Biodegradable magnesium Herbert screw – image quality and artifacts with radiography, CT and MRI

Sonnow, Lena; Könneker, Sören; Vogt, Peter M.; Wacker, Frank; Falck, Christian von

doi:10.1186/s12880-017-0187-7

Cited by 52 publications

(48 citation statements)

References 29 publications

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“…Even though magnetic implants are usually avoided to be scanned under MRI, an Fe stent implanted in rabbit abdominal aorta was successfully imaged by this instrument despite the presence of artifacts (Figure 5c) [22]. However, it was shown that MRI has a modality to image tissueimplant interaction in better quality for absorbable Mg alloys, i.e., less artifacts, compared to that of inert metals such as titanium [65]. More recent diagnostic instruments used to assess the in-vivo corrosion of absorbable metals are Micro-Computed Tomography (µCT) and Magnetic Resonance Imaging (MRI).…”

Section: Ultrasonography and Radiographymentioning

confidence: 99%

In-Vivo Corrosion Characterization and Assessment of Absorbable Metal Implants

et al. 2019

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Absorbable metals have been introduced as materials to fabricate temporary medical implants. Iron, magnesium and zinc have been considered as major base elements of such metals. The metallurgical characterization and in-vitro corrosion assessment of these metals have been covered by the new ASTM standards F3160 and F3268. However, the in-vivo corrosion characterization and assessment of absorbable metal implants are not yet well established. The corrosion of metals in the in-vivo environment leads to metal ion release and corrosion product formation that may cause excessive toxicity. The aim of this work is to introduce the techniques to assess absorbable metal implants and their in-vivo corrosion behavior. This contains the existing approaches, e.g., implant retrieval and histological analysis, ultrasonography and radiography, and the new techniques for real-time in-vivo corrosion monitoring.

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Section: Ultrasonography and Radiographymentioning

confidence: 99%

In-Vivo Corrosion Characterization and Assessment of Absorbable Metal Implants

et al. 2019

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“…Moreover, the released appropriate Mg ions could regulate signaling pathways of bone marrow stromal cells and stimulate new bone formation 2 . Clinically, a prospective study of MAGNEZIX ® Mg screws (Syntellix AG, Hannover, Germany) demonstrated that they functioned equivalently to titanium screws during the slight hallux valgus deformities healing 3 . However, rapid and continuous degradation may reduce the mechanical integrity and support properties of Mg implants.…”

Section: Introductionmentioning

confidence: 99%

Regulation of osteogenesis and osteoclastogenesis by zoledronic acid loaded on biodegradable magnesium-strontium alloy

Wan

Wang

et al. 2019

Sci Rep

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Inhibiting osteoclasts and osteoclast precursors to reduce bone resorption is an important strategy to treat osteoclast-related diseases, such as peri-prosthetic osteolysis. In this study, our objective was to study the role of zoledronic acid (ZA), as a highly potent and nitrogen-containing bisphosphonate, in promoting osteogenesis and inhibiting osteoclastogenesis properties of magnesium (Mg)-based implants. ZA was chemically associated with calcium phosphate (CaP) deposited on magnesium-strontium (Mg-Sr) alloy, which was confirmed by the morphological observation, phase composition and drug releasing via SEM, XRD spectrum and High Performance Liquid Chromatography (HPLC), respectively. The in vitro performances indicated that ZA-CaP bilayer coating Mg-Sr alloy could enhance the proliferation and the osteogenic differentiation as well as the mineralization of pre-osteoblasts, however, induce the apoptosis and inhibit the osteoclast differentiation. We further investigated the possible molecular mechanisms by using Quantitative real-time PCR (qRT-PCR) and Western Blotting, and the results showed that ZA-CaP bilayer coating Mg-Sr alloy could regulate the osteogenesis and osteoclastogenesis through the Estrogen Receptor α (ERα) and NF-κB signaling pathway. Moreover, ZA-CaP bilayer coating Mg-Sr alloy could regulate the cross talk of osteoblast-osteoclast and increase the ratio of OPG: RANKL in the co-culture system through OPG/RANKL/RANK signaling pathway, which promoting the balance of bone remodeling process. Therefore, these promising results suggest the potential clinical applications of ZA pretreated Mg-Sr alloys for bone defect repairs and periprosthetical osteolysis due to the excessive differentitation and maturation of osteoclasts.

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“…Artifacts will be measured as described by Sonnow et al [15] to evaluate changes of artifact appearance over time. In detail, all artifacts will be assessed in an axial plane or reconstruction of the screw.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, magnesium-based implants produce almost no artifacts in MRI or CT even when imaging was done immediately after implantation [9, 15]. In contrast, titanium screws generally create interference.…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, titanium screws generally create interference. On the 3 T scanner employed by Sonnow et al [15], the largest difference in artifacts between magnesium-based and titanium implants was observed when imaging was done with the T1w turbo spin echo (TSE) sequences. Fewer artifacts were also observed for the proton density weighted (PDw) TSE and PDw TSE metal-artifact reduction (WARP) sequences.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of SCAphoid fracture osteosynthesis by MAGnesium-based headless Herbert screws with titanium Herbert screws: protocol for the randomized controlled SCAMAG clinical trial

Könneker

Krockenberger

Pieh

et al. 2019

BMC Musculoskelet Disord

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Background Scaphoid fractures are the most common carpal fractures. They often need to be treated by surgery, where the use of a compression screw is the globally accepted gold standard. Surgeons may choose between different implant materials including titanium alloys, which remain in the body or are removed after healing. An alternative are biodegradable magnesium-based implants. Properties of magnesium alloys include high stability, osteoconductivity, potential reduction of infections and few artifacts in magnetic resonance imaging (MRI). The aim of this trial is to demonstrate non-inferiority of magnesium-based compression screws compared with titanium Herbert screws for scaphoid fractures. Methods The trial is designed as a multicenter, blinded observer, randomized controlled parallel two-group post market trial. Approximately 190 patients will be randomized (1:1) with stratification by center either to titanium or magnesium-based compression screws. Follow-up is 1 year per patient. Surgical procedures and aftercare will be performed according to the German treatment guideline for scaphoid fractures. The first primary endpoint is the patient-rated wrist evaluation (PRWE) score after 6 months. The second primary endpoint is a composite safety endpoint including bone union until 6 months, no adverse device effect (ADE) during surgery or wound healing and no serious ADE or reoperation within 1 year. The third primary endpoint is the difference in change MRI artifacts over time. Non-inferiority will be investigated for primary endpoints 1 (t-test confidence interval) and 2 (Wilson’s score interval) using both the full analysis set (FAS) and the per protocol population at the one-sided 2.5% test-level. Superiority of magnesium over titanium screws will be established using the FAS at the two-sided 5% test-level (Welch test) only if non-inferiority has been established for both primary endpoints. Secondary endpoints include quality of life. Discussion This study will inform care providers whether biodegradable magnesium-based implants are non-inferior to standard titanium Herbert screws for the treatment of scaphoid fractures in terms of wrist function and safety. Furthermore, superiority of magnesium-based implants may be demonstrated using MRI, which is used as surrogate endpoint for screw degradation. Trial registration DRKS, DRKS00013368 . Registered Dec 04, 2017. Electronic supplementary material The online version of this article (10.1186/s12891-019-2723-9) contains supplementary material, which is available to authorized users.

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Biodegradable magnesium Herbert screw – image quality and artifacts with radiography, CT and MRI

Cited by 52 publications

References 29 publications

In-Vivo Corrosion Characterization and Assessment of Absorbable Metal Implants

In-Vivo Corrosion Characterization and Assessment of Absorbable Metal Implants

Regulation of osteogenesis and osteoclastogenesis by zoledronic acid loaded on biodegradable magnesium-strontium alloy

Comparison of SCAphoid fracture osteosynthesis by MAGnesium-based headless Herbert screws with titanium Herbert screws: protocol for the randomized controlled SCAMAG clinical trial

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