Synthesis and characterization of TiNbZrMo medium-entropy bio-composites: Microstructure, mechanical properties, and in vitro degradation.

This study reports the synthesis and characterization of hydroxyapatite (HA)-based bio-composites reinforced with varying amounts (by weight, 1-15 wt.%) of bio-medium entropy alloy (BioMEA) for load-bearing implant applications. BioMEA powders consisting of Ti, Nb, Zr, and Mo were mechanically alloyed for 100 h and subsequently added to HA using powder metallurgy techniques. To show the effect of BioMEA, the microstructure, density, and mechanical tests have been conducted and the synthesized BioMEA was characterized by scanning electron microscope (SEM), x-ray diffractometer (XRD), and Fourier-transform infrared spectroscopy (FTIR) analysis. In addition, in vitro degradation behavior and bioactivity analyses of bio-composites have been conducted. XRD analysis revealed the formation of BioMEA after 20 h of mechanical alloying. The highest density value of 2.47 g/cm3 was found in 15 wt.% BioMEA-reinforced bio-composite. The addition of BioMEA reinforcement led to a significant increase in hardness and tensile strength values, with the highest values observed at 15 wt.% reinforcement. Compression tests demonstrated a significant increase in compressive strength and deformation capability of the bio-composites with the highest values observed at 15 wt.% BioMEA addition. The highest toughness of 7.68 kJ/m2 was measured in 10 wt.% MEA-reinforced bio-composites. The produced bio-composite materials have an elastic modulus between 3.5-5.5 GPa, which may provide a solution to the stress shielding problems caused by the high elastic modulus of metallic implant materials. The most severe degradation occurred in 15 wt.% MEA-reinforced bio-composites, and the effect of degradation caused a decrease in Ca and an increase in Ti-Ni-Zr-Mo in all bio-composites. These findings suggest that HA/BioMEA bio-composites have the potential to be developed as advanced biomaterials with moderate mechanical and biological properties for load-bearing implant applications.

A biomechanical study: Comparison of three different implant options in high Tibial osteotomy.

BACKGROUND: Many implant options could be preferable for fixation after osteotomy in varus knee medial compartment arthrosis. Due to usage characteristics, it is important to compare the biomechanical properties of them. For this purpose, we aimed to examine three different implant types biomechanically in our study. METHODS: Ovine tibiae undergoing medial open-wedge high tibial osteotomy were fixed in vitro with three different implants using an angular wedge plate, a metal block plate and an external fixator system. The fixed ovine tibiae were subjected to axial tensile, axial loading and three-point bending tests in a test machine. All biomechanical tests were repeated five times, the maximum and minimum values were ignored, and the average values of the remaining three test results were taken into account. The test results were interpreted after converted into force-elongation curves in Trapezium-X software. FINDINGS: Biomechanical test results revealed some differences between implant types. While the metal block plate had the highest axial tensile strength value, it was the fixation group showing the lowest strength in axial load tests. The used fixator system was the highest strength in axial load tests and the lowest strength in axial tensile tests. INTERPRETATION: Considering the clinically significant forces related to the biomechanical stability of the three different implants used for high tibial osteotomy, the fixator system would appear to be slightly superior, although it should be noted that torsional forces, as well as parameters that could change in living tissue, might affect the results.

The effect of the platelet-rich plasma and ozone therapy on tendon-to-bone healing in the rabbit rotator cuff repair model.

BACKGROUND: The aim of this study is to histologically and biomechanically investigate the effects of local PRP and ozone therapy (O2O3) on tendon-to-bone healing in a rabbit model of the supraspinatus tendon tear. METHODS: Four groups were formed to have seven rabbits in each group: repair, R; repair + PRP, RP; repair + ozone, RO; and repair + PRP + ozone, RPO. The supraspinatus tendon was detached by sharp dissection from the footprint and an acute tear pattern was created. Thereafter, tendon repair was performed with the transosseous technique. In the RP group, PRP, and in the RPO group, PRP + O2O3 mixture was injected to the tendon repair site. In the RO group, O2O3 gas mixture was injected into subacromial space three times a week for a total of 4 weeks. The study was ended at postoperative 6th week. RESULTS: When compared with the R group, a statistically significant increase was observed in the biomechanical strength of the RP and RPO groups. The highest increase in biomechanical strength was detected in the RPO group. The histology of the RO and RPO groups showed better collagen fiber continuity and orientation than the R and RP groups. CONCLUSIONS: The results obtained from this study show that the ozonized PRP can be used as biological support to increase tendon-to-bone healing. However, these results need to be supported by clinical studies.

Grape seed extract supplement increases bone callus formation and mechanical strength: an animal study.

BACKGROUND: The positive effects of grape seed proanthocyanidin extract (GSPE) on bone health, which is a potent antioxidant, are known but its effects on fracture healing are not sufficiently covered in the literature. This study aims to investigate the effects of GSPE on fracture healing and biomechanics of healing bone. MATERIALS AND METHODS: Sixty-four adult Wistar-Albino male rats were divided into 8 groups of 8 animals in each group. Osteotomy was performed to the right femurs of all groups except the negative control (G1) and positive control (G2) groups, and intramedullary Kirchner wire was used for fixation. GSPE was given to half of the rats (G2-G4-G6-G8) 100 mg/kg/day by oral gavage. The rats were sacrificed on the tenth (G3-G4), twentieth (G5-G6), and thirtieth (G1-G2-G7-G8) days, respectively, and histopathological, radiological, and biomechanical examinations were performed. RESULTS: Histopathological examination of the specimens from the callus tissues revealed that bone healing was more prominent in the groups supplemented with GSPE (G4, G6, G8). There was a statistically significant improvement in radiological recovery scores and callus volumes in groups with GSPE. When biomechanical strengths were evaluated, it was found that GSPE increased bone strength not only in fracture groups but also in the positive control group (G2). CONCLUSIONS: As a result, this study showed that GSPE, a potent anti-oxidant, had a positive effect on bone healing and improved mechanical strength of the healing bone.

Biomechanical comparison of straight DCP and helical plates for fixation of transverse and oblique bone fractures.

PURPOSE: Biomechanical comparison of straight DCP and helical plates for fixation of transversal and oblique tibial bone fractures were analyzed and compared to each other by axial compression, bending and torsion tests. METHOD: An in vitro osteosynthesis of transverse (TF) and oblique bone fracture (OF) fixations have been analysed on fresh sheep tibias by using the DCP and helical compression plates (HP). RESULTS: Statistically significant differences were found for both DCP and helical plate fixations under axial compression, bending and torsional loads. The strength of fixation systems was in favor of DC plating with exception of the TF-HP fixation group under compression loads and torsional moments. The transvers fracture (TF) stability was found to be higher than that found in oblique fracture (OF) fixed by helical plates (HP). However, under torsional testing, compared to conventional plating, the helical plate fixations provided a higher torsional resistance and strength. The maximum stiffness at axial compression loading and maximum torsional strength was achieved in torsional testing for the TF-HP fixations. CONCLUSION: From in vitro biomechanical analysis, fracture type and plate fixation system groups showed different responses under different loadings. Consequently, current biomechanical analyses may encourage the usage of helical HP fixations in near future during clinical practice for transverse bone fractures.

An alternative method in fixation of tibial transverse fractures by intramedullar nailing: biomechanical and histopathologic investigation.

A new method was used in fixation of tibial bone fractures. Intramadular nailing (IMN) has been used into mid-diaphysis on left tibias of New Zeland rabbits (n = 5) via an in vivo work. To enable fixation of fracture, without causing too much screw damage on bone and avoiding malunion, nano- and micro-scale hydroxyapatite (HA) was coated at two ends (25 mm in length) of intramadular nails before implantation. After six weeks of survival period and sacrifizing, biomechanical tests and histopathologic examinations were executed. Such experiments have revealed that good stabilization and hence better fracture union for both treated IMN groups (NHA and MHA) over the standard IMN'. Pull-out tests showed the tensile strengths obtained to be significantly higher for the nano (NHA) and micro scale-MHA coated IMN compared to the uncoated standard IM nailing.