Magnesium biomaterials for orthopedic application: A review from a biological perspective

Abstract

Magnesium (Mg) has a long history of investigation as a degradable biomaterial. Physicians first began using Mg for biomedical applications in the late 19th century. Experimentation continued with varying levels of success until the mid-20th century when interest in the metal waned. In recent years the field of Mg-based biomaterials has once again become popular, likely due to advancements in technology allowing improved control of corrosion. Although this has led to success in vascular applications, continued difficulties in predicting and controlling the corrosion rate of Mg in an intraosseous environment has impeded the development of Mg-based biomaterials for orthopedic applications. In this review, an initial summary of the basic properties and the physiological role of Mg are followed by a discussion of the physical characteristics of the metal which lend it to use as a degradable biomaterial. A description of the historical and modern applications for Mg in the medical field is followed by a discussion of the methods used to control and assess Mg corrosion, with an emphasis on alloying. The second part of this review concentrates on the methods used to assess the corrosion and biocompatibility of Mg-based orthopedic biomaterials. This review provides a summary of Mg as a biomaterial from a biological perspective.

Topical Notions About in Vivo Analysis for Degradable Biomaterials with Utility in Human Body

“…This technique can be supplemented by following the microscopic aspect (tissue response to implants) Another standard and widely accepted technique for initial in vivo investigations is the implantation of magnesium-based biomaterials in a subcutaneous or intramuscular environment with several specific benefits: the implant can be easy removed and evaluated for corrosion behavior, and tissue interacts much better with a possible hydrogen gas production. Several other investigations have used similar techniques to analyze soft tissue reaction in magnesium implants by specifically removing the muscle and connective tissue covering but these techniques are time consuming, costly and require the use of antibodies for a wide range of antigens to provide a complete picture of the tissue reaction that is taking place [4,13].…”

“…A major pillar in the development and implementation of vascular and orthopedic applications, the two main areas of investigation associated with the development of magnesium materials and alloys, is the in vivo assessment of the compatibility of biomaterials and medical devices with tissues, a branch that has begun to be developed in recent years [4,5]. Magnesium-based biomaterials have amazing advantages over stainless steel, titanium or Co-Cr-Ni alloys, which leave metallic residues resulting from in vivo abrasion with toxic effects that can cause hypersensitivity, local inflammation or tissue necrosis [1,4,6]. Magnesium alloy has chemically active properties and is susceptible to degradation in the physiological environment after implantation without causing toxic and secondary effects [3,7,8].…”

“…In addition to its importance in reactions involving ATP, Mg plays roles in protein and nucleic acid synthesis, mitochondrial activity and integrity, ion channel modulation, plasma membrane stabilization and translation processes, and many other cellular functions . Due to the importance of this element, homeostasis as well as the potential pathological effects of a possible mineral imbalance should be studied closely before the human body is exposed to an excess of Mg as a result of its use as a biomaterial [4,9]. Magnesium homeostasis is effectively maintained by the combination of intestinal absorption, renal excretion and bone use as a magnesium deposit.…”

“…Exposure to degradable material may cause disruption to these systems causing discontinuation of homeostasis and pathological ailment due to an excess of deposits that may be clinically manifested as hypermagnesemia. Acute destruction of muscle tissue can also lead to an excess of magnesium [4,9]. To date, studies have not demonstrated that hypomagnesaemia can be associated with the implantation of magnesium-based biomaterials.…”

“…This is the ability of the material to come into contact with living tissue so that it does not produce toxic and allergic side effects and its level of adaptability to the biological environment is as high as possible [2,4,10].…”