Porous TiNi alloys fabricated by self-propagating high-temperature synthesis (SHS) are biomaterials designed for medical application in substituting tissue lesions and they were clinically deployed more than 30 years ago. The SHS process, as a very fast and economically justified route of powder metallurgy, has distinctive features which impart special attributes to the resultant implant, facilitating its integration in terms of bio-mechanical/chemical compatibility. On the phenomenological level, the fact of high biocompatibility of porous SHS TiNi (PTN) material in vivo has been recognized and is not in dispute presently, but the rationale is somewhat disputable. The features of the SHS TiNi process led to a multifarious intermetallic Ti₄Ni₂(O,N,C)-based constituents in the amorphous-nanocrystalline superficial layer which entirely conceals the matrix and enhances the corrosion resistance of the unwrought alloy. In the current article, we briefly explore issues of the high biocompatibility level on which additional studies could be carried out, as well as recent progress and key fields of clinical application, yet allowing innovative solutions.

In this study, we assessed the outcomes after surgical treatment of thoracic post-excision defects in 15 patients, using TiNi knitted surgical meshes and customized artificial TiNi-based ribs. Methods: Eight patients were diagnosed with advanced non-small cell lung cancer (NSCLC) invading the chest wall, of which five patients were T₃N₀M₀, two were T₃N₁M₀, and one was T₃N₂M₀. Squamous cell carcinoma was identified in three of these patients and adenocarcinoma in five. In two cases, chest wall resection and repair were performed for metastases of kidney cancer after radical nephrectomy. Three-dimensional CT reconstruction and X-ray scans were used to plan the surgery and customize the reinforcing TiNi-based implants. All patients received TiNi-based devices and were prospectively followed for a few years. Results: So far, there have been no lethal outcomes, and all implanted devices were consistent in follow-up examinations. Immediate complications were noted in three cases (ejection of air through the pleural drains, paroxysm of atrial fibrillation, and pleuritis), which were conservatively managed. In the long term, no complications, aftereffects, or instability of the thoracic cage were observed. Conclusion: TiNi-based devices used for extensive thoracic lesion repair in this context are promising and reliable biomaterials that demonstrate good functional, clinical, and cosmetic outcomes.

This study aims to look into the applicability of a porous TiNi-based shape memory alloy (SMA) scaffold as an incubator for bone marrow mesenchymal cells, hepatocytes, and pancreatic islet cells. The porous TiNi-based SMA used was fabricated using a self-propagating high-temperature synthesis (SHS) technique, in which scaffold blocks measuring 4 × 4 × 10 mm were prepared. In vitro tests were done using mesenchymal stem cells (MSC) isolated from mature bone marrow of CBA/j inbred mice, and cultured in 3 different culture media - Control medium, Osteogenic medium, and Chondrogenic medium. Hepatocytes and islet cells were isolated from the livers and pancreatic glands of Wistar rats respectively, seeded on porous TiNi-based SMA scaffolds, and cultured. The scaffolds were then implanted into the abdominal cavity of Wistar rats and later harvested, at days 7, 14, 21, and 28, post-implantation. SEM imaging was performed with pre-implanted scaffolds at day 0 and harvested scaffolds at days 7, 14, 21, and 28, post-implantation. Based on weight increase percentages, the in vitro study revealed that the osteogenic group showed a 2-fold increase, and the chondrogenic group showed a 1.33-fold increase, compared to the control group. The in vivo study, on the other hand, showed that from day 7 post-implantation, the cellular in-growth gradually invaded the inner porous structure from the periphery towards the center, and at day-28 post-implantation, all pores were closed and completely filled with cells and the extracellular matrix. The results show that porous TiNi-based SMA is a unique biocompatible incubator for cell cultures and can be successfully used for tissue bioengineering and artificial organs.

The microstructural and functional behavior of TiNi-based wires with a silver content of 0–1.5 at.% was evaluated. The concentration range for Ag doping determined for the TiNi wires with potential for the medical industry was 0–0.2 at.%. Microstructure analysis of TiNi wires with different silver contents at room temperature indicated a multiphase structural state. Various internal structures with tangled grain boundaries were formed by intense plastic deformation. The nanocrystalline structure and phase state of wire with the minimum silver content (0.1 at.% Ag) provide full shape recovery, the greatest reversible strain, and optimal strength and ductility. TiNi ingots with a high Ag content (0.5–1.5 at.%) cracked under minimum load due to excess silver that crystallized along the grain boundaries and broke cohesion bonds between the TiNi grains.

Objectives: The aim of this cohort study is to improve the procedure of fertility-sparing surgery and to assess oncological and reproductive follow-up outcomes after radical trachelectomy (RT) for cervical cancer (T_1a2-1bN_xM₀). Methods: We have suggested the method combining sentinel lymph nodes (SLNs) and cervicoisthmic cerclage using a superelastic knitted TiNi mesh (KTNM) implant to facilitate the primary biomechanical/retention function of the uterus. Sixty-eight consented patients, who underwent fertility-sparing surgery using both transabdominal and laparoscopic route from 2009 through 2019, were recruited in the study and prospectively followed for a mean of 69 months. Results: There were no intraoperative or postoperative complications. No cervical stenoses or mesh failures were noted in all cases. The 5‐year overall and recurrence‐free survival rates were 100% and 97%, respectively. Two patients indicated recurrence, it occurred in 3 and 36 months. There were 19 (28%) spontaneous pregnancies, 6 resulted in full-term delivery, whereas 2 and 11 ended in miscarriage and early abortion, respectively. Conclusions: This sparing-surgery technique is turned out to be feasible and efficient as allows to achieve well oncologic and fertility outcomes, mimicking the effect of the cervix. It complements existing surgical approaches and may provide further insight into how to overcome challenges even in aggravated cases or previously failed procedures.