Alexander Kopp, Alina Schmitz, Henri Kreiker, Heilwig Fischer, Ana Prates Soares, Katharina Schmidt‐Bleek, Georg Duda, Henning Hanken, Nadja Kröger, Max Heiland, Ralf Smeets, Carsten Rendenbach
Background: Magnesium-based implants are increasingly investigated as bioabsorbable materials for temporary osteosynthesis applications due to their favorable biocompatibility and bone-like elastic modulus. However, controlling the degradation rate remains a critical barrier to clinical translation, as rapid corrosion can compromise mechanical integrity and lead to adverse effects, such as gas formation. Methods: PEO-modified WE43MEO (WE43-PEO) and non-modified WE43MEO screws and plates were implanted in the humerus and femur of Göttinger minipigs in a non-fracture model and assessed after 18 months. Explants were analyzed using micro-computed tomography and non-decalcified histology with histomorphometric quantification of residual implant structure and peri-implant bone response. Results: No significant differences in cortical implant volume were observed. However, PEO modified implants were surrounded by significantly higher volumes of lamellar bone, suggesting reduced remodeling and improved bone integration. Non-modified WE43MEO implants underwent complete degradation, while PEO modified implants showed partial resorption with preserved structure, indicating effective degradation control. Both implant types remained integrated without long-term complications. Conclusion: PEO surface modification of WE43 magnesium implants supports predictable, biocompatible long-term degradation and promotes favorable bone quality without late complications, underscoring the potential of surface-engineered magnesium fixation devices for load-bearing applications. The translational potential of this article: PEO-modified WE43MEO osteosynthesis systems may offer clinically relevant, bioabsorbable fixation with controlled degradation and improved long-term bone integration, potentially reducing implant-related complications and the need for secondary removal procedures in orthopaedic and craniomaxillofacial surgery.