Abstract
Biodegradable Mg‐based metals may be promising orthopedic implants for treating challenging bone diseases, attributed to their desirable mechanical and osteopromotive properties. This Review summarizes the current status and future research trends for Mg‐based orthopedic implants. First, the properties between Mg‐based implants and traditional orthopedic implants are compared on the following aspects: in vitro and in vivo degradation mechanisms of Mg‐based implants, peri‐implant bone responses, the fate of the degradation products, and the cellular and molecular mechanisms underlying the beneficial effects of Mg ions on osteogenesis. Then, the preclinical studies conducted at the low weight bearing sites of animals are introduced. The innovative strategies (for example, via designing Mg‐containing hybrid systems) are discussed to address the limitations of Mg‐based metals prior to their clinical applications at weight‐bearing sites. Finally, the available clinical studies are summarized and the challenges and perspectives of Mg‐based orthopedic implants are discussed. Taken together, the progress made on the development of Mg‐based implants in basic, translational, and clinical research has laid down a foundation for developing a new era in the treatment of challenging and prevalent bone diseases.
Highlights
Biodegradable Mg-based metals may be promising orthopedic implants for limited to osteoporotic fracture.[1]
Inspired by previous literatures reporting that Mg ions promoted the CGRP secretion in women with preeclampsia,[58] we further found that transport of Mg ions into the neurons in the dorsal root ganglions was mediated by Mg transporter 1 (MagT1) and Transient Receptor Potential cation channel subfamily member 7 (TRPM7) which promoted the release of Calcitonin GeneRelated Peptide (CGRP).[18,56]
Yoshizawa et al reported that an addition of 10 × 10−3 m Mg ions to cell cultures of human bone marrow mesenchymal stem cells and differentiating osteoblasts (Figure 5D), enhanced the mineralization of the extracellular matrix (ECM) by increasing the production of collagen-X and vascular endothelial growth factor (VEGF).[53]
Summary
Mg and its alloys have a higher strength relative to natural bone, but the Young’s modulus closely matches that of cortical bone, implying it unique feature on reducing stress shielding during load transfer at the interface of implant to bone (Figure 1) These properties overcome the shortcomings of traditional metallic and synthetic polymeric orthopedic devices, making it a more suitable candidate for treating the challenging bone diseases.[17]. Ling Qin heads a research laboratory in the Department of Orthopaedics & Traumatology, the Chinese University of Hong Kong, focusing on a research and development (R&D) of innovative bioactive materials and drugs for orthopedic use. Qin looks at the potential healing mechanisms of Mg ions after implant degradation and makes great contributions to the clinical applications of Mg-based screws in patients suffering from osteonecrosis in their femoral heads
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