Abstract

Despite the high potential of healthy bone to regenerate, the reconstruction of large bone defects remains a challenge. Due to the lack of mechanical stability of existing bone substitutes, recently developed degradable metallic alloys are an interesting alternative providing higher load-bearing capabilities. Degradable iron-based alloys therefore might be an attractive innovation. To test the suitability of a newly-designed iron-based alloy for such applications, an animal experiment was performed. Porous iron-based degradable implants with two different densities and a control group were tested. The implants were positioned in the proximal tibia of Merino sheep. Over a period of 6 and 12 months, blood and histological parameters were monitored for signs of inflammation and degradation. In the histological evaluation of the implants` environment we found degraded alloy particles, but no inflammatory reaction. Iron particles were also found within the popliteal lymph nodes on both sides. The serum blood levels of phosphorus, iron and ferritin in the long term groups were elevated. Other parameters did not show any changes. Iron-based degradable porous bone replacement implants showed a good biocompatibility in this experiment. For a clinical application, however, the rate of degradation would have to be significantly increased. Biocompatibility would then have to be re-evaluated.

Highlights

  • Despite the high potential of healthy bone to regenerate, the reconstruction of large bone defects remains a challenge

  • A great variety of biodegradable materials has been developed as bone substitutes

  • An appropriate alloy for a metallic bioresorbable bone implant should degrade very slowly while the newly formed bone builds up stability and load transformation by progressive o­ steointegration[7]

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Summary

Introduction

Despite the high potential of healthy bone to regenerate, the reconstruction of large bone defects remains a challenge. Due to the lack of mechanical stability of existing bone substitutes, recently developed degradable metallic alloys are an interesting alternative providing higher load-bearing capabilities. Iron-based degradable porous bone replacement implants showed a good biocompatibility in this experiment. Despite a high regenerative potential of healthy bone, the replacement of large bone defects following complicated fractures, non-union, tumor resections, infection-related bone loss or in revision arthroplasty are persisting challenges Treatment of these bone defects is currently possible by several methods, but autologous bone transplantation is still considered the gold standard. Due to the lack of mechanical stability of existing resorbable and degradable bone substitutes, recently developed degradable metallic alloys are an interesting alternative providing higher load bearing p­ roperties[11,12]. Implant development currently focuses on iron- and magnesium-based alloys, whose mechanism of degradation is based on metal corrosion. Magnesium-based alloys may provide in the future provide an alternative for bone surgery but they have a higher degradation rate than the tissue healing ­rate[18,19]

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