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

Topological design and additive manufacturing of porous metals for bone scaffolds and orthopaedic implants: A review.

Stimulus-responsive shape memory materials: A review

Review on titanium and titanium based alloys as biomaterials for orthopaedic applications.

Ti-based alloys are finding ever-increasing applications in biomaterials due to their excellent mechanical, physical and biological performance. Nowdays, low modulus β-type Ti-based alloys are still being developed. Meanwhile, porous Ti-based alloys are being developed as an alternative orthopedic implant material, as they can provide good biological fixation through bone tissue ingrowth into the porous network. This paper focuses on recent developments of biomedical Ti-based alloys. It can be divided into four main sections. The first section focuses on the fundamental requirements titanium biomaterial should fulfill and its market and application prospects. This section is followed by discussing basic phases, alloying elements and mechanical properties of low modulus β-type Ti-based alloys. Thermal treatment, grain size, texture and properties in Ti-based alloys and their limitations are dicussed in the third section. Finally, the fourth section reviews the influence of microstructural configurations on mechanical properties of porous Ti-based alloys and all known methods for fabricating porous Ti-based alloys. This section also reviews prospects and challenges of porous Ti-based alloys, emphasizing their current status, future opportunities and obstacles for expanded applications. Overall, efforts have been made to reveal the latest scenario of bulk and porous Ti-based materials for biomedical applications.

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New Developments of Ti-Based Alloys for Biomedical Applications

It is commonly accepted that titanium and the titanium alloying elements of tantalum, niobium, zirconium, molybdenum, tin, and silicon are biocompatible. However, our research in the development of new titanium alloys for biomedical applications indicated that some titanium alloys containing molybdenum, niobium, and silicon produced by powder metallurgy show a certain degree of cytotoxicity. We hypothesized that the cytotoxicity is linked to the ion release from the metals. To prove this hypothesis, we assessed the cytotoxicity of titanium and titanium alloying elements in both forms of powder and bulk, using osteoblast-like SaOS(2) cells. Results indicated that the metal powders of titanium, niobium, molybdenum, and silicon are cytotoxic, and the bulk metals of silicon and molybdenum also showed cytotoxicity. Meanwhile, we established that the safe ion concentrations (below which the ion concentration is non-toxic) are 8.5, 15.5, 172.0, and 37,000.0 microg/L for molybdenum, titanium, niobium, and silicon, respectively.

Cytotoxicity of Titanium and Titanium Alloying Elements

Porous TiNbZr alloy scaffolds for biomedical applications

Mechanical properties and bioactive surface modification via alkali-heat treatment of a porous ti-18Nb-4Sn alloy for biomedical applications

Titanium–nickel (TiNi) shape memory alloy (SMA) foams with an open-cell porous structure were fabricated by space-holder sintering process and characterized by scanning electron microscopy (SEM) and X-ray diffraction (XRD) analysis. The mechanical properties and shape memory properties of the TiNi foam samples were investigated using compressive test. Results indicate that the plateau stresses and elastic moduli of the foams under compression decrease with the increase of their porosities. The plateau stresses and elastic moduli are measured to be from 1.9 to 38.3 MPa and from 30 to 860 MPa for the TiNi foam samples with porosities ranged from 71% to 87%, respectively. The mechanical properties of the TiNi alloy foams can be tailored to match those of bone. The TiNi alloy foams exhibit shape memory effect (SME), and it is found that the recoverable strain due to SME decreases with the increase of foam porosity.

Titanium–nickel shape memory alloy foams for bone tissue engineering

Porous titanium (Ti) and titanium alloys are promising scaffold biomaterials for bone tissue engineering, because they have the potential to provide new bone tissue ingrowth abilities and low elastic modulus to match that of natural bone. In the present study, a new highly porous Ti6Ta4Sn alloy scaffold with the addition of biocompatible alloying elements (tantalum (Ta) and tin (Sn)) was prepared using a space-holder sintering method. The strength of the Ti6Ta4Sn scaffold with a porosity of 75% was found to be significantly higher than that of a pure Ti scaffold with the same porosity. The elastic modulus of the porous alloy can be customized to match that of human bone by adjusting its porosity. In addition, the porous Ti6Ta4Sn alloy exhibited an interconnected porous structure, which enabled the ingrowth of new bone tissues. Cell culture results revealed that human SaOS(2) osteoblast-like cells grew and spread well on the surfaces of the solid alloy, and throughout the porous scaffold. The surface roughness of the alloy showed a significant effect on the cell behavior, and the optimum surface roughness range for the adhesion of the SaOS(2) cell on the alloy was 0.15 to 0.35 mum. The present study illustrated the feasibility of using the porous Ti6Ta4Sn alloy scaffold as an orthopedic implant material with a special emphasis on its excellent biomechanical properties and in vitro biocompatibility with a high preference by osteoblast-like cells.

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Jianyu Xiong

Papers

Cytotoxicity of Titanium and Titanium Alloying Elements

Porous TiNbZr alloy scaffolds for biomedical applications

Mechanical properties and bioactive surface modification via alkali-heat treatment of a porous ti-18Nb-4Sn alloy for biomedical applications

Titanium–nickel shape memory alloy foams for bone tissue engineering

Ti6Ta4Sn alloy and subsequent scaffolding for bone tissue engineering.