RESUMEN
There has been a tremendous amount of research in the past decade to optimize the mechanical properties and degradation behavior of the biodegradable Mg alloy for orthopedic implant. Despite the feasibility of degrading implant, the lack of fundamental understanding about biocompatibility and underlying bone formation mechanism is currently limiting the use in clinical applications. Herein, we report the result of long-term clinical study and systematic investigation of bone formation mechanism of the biodegradable Mg-5wt%Ca-1wt%Zn alloy implant through simultaneous observation of changes in element composition and crystallinity within degrading interface at hierarchical levels. Controlled degradation of Mg-5wt%Ca-1wt%Zn alloy results in the formation of biomimicking calcification matrix at the degrading interface to initiate the bone formation process. This process facilitates early bone healing and allows the complete replacement of biodegradable Mg implant by the new bone within 1 y of implantation, as demonstrated in 53 cases of successful long-term clinical study.
Asunto(s)
Implantes Absorbibles , Aleaciones/farmacología , Magnesio/farmacología , Animales , Femenino , Fémur/diagnóstico por imagen , Fémur/ultraestructura , Estudios de Seguimiento , Humanos , Masculino , Osteogénesis/efectos de los fármacos , Implantación de Prótesis , Conejos , Radiografía , Factores de Tiempo , Cicatrización de Heridas/efectos de los fármacosRESUMEN
The immunotoxicity of implanted nanostructured titanium is a paramount issue for vascular, dental and orthopedic applications. However, it has been unclear whether implanted surface nanostructures can inhibit or aggrevate inflammatory responses. Herein, macrophage activation, as evidence of migration, on transparent flat and nanostructured titanium correlated with pro-inflammatory protein synthesis and cytokine release. Through the real-time monitoring of initial cytoskeleton variations, this study identified that macrophage movement was restricted on nanostructured titanium compared to flat titanium surfaces. Furthermore, nanostructured titanium elicited secretion of fewer pro-inflammatory enzyme molecules and cytokines, as well as reduced nitric oxide production. All results collectively indicated that initial macrophage activation can be mitigated by nanoscale surface topography alone, without modification of surface chemistry or stiffness.