Search Results (49)

Atypical joint spaces, such as those encountered in complex segmental bone loss and large structural defects, remain challenging to manage with conventional implants within divisions across orthopedics, including arthroplasty, tumor reconstruction, trauma, and spine. Additive manufacturing advances have made patient-specific implants a possibility, and this promising solution has enabled the creation of implants with customized geometry and controlled surface porosity to enhance osseointegration, reduce rejection rates, optimize biomechanics, and promote longevity. Despite its potential, patient-specific implants are still eclipsed in use by conventional, “off-the-shelf” implants due to their lower cost, documented long-term durability, insurance coverage, and the strength of available clinical evidence supporting their use. This narrative review summarizes current materials and manufacturing approaches for additively manufactured metal porous implants, including imaging and design workflows, lattice and pore architecture, and how the printing process influences implant stiffness, fatigue strength, surface roughness, and porosity. We also discuss the experimental and preclinical data on mechanical performance, fatigue resistance, and osseointegration for new developments in the field. Emerging trends such as material innovation, streamlined digital planning-to-implant workflows, 4D printing and other advanced additive manufacturing concepts, and cost-reduction efforts are examined in the context of clinical practicality. In this review, the integration of engineering principles with early clinical outcomes will provide orthopedic surgeons with a realistic understanding of the benefits and limitations of the future utilization of additive manufacturing in clinical practice. Full article

Orthopaedic plates are long-established medical devices conventionally manufactured from metals, most notably titanium alloys. The introduction of Additive Manufacturing (AM) has created new opportunities to design implants with complex internal architectures, enabling precise control over infill patterns and densities that directly influence mechanical properties and fatigue performance. Biodegradable polymers such as polylactic acid (PLA) have attracted growing interest in biomedical engineering, potentially reducing the need for secondary implant-removal surgery if degradation rates are carefully controlled and clinically approved. Additionally, AM offers the ability to customise internal structure for improved mechanical performance and load-bearing, while also providing the possibility of integrating advanced functionalities, such as controlled drug delivery. Building on previous work by our research group at the University of Belgrade, this study investigates the fatigue behaviour of the best-performing AM-optimised orthopaedic plate design. Numerical models incorporating honeycomb infill structures with the full range of achievable densities were developed to assess structural integrity under fatigue loading. Fatigue crack growth was simulated in ANSYS Mechanical (ANSYS Inc., Canonsburg, PA, USA) software, employing a four-point bending configuration in accordance with the ASTM F382 standard. A validated PLA material model was implemented at a reduced load level (10%) relative to previous studies. Direct comparison with titanium plates was avoided due to fundamentally different material properties, focusing instead on infill architecture to identify optimal AM design strategies for orthopaedic plates. Full article

In physiological environments, several metallic alloys, including titanium, stainless steel, cobalt–chromium, and emerging biodegradable systems such as magnesium (Mg), zinc (Zn), and iron (Fe), offer mechanical properties and biocompatibility suitable for load-bearing implants. With the rapid advancement of 3D printing technologies, these alloys can now be fabricated into patient-specific, complex geometries that enhance both structural performance and functional integration. Beyond serving as structural supports, 3D-printed alloys are increasingly engineered as localized drug-delivery platforms to release anti-inflammatory, antibacterial, anticancer, and osteogenic agents at the implant–tissue interface, addressing the dual clinical needs of site-specific therapy and mechanical stabilization. Nevertheless, this field remains underexplored because studies differ widely in alloy chemistry, surface topography, porosity, coating strategy, drug-loading methods, and release profiles, as well as in how material degradation or passivation interacts with pharmacokinetics. For the first time, this review consolidates drug-loading and elution strategies across 3D-printed alloy platforms, compares therapeutic categories in relation to alloy and coating types, and critically evaluates how the surface microstructure or alloy geometry influences release behavior. Full article

Titanium (Ti) and its alloys are widely used in orthopedic applications, including total hip and knee replacements, bone plates, and dental implants, because of their superior biocompatibility, bioactivity, corrosion resistance, and mechanical robustness. These alloys effectively overcome several limitations of conventional metallic implants, such as 316L stainless steel and Co-Cr alloys, particularly with respect to corrosion, fatigue performance, and biological response. However, dense Ti alloys possess a relatively high elastic modulus, which can cause stress shielding in load-bearing applications. This challenge has motivated significant research toward engineered porous Ti structures that exhibit a reduced and bone-matched modulus while preserving adequate mechanical integrity. This review provides a comprehensive examination of powder metallurgy and additive manufacturing approaches used to fabricate porous Ti and Ti-alloy scaffolds, including additive manufacturing and different powder metallurgy techniques. Processing routes are compared in terms of achievable porosity, pore size distribution, microstructural evolution, mechanical properties, and biological outcomes, with emphasis on the relationship between processing parameters, pore architecture, and functional performance. The reported findings indicate that optimized powder-metallurgy techniques can generate interconnected pores in the 100–500 μm range suitable for osseointegration while maintaining compressive strengths of 50–300 MPa, whereas additive manufacturing enables the precise control of hierarchical architectures but requires careful post-processing to remove adhered powder, stabilize microstructures, and ensure corrosion and wear resistance. In addition, this review integrates fundamental aspects of bone biology and bone implant interaction to contextualize the functional requirements of porous Ti scaffolds. Full article

Today, the engineering of load-bearing bone tissue after severe trauma still relies on metal-based (Ti, CoCrMo alloys or stainless steel) permanent implants. Such artificial scaffolds are typically applied in the body and come into direct contact with the recipient’s cells, whose adhesion affects the patient’s implant acceptance or rejection. The present study aims to create a nano-rough texture by means of ultra-short femtosecond laser (fs)-induced periodicity in the form of laser induced periodic surface structures (LIPSS) on the surface of a stainless steel implant model, which is additionally functionalized via magnetron-sputtering with a thin Cu layer, thus providing the as-created implants with a stable antimicrobial interface. Calcium phosphate (CaP) crystal growth was additionally applied due to the strong bioactive interface bond that CaPs provide to the bone connective tissue, as well as for the strong interface bond they create between the artificial implant and the surrounding bone tissue, thereby stabilizing the implanted structure within the body. The bioactive properties in the as-created antimicrobial hybrid topographical design, achieved through femtosecond laser-induced nanoscale surface structuring and micro-sized CaP crystal growth, have the potential for subsequent practical applications in bone tissue engineering. Full article

In recent years, apatite-based materials have garnered significant interest, particularly for applications in tissue engineering. Apatite is most commonly employed as a coating for metallic implants, as a component in composite materials, and as scaffolds for bone and dental tissue regeneration. Among its various forms, hydroxyapatite (HAP) is the most widely used, owing to its natural occurrence in human and animal hard tissues. An emerging area of research involves the use of fluoride-substituted apatite, particularly fluorapatite (FAP), which can serve as a direct fluoride source at the implant site, potentially offering several biological and therapeutic advantages. However, substituting HAP with FAP may lead to unforeseen changes in material behavior due to the differing physicochemical properties of these two calcium phosphate phases. This study investigates the effects of replacing hydroxyapatite with fluorapatite in ceramic–polymer composite materials incorporating β-1,3-glucan as a bioactive polymeric binder. The β-1,3-glucan polysaccharide was selected for its proven biocompatibility, biodegradability, and ability to form stable hydrogels that promote cellular interactions. Nitrogen adsorption analysis revealed that FAP/glucan composites had a significantly lower specific surface area (0.5 m²/g) and total pore volume (0.002 cm³/g) compared to HAP/glucan composites (14.15 m²/g and 0.03 cm³/g, respectively), indicating enhanced ceramic–polymer interactions in fluoride-containing systems. Optical profilometry measurements showed statistically significant differences in profile parameters (e.g., Rp: 134 μm for HAP/glucan vs. 352 μm for FAP/glucan), although average roughness (Ra) remained similar (34.1 vs. 27.6 μm, respectively). Microscopic evaluation showed that FAP/glucan composites had smaller particle sizes (1 μm) than their HAP counterparts (2 μm), despite larger primary crystal sizes in FAP, as confirmed by TEM. XRD analysis indicated structural differences between the apatites, with FAP exhibiting a reduced unit cell volume (524.6 ų) compared to HAP (528.2 ų), due to substitution of hydroxyl groups with fluoride ions. Spectroscopic analyses (FTIR, Raman, ³¹P NMR) confirmed chemical shifts associated with fluorine incorporation and revealed distinct ceramic–polymer interfacial behaviors, including an upfield shift of PO₄³⁻ bands (964 cm⁻¹ in FAP vs. 961 cm⁻¹ in HAP) and OH vibration shifts (3537 cm⁻¹ in FAP vs. 3573 cm⁻¹ in HAP). The glucan polymer showed different hydrogen bonding patterns when combined with FAP versus HAP, as evidenced by shifts in polymer-specific bands at 888 cm⁻¹ and 1157 cm⁻¹, demonstrating that fluoride substitution significantly influences ceramic–polymer interactions in these bioactive composite systems. Full article

Surface engineering and architectural design represent key frontiers in total ankle arthroplasty (TAA) implant development. This narrative review examines biointegration strategies, focusing on porous structures, surface modification techniques, and emerging smart technologies. Optimal porous architectures with 300–600 µm pore sizes facilitate bone ingrowth and osseointegration, while functionally graded structures address regional biomechanical demands. Surface modification encompasses bioactive treatments (such as calcium phosphate coatings), topographical modifications (including micro/nanotexturing), antimicrobial approaches (utilizing metallic ions or antibiotic incorporation), and wear-resistant technologies (such as diamond-like carbon coatings). Multifunctional approaches combine strategies to simultaneously address infection prevention, enhance osseointegration, and improve wear resistance. Emerging technologies include biodegradable scaffolds, biomimetic surface nanotechnology, and intelligent sensor-based monitoring systems. While many innovations remain in the research stage, they demonstrate the potential to establish TAA as a comprehensive alternative to arthrodesis. Successful implant design requires integrated surface engineering tailored to the ankle joint’s demanding biomechanical and biological environment Full article

Total ankle arthroplasty (TAA) has evolved significantly through advances in alloy selection and manufacturing technologies. This narrative review examines the metallurgical foundations of contemporary TAA implants, analyzing primary alloy systems and their mechanical properties. Cobalt-chromium alloys provide superior mechanical strength and durability but present metal ion release concerns, while titanium alloys (Ti6Al4V) optimize biocompatibility with elastic modulus values (101–113 GPa) closer to bone, despite tribological limitations. Novel β-titanium formulations (Ti-35Nb-7Zr-5Ta, Ti10Mo6Zr4Sn3Nb) eliminate toxic aluminum and vanadium components while achieving lower elastic modulus values (50–85 GPa) that better match cortical bone properties. Manufacturing has transitioned from traditional methods (investment casting, forging, CNC machining) toward additive manufacturing technologies. Selective laser melting and electron beam melting enable patient-specific geometries, controlled porosity, and optimized microstructures, though challenges remain with residual stresses, surface finish requirements, and post-processing needs. Emerging biodegradable materials, composite structures, and hybrid implant designs represent promising future directions for addressing current material limitations. This review provides evidence-based insights for alloy selection and manufacturing approaches, emphasizing the critical role of materials engineering in TAA implant performance and clinical outcomes. Full article

To improve implant osseointegration while preventing infection, we developed a strontium (Sr)-doped Ti₃C₂T_x MXene coating on titanium, aiming to synergistically enhance bone integration and antibacterial performance. MXene is a family of two-dimensional transition-metal carbides/nitrides whose abundant surface terminations endow high hydrophilicity and bioactivity. The coating was fabricated via anodic electrophoretic deposition (40 V, 2 min) of Ti₃C₂T_x nanosheets, followed by SrCl₂ immersion to incorporate Sr²⁺. The coating morphology, phase composition, chemistry, hydrophilicity, mechanical stability, and Sr²⁺ release were characterized. In vitro bioactivity was assessed with rat bone marrow mesenchymal stem cells (BMSCs)—with respect to viability, proliferation, migration, alkaline phosphatase (ALP) staining, and Alizarin Red S mineralization—while the antibacterial efficacy was evaluated against Staphylococcus aureus (S. aureus) via live/dead staining, colony-forming-unit enumeration, and AlamarBlue assays. The Sr-doped MXene coating formed a uniform lamellar structure, lowered the water-contact angle to ~69°, and sustained Sr²⁺ release (0.36–1.37 ppm). Compared to undoped MXene, MXene/Sr enhanced BMSC proliferation on day 5, migration by 51%, ALP activity and mineralization by 47%, and reduced S. aureus viability by 49% within 24 h. Greater BMSCs activity accelerates early bone integration, whereas rapid bacterial suppression mitigates peri-implant infection—two critical requirements for implant success. Sr-doped Ti₃C₂T_x MXene thus offers a simple, dual-function surface-engineering strategy for dental and orthopedic implants. Full article

Orthopedic implant technology has historically seen difficulties in attaining long-term stability and biological integration, leading to complications such as implant loosening, wear debris production, and heightened infection risk. Nanotechnology provides a revolutionary method for addressing these constraints through the introduction of materials characterized by exceptional biocompatibility, durability, and integration potential. Nanomaterials (NMs), characterized by distinctive surface topographies and elevated surface area-to-volume ratios, facilitate improved osseointegration and provide regulated medication release, thereby creating a localized therapeutic milieu surrounding the implant site. To overcome the long-standing constraints of conventional implants, such as poor osseointegration, low mechanical fixation, immunological rejection, and implant-related infections, nanotechnology is causing a revolution in the field of orthopedic research. NMs are ideally suited for orthopedic applications due to their exceptional features, including increased tribology, wear resistance, prolonged drug administration, and excellent tissue regeneration. Because of their nanoscale size, they can imitate the hierarchical structure of real bone, which in turn encourages the proliferation of cells, lowers the risk of infection, and helps with the mending of bone fractures. This article will investigate the wide-ranging possibilities of nanostructured ceramics, polymers, metals, and carbon materials in bone tissue engineering, diagnostics, and the treatment of implant-related infections, bone malignancies, and bone healing. In addition, this paper will provide a basic overview of the most recent discoveries in nanotechnology driving the future of translational orthopedic research. It will also highlight safety evaluations and regulatory requirements for orthopedic devices. Full article

TiNi-based alloys are widely utilized in various engineering and medical applications. This study presents a newly developed and optimized technology for producing TiNi wires with a diameter of 40 μm utilizing a combined mechano-chemical treatment and drawing process. The resulting thin wires were tested and characterized using multiple methods to determine their structural, phase, and mechanical properties. The structure of the TiNi wires, designed for use as textile implants in reconstructive medicine, features a TiNi metal matrix (B2 and B19′ phases) at the core and a surface oxide layer. A key structural characteristic of these wires is the presence of fine nanograins averaging 15–17 nm in size. No texturizing of the metallic material was observed during repeated plastic deformations throughout the drawing process. The applied mechano-chemical treatment aimed to modify the structure of the wires’ surface oxide layer. Specifically, reducing the thickness and roughness of this layer decreased the friction coefficient of the alloy during drawing, thus significantly reducing the number of breaks during production. At the same time, the cryogenic treatment of the final product was found to stabilize the martensitic phase B19′, which reduces the Young’s modulus by 10 GPa. Consequently, this newly developed methodology enhances the material’s quality and reduces labor costs during production. Full article

Existing implants used with Total Knee Arthroplasty (TKA), Total Hip Arthroplasty (THA), and other joint reconstruction treatments, have displayed premature failures and frequent needs for revision surgery in recent years, particularly with young active patients who represent more than 55% of all joint reconstruction patients. Bone cement and stress shielding have been identified as the major reasons for premature joint failures. A breakdown of the cement may happen, and revision surgery may be needed because of the aseptic loosening. The significant mismatch of stiffness properties of patient trabecular bones and metallic implant materials in joint reconstruction surgery results in the stress shielding phenomenon. This could lead to significant bone resorption and increased risk of bone fracture and the aseptic loosening of implants. The present project introduces an approach for development of customized cellular structures to match the mechanical properties and architecture of human trabecular bone. The present work aims at fulfilling the objectives of the introduced approach by exploring new designs of customized lattice structures and texture tailored to mimic closely patients’ bone anisotropic properties and that can incorporate an engineered biological press-fit fixation technique. The effects of various lattice design variables on the mechanical performance of the structure are examined through a systematic experimental plan using the statistical design of experiments technique and analysis of variance method. All tested lattice designs were explored under realistic geometrical, biological, and manufacturing constraints. Of the four design factors examined in this study, strut thickness was found to have the highest percent contribution (41%) regarding the structure stiffness, followed by unit cell type, and cell size. Strut shape was found to have the lowest effect with only 11% contribution. The introduced solution offers lattice structure designs that can be adjusted to match bone stiffness distribution and promote bone ingrowth and hence eliminating the phenomenon of stress shielding while incorporating biological press-fit fixation technique. Full article

Regenerative medicine aims to address substantial defects by amplifying the body’s natural regenerative abilities and preserving the health of tissues and organs. To achieve these goals, materials that can provide the spatial and biological support for cell proliferation and differentiation, as well as the micro-environment essential for the intended tissue, are needed. Scaffolds such as polymers and metallic materials provide three-dimensional structures for cells to attach to and grow in defects. These materials have limitations in terms of mechanical properties or biocompatibility. In contrast, biominerals are formed by living organisms through biomineralization, which also includes minerals created by replicating this process. Incorporating biominerals into conventional materials allows for enhanced strength, durability, and biocompatibility. Specifically, biominerals can improve the bond between the implant and tissue by mimicking the micro-environment. This enhances cell differentiation and tissue regeneration. Furthermore, biomineral composites have wound healing and antimicrobial properties, which can aid in wound repair. Additionally, biominerals can be engineered as drug carriers, which can efficiently deliver drugs to their intended targets, minimizing side effects and increasing therapeutic efficacy. This article examines the role of biominerals and their composite materials in regenerative medicine applications and discusses their properties, synthesis methods, and potential uses. Full article

The evolution of 3D printing has ushered in accessibility and cost-effectiveness, spanning various industries including biomedical engineering, education, and microfluidics. In biomedical engineering, it encompasses bioprinting tissues, producing prosthetics, porous metal orthopedic implants, and facilitating educational models. Hybrid Additive Manufacturing approaches and, more specifically, the integration of Fused Deposition Modeling (FDM) with bio-inkjet printing offers the advantages of improved accuracy, structural support, and controlled geometry, yet challenges persist in cell survival, interaction, and nutrient delivery within printed structures. The goal of this study was to develop and present a low-cost way to produce physical phantoms of human organs that could be used for research and training, bridging the gap between the use of highly detailed computational phantoms and real-life clinical applications. To this purpose, this study utilized anonymized clinical Computed Tomography (CT) data to create a liver physical model using the Creality Ender-3 printer. Polylactic Acid (PLA), Polyvinyl Alcohol (PVA), and light-bodied silicone (Polysiloxane) materials were employed for printing the liver including its veins and arteries. In brief, PLA was used to create a mold of a liver to be filled with biocompatible light-bodied silicone. Molds of the veins and arteries were printed using PVA and then inserted in the liver model to create empty channel. In addition, the PVA was then washed out by the final product using warm water. Despite minor imperfections due to the printer’s limitations, the final product imitates the computational model accurately enough. Precision adjustments in the design phase compensated for this variation. The proposed novel low-cost 3D printing methodology successfully produced an anatomically accurate liver physical model, presenting promising applications in medical education, research, and surgical planning. Notably, its implications extend to medical training, personalized medicine, and organ transplantation. The technology’s potential includes injection training for medical professionals, personalized anthropomorphic phantoms for radiation therapy, and the future prospect of creating functional living organs for organ transplantation, albeit requiring significant interdisciplinary collaboration and financial investment. This technique, while showcasing immense potential in biomedical applications, requires further advancements and interdisciplinary cooperation for its optimal utilization in revolutionizing medical science and benefiting patient healthcare. Full article

Hydrogels are three-dimensional (3D) water-swellable polymeric matrices that are used extensively in tissue engineering and drug delivery. Hydrogels can be conformed into any desirable shape using 3D bio-printing, making them suitable for personalized treatment. Among the different 3D bio-printing techniques, digital light processing (DLP)-based printing offers the advantage of quickly fabricating high resolution structures, reducing the chances of cell damage during the printing process. Here, we have used DLP to 3D bio-print biocompatible gelatin methacrylate (GelMA) scaffolds intended for bone repair. GelMA is biocompatible, biodegradable, has integrin binding motifs that promote cell adhesion, and can be crosslinked easily to form hydrogels. However, GelMA on its own is incapable of promoting bone repair and must be supplemented with pharmaceutical molecules or growth factors, which can be toxic or expensive. To overcome this limitation, we introduced zinc-based metal-organic framework (MOF) nanoparticles into GelMA that can promote osteogenic differentiation, providing safer and more affordable alternatives to traditional methods. Incorporation of this nanoparticle into GelMA hydrogel has demonstrated significant improvement across multiple aspects, including bio-printability, and favorable mechanical properties (showing a significant increase in the compressive modulus from 52.14 ± 19.42 kPa to 128.13 ± 19.46 kPa with the addition of ZIF-8 nanoparticles). The designed nanocomposite hydrogels can also sustain drug (vancomycin) release (maximum 87.52 ± 1.6% cumulative amount) and exhibit a remarkable ability to differentiate human adipose-derived mesenchymal stem cells toward the osteogenic lineage. Furthermore, the formulated MOF-integrated nanocomposite hydrogel offers the unique capability to coat metallic implants intended for bone healing. Overall, the remarkable printability and coating ability displayed by the nanocomposite hydrogel presents itself as a promising candidate for drug delivery, cell delivery and bone tissue engineering applications. Full article