用於高位脛骨截骨矯正手術以提供機械支撐及加強骨癒合之鎂基金屬玻璃複合物之開發

Osteoarthritis is a prevalent and debilitating medical condition, imposing a
substantial burden on affected individuals. Among the prominent risk factors for knee osteoarthritis, varus knee deformity arising from lower limb axis deformities is a significant concern. Medial opening wedge high tibial osteotomy (MOWHTO) has emerged as an effective intervention for correcting varus knee malalignment, promoting cartilage regeneration, and attenuating the progression of osteoarthritis. Nevertheless, MOWHTO entails inherent risks, including lateral cortical hinge fractures, loss of correction, nonunion, and delayed union. In response to these challenges, this study investigates the potential of a bioabsorbable magnesium-based bulk metallic glass composite (Mg67Zn28Ca5 BMGC), enriched with molybdenum particles, as an innovative solution for MOWHTO.
This research postulates that Mg67Zn28Ca5 BMGC, enhanced with molybdenum particles, exhibits superior mechanical properties and degradation profiles compared to conventional magnesium-based materials. Furthermore, we hypothesize that this composite creates an optimal microenvironment for bone growth through the gradual release of magnesium ions during degradation. Additionally, we propose that the incorporation of Mg67Zn28Ca5 BMGC with locking plate fixation in MOWHTO can enhance surgical stability and reduce stress concentrations, thereby mitigating the risks associated with correction loss and lateral hinge fractures.
This synergistic study encompasses a comprehensive array of experiments, including the fabrication of Mg67Zn28Ca5 BMGC with molybdenum particles, mechanical property assessments, in vitro investigations involving degradation tests, cell viability assessments, cell migration assays, extracellular calcium deposition analyses, and evaluations of osteoblast differentiation. In vivo experiments were conducted using Mg67Zn28Ca5 BMGC rods to assess biological effects and bone growth within the material. Additionally, finite element analysis was employed to assess the mechanical impact of the Mg67Zn28Ca5 BMGC wedge in human MOWHTO, both before and after degradation.
The results obtained demonstrate that Mg67Zn28Ca5 BMGC closely approximates
the mechanical properties of human cortical bone, albeit with notable strength reduction upon immersion in simulated body fluid. Importantly, it exhibits a slower degradation rate compared to commercial magnesium alloys. In cellular studies, Mg67Zn28Ca5 BMGC outperforms existing materials in terms of cell viability, migration, osteoblastic differentiation, and calcium deposition. In vivo experiments revealed progressive degradation and absorption alongside bone ingrowth, underscoring excellent material integration with surrounding tissue. Finite element analysis validates the mechanical efficacy of the Mg67Zn28Ca5 BMGC wedge in MOWHTO.
In conclusion, our research introduces a novel Mg67Zn28Ca5 BMGC augmented
with molybdenum particles, possessing favorable mechanical and degradation
characteristics. This composite holds promise for enhancing MOWHTO surgeries,
closely aligning with the mechanical properties of human cortical bone, showcasing controlled degradation, and promoting the release of beneficial ions for bone health. The successful integration of this material into surrounding bone tissue suggests its suitability for high tibial osteotomy surgeries, offering a potential solution to enhance the outcomes of knee osteoarthritis patients.