Current status and perspectives on design, fabrication, surface modification, and clinical applications of biodegradable magnesium alloys

• Five key techniques for enhancing performance of biomedical Mg alloys are reviewed. • Progress in regulating degradation, mechanical properties, and biocompatibility is summarized. • Clinical translation progress, challenges, and future strategies are assessed. Biodegradable metals have garnered considerable interest owing to their capacity for self-degradation following the repair of damaged tissues. This review commences with their historical development and clarifies the essential prerequisites for their successful clinical translation. Subsequently, a detailed review of magnesium-based materials is presented from five critical areas of alloying, fabrication techniques, purification, surface modification, and structural design, systematically addressing their progress in biodegradation rate retardation, mechanical reinforcement, and biocompatibility enhancement. Furthermore, recent breakthroughs in vivo animal experiments and clinical translation of magnesium alloys are summarized. Finally, this review concludes with a critical assessment of the achievements and challenges encountered in the clinical application of these materials, and proposes practical strategies to address current limitations and guide future research perspectives.