Bone Response to Biodegradable Metals and In Vitro Evaluation of the Cytocompatibility

Abstract This review focuses on the bone response to biodegradable metals used in temporary osteosynthesis devices. These implants are designed to degrade in vivo, fully dissolving after stabilizing fractures, osteotomies, and ligament fixations, thus eliminating the need for a second surgery. The review delves into the interactions between biodegradable metallic implants and bone tissue, emphasizing the bidirectional nature of this process. It covers the families of biodegradable metals and their degradation mechanisms, with particular attention paid to the time-dependence of the foreign body reaction and the local sterile inflammation response. Additionally, the review discusses current in vitro methods for evaluating biological safety, osteogenic properties, and inflammatory responses. The limitations of traditional cell culture models in replicating the in vivo bone environment are discussed, along with recent advancements in the field. The review concludes by proposing strategies to control the degradation of biodegradable metals and more accurately replicate bone tissue, which could potentially enable more precise in vitro degradation and biological characterization, reducing reliance on in vivo experiments.