Research progress of magnesium and magnesium alloy implants in sports medicine_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WU Yukuan ¹ , BAI Lang ¹ , LIU Yanlan ¹ , HAN Qian ¹ , LIU Qiaonan ¹ , AI Yixiang ¹ , XU Meiguang ¹ , WEN Nuanyang ¹ ,  SHAN Zhiwei ^2,3 ,  YIN Zhanhai ¹

1. Department of Orthopedics, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an Shaanxi, 710061, P. R. China;
2. Department of Materials Science and Engineering, Xi’an Jiaotong University, Xi’an Shaanxi, 710049, P. R. China;
3. Engineering Research Center for Magnesium-based New Materials, Xi’an Jiaotong University, Xi’an Shaanxi, 710049, P. R. China;

Corresponding author：

SHAN Zhiwei, Email: zwshan@mail.xjtu.edu.cn; YIN Zhanhai, Email: zhanhai.yin@mail.xjtu.edu.cn

Keywords：

Magnesium; magnesium alloy; biodegradable implant; sports medicine; repair and reconstruction

DOI：

10.7507/1002-1892.202401072

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To review the research progress of magnesium and magnesium alloy implants in the repair and reconstruction of sports injury. Methods Relevant literature of magnesium and magnesium alloys for sports injury repair and reconstruction was extensively reviewed. The characteristics of magnesium and its alloys and their applications in the repair and reconstruction of sports injuries across various anatomical sites were thoroughly discussed and summarized. Results Magnesium and magnesium alloys have advantages in mechanical properties, biosafety, and promoting tendon-bone interface healing. Many preclinical studies on magnesium and magnesium alloy implants for repairing and reconstructing sports injuries have yielded promising results. However, successful clinical translation still requires addressing issues related to mechanical strength and degradation behavior, where alloying and surface treatments offer feasible solutions. Conclusion The clinical translation of magnesium and magnesium alloy implants for repairing and reconstructing sports injuries holds promise. Subsequent efforts should focus on optimizing the mechanical strength and degradation behavior of magnesium and magnesium alloy implants. Conducting larger-scale biocompatibility testing and developing novel magnesium-containing implants represent new directions for future research.

Citation： WU Yukuan, BAI Lang, LIU Yanlan, HAN Qian, LIU Qiaonan, AI Yixiang, XU Meiguang, WEN Nuanyang, SHAN Zhiwei, YIN Zhanhai. Research progress of magnesium and magnesium alloy implants in sports medicine. Chinese Journal of Reparative and Reconstructive Surgery, 2024, 38(3): 380-386. doi: 10.7507/1002-1892.202401072 Copy

1.	Huang B, Yang M, Kou Y, et al. Absorbable implants in sport medicine and arthroscopic surgery: A narrative review of recent development. Bioact Mater, 2024, 31: 272-283.
2.	乔玉成, 周威. 我国运动医学学科定位6个基本问题辨析. 体育学刊, 2020, 27(3): 136-144.
3.	Aboutalebianaraki N, Zeblisky P, Sarker MD, et al. An osteogenic magnesium alloy with improved corrosion resistance, antibacterial, and mechanical properties for orthopedic applications. J Biomed Mater Res A, 2023, 111(4): 556-574.
4.	Qi T, Weng J, Yu F, et al. Insights into the role of magnesium ions in affecting osteogenic differentiation of mesenchymal stem cells. Biol Trace Elem Res, 2021, 199(2): 559-567.
5.	Bennett J, De Hemptinne Q, Mccutcheon K. Magmaris resorbable magnesium scaffold for the treatment of coronary heart disease: overview of its safety and efficacy. Expert Rev Med Devic, 2019, 16(9): 757-769.
6.	Sun JH, Li ZP, Liu SW, et al. Biodegradable magnesium screw, titanium screw and direct embedding fixation in pedicled vascularized iliac bone graft transfer for osteonecrosis of the femoral head: a randomized controlled study. J Orthop Surg Res, 2023, 18(1): 523.
7.	Apostolakos J, Durant TJ, Dwyer CR, et al. The enthesis: a review of the tendon-to-bone insertion. Muscles Ligaments Tendons J, 2014, 4(3): 333-342.
8.	Zhang H, Ma Y, Wang Y, et al. Rational design of soft-hard interfaces through bioinspired engineering. Small, 2023, 19(1): e2204498.
9.	Golman M, Abraham AC, Kurtaliaj I, et al. Toughening mechanisms for the attachment of architectured materials: The mechanics of the tendon enthesis. Sci Adv, 2021, 7(48): eabi5584.
10.	Masi AT, Benjamin M, Vleeming A. CHAPTER 14-Anatomical, biomechanical, and clinical perspectives on sacroiliac joints: an integrative synthesis of biodynamic mechanisms related to ankylosing spondylitis//Vleeming A, Mooney V, Stoeckart R, et al. Movement, Stability & Lumbopelvic Pain. 2nd Ed. Edinburgh: Churchill Livingstone, 2007: 205-227.
11.	Fang F, Sup M, Luzzi A, et al. Hedgehog signaling underlying tendon and enthesis development and pathology. Matrix Biol, 2022, 105: 87-103.
12.	Vasiliadis AV, Katakalos K. The role of scaffolds in tendon tissue engineering. J Funct Biomater, 2020, 11(4): 78.
13.	Luo Y, Zhang C, Wang J, et al. Clinical translation and challenges of biodegradable magnesium-based interference screws in ACL reconstruction. Bioact Mater, 2021, 6(10): 3231-3243.
14.	Wang J, Xu J, Hopkins C, et al. Biodegradable magnesium-based implants in orthopedics—A general review and perspectives. Adv Sci, 2020, 7(8): 1902443.
15.	Modrák M, Trebuňová M, Balogová AF, et al. Biodegradable materials for tissue engineering: development, classification and current applications. J Funct Biomater, 2023, 14(3): 159.
16.	Senra MR, Marques MFV, Monteiro SN. Poly (ether-ether-ketone) for biomedical applications: from enhancing bioactivity to reinforced-bioactive composites-an overview. Polymers (Basel), 2023, 15(2): 373.
17.	Pohanka M. D-lactic acid as a metabolite: toxicology, diagnosis, and detection. Biomed Res Int, 2020, 2020: 3419034.
18.	Barber FA, Dockery WD. Biocomposite interference screws in anterior cruciate ligament reconstruction: osteoconductivity and degradation. Arthrosc Sports Med Rehabil, 2020, 2(2): e53-e58.
19.	Galiveeti MRV, El-Abed K, Ahmad R. Early failure of primary total knee arthroplasty due to massive osteolysis caused by bio-absorbable interference screws. Cureus J Med Science, 2023, 15(4): e38143.
20.	Zhao D, Witte F, Lu F, et al. Current status on clinical applications of magnesium-based orthopaedic implants: A review from clinical translational perspective. Biomaterials, 2017, 112: 287-302.
21.	Seetharaman S, Sankaranarayanan D, Gupta M. Magnesium-based temporary implants: Potential, current status, applications, and challenges. J Funct Biomater, 2023, 14(6): 324.
22.	Sekar P, Narendranath S, Desai V. Recent progress in in vivo studies and clinical applications of magnesium based biodegradable implants—A review. J Magnes Alloy, 2021, 9(4): 1147-1163.
23.	Azadani MN, Zahedi A, Bowoto OK, et al. A review of current challenges and prospects of magnesium and its alloy for bone implant applications. Prog Biomater, 2022, 11(1): 1-26.
24.	Zhao D, Huang S, Lu F, et al. Vascularized bone grafting fixed by biodegradable magnesium screw for treating osteonecrosis of the femoral head. Biomaterials, 2016, 81: 84-92.
25.	Huang S, Wang B, Zhang X, et al. High-purity weight-bearing magnesium screw: Translational application in the healing of femoral neck fracture. Biomaterials, 2020, 238: 119829.
26.	Wang J, Xu J, Fu W, et al. Biodegradable magnesium screws accelerate fibrous tissue mineralization at the tendon-bone insertion in anterior cruciate ligament reconstruction model of rabbit. Sci Rep, 2017, 7: 40369.
27.	Chen B, Liang Y, Bai L, et al. Sustained release of magnesium ions mediated by injectable self-healing adhesive hydrogel promotes fibrocartilaginous interface regeneration in the rabbit rotator cuff tear model. Chem Eng J, 2020, 396: 125335.
28.	Cheng P, Han P, Zhao C, et al. High-purity magnesium interference screws promote fibrocartilaginous entheses regeneration in the anterior cruciate ligament reconstruction rabbit model via accumulation of BMP-2 and VEGF. Biomaterials, 2016, 81: 14-26.
29.	Cheng P, Weng Z, Hamushan M, et al. High-purity magnesium screws modulate macrophage polarization during the tendon-bone healing process in the anterior cruciate ligament reconstruction rabbit model. Regen Biomater, 2022, 9: rbac067.
30.	Gerhardt LC, Boccaccini AR. Bioactive glass and glass-ceramic scaffolds for bone tissue engineering. Materials, 2010, 3(7): 3867-3910.
31.	Geetha M, Singh AK, Asokamani R, et al. Ti based biomaterials, the ultimate choice for orthopaedic implants—A review. Prog Mater Sci, 2009, 54(3): 397-425.
32.	Dziaduszewska M, Zielinski A. Structural and material determinants influencing the behavior of porous Ti and its alloys made by additive manufacturing techniques for biomedical applications. Materials, 2021, 14(4): .712.
33.	Li EZ, Guo WL, Wang HD, et al. Research on tribological behavior of PEEK and glass fiber reinforced PEEK composite. Physcs Proc, 2013, 50: 453-460.
34.	Aloyaydi BA, Sivasankaran S. Low-velocity impact characteristics of 3D-printed poly-lactic acid thermoplastic processed by fused deposition modeling. T Indian I Metals, 2020, 73(6): 1669-1677.
35.	Staiger MP, Pietak AM, Huadmai J, et al. Magnesium and its alloys as orthopedic biomaterials: A review. Biomaterials, 2006, 27(9): 1728-1734.
36.	Niinomi M, Nakai M, Hieda J. Development of new metallic alloys for biomedical applications. Acta Biomaterialia, 2012, 8(11): 3888-3903.
37.	Chen QZ, Thouas GA. Metallic implant biomaterials. Mat Sci Eng R, 2015, 87: 1-57.
38.	Suroto H, Anindita Satmoko B, Prajasari T, et al. Biodegradable vs nonbiodegradable suture anchors for rotator cuff repair: a systematic review and meta-analysis. EFORT Open Rev, 2023, 8(10): 731-747.
39.	Cho CH, Bae KC, Kim DH. Biomaterials used for suture anchors in orthopedic surgery. Clin Orthop Surg, 2021, 13(3): 287-292.
40.	Chen Y, Sun Y, Wu X, et al. Rotator cuff repair with biodegradable high-purity magnesium suture anchor in sheep model. J Orthop Transl, 2022, 35: 62-71.
41.	Ma D, Wang J, Zheng M, et al. Degradation behavior of ZE21C magnesium alloy suture anchors and their effect on ligament-bone junction repair. Bioact Mater, 2023, 26: 128-141.
42.	Su TS, Tang HY, Jang JSC, et al. Design and development of magnesium-based suture anchor for rotator cuff repair using finite element analysis and in vitro testing. Appl Sci-Basel, 2021, 11(20): 9602.
43.	Chen B, Liang Y, Zhang J, et al. Synergistic enhancement of tendon-to-bone healing via anti-inflammatory and pro-differentiation effects caused by sustained release of Mg²⁺/curcumin from injectable self-healing hydrogels. Theranostics, 2021, 11(12): 5911-5925.
44.	Bockmann B, Jaeger E, Dankl L, et al. A biomechanical comparison of steel screws versus PLLA and magnesium screws for the Latarjet procedure. Arch Orthop Trauma Surg, 2022, 142(6): 1091-1098.
45.	Song B, Li W, Chen Z, et al. Biomechanical comparison of pure magnesium interference screw and polylactic acid polymer interference screw in anterior cruciate ligament reconstruction-A cadaveric experimental study. J Orthop Translat, 2016, 8: 32-39.
46.	Wang J, Xu J, Song B, et al. Magnesium (Mg) based interference screws developed for promoting tendon graft incorporation in bone tunnel in rabbits. Acta Biomater, 2017, 63: 393-410.
47.	Wang J, Wu Y, Li H, et al. Magnesium alloy based interference screw developed for ACL reconstruction attenuates peri-tunnel bone loss in rabbits. Biomaterials, 2018, 157: 86-97.
48.	Diekmann J, Bauer S, Weizbauer A, et al. Examination of a biodegradable magnesium screw for the reconstruction of the anterior cruciate ligament: A pilot in vivo study in rabbits. Mat Sci Eng C-Mater, 2016, 59: 1100-1109.
49.	Fu Y, Yin Y, Guan J, et al. The evaluation of a degradable Magnesium alloy Bio-Transfix nail system compounded with bone morphogenetic protein-2 in a beagle anterior cruciate ligament reconstruction model. J Biomater Appl, 2019, 34(5): 687-698.
50.	Hantes ME, Kotsovolos ES, Mastrokalos DS, et al. Arthroscopic meniscal repair with an absorbable screw: results and surgical technique. Knee Surg Sports Traumatol Arthrosc, 2005, 13(4): 273-279.
51.	Tsai AM, Mcallister DR, Chow S, et al. Results of meniscal repair using a bioabsorbable screw. Arthroscopy, 2004, 20(6): 586-590.
52.	Doral MN, Bilge O, Huri G, et al. Modern treatment of meniscal tears. EFORT Open Rev, 2018, 3(5): 260-268.
53.	Zhang Z, Zhou Y, Li W, et al. Local administration of magnesium promotes meniscal healing through homing of endogenous stem cells: a proof-of-concept study. Am J Sports Med, 2019, 47(4): 954-967.
54.	Sun Y, Zhang Y, Wu Q, et al. 3D-bioprinting ready-to-implant anisotropic menisci recapitulate healthy meniscus phenotype and prevent secondary joint degeneration. Theranostics, 2021, 11(11): 5160-5173.
55.	Liu C, Yang GZ, Zhou ML, et al. Magnesium ammonium phosphate composite cell-laden hydrogel promotes osteogenesis and angiogenesis. Acs Omega, 2021, 6(14): 9449-9459.
56.	Han P, Cheng P, Zhang S, et al. In vitro and in vivo studies on the degradation of high-purity Mg (99.99wt%) screw with femoral intracondylar fractured rabbit model . Biomaterials, 2015, 64: 57-69.
57.	Han HS, Loffredo S, Jun I, et al. Current status and outlook on the clinical translation of biodegradable metals. Mater Today, 2019, 23: 57-71.
58.	Xin Y, Hu T, Chu P. In vitro studies of biomedical magnesium alloys in a simulated physiological environment: a review. Acta Biomater, 2011, 7(4): 1452-1459.
59.	Xie K, Wang L, Guo Y, et al. Effectiveness and safety of biodegradable Mg-Nd-Zn-Zr alloy screws for the treatment of medial malleolar fractures. J Orthop Translat, 2021, 27: 96-100.
60.	Yang Y, Michalczyk C, Singer F, et al. In vitro study of polycaprolactone/bioactive glass composite coatings on corrosion and bioactivity of pure Mg. Appl Surf Sci, 2015, 355: 832-841.
61.	Xing F, Li S, Yin D, et al. Recent progress in Mg-based alloys as a novel bioabsorbable biomaterials for orthopedic applications. J Magnes Alloy, 2022, 10(6): 1428-1456.
62.	Herickhoff P, Safran M, Yung P, et al. Pros and cons of different ACL graft fixation devices. Berlin: Springer, 2017: 277-288.

1. Huang B, Yang M, Kou Y, et al. Absorbable implants in sport medicine and arthroscopic surgery: A narrative review of recent development. Bioact Mater, 2024, 31: 272-283.
2. 乔玉成, 周威. 我国运动医学学科定位6个基本问题辨析. 体育学刊, 2020, 27(3): 136-144.
3. Aboutalebianaraki N, Zeblisky P, Sarker MD, et al. An osteogenic magnesium alloy with improved corrosion resistance, antibacterial, and mechanical properties for orthopedic applications. J Biomed Mater Res A, 2023, 111(4): 556-574.
4. Qi T, Weng J, Yu F, et al. Insights into the role of magnesium ions in affecting osteogenic differentiation of mesenchymal stem cells. Biol Trace Elem Res, 2021, 199(2): 559-567.
5. Bennett J, De Hemptinne Q, Mccutcheon K. Magmaris resorbable magnesium scaffold for the treatment of coronary heart disease: overview of its safety and efficacy. Expert Rev Med Devic, 2019, 16(9): 757-769.
6. Sun JH, Li ZP, Liu SW, et al. Biodegradable magnesium screw, titanium screw and direct embedding fixation in pedicled vascularized iliac bone graft transfer for osteonecrosis of the femoral head: a randomized controlled study. J Orthop Surg Res, 2023, 18(1): 523.
7. Apostolakos J, Durant TJ, Dwyer CR, et al. The enthesis: a review of the tendon-to-bone insertion. Muscles Ligaments Tendons J, 2014, 4(3): 333-342.
8. Zhang H, Ma Y, Wang Y, et al. Rational design of soft-hard interfaces through bioinspired engineering. Small, 2023, 19(1): e2204498.
9. Golman M, Abraham AC, Kurtaliaj I, et al. Toughening mechanisms for the attachment of architectured materials: The mechanics of the tendon enthesis. Sci Adv, 2021, 7(48): eabi5584.
10. Masi AT, Benjamin M, Vleeming A. CHAPTER 14-Anatomical, biomechanical, and clinical perspectives on sacroiliac joints: an integrative synthesis of biodynamic mechanisms related to ankylosing spondylitis//Vleeming A, Mooney V, Stoeckart R, et al. Movement, Stability & Lumbopelvic Pain. 2nd Ed. Edinburgh: Churchill Livingstone, 2007: 205-227.
11. Fang F, Sup M, Luzzi A, et al. Hedgehog signaling underlying tendon and enthesis development and pathology. Matrix Biol, 2022, 105: 87-103.
12. Vasiliadis AV, Katakalos K. The role of scaffolds in tendon tissue engineering. J Funct Biomater, 2020, 11(4): 78.
13. Luo Y, Zhang C, Wang J, et al. Clinical translation and challenges of biodegradable magnesium-based interference screws in ACL reconstruction. Bioact Mater, 2021, 6(10): 3231-3243.
14. Wang J, Xu J, Hopkins C, et al. Biodegradable magnesium-based implants in orthopedics—A general review and perspectives. Adv Sci, 2020, 7(8): 1902443.
15. Modrák M, Trebuňová M, Balogová AF, et al. Biodegradable materials for tissue engineering: development, classification and current applications. J Funct Biomater, 2023, 14(3): 159.
16. Senra MR, Marques MFV, Monteiro SN. Poly (ether-ether-ketone) for biomedical applications: from enhancing bioactivity to reinforced-bioactive composites-an overview. Polymers (Basel), 2023, 15(2): 373.
17. Pohanka M. D-lactic acid as a metabolite: toxicology, diagnosis, and detection. Biomed Res Int, 2020, 2020: 3419034.
18. Barber FA, Dockery WD. Biocomposite interference screws in anterior cruciate ligament reconstruction: osteoconductivity and degradation. Arthrosc Sports Med Rehabil, 2020, 2(2): e53-e58.
19. Galiveeti MRV, El-Abed K, Ahmad R. Early failure of primary total knee arthroplasty due to massive osteolysis caused by bio-absorbable interference screws. Cureus J Med Science, 2023, 15(4): e38143.
20. Zhao D, Witte F, Lu F, et al. Current status on clinical applications of magnesium-based orthopaedic implants: A review from clinical translational perspective. Biomaterials, 2017, 112: 287-302.
21. Seetharaman S, Sankaranarayanan D, Gupta M. Magnesium-based temporary implants: Potential, current status, applications, and challenges. J Funct Biomater, 2023, 14(6): 324.
22. Sekar P, Narendranath S, Desai V. Recent progress in in vivo studies and clinical applications of magnesium based biodegradable implants—A review. J Magnes Alloy, 2021, 9(4): 1147-1163.
23. Azadani MN, Zahedi A, Bowoto OK, et al. A review of current challenges and prospects of magnesium and its alloy for bone implant applications. Prog Biomater, 2022, 11(1): 1-26.
24. Zhao D, Huang S, Lu F, et al. Vascularized bone grafting fixed by biodegradable magnesium screw for treating osteonecrosis of the femoral head. Biomaterials, 2016, 81: 84-92.
25. Huang S, Wang B, Zhang X, et al. High-purity weight-bearing magnesium screw: Translational application in the healing of femoral neck fracture. Biomaterials, 2020, 238: 119829.
26. Wang J, Xu J, Fu W, et al. Biodegradable magnesium screws accelerate fibrous tissue mineralization at the tendon-bone insertion in anterior cruciate ligament reconstruction model of rabbit. Sci Rep, 2017, 7: 40369.
27. Chen B, Liang Y, Bai L, et al. Sustained release of magnesium ions mediated by injectable self-healing adhesive hydrogel promotes fibrocartilaginous interface regeneration in the rabbit rotator cuff tear model. Chem Eng J, 2020, 396: 125335.
28. Cheng P, Han P, Zhao C, et al. High-purity magnesium interference screws promote fibrocartilaginous entheses regeneration in the anterior cruciate ligament reconstruction rabbit model via accumulation of BMP-2 and VEGF. Biomaterials, 2016, 81: 14-26.
29. Cheng P, Weng Z, Hamushan M, et al. High-purity magnesium screws modulate macrophage polarization during the tendon-bone healing process in the anterior cruciate ligament reconstruction rabbit model. Regen Biomater, 2022, 9: rbac067.
30. Gerhardt LC, Boccaccini AR. Bioactive glass and glass-ceramic scaffolds for bone tissue engineering. Materials, 2010, 3(7): 3867-3910.
31. Geetha M, Singh AK, Asokamani R, et al. Ti based biomaterials, the ultimate choice for orthopaedic implants—A review. Prog Mater Sci, 2009, 54(3): 397-425.
32. Dziaduszewska M, Zielinski A. Structural and material determinants influencing the behavior of porous Ti and its alloys made by additive manufacturing techniques for biomedical applications. Materials, 2021, 14(4): .712.
33. Li EZ, Guo WL, Wang HD, et al. Research on tribological behavior of PEEK and glass fiber reinforced PEEK composite. Physcs Proc, 2013, 50: 453-460.
34. Aloyaydi BA, Sivasankaran S. Low-velocity impact characteristics of 3D-printed poly-lactic acid thermoplastic processed by fused deposition modeling. T Indian I Metals, 2020, 73(6): 1669-1677.
35. Staiger MP, Pietak AM, Huadmai J, et al. Magnesium and its alloys as orthopedic biomaterials: A review. Biomaterials, 2006, 27(9): 1728-1734.
36. Niinomi M, Nakai M, Hieda J. Development of new metallic alloys for biomedical applications. Acta Biomaterialia, 2012, 8(11): 3888-3903.
37. Chen QZ, Thouas GA. Metallic implant biomaterials. Mat Sci Eng R, 2015, 87: 1-57.
38. Suroto H, Anindita Satmoko B, Prajasari T, et al. Biodegradable vs nonbiodegradable suture anchors for rotator cuff repair: a systematic review and meta-analysis. EFORT Open Rev, 2023, 8(10): 731-747.
39. Cho CH, Bae KC, Kim DH. Biomaterials used for suture anchors in orthopedic surgery. Clin Orthop Surg, 2021, 13(3): 287-292.
40. Chen Y, Sun Y, Wu X, et al. Rotator cuff repair with biodegradable high-purity magnesium suture anchor in sheep model. J Orthop Transl, 2022, 35: 62-71.
41. Ma D, Wang J, Zheng M, et al. Degradation behavior of ZE21C magnesium alloy suture anchors and their effect on ligament-bone junction repair. Bioact Mater, 2023, 26: 128-141.
42. Su TS, Tang HY, Jang JSC, et al. Design and development of magnesium-based suture anchor for rotator cuff repair using finite element analysis and in vitro testing. Appl Sci-Basel, 2021, 11(20): 9602.
43. Chen B, Liang Y, Zhang J, et al. Synergistic enhancement of tendon-to-bone healing via anti-inflammatory and pro-differentiation effects caused by sustained release of Mg²⁺/curcumin from injectable self-healing hydrogels. Theranostics, 2021, 11(12): 5911-5925.
44. Bockmann B, Jaeger E, Dankl L, et al. A biomechanical comparison of steel screws versus PLLA and magnesium screws for the Latarjet procedure. Arch Orthop Trauma Surg, 2022, 142(6): 1091-1098.
45. Song B, Li W, Chen Z, et al. Biomechanical comparison of pure magnesium interference screw and polylactic acid polymer interference screw in anterior cruciate ligament reconstruction-A cadaveric experimental study. J Orthop Translat, 2016, 8: 32-39.
46. Wang J, Xu J, Song B, et al. Magnesium (Mg) based interference screws developed for promoting tendon graft incorporation in bone tunnel in rabbits. Acta Biomater, 2017, 63: 393-410.
47. Wang J, Wu Y, Li H, et al. Magnesium alloy based interference screw developed for ACL reconstruction attenuates peri-tunnel bone loss in rabbits. Biomaterials, 2018, 157: 86-97.
48. Diekmann J, Bauer S, Weizbauer A, et al. Examination of a biodegradable magnesium screw for the reconstruction of the anterior cruciate ligament: A pilot in vivo study in rabbits. Mat Sci Eng C-Mater, 2016, 59: 1100-1109.
49. Fu Y, Yin Y, Guan J, et al. The evaluation of a degradable Magnesium alloy Bio-Transfix nail system compounded with bone morphogenetic protein-2 in a beagle anterior cruciate ligament reconstruction model. J Biomater Appl, 2019, 34(5): 687-698.
50. Hantes ME, Kotsovolos ES, Mastrokalos DS, et al. Arthroscopic meniscal repair with an absorbable screw: results and surgical technique. Knee Surg Sports Traumatol Arthrosc, 2005, 13(4): 273-279.
51. Tsai AM, Mcallister DR, Chow S, et al. Results of meniscal repair using a bioabsorbable screw. Arthroscopy, 2004, 20(6): 586-590.
52. Doral MN, Bilge O, Huri G, et al. Modern treatment of meniscal tears. EFORT Open Rev, 2018, 3(5): 260-268.
53. Zhang Z, Zhou Y, Li W, et al. Local administration of magnesium promotes meniscal healing through homing of endogenous stem cells: a proof-of-concept study. Am J Sports Med, 2019, 47(4): 954-967.
54. Sun Y, Zhang Y, Wu Q, et al. 3D-bioprinting ready-to-implant anisotropic menisci recapitulate healthy meniscus phenotype and prevent secondary joint degeneration. Theranostics, 2021, 11(11): 5160-5173.
55. Liu C, Yang GZ, Zhou ML, et al. Magnesium ammonium phosphate composite cell-laden hydrogel promotes osteogenesis and angiogenesis. Acs Omega, 2021, 6(14): 9449-9459.
56. Han P, Cheng P, Zhang S, et al. In vitro and in vivo studies on the degradation of high-purity Mg (99.99wt%) screw with femoral intracondylar fractured rabbit model . Biomaterials, 2015, 64: 57-69.
57. Han HS, Loffredo S, Jun I, et al. Current status and outlook on the clinical translation of biodegradable metals. Mater Today, 2019, 23: 57-71.
58. Xin Y, Hu T, Chu P. In vitro studies of biomedical magnesium alloys in a simulated physiological environment: a review. Acta Biomater, 2011, 7(4): 1452-1459.
59. Xie K, Wang L, Guo Y, et al. Effectiveness and safety of biodegradable Mg-Nd-Zn-Zr alloy screws for the treatment of medial malleolar fractures. J Orthop Translat, 2021, 27: 96-100.
60. Yang Y, Michalczyk C, Singer F, et al. In vitro study of polycaprolactone/bioactive glass composite coatings on corrosion and bioactivity of pure Mg. Appl Surf Sci, 2015, 355: 832-841.
61. Xing F, Li S, Yin D, et al. Recent progress in Mg-based alloys as a novel bioabsorbable biomaterials for orthopedic applications. J Magnes Alloy, 2022, 10(6): 1428-1456.
62. Herickhoff P, Safran M, Yung P, et al. Pros and cons of different ACL graft fixation devices. Berlin: Springer, 2017: 277-288.

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Research progress of magnesium and magnesium alloy implants in sports medicine

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