A Systematic Review and Network Meta‐Analysis of Biomedical Mg Alloy and Surface Coatings in Orthopedic Application

Abstract

Magnesium alloys have great application prospects as ideal bone implant materials. However, their poor corrosion resistance limits their clinical orthopedic application. Surface modification promotes the corrosion resistance of magnesium. Conversion coatings, such as calcium phosphate (Ca-P) coating, microarc oxidation (MAO) treatment, and fluoride (FLU) treatment, have been extensively investigated in in vivo studies. This systematic review and network meta-analysis compared the influence of different conversion coatings on bone repair, material properties, and systemic host response in orthopedic applications. Using the PICOS model, the inclusion criteria for biodegradable magnesium and its alloys were determined for in vivo studies. Four databases were used. The standard and weight mean differences with 95% confidence intervals were used to analyze new bone formation and degradation rate. Network structure and forest plots were created, and ranking probabilities were estimated. The risk of bias and quality of evidence were assessed using SYRCLE, CERQual, and GRADE tools. In the qualitative analysis, 43 studies were selected, and the evaluation of each outcome indicator was not entirely consistent from article to article. In the quantitative analysis, 21 articles were subjected to network meta-analysis, with 16 articles on implant degradation and 8 articles for new bone formation. Additionally, SUCRA indicated that Ca-P coating exhibited the highest corrosion resistance, followed by FLU treatment. MAO demonstrated the best capability for new bone formation, followed by Ca-P coating. Ca-P coating exhibited the highest overall performance. To conclude, coated Mg can promote better new bone formation than bare Mg and has considerable biocompatibility. Ca-P-coated Mg and MAO-coated Mg have the greatest potential to significantly promote corrosion resistance and bone regeneration, respectively. The findings of this study will provide a theoretical basis for the investigation of composite coatings and guidance for the orthopedic application of Mg bone implants.

Self-Healing Micro Arc Oxidation and Dicalcium Phosphate Dihydrate Double-Passivated Coating on Magnesium Membrane for Enhanced Bone Integration Repair

“…Micro arc oxidation (MAO) is a common and mature surface treatment method for forming functionalized coatings with good physical, chemical, and biological properties on metal substrates. , MAO pretreatment of a magnesium substrate can form a high-quality MgO ceramic coating, strengthening the interface bonding between the coatings and metal substrates and improving corrosion resistance of the substrates. , In this study, we combined DCPD self-healing coatings with MAO to form biodegradable magnesium with excellent osteoinduction capabilities and corrosion resistance. Double-passivated treatment of the MAO and DCPD coatings (Mg-MAO/DCPD) exhibited mild preparation conditions and effectively maintained the integrity of the magnesium substrates.…”

Selective Laser Melting of the Porous Ta Scaffold with Mg-Doped Calcium Phosphate Coating for Orthopedic Applications

“…Interestingly, magnesium ions can promote the expression of human osteoblast integrins and enhance the adhesion of osteoblasts. 20 Magnesium ions primarily reside in the skeleton, constituting 0.5−1% of the skeleton's mineral content. These ions can influence the metabolism of bone minerals and matrix by modulating hormones associated with bone metabolism, 21 growth factors, and factors related to signaling pathways.…”

“…Magnesium, the fourth most abundant cation in the human body, is present in significant quantities in the cell matrix. Interestingly, magnesium ions can promote the expression of human osteoblast integrins and enhance the adhesion of osteoblasts . Magnesium ions primarily reside in the skeleton, constituting 0.5–1% of the skeleton’s mineral content.…”

Study of in vitro wear resistance and degradation properties of self-made treated medical magnesium alloys

“…Material properties, mechanical properties, and biocompatibility are the main factors affecting the safety and effectiveness of surgery. [1][2][3][4][5] Although the commonly used bone plate materials (such as titanium alloy, stainless steel, cobalt-based alloy, etc.) have strong advantages in strength, toughness, and elastic modulus, they differ significantly in mechanical properties from those of human bones.…”