The unique characteristics of polyether ether ketone (PEEK) including low elastic modulus, high mechanical strength, and biocompatibility have made it an attractive alternative for the metallic biomaterials. However, its bioinert property is always the main concern, which could lead to poor osseointegration and subsequent clinical failure of the implant. Changing the surface structure to porous structure and mixing it with bioactive hydroxyapatite (HA) are the common methods, which could be used to enhance the properties of the PEEK-based implants. In this study, friction stir processing was utilized for the fabrication of porous HA/PEEK surface nanocomposite. Scanning electron microscopic image of the nanocomposite surface showed nano-scale roughness of the porous structure. Water contact angle test confirmed the increase in the wettability of the treated specimens. In vitro bioactivity test via simulated body fluid solution, initial cell adhesion, cell proliferation, and cell differentiation assay also confirmed the enhancement in bioactivity of the treated surface in comparison to the bare PEEK. This surface modification method requires no special equipment and would not damage the heat-sensitive PEEK substrate due to the low temperature used during the fabrication process.
Autologous bone grafting remains the gold standard for almost all bone void-filling orthopedic surgery. However, autologous bone grafting has several limitations, thus scientists are trying to identify an ideal synthetic material as an alternative bone graft substitute. Magnesium-doped biphasic calcium phosphate (Mg-BCP) has recently been in the spotlight and is considered to be a potential bone substitute. The Mg-BCP is a mixture of two bioceramics, that is, hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP), doped with Mg2+ , and can be synthesized through chemical wet-precipitation, sol-gel, single diffusion gel, and solid state reactions. Regardless of the synthesis routes, it is found that the Mg2+ preferentially accommodates in β-TCP lattice instead of the HA lattice. The addition of Mg2+ to BCP leads to desirable physicochemical properties and is found to enhance the apatite-forming ability as compared to pristine BCP. In vitro results suggest that the Mg-BCP is bioactive and not toxic to cells. Implantation of Mg-BCP in in vivo models further affirmed its biocompatibility and efficacy as a bone substitute. However, like the other bioceramics, the optimum physicochemical properties of the Mg-BCP scaffold have yet to be determined. Further investigations are required regarding Mg-BCP applications in bone tissue engineering.
Diamond like carbon (DLC) is applied as a thin film onto substrates to obtain desired surface properties such as increased hardness and corrosion resistance, and decreased friction and wear rate. Microdimple is an advanced surface modification technique enhancing the tribological performance. In this study, DLC coated microdimples were fabricated on hip prosthesis heads and their mechanical, material and surface properties were characterized. An Electro discharge machining (EDM) oriented microdrilling was utilized to fabricate a defined microdimple array (diameter of 300 µm, depth of 70 µm, and pitch of 900 µm) on stainless steel (SS) hip prosthesis heads. The dimpled surfaces were then coated by hydrogenated amorphous carbon (a-C:H) and tetrahedral amorphous carbon (Ta-C) layers by using a magnetron sputtering technology. A preliminary tribology test was conducted on these fabricated surfaces against a ceramic ball in simulated hip joint conditions. It was found that the fabricated dimples were perpendicular to the spherical surfaces and no cutting-tools wear debris was detected inside the individual dimples. The a-C:H and Ta-C coatings increased the hardness at both the dimple edges and the nondimpled region. The tribology test showed a significant reduction in friction coefficient for coated surfaces regardless of microdimple arrays: the lowest friction coefficient was found for the a-C:H samples (µ = 0.084), followed by Ta-C (µ = 0.119), as compared to the SS surface (µ = 0.248).
A major weakness of current orthopedic implant materials, for instance sintered hydroxyapatite (HA), is that they exist as a hardened form, requiring the surgeon to fit the surgical site around an implant to the desired shape. This can cause an increase in bone loss, trauma to the surrounding tissue, and longer surgical time. A convenient alternative to harden bone filling materials are injectable bone substitutes (IBS). In this article, recent progress in the development and application of calcium phosphate (CP)-based composites use as IBS is reviewed. CP materials have been used widely for bone replacement because of their similarity to the mineral component of bone. The main limitation of bulk CP materials is their brittle nature and poor mechanical properties. There is significant effort to reinforce or improve the mechanical properties and injectability of calcium phosphate cement (CPC) and this review resumes different alternatives presented in this specialized literature.
This work is dedicated to the investigation of drug-release control by a direct effect of degradation from biodegradable metallic surfaces. Degradation behaviors characterized by surface morphology, immersion, and electrochemical techniques demonstrated that curcumin-coated zinc (c-Zn) had a higher degradation rate compared to curcumin-coated Fe (c-Fe). High anodic dissolution rate due to the higher degradation rate and widely extended groove-like degradation structure of c-Zn propelled a higher curcumin release. On the other hand, a slower curcumin release rate shown by c-Fe scaffolds is ascribed to its lower anodic dissolution and to its pitting degradation regime with relatively smaller pits. These findings illuminate the remarkable advantage of different degradation behaviors of degradable metallic surfaces in directly controlling the drug release without the need for external electrical stimulus.
Iron (Fe) and Fe-based scaffolds have become a research frontier in absorbable materials which is inherent to their promising mechanical properties including fatigue strength and ductility. Nevertheless, their slow corrosion rate and low biocompatibility have been their major obstacles to be applied in clinical applications. Over the last decade, various modifications on porous Fe-based scaffolds have been performed to ameliorate both properties encompassing surface coating, microstructural alteration via alloying, and advanced topologically order structural design produced by additive manufacturing (AM) techniques. The recent advent of AM produces topologically ordered porous Fe-based structures with an optimized architecture having controllable pore size and strut thickness, intricate internal design, and larger exposed surface area. This undoubtedly opens up new options for controlling Fe corrosion and its structural strengths. However, the in vitro biocompatibility of the AM porous Fe still needs to be addressed considering its higher corrosion rate due to the larger exposed surface area. This review summarizes the latest progress of the modifications on porous Fe-based scaffolds with a specific focus on their responses on the corrosion behavior and biocompatibility.
This article describes the development of a partially degradable metal bone pin, proposed to minimize the occurrence of bone refracture by avoiding the creation of holes in the bone after pin removal procedure. The pin was made by friction welding and composed of two parts: the degradable part that remains in the bone and the nondegradable part that will be removed as usual. Rods of stainless steel 316L (nondegradable) and pure iron (degradable) were friction welded at the optimum parameters: forging pressure = 33.2 kPa, friction time = 25 s, burn-off length = 15 mm, and heat input = 4.58 J/s. The optimum tensile strength and elongation was registered at 666 MPa and 13%, respectively. A spiral defect formation was identified as the cause for the ductile fracture of the weld joint. A 40-µm wide intermetallic zone was identified along the fusion line having a distinct composition of Cr, Ni, and Mo. The corrosion rate of the pin gradually decreased from the undeformed zone of pure iron to the undeformed zone of stainless steel 316L. All metallurgical zones of the pin showed no toxic effect toward normal human osteoblast cells, confirming the ppb level of released Cr and Ni detected in the cell media were tolerable.
This article reports a degradation study that was done on stent prototypes made of biodegradable Fe35Mn alloy in a simulated human coronary arterial condition. The stent degradation was observed for a short-term period from 0.5 to 168 h, which simulates the early period of stenting procedure. Potentiodynamic polarization and electrochemical impedance spectroscopy were used to quantify degradation rate and surface property of the stents. Results showed that signs of degradation were visible on both crimped and expanded stents after 1 h of test, mostly located on the stent's curvatures. The degradation rate of stent was higher compared to that of the original alloy, indicating the surface altering effect of stent fabrication processing to degradation. A single oxide layer was formed and detected as a porous structure with capacitive behavior. Expanded stents exhibited lower polarization resistance compared to the nonexpanded ones, indicating the cold work effect of expansion procedure to degradation.
Skin grafts are indicated when there is a major loss of skin. Full-thickness skin graft is an ideal choice to reconstruct defect of irregular surface that is difficult to immobilize. Full-thickness mesh grafts can be applied to patch large skin defect when there is less donor site in extensively traumatized and burned surgical patients. The concept of using natural biomaterials such as keratin, basic fibroblast growth factor is slowly gaining popularity in the field of medical research to achieve early healing. The main objective of this study is to evaluate the efficacy of gelatin conjoined with keratin processed from the poultry feather and commercially available basic fibroblast growth factor (bFGF) as a sandwich layer in promoting the viability of full-thickness skin mesh grafts. The efficacy was assessed from the observation of clinical, bacteriological, and histopathological findings in three groups of experimental dogs. The clinical observations such as color, appearance and discharge, and hair growth were selected as criteria which indicated good and early acceptance of graft in keratin-gelatin (group II). On bacteriological examination, Staphylococcus aureus and Proteus was identified in few animals. Histopathological study of the patched graft revealed early presences of hair follicles; sebaceous gland, and normal thickness of the epidermis in keratin-gelatin in group II treated animals compared with other group (group I-control, group III-bFGF-gelatin).
Iron-bioceramic composites have been developed as biodegradable implant materials with tailored degradation behavior and bioactive features. In the current work, in vivo bioactivity of the composites was comprehensively studied by using sheep animal model. Five groups of specimens (Fe-HA, Fe-TCP, Fe-BCP composites, and pure-Fe and SS316L as controls) were surgically implanted into medio proximal region of the radial bones. Real-time ultrasound analysis showed a decreased echo pattern at the peri-implant biodegradation site of the composites indicating minimal tissue response during the wound healing process. Peripheral whole blood biomarkers monitoring showed a normal dynamic change of blood cellular responses and no stress effect was observed. Meanwhile, the released Fe ion concentration was increasing along the implantation period. Histological analysis showed that the composites corresponded with a lower inflammatory giant cell count than that of SS316L. Analysis of the retrieved implants showed a thicker degradation layer on the composites compared with pure-Fe. It can be concluded that the iron-bioceramic composites are bioactive and induce a preferable wound healing process.
Malaysian sea cucumber was incorporated into hydrogel formulation by using electron beam irradiation technique and was introduced as novel cross-linked Gamat Hydrogel dressing. This study investigated whether Gamat Hydrogel enhanced repair of deep partial skin thickness burn wound in rats and its possible mechanism. Wounds were treated with either Gamat Hydrogel, control hydrogel, OpSite® film dressing or left untreated. Skin samples were taken at 7, 14, 21, and 28 days post burn for histological and molecular evaluations. Gamat Hydrogel markedly enhanced wound contraction and improved histological reorganization of the regenerating tissue. Furthermore, the dressing modulated the inflammatory responses, stimulated the activation and proliferation of fibroblasts, and enhanced rapid production of collagen fiber network with a consequently shorter healing time. The level of proinflammatory cytokines; IL-1α, IL-1β, and IL-6, were significantly reduced in Gamat Hydrogel treated wounds compared with other groups as assessed by reverse transcription-polymerase chain reaction (RT-PCR). In summary, our results showed that Gamat Hydrogel promoted burn wound repair via a complex mechanism involving stimulation of tissue regeneration and regulation of pro-inflammatory cytokines. The resultant wound healing effects were attributed to the synergistic effect of the hydrogel matrix and incorporated sea cucumber.