Clinical translation and challenges of biodegradable magnesium-based interference screws in ACL reconstruction

Abstract

As one of the most promising fixators developed for anterior cruciate ligament (ACL) reconstruction, biodegradable magnesium (Mg)-based interference screws have gained increasing attention attributed to their appropriate modulus and favorable biological properties during degradation after surgical insertion. However, its fast degradation and insufficient mechanical strength have also been recognized as one of the major causes to limit their further application clinically. This review focused on the following four parts. Firstly, the advantages of Mg or its alloys over their counterparts as orthopaedic implants in the fixation of tendon grafts in ACL reconstruction were discussed. Subsequently, the underlying mechanisms behind the contributions of Mg ions to the tendon-bone healing were introduced. Thirdly, the technical challenges of Mg-based interference screws towards clinical trials were discussed, which was followed by the introduction of currently used modification methods for gaining improved corrosion resistance and mechanical properties. Finally, novel strategies including development of Mg/Titanium (Ti) hybrid fixators and Mg-based screws with innovative structure for achieving clinically customized therapies were proposed. Collectively, the advancements in the basic and translational research on the Mg-based interference screws may lay the foundation for exploring a new era in the treatment of the tendon-bone insertion (TBI) and related disorders.

Meta-Analysis of Knee Joint Function Recovery after Anterior Cruciate Ligament Reconstruction by Accelerated Rehabilitation Surgery

“…With the renewal of the concept of knee rehabilitation, the recovery level of postoperative motor ability has been greatly improved in the past 30 years. Accelerated rehabilitation surgery (ERAS) is a perioperative management method based on evidence-based medicine, which can reduce surgical trauma, reduce physical and psychological trauma stress, accelerate patient recovery, shorten hospital stay, and reduce hospitalization costs [ 24 ]. At the same time, it is a new type of perioperative medical cooperation project with surgery, anesthesiology, nursing, rehabilitation therapy, and so on.…”

Biofunctional magnesium-coated Ti6Al4V scaffolds promote autophagy-dependent apoptosis in osteosarcoma by activating the AMPK/mTOR/ULK1 signaling pathway

“…In our research, the surface of Ti6Al4V scaffolds was successfully coated with Mg [ 20 , 21 ]. Mg, an excellent biodegradable and bioactive metal, can perform multiple biological functions through Mg 2+ ion release during degradation [ 42 ]. In recent years, the tumor-inhibiting effects of Mg have received extensive attention.…”

Treatment of Knee Osteochondral Fractures

“…Unfortunately, the low zinc mechanical strength and toxicity of the degradation products and the magnetic nature of iron and iron oxide degradation results led to additional research regarding Zn- and Fe-based alloys until a suitable solution can be developed. With their good biocompatibility, suitable Young’s modulus value, and increased ions rate release that promote bone healing and regeneration, the magnesium-based alloys emerged as the most promising biocompatible metal [ 48 , 49 ]. Magnesium is a natural component of the human body, exhibiting many advantages in orthopedic surgery such as lightweight, good compressive and tensile strengths, and Young’s modulus value closed to the one of the human bone (41 ÷ 45 GPa) [ 50 , 51 ].…”