Human tissue is structured mainly of self-assembled polymers (proteins) and ceramics (bone minerals), with metals present as trace elements with molecular scale functions. However, metals and their alloys have played a predominant role as structural biomaterials in reconstructive surgery, especially orthopedics, with more recent uses in non-osseous tissues, such as blood vessels. With the successful routine use of a large variety of metal implants clinically, issues associated with long-term maintenance of implant integrity have also emerged. This review focuses on metallic implant biomaterials, identifying and discussing critical issues in their clinical applications, including the systemic toxicity of released metal ions due to corrosion, fatigue failure of structural components due to repeated loading, and wearing of joint replacements due to movement. This is followed by detailed reviews on specific metallic biomaterials made from stainless steels, alloys of cobalt, titanium and magnesium, as well as shape memory alloys of nickel–titanium, silver, tantalum and zirconium. For each, the properties that affect biocompatibility and mechanical integrity (especially corrosion fatigue) are discussed in detail. Finally, the most critical challenges for metallic implant biomaterials are summarized, with emphasis on the most promising approaches and strategies.

Metallic implant biomaterials

Fundamentals and advances in magnesium alloy corrosion

Bioceramics of calcium orthophosphates

/pdf/the-big-picture-on-nanomedicine-the-state-of-investigational-3ubppxusg2.pdf

The big picture on nanomedicine: the state of investigational and approved nanomedicine products

Scaffolds for Bone Tissue Engineering: State of the art and new perspectives.

At present, strong requirements in orthopaedics are still to be met, both in bone and joint substitution and in the repair and regeneration of bone defects. In this framework, tremendous advances in the biomaterials field have been made in the last 50 years where materials intended for biomedical purposes have evolved through three different generations, namely first generation (bioinert materials), second generation (bioactive and biodegradable materials) and third generation (materials designed to stimulate specific responses at the molecular level). In this review, the evolution of different metals, ceramics and polymers most commonly used in orthopaedic applications is discussed, as well as the different approaches used to fulfil the challenges faced by this medical field.

https://royalsocietypublishing.org/doi/pdf/10.1098/rsif.2008.0151

Biomaterials in orthopaedics.

https://www.cell.com/trends/biotechnology/pdf/S0167-7799(07)00289-2.pdf

Nanotechnology in regenerative medicine: the materials side

The influence of surface energy on competitive protein adsorption on oxidized NiTi surfaces.

Various oxidation treatments were applied to nearly equiatomic NiTi alloys so as to form a Ni-free protective oxide on the surface. Sample surfaces were analyzed by X-ray Photoelectron Spectroscopy, and NiTi transformation temperatures were determined by differential scanning calorimetry (DSC) before and after the surface treatment. An ion release experiment was carried out up to one month of immersion in SBF for both oxidized and untreated surfaces. The results show that oxidation treatment in a low-oxygen pressure atmosphere leads to a high surface Ti/Ni ratio, a very low Ni surface concentration and a thick oxide layer. This oxidation treatment does not significantly affect the shape memory properties of the alloy. Moreover, the oxide formed significantly decreases Ni release into exterior medium comparing with untreated surfaces. As a consequence, this new oxidation treatment could be of great interest for biomedical applications, as it could minimize sensitization and allergies and improve biocompatibility and corrosion resistance of NiTi shape memory alloys.

New oxidation treatment of NiTi shape memory alloys to obtain Ni-free surfaces and to improve biocompatibility.

A new oxidation treatment (OT) for NiTi Shape Memory Alloys used in biomedical applications has been developed in a previous work to reduce Ni surface concentration and, consequently, decrease Ni ions release into the exterior medium. This OT treatment is expected to minimize adverse and toxic reactions associated to Ni ions. However, in order to assess the biocompatibility of a metallic material, its corrosion resistance has to be evaluated. In this work, the electrochemical behaviour of NiTi surfaces oxidized by the new OT treatment was compared to untreated NiTi surfaces (NT). For this purpose, tests of open-circuit potential and cyclic voltammetry were performed at 37 °C in a Hanks Balance Salt Solution. A significant increase of the corrosion (Ecorr) and breakdown (Eb) potentials was observed for OT surfaces, in comparison with NT surfaces. Moreover, the qualitative potentiodynamic behaviour of OT NiTi and Ti surfaces are similar. This observation suggests that the OT treatment leads to the formation of an oxide on NiTi surface that has similar structure and electrochemical property to native Ti oxide. This new oxidation treatment is efficient to protect NiTi alloys from electrochemical degradation and, therefore, it may be an excellent candidate for biomedical applications.

A. Michiardi

Papers

Biomaterials in orthopaedics.

Nanotechnology in regenerative medicine: the materials side

The influence of surface energy on competitive protein adsorption on oxidized NiTi surfaces.

New oxidation treatment of NiTi shape memory alloys to obtain Ni-free surfaces and to improve biocompatibility.

Electrochemical behaviour of oxidized NiTi shape memory alloys for biomedical applications