Abstract
The use of biodegradable magnesium implants in pediatric trauma surgery would render surgical interventions for implant removal after tissue healing unnecessary, thereby preventing stress to the children and reducing therapy costs. In this study, we report on the immunological response to biodegradable magnesium implants—as an important aspect in evaluating biocompatibility—tested in a growing rat model. The focus of this study was to investigate the response of the innate immune system to either fast or slow degrading magnesium pins, which were implanted into the femoral bones of 5-week-old rats. The main alloying element of the fast-degrading alloy (ZX50) was Zn, while it was Y in the slow-degrading implant (WZ21). Our results demonstrate that degrading magnesium implants beneficially influence the immune system, especially in the first postoperative weeks but also during tissue healing and early bone remodeling. However, rodents with WZ21 pins showed a slightly decreased phagocytic ability during bone remodeling when the degradation rate reached its maximum. This may be due to the high release rate of the rare earth-element yttrium, which is potentially toxic. From our results we conclude that magnesium implants have a beneficial effect on the innate immune system but that there are some concerns regarding the use of yttrium-alloyed magnesium implants, especially in pediatric patients.
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N. Simanovsky, M.A. Tair, N. Simanovsky, and S. Porat, J. Pediatr. Orthop. 26, 188 (2006).
E.M. Raney, D.M. Freccero, L.A. Dolan, D.E. Lighter, R.R. Fillman, and H.G. Chambers, J. Pediatr. Orthop. 28, 701 (2008).
P.O. Newton and S.J. Mubarak, J. Pediatr. Orthop. 14, 508 (1994).
L.E. Claes, Clin. Mater. 10, 41 (1992).
M.P. Staiger, A.M. Pietak, J. Huadmai, and G. Dias, Biomaterials 27, 1728 (2006).
D. Persaud-Sharma, A. McGoron, and J. Biomim, Biomater. Tissue Eng. 3, 25 (2012).
B. Zberg, P.J. Uggowitzer, and J.F. Löffler, Nat. Mater. 8, 887 (2009).
E. Aghion, G. Levy, and S. Ovadia, J. Mater. Sci. Mater. Med. 23, 805 (2012).
A.C. Hänzi, I. Gerber, M. Schinhammer, J.F. Löffler, and P.J. Uggowitzer, Acta Biomater. 6, 1824 (2010).
Z.G. Huan, M.A. Leeflang, J. Zhou, L.E. Fratila-Apachitei, and J. Duszczyk, J. Mater. Sci. Mater. Med. 21, 2623 (2010).
A. Krause, N. Höh, D. Bormann, C. Krause, F.W. Bach, H. Windhagen, and A. Meyer-Lindenberg, J. Mater. Sci. 45, 624 (2010).
F. Witte, N. Hort, C. Vogt, S. Cohen, K.U. Kainer, R. Willumeit, and F. Feyerabend, Curr. Opin. Solid State Mater. Sci. 12, 63 (2008).
F. Witte, V. Kaese, H. Haferkamp, E. Switzer, A. Meyer-Lindenberg, C.J. Wirth, and H. Windhagen, Biomaterials 26, 3557 (2005).
P.A. Lalor, P.A. Revell, A.B. Gray, S. Wright, G.T. Railton, and M.A. Freeman, J. Bone Joint Surg. Br. 73, 25 (1991).
K. Merritt and J.J. Rodrigo, Clin. Orthop. Relat. Res. 326, 71 (1996).
N. Hallab, J.J. Jacobs, and J. Black, Biomaterials 21, 1301 (2000).
K.H. Lam, J.M. Schakenraad, H. Esselbrugge, J. Feijen, and P. Nieuwenhuis, J. Biomed. Mater. Res. 27, 1569 (1993).
Q. Rahman, M. Lohani, E. Dopp, H. Pemsel, L. Jonas, D.G. Weiss, and D. Schiffmann, Environ. Health Perspect. 110, 797 (2002).
L. Wang, J. Mao, G.H. Zhang, and M.J. Tu, World J. Gastroenterol. 7, 4011 (2007).
F. Witte, H. Ulrich, M. Rudert, and E. Willbold, J. Biomed. Mater. Res. A 81, 748 (2007).
T. Kraus, S.F. Fischerauer, A.C. Hänzi, P.J. Uggowitzer, J.F. Löffler, and A.M. Weinberg, Acta Biomater. 8, 1230 (2012).
P. Gunde, A.C. Hänzi, A.S. Sologubenko, and P.J. Uggowitzer, Mater. Sci. Eng. A 528, 1047 (2011).
W. Hirt, T. Nebe, and C. Birr, Wien. Klin. Wochenschr. 106, 250 (1994).
S.F. Fischerauer, T. Kraus, X. Wu, S. Tangl, E. Sorantin, A.C. Hänzi, J.F. Löffler, P.J. Uggowitzer, and A.M. Weinberg, Acta Biomater. 9, 5411 (2013).
A.C. Hänzi, A.S. Sologubenko, P. Gunde, M. Schinhammer, and P.J. Uggowitzer, Philos. Mag. Lett. 92, 417 (2012).
H.R. Bakhsheshi-Rad, M.R.A. Kadir, M.H. Idris, and S. Farahany, Corrosion Science Conference Proceedings (2012).
A.C. Hänzi, A.S. Sologubenko, and P.J. Uggowitzer, Materials Science Forum Conference Proceedings (2009).
M. Yamasaki, K. Nyu, and Y. Kawamura, Materials Science Forum Conference Proceedings (2003).
D. Fröhlich, G. Rothe, B. Schwall, P. Schmid, G. Schmitz, K. Taeger, and J. Hobbhahn, Br. J. Anaesth. 78, 718 (1997).
M. Nakagawara, K. Takeshige, J. Takamatsu, S. Takahashi, J. Yoshitake, and S. Minakami, Anesthesiology 64, 4 (1986).
S. Kurosawa and M. Kato, J. Anesth. 22, 263 (2008).
M.D. Menger and B. Vollmar, Langenbecks Arch. Surg. 389, 475 (2004).
B.V. Hogan, M.B. Peter, H.G. Shenoy, K. Horgan, and T.A. Hughes, Surgeon 9, 38 (2011).
M.E. Bolander, Proc. Soc. Exp. Biol. Med. 200, 165 (1992).
F. Witte, I. Abeln, E. Switzer, V. Kaese, A. Meyer-Lindenberg, and H. Windhagen, J. Biomed. Mater. Res. A 86, 1041 (2008).
A. Bondarenko, M. Hewicker-Trautwein, N. Erdmann, N. Angrisani, J. Reifenrath, and A. Meyer-Lindenberg, Biomed. Eng. Online 10, 32 (2011).
M. Thomsen, M. Rozak, and P. Thomas, Acta Orthop. 82, 386 (2011).
B. Summer, C. Paul, F. Mazoochian, C. Rau, M. Thomsen, I. Banke, H. Gollwitzer, K.A. Dietrich, S. Mayer-Wagner, T. Ruzicka, and P. Thomas, Contact Dermatitis 63, 15 (2010).
P. Thomas, W.D. Bandl, S. Maier, B. Summer, and B. Przybilla, Contact Dermatitis 55, 199 (2006).
P. Thomas, A. Schuh, R. Eben, and M. Thomsen, Orthopade 37, 117 (2008).
J.Y. Wang, B.H. Wicklund, R.B. Gustilo, and D.T. Tsukayama, Clin. Orthop. Relat. Res. 339, 216 (1997).
D.R. Haynes, T.N. Crotti, and H. Zreiqat, Biomaterials 25, 4877 (2004).
T. Rae, J. Bone Joint Surg. Br. 57, 444 (1975).
R. Garrett, J. Wilksch, and B. Vernon-Roberts, Aust. J. Exp. Biol. Med. Sci. 61, 355 (1983).
S.K. Butcher, H. Chahal, L. Nayak, A. Sinclair, N.V. Henriquez, E. Sapey, D. O’Mahony, and J.M. Lord, J. Leukoc. Biol. 70, 881 (2001).
A. Filias, G.L. Theodorou, S. Mouzopoulou, A.A. Varvarigou, S. Mantagos, and M. Karakantza, BMC Pediatr. 11, 29 (2011).
W. Cantrell and E.E. Elko, Exp. Parasitol. 34, 337 (1973).
A. Drynda, N. Deinet, N. Braun, and M. Peuster, J. Biomed. Mater. Res. A 91, 360 (2009).
F. Feyerabend, J. Fischer, J. Holtz, F. Witte, R. Willumeit, H. Drücker, C. Vogt, and N. Hort, Acta Biomater. 6, 1834 (2010).
C.T. Horovitz, Biochemistry of Scandium and Yttrium, Part 2: Biochemistry and Applications (Biochemistry of the Elements), 1st ed. (New York: Kluwer Academic/Plenum Publishers, 2000), pp. 83–136 and pp. 208–210
S. Hirano and K.T. Suzuki, Environ. Health Perspect. 104, 85 (1996).
W.H. Wells and V.L. Wells, Patty’s Toxicology (Hoboken, NJ: Wiley, 2000).
Acknowledgements
The authors acknowledge support from the Laura Bassi Center of Expertise BRIC (Bioresorbable Implants for Children; FFG—Austria). The authors would also like to thank Ms. Katharina Angerpointer (Department of Pediatric Surgery, Medical University of Graz, Austria) and Ms. Verena Krischnan for their help with collection and workup of the blood specimens.
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Pichler, K., Fischerauer, S., Ferlic, P. et al. Immunological Response to Biodegradable Magnesium Implants. JOM 66, 573–579 (2014). https://doi.org/10.1007/s11837-014-0874-6
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DOI: https://doi.org/10.1007/s11837-014-0874-6