He Xuan, Li Ye, Zou Da, Zu Haiyue, Li Weishi, Zheng Yufeng
Department of Orthopaedics, Peking University Third Hospital, No.49 North Huayuan Road, Haidian, Beijing, PR China.
Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hong Kong SAR, PR China.
Bioact Mater. 2024 May 30;39:456-478. doi: 10.1016/j.bioactmat.2024.04.026. eCollection 2024 Sep.
Due to matching biomechanical properties and significant biological activity, Mg-based implants present great potential in orthopedic applications. In recent years, the biocompatibility and therapeutic effect of magnesium-based implants have been widely investigated in trauma repair. In contrast, the R&D work of Mg-based implants in spinal fusion is still limited. This review firstly introduced the general background for Mg-based implants. Secondly, the mechanical properties and degradation behaviors of Mg and its traditional and novel alloys were reviewed. Then, different surface modification techniques of Mg-based implants were described. Thirdly, this review comprehensively summarized the biological pathways of Mg degradation to promote bone formation in neuro-musculoskeletal circuit, angiogenesis with H-type vessel formation, osteogenesis with osteoblasts activation and chondrocyte ossification as an integrated system. Fourthly, this review followed the translation process of Mg-based implants via updating the preclinical studies in fracture fixation, sports trauma repair and reconstruction, and bone distraction for large bone defect. Furthermore, the pilot clinical studies were involved to demonstrate the reliable clinical safety and satisfactory bioactive effects of Mg-based implants in bone formation. Finally, this review introduced the background of spine fusion surgeryand the challenges of biological matching cage development. At last, this review prospected the translation potential of a hybrid Mg-PEEK spine fusion cage design.
由于具有匹配的生物力学性能和显著的生物活性，镁基植入物在骨科应用中具有巨大潜力。近年来，镁基植入物的生物相容性和治疗效果在创伤修复方面得到了广泛研究。相比之下，镁基植入物在脊柱融合方面的研发工作仍然有限。本综述首先介绍了镁基植入物的一般背景。其次，综述了镁及其传统和新型合金的力学性能和降解行为。然后，描述了镁基植入物的不同表面改性技术。第三，本综述全面总结了镁降解促进神经肌肉骨骼回路骨形成、形成H型血管的血管生成、激活成骨细胞的成骨作用以及软骨细胞骨化作为一个综合系统的生物学途径。第四，本综述通过更新骨折固定、运动创伤修复与重建以及大骨缺损骨牵张方面的临床前研究，跟踪了镁基植入物的转化过程。此外，还纳入了初步临床研究，以证明镁基植入物在骨形成方面具有可靠的临床安全性和令人满意的生物活性效果。最后，本综述介绍了脊柱融合手术的背景以及生物匹配椎间融合器开发面临的挑战。最后，本综述展望了混合镁-聚醚醚酮脊柱融合椎间融合器设计的转化潜力。
