data. RESULTS: During the median two year follow up, 28% of the cohort (32% SPS vs. 24% DES, p = .07) developed target lesion restenosis (TLR) > 50%. Among the 121 case matched pairs of patients, those with SPS vs. DES were not significantly more likely to develop TLR >50% (31% vs. 27%, p = .34), or stent occlusion (13% vs. 12%, p = .85 - secondary patency rate 87% vs. 88%), have a major amputation (10% vs. 6%, p = .16), require re-intervention (14% vs. 9%, p = .12), or die (7% vs.4%, p = .31). Plaque calcification did not predict restenosis or occlusion in either stent group, both in the matched and non matched populations. Multivariable analysis adjusted for patient and plaque characteristics revealed that the main predictors of restenosis >50% at two years were female sex [odds ratio (OR): 2.05, p = .01], hypertension (OR: 2.10, p = .04) and previous F-P occlusion (OR: 1.35, p = .04). CONCLUSION: Medium term results following F-P PTA with either SPS or DES are comparable, regardless of plaque calcification and patient characteristics.


Asunto(s)
Aleaciones/uso terapéutico , Angioplastia/instrumentación , Arteria Femoral , Oclusión de Injerto Vascular , Enfermedad Arterial Periférica , Arteria Poplítea , Stents , Anciano , Angioplastia/efectos adversos , Angioplastia/métodos , Angiografía por Tomografía Computarizada/métodos , Angiografía por Tomografía Computarizada/estadística & datos numéricos , Extremidades/irrigación sanguínea , Femenino , Arteria Femoral/patología , Arteria Femoral/cirugía , Oclusión de Injerto Vascular/diagnóstico , Oclusión de Injerto Vascular/epidemiología , Oclusión de Injerto Vascular/etiología , Humanos , Recuperación del Miembro/métodos , Masculino , Evaluación de Procesos y Resultados en Atención de Salud , Enfermedad Arterial Periférica/patología , Enfermedad Arterial Periférica/fisiopatología , Enfermedad Arterial Periférica/cirugía , Placa Aterosclerótica/diagnóstico por imagen , Arteria Poplítea/patología , Arteria Poplítea/cirugía , Pronóstico , Stents/efectos adversos , Stents/clasificación , Calcificación Vascular/diagnóstico por imagen , Grado de Desobstrucción Vascular
14.
Acta Biomater ; 97: 1-22, 2019 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-31351253

RESUMEN

Absorbable metals have the potential to serve as the next generation of temporary medical implant devices by safely dissolving in the human body upon vascular tissue healing and bone regeneration. Their implementation in the market could greatly reduce the need of costly and risky additional surgeries for either implant replacement or removal, often required in current permanent implants. Despite the extensive research done over the last two decades on magnesium (Mg) and iron (Fe) based alloys, they have not generally shown a satisfactory combination of mechanical properties, biocompatibility and controlled degradation rate in the physiological environment. Consequently, zinc (Zn) based alloys were introduced in the last few years as alternative materials to overcome the limitations of Fe and Mg-based alloys. The blend of different alloying elements and processing conditions have led to a wide variety of Zn-based alloys having tunable mechanical properties and corrosion rates. This review provides the most recent progress in the development of absorbable Zn-based alloys for biomedical implant applications, primarily for cardiovascular and orthopedic devices. Their biocompatibility, processability and metallurgical aspects, as well as their mechanical behavior and corrosion properties are presented and discussed, including their opportunities, limitations and future research directions. STATEMENT OF SIGNIFICANCE: Temporary orthopedic bioimplants have become increasingly popular as they offer an alternative to prevent complications, like infections or secondary surgeries, often related to the implantation of permanent devices. Iron and magnesium alloys were extensively studied as candidates for absorbable medical applications, but they generally failed to provide a desirable mechanical performance and corrosion characteristics in the physiological environment. Zinc was introduced in the last decade as a potential implant material after showing outstanding biocompatibility and biodegradability. This review summarizes the research advances to date and provides a thorough discussion of the future challenges of absorbable zinc alloys to satisfy the demanding clinical benchmarks for absorbable medical applications. Their biocompatibility, mechanical, and corrosion aspects, both in vitro and in vivo, are comprehensively reviewed and assessed accordingly.


Asunto(s)
Implantes Absorbibles , Aleaciones/uso terapéutico , Materiales Biocompatibles/uso terapéutico , Aleaciones/química , Materiales Biocompatibles/química , Corrosión , Humanos , Hierro/química , Hierro/uso terapéutico , Magnesio/química , Magnesio/uso terapéutico , Zinc/química , Zinc/uso terapéutico
15.
Acta Biomater ; 97: 23-45, 2019 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-31349057

RESUMEN

To date, more than fifty articles have been published on the feasibility studies of zinc and its alloys as biodegradable metals. These preliminary in vitro and in vivo studies showed acceptable biodegradability and reasonable biocompatibility in bone and blood microenvironments for the experimental Zn-based biodegradable metals and, for some alloy systems, superior mechanical performance over Mg-based biodegradable metals. For instance, the Zn-Li alloys exhibited higher UTS (UTS), and the Zn-Mn alloys exhibited higher elongation (more than 100%). On the one hand, similar to Mg-based biodegradable metals, insufficient strength and ductility, as well as relatively low fatigue strength, may lead to premature failure of medical devices. On the other hand, owing to the low melting point of the element Zn, several new uncertainties with regard to the mechanical properties of biomedical zinc alloys, including low creep resistance, high susceptibility to natural aging, and static recrystallization (SRX), may lead to device failure during storage at room temperature and usage at body temperature. This paper comprehensively reviews studies on these mechanical aspects of industrial Zn and Zn alloys in the last century and biomedical Zn and Zn alloys in this century. The challenges for the future design of biomedical zinc alloys as biodegradable metals to guarantee 100% mechanical compatibility are pointed out, and this will guide the mechanical property design of Zn-based biodegradable metals. STATEMENT OF SIGNIFICANCE: Previous studies on mechanical properties of industrial Zn and Zn alloys in the last century and biomedical Zn and Zn alloys in this century are comprehensively reviewed herein. The challenges for the future design of zinc-based biodegradable materials considering mechanical compatibility are pointed out. Common considerations such as strength, ductility, and fatigue behaviors are covered together with special attention on several new uncertainties including low creep resistance, high susceptibility to natural aging, and static recrystallization (SRX). These new uncertainties, which are not significantly observed in Mg-based and Fe-based materials, are largely due to the low melting point of the element Zn and may lead to device failure during storage at room temperature and clinical usage at body temperature. Future studies are urgently needed on these topics.


Asunto(s)
Implantes Absorbibles , Aleaciones , Materiales Biocompatibles , Ensayo de Materiales , Zinc , Aleaciones/química , Aleaciones/uso terapéutico , Materiales Biocompatibles/química , Materiales Biocompatibles/uso terapéutico , Humanos , Resistencia a la Tracción , Zinc/química , Zinc/uso terapéutico
16.
Arch Orthop Trauma Surg ; 139(12): 1681-1690, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31098688

RESUMEN

INTRODUCTION: A multitude of procedures has been described in the literature for the treatment of lesser toe deformities and there is currently no general consensus on the optimal method of fixation. The aim of this study is to assess the clinical and radiological outcomes of an intramedullary nitinol implant for the correction of lesser toe deformities, and to determine if the distal interphalangeal (DIP) joint and metatarsophalangeal (MTP) joint are modified during patient follow-up after correction of the PIP joint. MATERIALS AND METHODS: A prospective analysis of 36 patients with claw toe or hammertoe who were treated with an intramedullary nitinol implant. Clinical manifestations and angulation of the metatarsophalangeal, proximal and distal interphalangeal (MTP, PIP, DIP) joints were evaluated in radiographic studies preoperatively, at first medical revision post-surgery, and after a minimum of 1 year of follow-up. Complications such as non-union rate, implant rupture, and implant infection were also evaluated during follow-up. RESULTS: All patients were women with an average age of 65.5 (range 47-82) years. The average follow-up time was 2.4 (range 1-5.7) years. Fifty intramedullary nitinol implants were used. The MTP joint extension and PIP joint flexion decreased by 15.9° (95% CI - 19.11 to - 12.63) and 49.4° (95% CI - 55.29 to - 43.52), respectively, at the end of follow-up. Moreover, the DIP joint flexion increased progressively during follow-up (13.7° pre-surgery versus 35.6 in last medical check-up, 95% CI 13.24-30.57). There were four (8%) asymptomatic implant ruptures. The rate of fusion was 98%. CONCLUSION: The reduction of the PIP joint using an intramedullary nitinol implant is a good option in lesser toe deformities, with few complications and a high rate of arthrodesis. Moreover, the PIP joint reduction affects both the MTP and DIP joints.


Asunto(s)
Aleaciones/uso terapéutico , Artrodesis/métodos , Síndrome del Dedo del Pie en Martillo/cirugía , Procedimientos de Cirugía Plástica/métodos , Prótesis e Implantes , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Examen Físico , Complicaciones Posoperatorias/cirugía , Estudios Prospectivos , Rango del Movimiento Articular
17.
Neurol Res ; 41(7): 665-670, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31044660

RESUMEN

Objectives: Neurovascular compression syndromes (NVCS) could be cured with an intravascular device that releases compression of the root entry zone of cranial nerves by changing the course of offending vessels. The purpose of this study was to report our results of in vitro and in vivo experiments with a novel intra-arterial neurovascular decompressor (IA-NVD) for NVCS. Methods: A nitinol-based IA-NVD was developed to release pressure applied to the root entry zone of cranial nerves by changing the course or angle of an offending vessel, which can possibly cure NVCS. We performed in vitro tests for safety and feasibility and preliminary in vivo tests up to 4 weeks for safety. Results: The bending stiffness of the device was similar to but slightly stronger than that of current, closed-cell intracranial stents. Hemocompatibility tests showed no significant thrombogenesis in whole blood. After the 4-week follow-up, all animals (20-month-old female Gottingen mini-pigs weighing 15-18 kg, n = 4) had a normal upright position and gait. Scanning electron microscopy images and H&E staining of arteries containing the devices showed good neointima formation on the devices. Intima hyperplasia occurred over wires and connecting tubes, but it did not interrupt the patency of the arterial lumen. Discussion: An IA-NVD was created and tested to demonstrate its functionality and biocompatibility in the present experiments. The device may be safely applied to intracranial arteries, providing us a chance to test the efficacy of an upgrade version of the device on changing the course of an artery that compresses a cranial nerve. Abbreviations: CN = cranial nerve; EVT = endovascular treatment; H&E = hematoxylin and eosin; HFS = hemifacial spasm; IA-NVD = intra-arterial neurovascular decompressor; MVD = microvascular decompression; NVCS = neurovascular compression syndrome; REZ = root entry zone; SEM = scanning electron microscopy; TN = trigeminal neuralgia.


Asunto(s)
Cirugía para Descompresión Microvascular/instrumentación , Síndromes de Compresión Nerviosa/cirugía , Aleaciones/uso terapéutico , Animales , Estudios de Factibilidad , Femenino , Técnicas In Vitro , Cirugía para Descompresión Microvascular/efectos adversos , Procedimientos Neuroquirúrgicos/instrumentación , Procedimientos Neuroquirúrgicos/métodos , Porcinos
18.
Mater Sci Eng C Mater Biol Appl ; 99: 1048-1057, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30889637

RESUMEN

Bioresorbable metallic implants are considered to be a new generation of transient fixation devices, which provide strong mechanical support during healing as well as effective integration with the host bone tissues, free of secondary surgery. We evaluated the microstructures and mechanical properties of iron­manganese alloys (Fe30Mn) with 0-, 5-, 10-, and 60-volume percent porosity, which was produced through ammonium bicarbonate (NH4HCO3) decomposition. We also investigated the influence of porosity concentration on the corrosion rate and cytotoxicity of the alloy. The average value of maximum compressive strength was 2-fold greater in the 0-vol% scaffolds than that in 60-vol% scaffolds. Scaffolds with 60-vol% porosity exhibited the highest average value of corrosion rate in a potentiodynamic polarization test among the four groups. However, the group influenced cellular viability negatively in a subsequent cytotoxicity test. Fe30Mn scaffolds with 10-vol% NH4HCO3 are considered promising resorbable scaffolds based on the results of compression tests, corrosion experiments and cytotoxicity studies.


Asunto(s)
Aleaciones , Fenómenos Mecánicos , Aleaciones/efectos adversos , Aleaciones/química , Aleaciones/uso terapéutico , Animales , Muerte Celular/efectos de los fármacos , Supervivencia Celular , Fuerza Compresiva , Corrosión , Módulo de Elasticidad , Humanos , Iones , Masculino , Manganeso/análisis , Células Madre Mesenquimatosas/citología , Células Madre Mesenquimatosas/metabolismo , Ratones , Fenómenos Ópticos , Oxidación-Reducción , Porosidad , Difracción de Rayos X , Adulto Joven
19.
J Biomater Appl ; 33(9): 1178-1194, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30732513

RESUMEN

Biodegradable magnesium (Mg) alloys exhibit improved mechanical properties compared to degradable polymers while degrading in vivo circumventing the complications of permanent metals, obviating the need for surgical removal. This study investigated the safety and efficacy of Mg-Y-Zn-Zr-Ca (WZ42) alloy compared to non-degradable Ti6Al4V over a 14-week follow-up implanted as pins to fix a full osteotomy in rat femurs and as wires wrapped around the outside of the femurs as a cerclage. We used a fully load bearing model allowing implants to intentionally experience realistic loads without immobilization. To assess systemic toxicity, blood cell count and serum biochemical tests were performed. Livers and kidneys were harvested to observe any accumulation of alloying elements. Hard and soft tissues adjacent to the fracture site were also histologically examined. Degradation behavior and bone morphology were determined using micro-computed tomography scans. Corrosion occurred gradually, with degradation seen after two weeks of implantation with points of high stress observed near the fracture site ultimately resulting in WZ42 alloy pin fracture. At 14 weeks however, normal bone healing was observed in femurs fixed with the WZ42 alloy confirmed by the presence of osteoid, osteoblast activity, and new bone formation. Blood testing exhibited no significant changes arising from the WZ42 alloy compared to the two control groups. No recognizable differences in the morphology and more importantly, no accumulation of Mg, Zn, and Ca in the kidney and liver of rats were observed. These load bearing model results collectively taken, thus demonstrate the feasibility for use of the Mg-Y-Zn-Zr-Ca alloy for long bone fracture fixation applications.


Asunto(s)
Implantes Absorbibles , Aleaciones/uso terapéutico , Clavos Ortopédicos , Fracturas del Fémur/cirugía , Implantes Absorbibles/efectos adversos , Aleaciones/efectos adversos , Animales , Materiales Biocompatibles/efectos adversos , Materiales Biocompatibles/uso terapéutico , Clavos Ortopédicos/efectos adversos , Calcio/efectos adversos , Calcio/uso terapéutico , Corrosión , Femenino , Fracturas del Fémur/patología , Fracturas del Fémur/terapia , Fémur/patología , Fémur/cirugía , Ensayo de Materiales , Ratas Sprague-Dawley , Titanio/efectos adversos , Titanio/uso terapéutico
20.
Sci Rep ; 9(1): 117, 2019 01 15.
Artículo en Inglés | MEDLINE | ID: mdl-30644432

RESUMEN

Magnesium (Mg) and its alloys have attracted much attention as a promising candidate for degradable implant applications however the rapid corrosion of magnesium inside the human body greatly limits its use as an implant material. Therefore, coating the alloy surface with a multifunctional film is a promising way to overcome the drawbacks. Here we propose for the first time a multifunction layer coating to enhance the cell viability, antibacterial property and decelerated corrosion rates to act as a novel material to be used for degradable implant Applications. For that, the magnesium alloy (AZ31) was first treated with hydrofluoric acid (HF) and then dopamine tris Hydrochloric acid (tris-HCL) solution. The reducing catechol groups in the polydopamine (PD) layer subsequently immobilize silver/gold ions in situ to form uniformly dispersed Ag/Au nanoparticles on the coating layer. The successful formation of Ag/Au nanoparticles on the HF-PD AZ31 alloy was confirmed using XPS and XRD, and the morphology of all the coated samples were investigated using SEM images. The alloy with HF-PDA exhibit enhanced cell attachment and proliferation. Moreover, the nanoparticle immobilized HF-PD alloy exhibited dramatic corrosion resistance enhancement with superior antibacterial properties and accountable biocompatibility. Thus the result suggest that HF-PD Ag/Au alloy has great potential in the application of degradable implant and the surface modification method is of great significance to determine its properties.


Asunto(s)
Antibacterianos/farmacología , Materiales Biocompatibles Revestidos/farmacología , Oro/farmacología , Ácido Fluorhídrico/farmacología , Indoles/farmacología , Polímeros/farmacología , Plata/farmacología , Aleaciones/uso terapéutico , Animales , Células Cultivadas , Corrosión , Ensayo de Materiales , Nanopartículas del Metal , Prótesis e Implantes , Propiedades de Superficie
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