Optimization of the manufacturing process and mechanical evaluation of a functionally graded biodegradable composite screw for orthopedic applications.

Background: Metal screws are commonly used for fracture fixations. However, the high modulus of elasticity relative to bones and releasing metallic ions by the metal screw needed a second surgery to remove the implant after the healing period. Furthermore, the removal of metal screws following the healing of the bone is a serious problem that can lead to refracture due to the presence of holes in the screw. Bioresorbable screws can overcome most of the problems associated with metallic screws which motivated research on manufacturing nonmetallic screws. Methods: In this study, three-layer poly L-lactic acid/bioactive glass composite screws were manufactured according to functionally graded material theory, by the forging process. All of the physical and chemical parameters in the manufacturing stages from making composite layers to the forging process were optimized to obtain suitable mechanical properties and durability off the screw in load-bearing positions. Results: The tri-layer composite screw with unidirectional, ±20° angled, and random fibers orientation from core to shell shows a flexural load of 661.5 ± 20.3 (N) with a decrease about 31% after 4-week degradation. Furthermore, its pull-out force was 1.8 ± 0.1 (N) which is considerably more than the degradable polymeric screws. Moreover, the integrity of the composite screws was maintained during the degradation process. Conclusions: By optimizing the manufacturing process and composition of the composite and crystallinity, mechanical properties (flexural, torsion, and pull-out) were improved and making it a perfect candidate for load-bearing applications in orthopedic implants. Improving the fiber/matrix interface through the use of a coupling agent was also considered to preserve the initial mechanical properties. The manufactured screw is sufficiently robust enough to replace metals for orthopedic load-bearing applications. [ABSTRACT FROM AUTHOR]