Improved in vivo osseointegration and degradation behavior of PEO surface-modified WE43 magnesium plates and screws after 6 and 12 months

Rendenbach, Carsten; Fischer, Heilwig; Kopp, Alexander; Schmidt‐Bleek, Katharina; Kreiker, Henri; Stumpp, Sabine; Thiele, Mario; Duda, Georg N.; Hanken, Henning; Beck‐Broichsitter, Benedicta; Jung, Ole; Kröger, Nadja; Smeets, Ralf; Heiland, Max

doi:10.1016/j.msec.2021.112380

Cited by 50 publications

(56 citation statements)

References 26 publications

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“…Complete bone healing in mandibular fractures can take up to 6 months; however, functional loading is progressively restored starting from the fourth week after surgery ( Friedman, 2014 ). Therefore, it is expected that material degradation does not highly interfere with the healing process, and it should not influence the conclusions drawn in this study due to slow degradation rates for both materials ( Yerit et al, 2005 ; Rendenbach et al, 2021 ); however, this aspect remains to be further investigated.…”

Section: Discussionmentioning

confidence: 95%

“…Therefore, magnesium regained relevance for clinical use in load-bearing applications of reconstructive and trauma surgery. Several in vivo preclinical studies successfully observed new bone deposition around WE43 plates and screws (Schaller et al, 2016;Naujokat et al, 2017;Byun et al, 2020;Imwinkelried et al, 2020;On et al, 2020;Rendenbach et al, 2021;Torroni et al, 2021) and a preserved structural integrity in the first 12 weeks of the healing process (Marukawa et al, 2016;Levorova et al, 2018). However, to date, only Leonhardt et al (Leonhardt et al, 2017;Leonhardt et al, 2021) reported a clinical application of magnesium-based lag screws for mandibular condylar head fracture fixation.…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, the clinical use of magnesium in fracture fixation was not possible for many years due to its high reactivity in vivo , resulting in rapid hydrogen gas formation in bone and soft tissues during degradation by corrosion and, consequently, wound healing disorders and fixation failure ( Witte, 2010 ). Recently, however, less reactive alloys, like WE43, and, more importantly, surface modification via plasma electrolytic oxidation (PEO) ( Arrabal et al, 2008 ; Simchen et al, 2020 ; Hartjen et al, 2021 ; Rendenbach et al, 2021 ) have been introduced. In particular, PEO-coated WE43 alloy showed improved cytocompatibility, cell viability, and corrosion resistance compared to the corresponding non-coated alloys ( Hartjen et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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In Silico Biomechanical Evaluation of WE43 Magnesium Plates for Mandibular Fracture Fixation

Orassi

Fischer

Duda

et al. 2022

Front. Bioeng. Biotechnol.

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Titanium fixation devices are the gold standard for the treatment of mandibular fractures; however, they present serious limitations, such as non-degradability and generation of imaging artifacts. As an alternative, biodegradable magnesium alloys have lately drawn attention due to their biodegradability and biocompatibility. In addition, magnesium alloys offer a relatively high modulus of elasticity in comparison to biodegradable polymers, being a potential option to substitute titanium in highly loaded anatomical areas, such as the mandible. This study aimed to evaluate the biomechanical competence of magnesium alloy WE43 plates for mandibular fracture fixation in comparison to the clinical standard or even softer polymer solutions. A 3D finite element model of the human mandible was developed, and four different fracture scenarios were simulated, together with physiological post-operative loading and boundary conditions. In a systematic comparison, the material properties of titanium alloy Ti-6Al-4V, magnesium alloy WE43, and polylactic acid (PLA) were assigned to the fixation devices, and two different plate thicknesses were tested. No failure was predicted in the fixation devices for any of the tested materials. Moreover, the magnesium and titanium fixation devices induced a similar amount of strain within the healing regions. On the other hand, the PLA devices led to higher mechanical strains within the healing region. Plate thickness only slightly influenced the primary fixation stability. Therefore, magnesium alloy WE43 fixation devices seem to provide a suitable biomechanical environment to support mandibular fracture healing in the early stages of bone healing. Magnesium WE43 showed a biomechanical performance similar to clinically used titanium devices with the added advantages of biodegradability and radiopacity, and at the same time it showed a remarkably higher primary stability compared to PLA fixation devices, which appear to be too unstable, especially in the posterior and more loaded mandibular fracture cases.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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In Silico Biomechanical Evaluation of WE43 Magnesium Plates for Mandibular Fracture Fixation

Orassi

Fischer

Duda

et al. 2022

Front. Bioeng. Biotechnol.

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“…Numerous studies have treated Mg with PEO and investigated its orthopedic applications [ 19 , 20 ]. Rendenbach et al modified WE43 Mg alloy with PEO treatment and found that the PEO-treated Mg alloy showed enhanced corrosion resistance and osteointegration upon implantation in Gottingen miniature pigs [ 21 ]. However, the dielectric breakdown effect caused pore formation and cracks easily formed and spread over the PEO coating, which is unfavorable for long-term corrosion resistance.…”

Section: Introductionmentioning

confidence: 99%

Oxyhydroxide-Coated PEO–Treated Mg Alloy for Enhanced Corrosion Resistance and Bone Regeneration

Xie

Cheng

Zhou

et al. 2022

JFB

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Plasma electrolytic oxidation (PEO) is widely used as a surface modification method to enhance the corrosion resistance of Mg alloy, the most likely applied biodegradable material used in orthopedic implants. However, the pores and cracks easily formed on the PEO surface are unfavorable for long-term corrosion resistance. In this study, to solve this problem, we used simple immersion processes to construct Mn and Fe oxyhydroxide duplex layers on the PEO-treated AZ31 (PEO–Mn/Fe). As control groups, single Mn and Fe oxyhydroxide layers were also fabricated on PEO (denoted as PEO–Mn and PEO–Fe, respectively). PEO–Mn showed a similar porous morphology to the PEO sample. However, the PEO–Fe and PEO–Mn/Fe films completely sealed the pores on the PEO surfaces, and no cracks were observed even after the samples were immersed in water for 7 days. Compared with PEO, PEO–Mn, and PEO–Fe, PEO–Mn/Fe exhibited a significantly lower self-corrosion current, suggesting better corrosion resistance. In vitro C3H10T1/2 cell culture showed that PEO–Fe/Mn promoted the best cell growth, alkaline phosphatase activity, and bone-related gene expression. Furthermore, the rat femur implantation experiment showed that PEO–Fe/Mn–coated Mg showed the best bone regeneration and osteointegration abilities. Owing to enhanced corrosion resistance and osteogenesis, the PEO–Fe/Mn film on Mg alloy is promising for orthopedic applications.

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“…Darüber hinaus zeigte sich histologisch ein signifikant höherer Knochenanteil über den PEO-modifizierten Platten nach 6 Monaten. Aufgrund des höheren Knochenanteils im subperiostalen Kompartiment über den Platten konnte auf eine durch die PEO-Oberflächenmodifikation begünstigte osteostimulative Wirkung geschlossen werden [9]. Ziel dieses Projektes ist es, den Grund für den beobachteten osteostimulativen Effekt besser zu verstehen.…”

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Improved in vivo osseointegration and degradation behavior of PEO surface-modified WE43 magnesium plates and screws after 6 and 12 months

Cited by 50 publications

References 26 publications

In Silico Biomechanical Evaluation of WE43 Magnesium Plates for Mandibular Fracture Fixation

In Silico Biomechanical Evaluation of WE43 Magnesium Plates for Mandibular Fracture Fixation

Oxyhydroxide-Coated PEO–Treated Mg Alloy for Enhanced Corrosion Resistance and Bone Regeneration

Evaluation des osteoimmunologischen Potenzials von Magnesiumimplantaten in vitro

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