Tree-inspired magnesium hybrid column for preventing hip collapse in steroid-associated osteonecrosis in bipedal emus

Haiyue Zu, Lizhen Zheng, Mengke Huo, Kevin Liu, Chris Halling Dreyer, Yuantao Zhang, Xuan He, Ye Li, Li Zou, Le Huang, Xueting Yi, Antonia Rujia Sun, Xiangbo Meng, Keda Shi, Huijuan Cao, Xiaoshui Zu, Wenxue Tong, Dick Hokiu Chow, Xinluan Wang, Yuxiao LaiJiankun Xu, Ming Ding, Jian Lu, Ling Qin*

*Corresponding author for this work

    Research output: Journal Publications and ReviewsRGC 21 - Publication in refereed journalpeer-review

    3 Citations (Scopus)
    10 Downloads (CityUHK Scholars)

    Abstract

    Biodegradable magnesium (Mg)-based materials show promise in managing musculoskeletal diseases, attributed to their desired proper mechanical strength, and facilitating self-regenerative processes via spatiotemporal degradation during treatments for non-weight-bearing skeletal sites. However, to achieve a long-term steady state of the local biomechanical environment, it is essential to coupling implant degeneration and neo-tissue ingrowth without sacrificing local mechanical integrity. Steroid-associated osteonecrosis (SAON) presents a formidable clinical challenge, necessitating robust mechanical support to prevent collapse of weight-bearing hip joints while reversing pathological progression. Herein, a novel tree-inspired Mg hybrid column (Mg + BC) incorporating cannulated Mg screw and injectable Mg-containing bone cement (BC) is reported. Mg + BC tuned the gradual release of mineral ions (Mg, Ca, P), OH and H2 via electrochemical suppression and crystal re-deposition during degradation. Finite element analysis demonstrated that Mg + BC significantly reduced the proportion of relatively high load-bearing regions (CD: 26.0 %, Mg: 26.6 %, BC: 18.2 %, Mg + BC: 17.5 %) and effectively shifted the predominant loading from subchondral trabeculae to the femoral shaft cortex. The efficacy of the tree-inspired Mg hybrid column was validated in a clinically relevant bipedal emu model of SAON. Compared to standalone Mg screws, Mg + BC exhibited sustained degradation and enhanced bone-implant contact, indicating improved alignment between material degradation and tissue regeneration. After 6 months in vivo, the implant residue volume was significantly higher in the Mg + BC group (73.53 ± 10.90 %) compared to the Mg screw group (39.10 ± 11.31 %). The optimized degradation pattern of Mg + BC facilitated bone regeneration through modulation of macrophage recruitment and M1-to-M2 polarization shift. Notably, Mg + BC treatment significantly reduced hip joint collapse incidence (1/10) compared to CD group (7/10). The Mg + BC group maintained greater articular cartilage thickness in the intact region (1.74 ± 0.25 mm) compared to CD group (0.71 ± 0.15 mm). Gait analysis revealed substantial improvement in stride length for the Mg + BC group (87.14 ± 2.29 cm) compared to CD group (60.03 ± 1.31 cm), indicating maintenance of the hip anatomical structure and functional performance. Taken together, the tree-inspired Mg hybrid column is expected to be a unique hybrid system for bone tissue regeneration and prevention of joint collapse in weight-bearing regions affected by SAON, offering promising translational potential for clinical application. © 2024 The Author(s).
    Original languageEnglish
    Pages (from-to)113-138
    Number of pages26
    JournalMaterials Today
    Volume80
    Online published13 Sept 2024
    DOIs
    Publication statusPublished - Nov 2024

    Funding

    The work was supported by the Areas of Excellence Scheme (AoE/M402/20) and Theme-based Research Scheme (T13-402/17N) under the Research Grant Council of Hong Kong, Mainland-Hong Kong Joint Funding Scheme (MHP/030/20), Health and Medical Research Fund from Food and Health Bureau (18190481), National Natural Science Foundation of China (32171332), Natural Science Foundation of Guangdong Province (2021A1515011204), Gusu Talent Program (GSWS2023090) and the Research Funds from Health@InnoHK Program launched by Innovation Technology Commission of the Hong Kong SAR, China.

    Publisher's Copyright Statement

    • This full text is made available under CC-BY-NC-ND 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/

    Fingerprint

    Dive into the research topics of 'Tree-inspired magnesium hybrid column for preventing hip collapse in steroid-associated osteonecrosis in bipedal emus'. Together they form a unique fingerprint.

    Cite this