title: Biodegradable Mg-Cu alloy implants with antibacterial activity for the treatment of osteomyelitis: In vitro and in vivo evaluations.
abstract: Treatment of chronic osteomyelitis (bone infection) remains a clinical challenge; in particular, it requires an implantable material with improved antibacterial activity. Here, we prepared biodegradable magnesium (Mg)-copper (Cu) alloys with different Cu contents (0.05, 0.1, and 0.25 wt%) and assessed their potential for treating methicillin-resistant Staphylococcus aureus-induced osteomyelitis. We evaluated the microstructures, mechanical properties, corrosion behavior, and ion release of the alloys in vitro, and their biocompatibility and antibacterial activity in vitro and in vivo. The antibacterial activity of the Mg-Cu alloys in vitro was demonstrated by microbiological counting assays, bacterial viability assays, biofilm formation observations, and the expression of biofilm, virulence, and antibiotic-resistance associated genes. The antibacterial activity of Mg-Cu alloys in vivo was confirmed by imaging examination, microbiological cultures, and histopathology. The biocompatibility of Mg-Cu alloys was confirmed by cell proliferation, vitality, and morphology assays in vitro and Cu(2+) or Mg(2+) ion assays, blood biochemical tests, and histological evaluation in vivo. The alloy containing 0.25 wt% Cu exhibited the highest antibacterial activity among the tested alloys, with favorable biocompatibility. Collectively, our results indicate the potential utility of Mg-Cu alloy implants with 0.25 wt% Cu in treating orthopedic infections.
authors: Department of Orthopaedic Surgery, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors: Yang
authors: Y
authors: Li
authors: Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors: Lina
authors: L
authors: Liu
authors: Institute of Metal Research, Chinese Academy of Sciences, Shenyang, China.
authors: Peng
authors: P
authors: Wan
authors: Department of Orthopaedic Surgery, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors: Zanjing
authors: Z
authors: Zhai
authors: Department of Orthopaedic Surgery, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors: Zhenyang
authors: Z
authors: Mao
authors: Department of Orthopaedic Surgery, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors: Zhengxiao
authors: Z
authors: Ouyang
authors: Department of Orthopaedic Surgery, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors: Degang
authors: D
authors: Yu
authors: Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors: Qi
authors: Q
authors: Sun
authors: Institute of Metal Research, Chinese Academy of Sciences, Shenyang, China.
authors: Lili
authors: L
authors: Tan
authors: Institute of Metal Research, Chinese Academy of Sciences, Shenyang, China.
authors: Ling
authors: L
authors: Ren
authors: Department of Orthopaedic Surgery, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors: Zhenan
authors: Z
authors: Zhu
authors: Department of Orthopaedic Surgery, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors: Yongqiang
authors: Y
authors: Hao
authors: Department of Orthopaedic Surgery, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. Electronic address: xinhua_qu@126.com.
authors: Xinhua
authors: X
authors: Qu
authors: Institute of Metal Research, Chinese Academy of Sciences, Shenyang, China. Electronic address: kyang@imr.ac.cn.
authors: Ke
authors: K
authors: Yang
authors: Department of Orthopaedic Surgery, Shanghai Key Laboratory of Orthopaedic Implants, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. Electronic address: krdai@163.com.
authors: Kerong
authors: K
authors: Dai
mesh_terms: D020341:Absorbable Implants; D000497:Alloys / Q000008:administration & dosage / Q000737:chemistry; D000818:Animals; D000900:Anti-Bacterial Agents; D003300:Copper / Q000008:administration & dosage* / Q000737:chemistry; D004343:Drug Implants / Q000008:administration & dosage*; D008274:Magnesium / Q000008:administration & dosage* / Q000737:chemistry; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D010019:Osteomyelitis / Q000188:drug therapy* / Q000473:pathology; D011817:Rabbits; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000497:Alloys; D000900:Anti-Bacterial Agents; D004343:Drug Implants; D003300:Copper; D008274:Magnesium
keywords: Antibacterial activity; Biodegradable; Mg-Cu alloy; Osteomyelitis