Bacterial Biofilm Formation on Resorbing Magnesium Implants

Background: Implant-associated infections are a result of bacterial adhesion to an implant surface and subsequent biofilm formation at the implantation site. This study compares different magnesium materials based on their ability to resist bacterial adhesion as well as further biofilm formation. Material and Methods: The surfaces of four magnesium-based materials (Mg2Ag, Mg10Gd, WE43 and 99.99% pure Mg) were characterized using atomic force microscope. In addition, the samples were tested for their ability to resist biofilm formation. Planktonic bacteria of either S. epidermidis or E. faecalis were allowed to adhere to the magnesium surfaces for two hour followed by rinsing and, for S. epidermidis, further incubation of 24, 72 and 168 h was carried out. Results: E. faecalis had a significantly stronger adhesion to all magnesium surfaces compared to S. epidermidis (p = 0.001). Biofilm growth of S. epidermidis was different on various magnesium materials: the amount of bacteria increased up to 72 h but interestingly a significant decrease was seen at 168 h on Mg2Ag and WE43 surfaces. For pure Mg and Mg10Gd the biofilm formation reached plateau at 72 h. Surface characteristics of resorbable magnesium materials were changing over time, and the surface was generally less rough at 168 h compared to earlier time points. No correlation was found between the surface topology and the amount of adherent bacteria. Conclusion: In early stages of biofilm adhesion, no differences between magnesium materials were observed. However, after 72 h Mg2Ag and WE43 had the best ability to suppress S. epidermidis’ biofilm formation. Also, bacterial adhesion to magnesium materials was not dependent on samples’ surface topology.

On the material dependency of peri-implant morphology and stability in healing bone

The microstructural architecture of remodeled bone in the peri-implant region of screw implants plays a vital role in the distribution of strain energy and implant stability.We present a study in which screw implants made from titanium,polyetheretherketone and biodegradable magnesium-gadolinium alloys were implanted into rat tibia and subjected to a push-out test four,eight and twelve weeks after implantation.Screws were 4 mm in length and with an M2 thread.The loading experiment was accompanied by simultaneous three-dimensional imaging using synchrotron-radiation microcomputed tomography at 5μm resolution.Bone deformation and strains were tracked by applying optical flow-based digital volume correlation to the recorded image sequences.Implant stabilities measured for screws of biodegradable alloys were comparable to pins whereas non-degradable biomaterials experienced additional mechanical stabilization.Peri-implant bone morphology and strain transfer from the loaded implant site depended heavily on the biomaterial utilized.Titanium implants stimulated rapid callus formation displaying a consistent monomodal strain profile whereas the bone volume fraction in the vicinity of magnesium-gadolinium alloys exhibited a minimum close to the interface of the implant and less ordered strain transfer.Correlations in our data suggest that implant stability benefits from disparate bone morphological properties depending on the biomaterial utilized.This leaves the choice of biomaterial as situational depending on local tissue properties.

High-resolution ex vivo analysis of the degradation and osseointegration of Mg-xGd implant screws in 3D

Biodegradable magnesium(Mg)alloys can revolutionize osteosynthesis,because they have mechanical properties similar to those of the bone,and degrade over time,avoiding the need of removal surgery.However,they are not yet routinely applied because their degradation behavior is not fully understood.In this study we have investigated and quantified the degradation and osseointegration behavior of two biodegradable Mg alloys based on gadolinium(Gd)at high resolution.Mg-5Gd and Mg-10Gd screws were inserted in rat tibia for 4,8 and 12 weeks.Afterward,the degradation rate and degradation homogeneity,as well as bone-to-implant interface,were studied with synchrotron radiation micro computed tomography and histology.Titanium(Ti)and polyether ether ketone(PEEK)were used as controls material to evaluate osseointegration.Our results showed that Mg-5Gd degraded faster and less homogeneously than Mg-10Gd.Both alloys gradually form a stable degradation layer at the interface and were surrounded by new bone tissue.The results were correlated to in vitro data obtained from the same material and shape.The average bone-to-implant contact of the Mg-xGd implants was comparable to that of Ti and higher than for PEEK.The results suggest that both Mg-xGd alloys are suitable as materials for bone implants.