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Hinchliffe JD, Parassini Madappura A, Syed Mohamed SMD, Roy I. Biomedical Applications of Bacteria-Derived Polymers. Polymers (Basel) 2021; 13:1081. [PMID: 33805506 PMCID: PMC8036740 DOI: 10.3390/polym13071081] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/23/2021] [Accepted: 03/24/2021] [Indexed: 12/12/2022] Open
Abstract
Plastics have found widespread use in the fields of cosmetic, engineering, and medical sciences due to their wide-ranging mechanical and physical properties, as well as suitability in biomedical applications. However, in the light of the environmental cost of further upscaling current methods of synthesizing many plastics, work has recently focused on the manufacture of these polymers using biological methods (often bacterial fermentation), which brings with them the advantages of both low temperature synthesis and a reduced reliance on potentially toxic and non-eco-friendly compounds. This can be seen as a boon in the biomaterials industry, where there is a need for highly bespoke, biocompatible, processable polymers with unique biological properties, for the regeneration and replacement of a large number of tissue types, following disease. However, barriers still remain to the mass-production of some of these polymers, necessitating new research. This review attempts a critical analysis of the contemporary literature concerning the use of a number of bacteria-derived polymers in the context of biomedical applications, including the biosynthetic pathways and organisms involved, as well as the challenges surrounding their mass production. This review will also consider the unique properties of these bacteria-derived polymers, contributing to bioactivity, including antibacterial properties, oxygen permittivity, and properties pertaining to cell adhesion, proliferation, and differentiation. Finally, the review will select notable examples in literature to indicate future directions, should the aforementioned barriers be addressed, as well as improvements to current bacterial fermentation methods that could help to address these barriers.
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Affiliation(s)
| | | | | | - Ipsita Roy
- Department of Materials Science and Engineering, Faculty of Engineering, University of Sheffield, Sheffield S1 3JD, UK; (J.D.H.); (A.P.M.); (S.M.D.S.M.)
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Guo L, Li R, Yang X, Yu C, Gui F. Polylactide pins can effectively fix severely comminuted and unsalvageable radial head fracture: A retrospective study of 40 patients. Injury 2020; 51:2253-2258. [PMID: 32718754 DOI: 10.1016/j.injury.2020.07.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/11/2020] [Accepted: 07/18/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND The treatment of comminuted unsalvageable radial head fracture remains controversial. Open reduction and internal fixation with metallic plates and screws are hard to achieve. Conventional techniques include radial head resection and arthroplasty. Both methods have inevitable complications. The purpose of this retrospective study is to prove the feasibility of treating unsalvageable radial head fractures with absorbable polylactide pins. METHODS A total of 17 patients with severely comminuted Mason type III radial head fractures were treated with open reduction and internal fixation using polylactide pins and 23 with metallic plates and screws. Patients receiving both modalities were followed-up for a mean of 24 months (standard deviation SD: 2.6). Radiographic analysis was conducted 2, 30, 60, and 120 days after surgery. Measurements of range of motion (ROM), disability of arm shoulder and hands, Mayo elbow performance score, and Broberg and Morrey elbow score were recorded, with treatments compared using a Mann-Whitney U test. RESULT By the time of last follow up, All fractures in both groups healed successfully. The duration (134 min SD:21 min to 131 min SD:19 min) and blood loss (121 ml SD: 25 ml to 124 ml SD: 27 ml) during surgery of polylactide pin and metallic implant group have no statistical differences. The MEPI score (91 SD:7 to 94 SD:9), the Broberg and Morrey score (93 SD:3 to 93 SD:5), the DASH outcome measures (4.5 SD: 3.0 to 3.7 SD: 3.5), the range of motion also shows no statistical differences. Complications were infrequent and did not cause disability in both groups. All patients were satisfied with the surgical outcomes. CONCLUSION Polylactide pins can feasibly treat severely comminuted radial head fractures, which usually are considered unreducible. This technique provides an optional treatment plan in addition to resection or arthroplasty, especially for young patients that refuse that form of treatment.
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Affiliation(s)
- Liang Guo
- Department of orthopedic, the University-town Hospital of Chongqing Medical University, China
| | - Ruifu Li
- Department of orthopedic, the University-town Hospital of Chongqing Medical University, China.
| | - Xuhui Yang
- Department of orthopedic, the University-town Hospital of Chongqing Medical University, China
| | - Chao Yu
- Department of orthopedic, the University-town Hospital of Chongqing Medical University, China
| | - Fei Gui
- Department of orthopedic, the University-town Hospital of Chongqing Medical University, China
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Pieske O, Bauer M, Schröder C, Michaelis I, Massen F, Wallmichrath J, Suero EM, Greiner A. Development and biomechanical evaluation of a new biodegradable intramedullary implant for osteosynthesis of midshaft fractures of small hollow bones. Technol Health Care 2020; 28:185-192. [PMID: 32224535 DOI: 10.3233/thc-191597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Up to date there is no intramedullary, biodegradable osteosynthesis commercially available to treat non-comminuted midshaft fractures of small hollow bones applying not only a stable osteosynthesis but an additional axial compression to the fracture site. OBJECTIVE AND METHODS Therefore we (1) designed different implant profiles and simulated the inner tension/volume using CAD. (2) Thereafter we manufactured a prototype with the best volume/tension-ratio using 70:30 poly-(L-lactide-co-D, L-lactide) (PLLA/PDLLA) and poly-ε-caprolactone (PCL) by injection moulding. Both materials are resorbable, licensed for medical use and show a slow degradation over at least one year. (3) The implants were tested in a universal testing machine (Zwick/RoellZ010) using a 3-point-bending-setup. (4) We compared the implants with different types of commercially available Ti6Al4V 6-hole 2, 3 mm-plates including interlocking systems (Leibinger Set, Stryker) (each group n= 6) using a 4-point-bending-test-setup with artificial metacarpal bones (Sawbones®). RESULTS The 3-point-bending-test-results showed that mean failure-force of PCL-tubes was 57.94 ± 4.28 N whereas the PLLA/PDLLA-tubes had an approximately four-fold higher value of 227.24 ± 1.87 N (p< 0.001). Additionally, the 4-point-bending-test-results showed that the maximum load of PLLA/PDLLA tubes (61.97 ± 3.58 N) was significantly higher than the strongest 6-hole metacarpal plate (22.81 ± 0.76 N) (p< 0.001). CONCLUSION The study showed that the new type of biodegradable, intramedullary tension-osteosynthesis made of PLLA/PDLLA is even more stable than common plate osteosynthesis in a small-hallow-bone-model. Further in vivo investigation should be performed to evaluate the surgical technique and long-term healing process of the bone and biodegradation process of the implant.
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Affiliation(s)
- Oliver Pieske
- Department of Trauma Surgery, Evangelic Hostpital Oldenburg, 26122 Oldenburg, Germany
| | - Maximilian Bauer
- Department of General Trauma and Reconstructive Surgery, University Hospital of Munich, 81377 Munich, Germany
| | - Christian Schröder
- Laboratory for Biomechanics and Experimental Orthopaedics, University Hospital of Munich, 81377 Munich, Germany
| | - Ina Michaelis
- Institute of Plastics Processing, RWTH Aachen, 52062 Aachen, Germany
| | - Felix Massen
- Department of General Trauma and Reconstructive Surgery, University Hospital of Munich, 81377 Munich, Germany
| | - Jens Wallmichrath
- Deparment of Dermatology, University Hospital of Munich, 80337 Munich, Germany
| | - Eduardo M Suero
- Department of General Trauma and Reconstructive Surgery, University Hospital of Munich, 81377 Munich, Germany
| | - Axel Greiner
- Department of General Trauma and Reconstructive Surgery, University Hospital of Munich, 81377 Munich, Germany
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4
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Yan G, Zhang R, Chuo W, Gao X, Zhou Q, Yang M. Open Reduction Effects of Digitally Treating Zygomaticomaxillary Complex Fractures With Bio-Resorbable Materials. J Oral Maxillofac Surg 2020; 78:986-995. [PMID: 32006489 DOI: 10.1016/j.joms.2019.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 12/11/2019] [Accepted: 12/15/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE The application of bio-resorbable plates in craniomaxillofacial surgery is increasing because of the advantage of avoiding secondary surgery. This study aimed to evaluate the effects of osteosynthesis with prebent bio-resorbable plates for treating zygomaticomaxillary complex (ZMC) fractures. MATERIALS AND METHODS We implemented a prospective case series composed of patients with ZMC fractures who underwent treatment at the School of Stomatology at China Medical University. Bio-resorbable plates were used for fracture fixation. The fractures were stabilized with bio-resorbable plates prebent on a 3-dimensionally printed skull model with the fractures reduced using virtual simulation. The primary outcome variable was the stability rate of reduced bone segments. Other study variables were mouth opening, occlusion, paresthesia or anesthesia in the infraorbital nerve region (PAIN), and diplopia. Outcome variables were determined by calculating stability rates of reduced bone segments, resolution rates of postoperative restricted mouth opening, malocclusion, PAIN, and diplopia. RESULTS The sample was composed of 11 patients recruited between November 2016 and September 2018. All surgical procedures were successful, with no severe complications. The stability rate of reduced bone segments from different mechanical buttress regions was 100%. Satisfactory postoperative stability of bio-resorbable plates was obtained in all cases. The resolution rates of postoperative restricted mouth opening and malocclusion were 75 and 100%, respectively. PAIN and diplopia symptoms resolved in 50 and 100% of cases, respectively. CONCLUSIONS The results suggest that osteosynthesis with bio-resorbable plates prebent on a 3-dimensionally printed skull model, designed by virtual simulation, works well for patients with ZMC fractures. Future studies should focus on the broader applications of these findings in the practice of oral and maxillofacial surgery.
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Affiliation(s)
- Guangqi Yan
- Associate Professor, Postgraduate, School of Stomatology, China Medical University, Shenyang, China
| | - Ran Zhang
- Resident Doctor, Postgraduate, School of Stomatology, China Medical University, Shenyang, China
| | - Wenyu Chuo
- Resident Doctor, Postgraduate, School of Stomatology, China Medical University, Shenyang, China
| | - Xiaobo Gao
- Resident Doctor, Postgraduate, Hospital Affiliated of Chifeng University, Chifeng, China
| | - Qing Zhou
- Professor, Postgraduate, School of Stomatology, China Medical University, Shenyang, China
| | - Mingliang Yang
- Associate Professor, School of Stomatology, China Medical University, Shenyang, China.
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Cao XY, Chen C, Tian N, Dong X, Liang X, Xu LJ, Cheng CK. Long-term study on the osteogenetic capability and mechanical behavior of a new resorbable biocomposite anchor in a canine model. J Orthop Translat 2020; 21:81-90. [PMID: 32110507 PMCID: PMC7033359 DOI: 10.1016/j.jot.2019.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 02/08/2023] Open
Abstract
Background Biodegradable suture anchors are commonly used for repairing torn rotator cuffs, but these biodegradable materials still suffer from low mechanical strength, poor osteointegration, and the generation of acidic degradation byproducts. Method The purpose of this study was to evaluate the long-term mechanical behavior and osteogenetic capabilities of a biocomposite anchor injection molded with 30% β-tricalcium phosphate microparticles blended with 70% poly (L-lactide-co-glycolide) (85/15). This study investigated in vitro degradation and in vivo bone formation in a canine model. The initial mechanical behavior, mechanical strength retention with degradation time, and degradation features were investigated. Results The results showed that the biocomposite anchor had sufficient initial mechanical stability confirmed by comparing the initial shear load on the anchor with the minimum shear load borne by an ankle fracture fixation screw, which is considered a worst-case implantation site for mechanical loading. The maximum shear load retention of the biocomposite anchor was 83% at 12 weeks, which is desirable, as it aligns with the rate of bone healing. The β-tricalcium phosphate fillers were evenly dispersed in the polymeric matrix and acted to slow the degradation rate and improve the mechanical strength of the anchor. The interface characteristics between the β-tricalcium phosphate particles and the polymeric matrix changed the degradation behavior of the biocomposite. Phosphate buffer saline was shown to diffuse through the interface into the biocomposite to inhibit the core accelerated degradation rate. In vivo, the addition of β-tricalcium phosphate induced new bone formation. The biocomposite material developed in this study demonstrated improved osteogenesis in comparison to a plain poly (L-lactide-co-glycolide) material. Neither anchor produced adverse tissue reactions, indicating that the biocomposite had favorable biocompatibility following long-term implantation. Conclusion In summary, the new biocomposite anchor presented in this study had favorable osteogenetic capability, mechanical property, and controlled degradation rate for bone fixation. Translational potential of this article The new biocomposite anchor had sufficient initial and long-term fixation stability and bone formation capability in the canine model. It is indicated that the new biocomposite anchor has a potential for orthopedic application.
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Affiliation(s)
- Xiao-Yan Cao
- School of Instrumentation and Optoelectronic Engineering, Beihang University, Beijing, 100191, China.,School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Cheng Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Na Tian
- Beijing Engineering Laboratory of Functional Medical Materials and Devices, Beijing Naton Technology Group Co. LTD, Beijing, 100094, China
| | - Xiang Dong
- Beijing Engineering Laboratory of Functional Medical Materials and Devices, Beijing Naton Technology Group Co. LTD, Beijing, 100094, China
| | - Xing Liang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Li-Jun Xu
- School of Instrumentation and Optoelectronic Engineering, Beihang University, Beijing, 100191, China.,Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beijing, 100191, China
| | - Cheng-Kung Cheng
- School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China.,Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, 100191, China
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Nguyen JC, Green DW, Lin BF, Endo Y. Magnetic resonance evaluation of the pediatric knee after arthroscopic fixation of osteochondral lesions with biodegradable nails. Skeletal Radiol 2020; 49:65-73. [PMID: 31214727 DOI: 10.1007/s00256-019-03258-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 05/31/2019] [Accepted: 06/10/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE To use magnetic resonance imaging (MRI) to investigate the knee joint of children following arthroscopic fixation of osteochondral lesions using bioabsorbable nails and to correlate these imaging findings with time from arthroscopic treatment and with risk factors at the time of imaging. MATERIALS AND METHODS Our study included postarthroscopic MRI studies from 58 children (mean age at arthroscopy, 13.8 + 2.1 years) who have undergone bioabsorbable nail fixation of unstable osteochondral lesions between February 1, 2011 and September 30, 2017. All studies were retrospectively reviewed for broken nails, intra-articular debris, and internal knee derangement. Demographic information and information pertaining to active symptoms was obtained from both MRI questionnaire that was completed at the time of the study and clinical note that preceded the study. Marginal logistic regression models estimated using generalized estimating equations (GEE) were used to identify factors associated with a broken nail and joint effusion. RESULTS A total of 104 postoperative studies were reviewed, which included 60 with symptoms and 44 without symptoms. Nail breakage was present in 38 (36.6%) studies and associated with presence of symptoms (OR 2.43, p = 0.036) and effusion (OR 2.76, p = 0.025). An effusion was present in 40 (38.5%) studies which decreased with increasing time from treatment (OR 0.89, p = 0.007) and increased with symptoms (OR 10.87, p < 0.001). Meniscal tear was present on 8 (7.7%) and chondral irregularity on 14 (13.5%) studies. CONCLUSION Broken nail, effusion, and less commonly, meniscal tears and chondral irregularity, are all complications that can arise following fixation of osteochondral lesions with bioabsorbable nails. MRI can serve as a valuable tool in assessing these complications.
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Affiliation(s)
- Jie C Nguyen
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.
| | - Daniel W Green
- Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th street, New York, NY, 10021, USA
| | - Bin F Lin
- Department of Radiology and Imaging, Hospital for Special Surgery, 535 East 70th street, New York, NY, 10021, USA
| | - Yoshimi Endo
- Department of Radiology and Imaging, Hospital for Special Surgery, 535 East 70th street, New York, NY, 10021, USA
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Hak Roh Y, Kim S, Sik Gong H, Hyun Baek G. WITHDRAWN: Internal fixation of unstable radial head fracture: A comparison of metallic and biodegradable implants. Injury 2019:S0020-1383(19)30460-7. [PMID: 31416602 DOI: 10.1016/j.injury.2019.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 08/02/2019] [Accepted: 08/06/2019] [Indexed: 02/02/2023]
Abstract
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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Affiliation(s)
- Young Hak Roh
- Department of Orthopaedic Surgery, Ewha Womans University Medical Center, Ewha Womans University College of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, South Korea.
| | - Sangwoo Kim
- Department of Orthopaedic Surgery, Ewha Womans University Medical Center, Ewha Womans University College of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 07985, South Korea
| | - Hyun Sik Gong
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 173 Gumi-ro, Bundang-gu, Sungnam 13620, South Korea
| | - Goo Hyun Baek
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea
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Wyrwa R, Otto K, Voigt S, Enkelmann A, Schnabelrauch M, Neubert T, Schneider G. Electrospun mucosal wound dressings containing styptics for bleeding control. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 93:419-428. [DOI: 10.1016/j.msec.2018.07.066] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 05/12/2018] [Accepted: 07/23/2018] [Indexed: 12/12/2022]
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Ginjupalli K, Shavi GV, Averineni RK, Bhat M, Udupa N, Nagaraja Upadhya P. Poly(α-hydroxy acid) based polymers: A review on material and degradation aspects. Polym Degrad Stab 2017. [DOI: 10.1016/j.polymdegradstab.2017.08.024] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Wu Q, Yi J, Wang S, Liu D, Song X, Zhang G. Synthesis and self-assembly of new amphiphilic thermosensitive poly(N-vinylcaprolactam)/poly(d,l-lactide) block copolymers via the combination of ring-opening polymerization and click chemistry. Polym Bull (Berl) 2015. [DOI: 10.1007/s00289-015-1348-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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11
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Augat P, Robioneck PB, Abdulazim A, Wipf F, Lips KS, Alt V, Schnettler R, Heiss C. Fixation performance of an ultrasonically fused, bioresorbable osteosynthesis implant: A biomechanical and biocompatibility study. J Biomed Mater Res B Appl Biomater 2015; 104:170-9. [DOI: 10.1002/jbm.b.33382] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 12/10/2014] [Accepted: 01/09/2015] [Indexed: 11/06/2022]
Affiliation(s)
- P. Augat
- Institute of Biomechanics, Trauma Center Murnau; Murnau Germany
- Institute of Biomechanics, Paracelsus Medical University; Salzburg Austria
| | - P. B. Robioneck
- Research and Development Department; Stryker Trauma GmbH; Schönkirchen Germany
| | - A. Abdulazim
- Institute of Biomechanics, Trauma Center Murnau; Murnau Germany
| | - F. Wipf
- Research and Development Department; Stryker Trauma AG; Selzach Switzerland
| | - K. S. Lips
- Laboratory of Experimental Trauma Surgery; Justus-Liebig-University of Giessen; Giessen Germany
| | - V. Alt
- Laboratory of Experimental Trauma Surgery; Justus-Liebig-University of Giessen; Giessen Germany
- Department of Trauma Surgery; University Hospital of Giessen-Marburg; Giessen Germany
| | - R. Schnettler
- Laboratory of Experimental Trauma Surgery; Justus-Liebig-University of Giessen; Giessen Germany
- Department of Trauma Surgery; University Hospital of Giessen-Marburg; Giessen Germany
| | - C. Heiss
- Laboratory of Experimental Trauma Surgery; Justus-Liebig-University of Giessen; Giessen Germany
- Department of Trauma Surgery; University Hospital of Giessen-Marburg; Giessen Germany
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Neumann H, Breer S, Reimers N, Kasch R, Schulz AP, Kienast B. Osteosynthesis-screw augmentation by ultrasound-activated biopolymer--an ovine in vivo study assessing biocompatibility and bone-to-implant contact. J Orthop Surg Res 2015; 10:18. [PMID: 25628015 PMCID: PMC4314756 DOI: 10.1186/s13018-015-0156-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 01/04/2015] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Screw fixation and fragment anchoring in osteoporotic bones is often difficult. Problems like the cut out phenomenon and implant migration in osteoporotic bones have been reported. One possibility of improving the anchoring force of screws is augmentation of the screw. Cement-augmented screws in spinal surgery could exhibit a better anchoring in osteoporotic bones. METHODS The purpose of this study was to examine the effect of screw augmentation using a resorbable polymer. Ultrasound-activated biodegradable pins were used for the purpose of a resorbable augmentation technique. Cannulated screws were inserted into the femur of 12 sheep and augmented by an ultrasound-activated polylactic acid (PLDLA) pin. In a paired approach, four screws were implanted in each animal: 2× a 10-mm thread and 2× a 20-mm thread, both of which were augmented with polymer. Both screws, named A and B, were also applied without augmentation (control group) and implanted into the contralateral hind limb. After 4, 8, and 12 weeks, the sheep were euthanized and a macroscopical and histological examination followed. RESULTS The polymer spread well out of the screws into the cancellous lacunae. Around the polymer, the peripheral bone showed signs of healthy and active bone tissue. No evidence of inflammation or infection was observed. The boneto-implant contact was significantly higher in the augmented screws. Biocompatibility was proven in histopathological examination. After 12 weeks, no pathological changes were found. CONCLUSION Ultrasound-activated polymer augmentation of cannulated screws may improve the anchoring in osteoporotic bone. ARTICLE FOCUS Can screw augmentation using a resorbable polymer improve the bone-to-implant contact in case of screw osteosynthesis? Is there any effect on the surrounding tissue by the induced temperature and liquefied polymer? Can biocompatibility be proven by this new osteosynthesis? KEY MESSAGES Screw augmentation by ultrasound-activated biopolymer leads to a significant higher bone-to-implant contact than pure screw osteosynthesis. No tissue damage could be observed by the application of the SonicFusion™. STRENGTH AND LIMITATIONS OF THIS STUDY The ovine in vivo study concept can simulate physiological conditions. First examination of screw augmentation by ultrasound-activated biopolymer. No biomechanical testing of the higher bone-to-implant contact by now.
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Affiliation(s)
| | | | - Nils Reimers
- Medical Faculty, University of Lübeck, Lübeck, Germany.
| | - Richard Kasch
- Department of Orthopaedics, University Greifswald, Greifswald, Germany.
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13
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Rustamov IR, Dyatlov VA, Grebeneva TA, Dyatlov AV, Zaitsev VV, Maleev VI. Polycyanoacrylate porous material for bone tissue substitution. J Mater Chem B 2014; 2:4310-4317. [PMID: 32261569 DOI: 10.1039/c4tb00554f] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A proof of concept study has been conducted for the design of a porous biodegradable material containing nanocapsules and two actives with independent release-bimodal drug-eluting implants. Completely safe synthetic material free from risk of prion and virus contamination was tested in vivo, and a method for controlling the rate of biodegradation of poly-2-cyanoacrylic polymer was developed. Novel perfluorinated 2-cyanoacrylic esters have been applied for the chemical modification of polyethyl-2-cyanoacrlylate copolymers. Internal imide-cycle formation has been used to retard the rate of enzymatic hydrolysis of the 2-cyanoacrylic copolymer main chain.
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Affiliation(s)
- I R Rustamov
- D. Mendeleev University of Chemical Technology of Russia, Russia
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14
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Li T, Zhang Y, Shao B, Gao Y, Zhang C, Cao Q, Kong L. Partially Biodegradable Distraction Implant to Replace Conventional Implants in Alveolar Bone of Insufficient Height: A Preliminary Study in Dogs. Clin Implant Dent Relat Res 2014; 17:1164-73. [PMID: 24888978 DOI: 10.1111/cid.12229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Dental implants have been widely used in the last few decades. However, patients with insufficient bone height need reconstructive surgeries before implant insertion. The distraction implant (DI) has been invented to simplify the treatment procedure, but the shortcomings of DIs have limited their clinical use. We incorporated biodegradable polyester into a novel DI called the partially biodegradable distraction implant (PBDI). PURPOSE The purpose of this study was to assess the radiological, histological, and biomechanical properties of the PBDI in animal models. MATERIAL AND METHODS PBDIs were manufactured and inserted into the atrophied mandibles of nine dogs. Box-shaped alveolar bones were segmented and distracted. The dogs were randomly divided into three groups that were sacrificed 1, 2, and 3 months after the implant insertion. Actual augmentation height (AAH) of the bone segments was measured to evaluate the effect of distraction. X-ray examination and micro-CT reconstruction and analysis were used to evaluate the regenerated bone in the distraction gap and bone around the functional element. Histological sections were used to evaluate the osseointegration and absorption of the PBDI. Fatigue tests were used to evaluate the biomechanical properties of the PBDI. RESULTS Little change was found in AAH among the three groups. X-ray examination and micro-CT reconstruction showed good growth of regenerated bone in the distraction gap. Alveolar bone volume around the functional element increased steadily. No obvious bone absorption occurred in the alveolar crest around PBDI. Three months after distraction, the functional element achieved osseointegration, and the support element began to be absorbed. All PBDIs survived the fatigue test. CONCLUSIONS The PBDI is a novel and reliable dental implant. It becomes a conventional implant after the absorption of the support element and the removal of the distraction screw. It is a promising replacement for conventional implants in patients with insufficient alveolar bone height.
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Affiliation(s)
- Tao Li
- State Key Laboratory of Military Stomatology, Department of Orthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, China.,Department of Stomatology, PLA Second Artillery General Hospital, Beijing, China
| | - Yongqiang Zhang
- State Key Laboratory of Military Stomatology, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Bo Shao
- State Key Laboratory of Military Stomatology, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Yuan Gao
- Department of Stomatology, No. 263 Clinical Section of the General Hospital of Beijing Military Region, Beijing, China
| | - Chen Zhang
- Department of Neurology, PLA Second Artillery General Hospital, Beijing, China
| | - Qiang Cao
- State Key Laboratory of Military Stomatology, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Liang Kong
- State Key Laboratory of Military Stomatology, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
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Lateral condyle fracture of the humerus in children treated with bioabsorbable materials. ScientificWorldJournal 2013; 2013:869418. [PMID: 24228016 PMCID: PMC3817636 DOI: 10.1155/2013/869418] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 09/17/2013] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to compare clinical and radiological outcome of lateral condyle fracture of the elbow in children treated with bioabsorbable or metallic material. From January 2008 to December 2009, 16 children with similar fractures and ages were grouped according to the fixation material used. Children were seen at 3, 6, and 12 months and more than 4 years (mean 51.8 months) postoperatively. The clinical results were compared using the Mayo Elbow Performance Score (MEPS). Radiographic studies of the fractured and opposite elbow were assessed at last follow-up control. Twelve children had a sufficient followup and could be included in the study. Seven could be included in the traditional group and 5 in the bioabsorbable group. At 12 months, the MEPS was 100 for every child in both groups. Asymptomatic bony radiolucent visible tracks and heterotopic ossifications were noted in both groups. There were no significant differences in terms of clinical and radiological outcome between the two groups. The use of bioabsorbable pins or screws is a reasonable alternative to the traditional use of metallic materials for the treatment of lateral condyle fracture of the elbow in children.
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Troiano NW, Kacena MA. Bone Implants: Processing, Embedding, Cutting, and Histopathology. J Histotechnol 2013. [DOI: 10.1179/his.2006.29.4.253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Wu Q, Wang C, Zhang D, Song X, Liu D, Wang L, Zhang G. Synthesis and micellization of a new amphiphilic star-shaped poly(D,L-lactide)/polyphosphoester block copolymer. REACT FUNCT POLYM 2012. [DOI: 10.1016/j.reactfunctpolym.2012.04.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Pina S, Ferreira J. Bioresorbable Plates and Screws for Clinical Applications: A Review. JOURNAL OF HEALTHCARE ENGINEERING 2012. [DOI: 10.1260/2040-2295.3.2.243] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Heidenreich D, Langhoff JD, Nuss K, Kluge K, Kämpf K, Zlinsky K, Hilbe M, Mayer J, von Rechenberg B. The use of BoneWelding® technology in spinal surgery: an experimental study in sheep. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2011; 20:1821-36. [PMID: 21523457 PMCID: PMC3207336 DOI: 10.1007/s00586-011-1799-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Revised: 03/22/2011] [Accepted: 04/08/2011] [Indexed: 11/26/2022]
Abstract
The innovative BoneWelding(®) technology, where ultrasound energy bonds bioresorbable implants to bone, was tested for its feasibility in spine surgery and its local thermal effects. The three tested concepts consisted of implementation of a resorbable plating system, two converging polymer pins and suture anchors to the cervical vertebral bodies. Bioresorbable polylactide implants (PLDLLA 70/30) were inserted ventrally into the third and fourth vertebral body of seven sheep, of which six were sacrificed at 2 months and one sheep immediately after temperature measurements during implant insertion. Polymer screws were used as controls. Qualitative, semi-quantitative histological, and quantitative histomorphometrical evaluation showed excellent anchorage of the implants, new mineralized bone at the implant-bone interface, no inflammatory cell reaction or thermal damage to the adjacent bone in response to the novel insertion technology. The application of two converging pins, parallel inserted polymer pins, or fusion of the implant to the polymer plates did not affect the overall excellent tissue tolerance of the technology. Temperature increase during insertion was noticed but never exceeded 47°C for less than 1 s. The BoneWelding(®) technology was proven to be safe and easy to apply.
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Affiliation(s)
- Dorothee Heidenreich
- Musculoskeletal Research Unit, Equine Department, Vetsuisse Faculty ZH, University of Zurich, Winterthurerstr. 260, 8057 Zurich, Switzerland
| | | | - Katja Nuss
- Musculoskeletal Research Unit, Equine Department, Vetsuisse Faculty ZH, University of Zurich, Winterthurerstr. 260, 8057 Zurich, Switzerland
| | - Katharina Kluge
- Veterinary Anesthesiology, Equine Department, Vetsuisse Faculty ZH, University of Zurich, Winterthurerstr. 260, 8057 Zurich, Switzerland
| | - Käthi Kämpf
- Musculoskeletal Research Unit, Equine Department, Vetsuisse Faculty ZH, University of Zurich, Winterthurerstr. 260, 8057 Zurich, Switzerland
| | - Katalin Zlinsky
- Musculoskeletal Research Unit, Equine Department, Vetsuisse Faculty ZH, University of Zurich, Winterthurerstr. 260, 8057 Zurich, Switzerland
| | - Monika Hilbe
- Veterinary Pathology, Vetsuisse Faculty ZH, University of Zurich, Winterthurerstr. 260, 8057 Zurich, Switzerland
| | - Jörg Mayer
- SpineWelding AG, Wagistr. 6, 8952 Schlieren, Switzerland
| | - Brigitte von Rechenberg
- Musculoskeletal Research Unit, Equine Department, Vetsuisse Faculty ZH, University of Zurich, Winterthurerstr. 260, 8057 Zurich, Switzerland
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In Vivo and In Vitro Study of a Polylactide-Fiber-Reinforced β-Tricalcium Phosphate Composite Cage in an Ovine Anterior Cervical Intercorporal Fusion Model. Int J Biomater 2011; 2011:109638. [PMID: 22114603 PMCID: PMC3205610 DOI: 10.1155/2011/109638] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Accepted: 08/20/2011] [Indexed: 11/18/2022] Open
Abstract
A poly-70L/30DL-lactide (PLA70)–β-tricalcium phosphate (β-TCP) composite implant reinforced by continuous PLA-96L/4D-lactide (PLA96) fibers was designed for in vivo spinal fusion. The pilot study was performed with four sheep, using titanium cage implants as controls. The composite implants failed to direct bone growth as desired, whereas the bone contact and the proper integration were evident with controls 6 months after implantation. Therefore, the PLA70/β-TCP composite matrix material was further analyzed in the in vitro experiment by human and ovine adipose stem cells (hASCs and oASCs). The composites proved to be biocompatible as confirmed by live/dead assay. The proliferation rate of oASCs was higher than that of hASCs at all times during the 28 d culture period. Furthermore, the composites had only a minor osteogenic effect on oASCs, whereas the hASC osteogenesis on PLA70/β-TCP composites was evident. In conclusion, the composite implant material can be applied with hASCs for tissue engineering but not be evaluated in vivo with sheep.
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Synthesis and micellization of amphiphilic biodegradable methoxypolyethylene glycol/poly(d,l-lactide)/polyphosphate block copolymer. REACT FUNCT POLYM 2011. [DOI: 10.1016/j.reactfunctpolym.2011.06.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Arnoldi J, Henry P, Procter P, Robioneck B, Jönsson A. In vivo tissue response to ultrasound assisted application of biodegradable pins into cortical and cancellous bone structures: a histological and densitometric analysis in rabbits. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2011; 23:663-76. [PMID: 21375807 DOI: 10.1163/092050611x558288] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In orthopaedic traumatology biodegradable pins are increasingly used for fixation of small bone fragments. In the present study, the ultrasound-assisted anchoring technique (SonicFusion technique), a osteosynthesis method being recently introduced in cranial applications, in which ultrasonic energy is used to insert and anchor polymer pins in bone, was compared with the conventional pin application procedure. The aim of the present study was to assess the short and long term thermal impact of two different ultrasonic energy levels on different bone structures in the distal medial femur of rabbits. The treatment groups consisted of customized polylactide pins applied at a low and a high energy level, the Reference Control and a Negative Control. The thermal effect on bone tissues was evaluated by means of qualitative and semi-quantitative histology and micro-computerized tomography. Five days following surgery, all implant sites showed no tissue damage but normal signs of early ongoing tissue repair. Enhancing the energy level by about 30% had no significant impact on the tissue response. At 4 weeks after surgery test sites covered by ultrasound-aided implantation showed a significantly enhanced bone/implant contact as compared to pins applied by conventional application. In conclusion, the ultrasound assisted anchoring technique not only did not impair bone regeneration, but even improved implant integration.
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Affiliation(s)
- Jörg Arnoldi
- Stryker Osteosynthesis, Dr. Homer Stryker Strasse 1, CH-2545 Selzach, Switzerland.
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Hu W, Huang ZM. Biocompatibility of braided poly(L-lactic acid) nanofiber wires applied as tissue sutures. POLYM INT 2010. [DOI: 10.1002/pi.2695] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Adachi N, Motoyama M, Deie M, Ishikawa M, Arihiro K, Ochi M. Histological evaluation of internally-fixed osteochondral lesions of the knee. ACTA ACUST UNITED AC 2009; 91:823-9. [PMID: 19483241 DOI: 10.1302/0301-620x.91b6.20957] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We evaluated the histological changes before and after fixation in ten knees of ten patients with osteochondritis dissecans who had undergone fixation of the unstable lesions. There were seven males and three females with a mean age of 15 years (11 to 22). The procedure was performed either using bio-absorbable pins only or in combination with an autologous osteochondral plug. A needle biopsy was done at the time of fixation and at the time of a second-look arthroscopy at a mean of 7.8 months (6 to 9) after surgery. The biopsy specimens at the second-look arthroscopy showed significant improvement in the histological grading score compared with the pre-fixation scores (p < 0.01). In the specimens at the second-look arthroscopy, the extracellular matrix was stained more densely than at the time of fixation, especially in the middle to deep layers of the articular cartilage. Our findings show that articular cartilage regenerates after fixation of an unstable lesion in osteochondritis dissecans.
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Affiliation(s)
- N Adachi
- Department of Orthopaedic Surgery, Hiroshima University, Minami-ku, Hiroshima, Japan
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Givissis PK, Symeonidis PD, Ditsios KT, Dionellis PS, Christodoulou AG. Late results of absorbable pin fixation in the treatment of radial head fractures. Clin Orthop Relat Res 2008; 466:1217-24. [PMID: 18317861 PMCID: PMC2311474 DOI: 10.1007/s11999-008-0134-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2007] [Accepted: 01/16/2008] [Indexed: 01/31/2023]
Abstract
The use of bioabsorbable pins with prolonged degradation periods for fracture fixation has raised concerns about adverse soft tissue reactions, including seromas, discharging sinuses, or osteolytic changes. We asked whether bioabsorbable pins of self-reinforced polylactic acid polymer used in radial head fractures resulted in such reactions. We retrospectively reviewed 21 patients followed a minimum of 36 months (mean, 81 months; range, 36-136 months). There were nine Mason II, 10 Mason III, and two Mason IV fractures, which were evaluated clinically and radiographically. All fractures healed well with no radiographic signs of osteolysis. The mean Mayo Elbow Performance score was 93.8 (range, 20-100), which is comparable to the outcome of historical groups with radial head arthroplasty. The mean range of flexion of the elbow was 9 degrees to 132 degrees , with 79 degrees pronation and 77 degrees supination. The grip strength of the operated arm was not affected in comparison to the contralateral arm (mean range, 38.6 versus 40.9 kg). No material-related adverse effects were observed during and beyond the degradation period. Our data suggest concerns about soft tissue or bony reactions from these materials in radial head fractures are not justified.
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Affiliation(s)
- Panagiotis K. Givissis
- First Orthopaedic Department, Aristotle University of Thessaloniki “G Papanikolaou” Hospital, Thessaloniki, Greece ,9, Papanikolaou Street, Panorama, Mail Box 215, 55210 Thessaloniki, Greece
| | - Panagiotis D. Symeonidis
- First Orthopaedic Department, Aristotle University of Thessaloniki “G Papanikolaou” Hospital, Thessaloniki, Greece
| | - Konstantinos T. Ditsios
- First Orthopaedic Department, Aristotle University of Thessaloniki “G Papanikolaou” Hospital, Thessaloniki, Greece
| | - Panagiotis S. Dionellis
- First Orthopaedic Department, Aristotle University of Thessaloniki “G Papanikolaou” Hospital, Thessaloniki, Greece
| | - Anastasios G. Christodoulou
- First Orthopaedic Department, Aristotle University of Thessaloniki “G Papanikolaou” Hospital, Thessaloniki, Greece
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Mai R, Lauer G, Pilling E, Jung R, Leonhardt H, Proff P, Stadlinger B, Pradel W, Eckelt U, Fanghänel J, Gedrange T. Bone welding--a histological evaluation in the jaw. Ann Anat 2007; 189:350-5. [PMID: 17695991 DOI: 10.1016/j.aanat.2007.02.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The expansion of biodegradable osteosynthesis systems in clinical application correlates well to the progress in development of new materials as to the improvement of application methods. One of those new application methods is the ultrasound-aided insertion of Resorb-X pins. The aim of this study was the histological evaluation of possible thermal damage to bone due to the ultrasound insertion. For this purpose, condylar neck fractures in 12 sheep were produced, repositioned and fixed by Resorb-X plates and pins. The animals were sacrificed in two groups, one after 2 weeks and one after 9 weeks. The bone-pin interlinkage and the structure of the bone were histologically evaluated. After 2 weeks a tight bone-polymer interlinkage was seen. Neither a pronounced foreign body reaction nor an interposition of fibrous tissue at the interface or a thermally induced necrosis was observed. The late phase of wound healing after 9 weeks showed pathomorphological characteristics within the normal range of bone healing. The bone seemed to be free of any alteration caused by process engineering. We conclude that thermal stress caused by ultrasound-aided pin insertion does not lead to cellular reaction in the bone. The fast and easy application of this improved biodegradable osteosynthesis system will bring a clear advantage in clinical use.
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Affiliation(s)
- Ronald Mai
- Department of Oral and Maxillofacial Surgery, Medical Faculty Carl Gustav Carus, Technische Universitaet Dresden, Fetscherstrasse 74, D-01307 Dresden, Germany.
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Pluta M, Murariu M, Da Silva Ferreira A, Alexandre M, Galeski A, Dubois P. Polylactide compositions. II. Correlation between morphology and main properties of PLA/calcium sulfate composites. ACTA ACUST UNITED AC 2007. [DOI: 10.1002/polb.21277] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
A aplicação de polímeros biorreabsorvíveis em próteses temporárias é constante nos procedimentos médicos relacionados a fraturas ósseas. Dentre os polímeros bioreabsorvíveis, o poli(L-co-D, L ácido láctico), PLDLA, na relação 70:30, tem sido estudado visando à obtenção de placas e parafusos para a recuperação de traumas nas regiões buco e crâniomaxilofacial. Nessa relação de monômeros obtém-se um polímero amorfo, o que permite uma adaptação do dispositivo ao local do implante durante a cirurgia. Um fator limitante para o uso desse polímero é seu alto custo em função da importação. Neste trabalho o PLDLA foi sintetizado através da polimerização em massa dos monômeros cíclicos do L-ácido láctico e do D, L ácido láctico, utilizando como catalisador o Sn(Oct)2. Obteve-se material de alta massa molar (Mw = 10(5) g/mol), o qual foi caracterizado por ¹H RMN, 13C RMN, GPC, FTIR e DSC.
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Murariu M, Da Silva Ferreira A, Degée P, Alexandre M, Dubois P. Polylactide compositions. Part 1: Effect of filler content and size on mechanical properties of PLA/calcium sulfate composites. POLYMER 2007. [DOI: 10.1016/j.polymer.2007.02.067] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Joukainen A, Partio EK, Waris P, Joukainen J, Kröger H, Törmälä P, Rokkanen P. Bioabsorbable screw fixation for the treatment of ankle fractures. J Orthop Sci 2007; 12:28-34. [PMID: 17260114 DOI: 10.1007/s00776-006-1077-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2006] [Accepted: 09/11/2006] [Indexed: 11/30/2022]
Abstract
BACKGROUND Self-reinforced poly(L/dL)lactide 70:30 (SR-PLA70) retains its strength in bone for 24 weeks, whereas self-reinforced poly-L-lactide (SR-PLLA) retains its strength for over 36 weeks. In this prospective randomized study, bioabsorbable 4.5-mm SR-PLA70 screws were compared with SR-PLLA screws in the treatment of displaced ankle fractures in adults. METHODS Sixty-two patients with ankle fractures needing operative treatment were randomized into two groups. Comminuted fractures needing plating were excluded. In total 54 of 62 patients were followed up for 1 year by clinical evaluation, radiographs, and Olerud-Molander score. RESULTS The study groups differed significantly only in the mean duration of sick leave (SR-PLA70, 60 days; SR-PLLA, 65 days; P = 0.02). At the 1-year follow-up, syndesmotic ossification was more common in the SR-PLA70 group (5 versus 1 patient, not significant). Radiologically, the screw channel had not disappeared in any of the patients by the 1-year follow-up. CONCLUSIONS Both implant types proved to have good biocompatibility. SR-PLA70 and SR-PLLA screws are suitable in selected cases for the fixation of ankle fractures, but the mechanical stability of the fixation has to be carefully monitored perioperatively.
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Affiliation(s)
- Antti Joukainen
- Department of Orthopaedics and Traumatology, Kuopio University Hospital, P.O. Box 1777, FIN-70211, Kuopio, Finland
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Burger C, Kabir K, Rangger C, Mueller M, Minor T, Tolba RH. Polylactide (LTS) causes less inflammation response than polydioxanone (PDS): a meniscus repair model in sheep. Arch Orthop Trauma Surg 2006; 126:695-705. [PMID: 16896739 DOI: 10.1007/s00402-006-0207-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2006] [Indexed: 11/25/2022]
Abstract
BACKGROUND Incidence of meniscus injury has increased in today's active society. Arthroscopical refixation yields better results than partial meniscectomy. The best healing rates are achieved by sutures. As non-degradable sutures are permanent foreign bodies, slow absorbable materials are needed. A slow degradable suture with high concentration of polylactide acid, the so-called "long-term suture" (LTS, Panacryl), has been suggested to produce a higher inflammatory response than conventional polymer sutures [Vicryl, Dexon or polydioxanone (PDS)]. The aim of the study was to assess LTS for meniscus repair after a traumatic lesion and to evaluate immunological response, biodegradation and healing. METHODS In 24 randomised sheep, a radial tear of the medial meniscus was sutured by either PDS or LTS. Twelve sham-operated animals served as control. Half of the sheep were killed after 6 months, the other half after 12 months. The medial and lateral meniscus, synovial membrane, articular cartilage and ascendant lymph nodes up to the kidney were examined. Joint effusion was evaluated by MRI. RESULTS The synovial membrane was significantly thinner in the LTS group (6 months 85 +/- 10 microm, 1 year 100 +/- 28 microm) than in the PDS group (6 months 165 +/- 10 microm, 1 year 175 +/- 23 microm, P < 0.001) and the controls (6 months 150 +/- 17 microm, 12 months 192 +/- 21 microm, P < 0.001). The joint effusion was higher in the PDS than in the LTS group after 6 months, and tended to be higher in controls. In controls, effusion tended to be higher than in the LTS group. In all medial departments, osteoarthritis evolved much more intensely than in the lateral knee departments (P < 0.01). Bilateral lymph nodes from the groin up to the kidneys were larger (crosscut area) after 6 months in the controls (2.28 +/- 0.7 mm(2)) and PDS treated animals (2.3 +/- 0.7 mm(2)) than in the LTS group (1.3 +/- 0.3 mm(2), P < 0.001). After 1 year, node size differed significantly between controls and animals from the LTS group (1.98 +/- 0.4 mm(2) vs. 1.5 +/- 0.2 mm(2), P < 0.05), and between animals from the PDS and the LTS group (2.5 +/- 0.1 mm(2) vs. 1.5 +/- 0.2 mm(2), P < 0.001). CONCLUSION The polylactide thread LTS causes less immunological reaction and synovitis than a polydioxanone suture (PDS). CLINICAL RELEVANCE LTS may serve as an alternative to PDS for repair of slow healing structures such as tendons and menisci.
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Affiliation(s)
- Christof Burger
- Department of Trauma Surgery, University of Bonn Medical Center, Sigmund-Freud-Str. 25, 53127 Bonn, Germany.
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Kleinsasser NH, Wild PJ, Pérez Alvarez JC, Seidler TO, Schurr C, Froelich K, Hacki T, Hofstaedter F, Graf MA, Hagen R. Extrusion forces of resorbable tacks and titanium screws in laryngeal chondrosynthesis. Eur Arch Otorhinolaryngol 2006; 264:409-13. [PMID: 17123096 DOI: 10.1007/s00405-006-0184-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2006] [Accepted: 09/22/2006] [Indexed: 11/27/2022]
Abstract
Laryngotracheal trauma, partial laryngectomy and phonosurgery may necessitate reconstruction of the cartilaginous skeleton to ensure the quality of respiration and voice. The present report focuses on initial experience gained with a new resorbable material for plates and tacks that allows chondrosynthesis of the laryngeal skeleton. A comparison of the extrusion forces necessary to pull out the resorbable tacks versus conventional titanium screws and the degree of deformation until failure represent the experimental parameters of reconstruction quality under investigation. The PolyMax system (Synthes, Oberdorf, Switzerland) was used in a human cadaver dissection. Sixteen tacks with a diameter of 1.5 mm and sixteen titanium screws with a diameter of 1 mm were placed into the two wings of the thyroid cartilage. Extrusion forces and the degree of deformation occurring until mechanical failure of the device-body interface were measured for the two types of fixation systems. Results in N and mm were compared using a two-sided Wilcoxon test. Neither variable differed significantly between the two groups. However, within the two groups, the necessary strength to pull the tacks or the screws out of the cartilage varied markedly depending on both the inhomogeneous quality of cartilage and the degree of calcification. The PolyMax system with the tacks is recommended as an effective tool for reconstructing the cartilaginous skeleton of the larynx and the trachea with the inherent advantage of resorption as well as avoidance of a second surgery for material removal.
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Abstract
Biodegradable implants are established in the field of operative sports medicine. So-called composite implants are increasingly used. The idea to improve biocompatibility and osteoconductivity of biodegradable polymers by modifying them with a ceramic component, has led to the development of these composite implants. Today, an increasing variety of composite implants are available. They have substantially different material characteristics, which depend on matrix polymer choice and the additional ceramic. The material characteristics influence the mechanical properties, in vivo degradation, the osseous replacement and the host-tissue response. It is important to understand their biologic base for a better knowledge of the advantages and risks associated with using composite implants in the field of operative sports medicine. The purpose of this review is to focus on current developments in biodegradable composite implants and their biologic base.
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Affiliation(s)
- Karin Schlichting
- Sports Traumatology and Arthroscopy Service, Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger platz 1, 13353 Berlin, Germany
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Din R, Annear P, Scaddan J. Internal fixation of undisplaced lesions of osteochondritis dissecans in the knee. ACTA ACUST UNITED AC 2006; 88:900-4. [PMID: 16798992 DOI: 10.1302/0301-620x.88b7.17210] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A total of 11 patients (12 knees) with stable lesions of osteochondritis dissecans of the knee underwent arthroscopic fixation of the fragments using polylactide bioabsorbable pins. The site of the lesion was the medial femoral condyle in ten knees and the lateral femoral condyle in two. The mean age of the patients was 14.8 years (12 to 16). At a mean follow-up of 32.4 months (13 to 38 months) all fragments had MRI evidence of union. One patient developed early transient synovitis, which resolved with non-steroidal anti-inflammatory medication. All patients returned to sporting activities within eight months of operation and did not require a period of immobilisation.
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Affiliation(s)
- R Din
- Orthopaedic Department, Princess Margaret Hospital, Roberts Road, Subiaco, Perth, Western Australia.
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Helling HJ, Prokop A, Schmid HU, Nagel M, Lilienthal J, Rehm KE. Biodegradable implants versus standard metal fixation for displaced radial head fractures. A prospective, randomized, multicenter study. J Shoulder Elbow Surg 2006; 15:479-85. [PMID: 16831654 DOI: 10.1016/j.jse.2005.10.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2005] [Accepted: 10/18/2005] [Indexed: 02/01/2023]
Abstract
This multicenter, prospective, randomized study compares the use of biodegradable polylactide pins with standard metal mini-fragment implants for the treatment of displaced radial head fractures. It compares complication rates and clinical outcomes of both treatment methods. At 2 years, 135 (82%) of 164 patients were available for evaluation. Equivalence of treatment method was defined as a difference of 10% or less in the number of complication-free patients. Functional status was assessed by using the Broberg and Morrey Elbow Score and compared by an unpaired t test. Good or excellent clinical results were achieved by 92% (56/61) of the control patients and 96% (71/74) of the polylactide patients. The incidence of complication-free patients was 3.7% less in the polylactide group than in the control group. The 1-sided 95% confidence interval for the treatment difference between the 2 groups was more than -6.1%. Biodegradable polylactide pins have at least comparable outcomes as standard metal implants for the internal fixation of reconstructable displaced radial head fractures.
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Affiliation(s)
- Hanns-Joachim Helling
- Department of Trauma- Hand- and Reconstructive Surgery, University Hospital Cologne, Köln, Germany
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Aunoble S, Clément D, Frayssinet P, Harmand MF, Le Huec JC. Biological performance of a new β-TCP/PLLA composite material for applications in spine surgery:In vitro andin vivo studies. J Biomed Mater Res A 2006; 78:416-22. [PMID: 16721799 DOI: 10.1002/jbm.a.30749] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The objective of this research was to carry out an in vitro and in vivo study of the biological performance of PLLA/beta-TCP composite materials, to estimate the scope of their potential applications in bone surgery. Samples with increasing beta-TCP (0-60% w/w) contents were processed by injection molding. The in vitro study consisted of an evaluation of inflammatory potential by assaying the IL-1alpha secreted by monocytes, and then cell proliferation (counting) and phenotype expression (PAL and I collagen) in human osteogenous cells. The in vivo study was carried out using cylindrical implants of composite materials composed of composite materials containing 0 or 60% beta-TCP and pure beta-TCP, respectively. The implants were inserted in femoral sites in rabbits, using the Kathagen protocol. Each animal received a 60% implant, with either a 0 or a 100% implant in the contralateral femur, so that the materials could be compared with one another. Five animals were examined for each material and implantation period, giving a total of 30 animals. This study showed that adding increasing percentages of beta-TCP to a lactic acid polymer matrix stimulated the proliferation of human osteogenous cells and synthesis of the extracellular bone matrix in a dose-dependent manner. In vivo results indicate that, in comparison with pure PLA, tricalcium phosphate-containing composite materials had faster degradation kinetics, caused less inflammatory reaction, and promoted contact osteogenesis. The composite material containing 60% beta-TCP demonstrated a similar performance to pure tricalcium phosphate bone grafts in terms of osteogenesis, and is apparently compatible with the production of intra-osseous implants for situations representing high levels of mechanical strain.
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Affiliation(s)
- Stephane Aunoble
- Bordeaux 2 University, Spine Unit, 6th Floor, DETERCA Lab, 146 Leo Saignat, Bordeaux 33076, France
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Prokop A, Jubel A, Hahn U, Dietershagen M, Bleidistel M, Peters C, Höfl A, Rehm KE. A comparative radiological assessment of polylactide pins over 3 years in vivo. Biomaterials 2005; 26:4129-38. [PMID: 15664640 DOI: 10.1016/j.biomaterials.2004.10.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2004] [Accepted: 10/19/2004] [Indexed: 11/21/2022]
Abstract
Biodegradable polylactide implants allow secure fixation of osteochondral fractures with minimal adverse effects. The goal of this prospective, randomized animal study was to show whether osteoconductive effects can be achieved through the development of poly-L/DL(70/30)lactide composite implants with 10% beta-tricalcium phosphate, and whether degradation can be positively influenced and adverse effects minimized using such implants. An additional goal was to clarify which radiological procedure is most suitable to observe the course of follow-up. Thirtysix medial femoral condyle osteotomies of sheep were fixed with either 3 poly-L/DL-lactide pins or 3 composite pins, and the pin canal widths were measured with conventional radiographs, with CT, MRI, and histologically after 3, 18, and 36 months. All fractures healed completely without displacement or clinically relevant complications. The pin canals dilated secondary to pin degradation at the 12th month, and then decreased in size later. At 36 months, the pins had microscopically disappeared, and the canals were filled with bone or scar tissue. There were no statistically significant differences between the pin-types. Poly-L/DL-lactide pins and composite C-pins are suitable for secure fixation of small osteochondral fractures. Osteoconductive effects of biocompatibility or osseous integration relating to composite development were not evident. Conventional radiography and computer tomography were suitable techniques for observation of pin canals. Due to frequently observed artifact, MRI was not suitable to observe the course of the implants.
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Affiliation(s)
- Axel Prokop
- Department of Trauma and Reconstructive Surgery, University Hospital, Cologne, Joseph-Stelzmann-Street 9, D-50924 Cologne, Germany.
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Wildemann B, Sander A, Schwabe P, Lucke M, Stöckle U, Raschke M, Haas NP, Schmidmaier G. Short term in vivo biocompatibility testing of biodegradable poly(D,L-lactide)—growth factor coating for orthopaedic implants. Biomaterials 2005; 26:4035-40. [PMID: 15626449 DOI: 10.1016/j.biomaterials.2004.10.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2004] [Accepted: 10/02/2004] [Indexed: 11/28/2022]
Abstract
Fracture healing can be stimulated by exogenous application of growth factors. Using porcine and rat models the efficacy of locally delivered IGF-I and TGF-beta1 from an implant coating has been demonstrated. A thin and biomechanical stable biodegradable poly(D,L-lactide) was used to coat implants and serve as a drug carrier. Due to reports of possible foreign body reactions caused by polymer materials in orthopedic surgery, this study investigated the biocompatibility of the polylactide implant coating and the locally released growth factors during the time course of rat tibial fracture healing (days 5, 10, 15, and 28 after fracture). Monocytes/macrophages and osteoclast were detected using an monoclonal antibody against ED1 (comparable to CD68 in mice and human). The antibody ED1 stains monocytes, macrophages and osteoclast in the bone marrow and in the newly formed fracture callus. A moderate density of the monocytes/macrophages was seen in the proximal part of the medullary canal, but almost no cells were detectable in the region distal to the fracture. The amount of stained cells increased during the observation time with a maximum at days 10 and 15 followed by a decrease at day 28. No differences were detectable between the investigated groups from day 5 to 15 post fracture indicating, that the used poly(D,L-lactide) or the incorporated growth factors do not evoke an elevated immunological response compared to the uncoated titanium implant at the investigated time points. A significantly higher amount of ED1 positive cells was measured 28 days after fracture in the control group compared to the groups with the coated implants. In conclusion, no indication of a foreign body reaction due to the use of the polylactide or the growth factors was found indicating a good short-term biocompatibility of this bioactive coating.
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Affiliation(s)
- Britt Wildemann
- Center for Musculoskeletal Surgery, Charité, University Medicine, Augustenburger Platz 1, Berlin D-13353, Germany.
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De Jong WH, Eelco Bergsma J, Robinson JE, Bos RRM. Tissue response to partially in vitro predegraded poly-L-lactide implants. Biomaterials 2005; 26:1781-91. [PMID: 15576152 DOI: 10.1016/j.biomaterials.2004.06.026] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2004] [Accepted: 06/01/2004] [Indexed: 10/26/2022]
Abstract
The in vivo local reaction of as-polymerized poly-L-lactide composed of 96% L-lactide and 4% D-lactide (PLA96) was investigated by histology at 2, 13 and 26 weeks after subcutaneous implantation in rats. In order to simulate possible end stage reactions the PLA96 was also predegraded in vitro until approximately 50% weight loss. The local reaction of predegraded PLA (PLA96(168)) was compared to the local reaction of polyethylene (PE) and non-predegraded PLA (PLA96). For PE and PLA96 a mild local reaction was observed at all time points consisting of a minimal layer of macrophage like cells with incidentally multinucleated giant cells at the implant interface, surrounded by a mild connective tissue capsule. For PLA96 at weeks 13 and 26 some minimal alterations in terms of degradation and ingrowth of cells was noted. The in vitro incubation (90 degrees C for 168 h) of PLA96(168) resulted for the thin 0.2 mm samples in complete degradation. Predegraded 0.5, 1.0 and 2.0 mm PLA96(168) samples were implanted and evaluated. The 1.0 and 2.0 mm samples could be evaluated for all time points investigated, but some 0.5 mm PLA96(168) samples were already completely resorbed at week 2 after implantation. In general, responses found for the predegraded PLA96(168) at weeks 2, 13 and 26 were similar with a pronounced macrophage infiltrate containing birefringent material, encapsulation of polymer fragments, and the presence of a debris area consisting of polymer and cellular remnants. In lymph nodes foamy macrophages with birefringent material were only observed in lymph nodes draining sites with predegraded PLA96(168). Immunohistochemistry was performed for further characterization of the cellular infiltrate. At the implant interface of the non-degrading PE and PLA96, ED1 and OX6 (MHC class II) positive cells were identified. In the capsule macrophage like cells expressed all three macrophage markers ED1, ED2, and ED3. CD4 and CD8 positive cells, indicating T helper and T supressor/cytotoxic cells, respectively, could be observed in low numbers, CD4 more than CD8. Both CD4 and CD8 were occasionally observed within the degrading PLA96(168) implant. Polymorphonuclear neutrophilic granulocytes were mainly observed at 2 weeks after implantation. We showed that predegradation could be used as a means to study late tissue reactions to polymers. Complete degradation may be studied with relatively thin implants, but this may lead to rather optimistic interpretation of resorption periods. When materials are intended to be used for screws and/or plates for bone fixation, implants of at least 1.0-2.0 mm thickness should be used as these may show a more realistic representation of the resorption characteristics of the material under investigation.
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Affiliation(s)
- Wim H De Jong
- Laboratory for Toxicology, Pathology and Genetics, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands.
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Abstract
The current study was designed to clarify whether biodegradable poly-L/DL lactide pins provide an operative alternative for fixation of Pipkin fractures. Nine patients with Pipkin fractures (one with Pipkin Type I, one with Pipkin Type II, and seven with Pipkin Type IV fractures) were treated surgically between 1996 and 2002. In all patients, the femoral head fractures were fixed with biodegradable, 2.7-mm and 2.0-mm polylactide pins. Eight patients were followed up for an average of 54.2 months. One patient died before the final followup. Eight fractures healed uneventfully. In one patient, a persisting femoral head defect led to posttraumatic arthritis requiring insertion of a femoral endoprosthesis at 1 year. The average range of motion of the affected hips of all patients at followup was 109 degrees -0 degrees -0 degrees in flexion and extension. External and internal rotation averaged 37 degrees -0 degrees -29 degrees . One patient had Brooker Grade I heterotopic ossification develop, and another had a Grade II heterotopic develop. Merle d'Aubigne and Postel ratings showed two excellent and five satisfactory results (average score, 13.1). Adverse effects from the polylactide implants were not observed. Pipkin fractures can be fixed successfully with biodegradable polylactide pins.
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Affiliation(s)
- Axel Prokop
- Department of Trauma, Hand and Reconstructive Surgery, University of Cologne, Germany.
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Pyhältö T, Lapinsuo M, Pätiälä H, Pelto M, Törmälä P, Rokkanen P. Fixation of distal femoral osteotomies with self-reinforced polymer/bioactive glass rods: an experimental study on rabbits. Biomaterials 2005; 26:645-54. [PMID: 15282142 DOI: 10.1016/j.biomaterials.2004.03.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2003] [Accepted: 03/13/2004] [Indexed: 11/18/2022]
Abstract
Two self-reinforced poly(desamino tyrosyl-tyrosine ethyl ester carbonate), poly(DTE carbonate) or self-reinforced poly(DTE carbonate)/bioactive glass rods, (2 mm by 40 mm) were implanted into the dorsal subcutaneous tissue and osteotomies of the distal femur were fixed with these rods (2 mm by 26 mm) in 36 rabbits. The follow-up times varied from three to 100 weeks. After sacrifice, three-point bending and shear tests and molecular weight measurements were performed for subcutaneously placed rods. Radiological, histological, histomorphometrical, microradiographic, and oxytetracycline-fluorescence studies of the osteotomized and intact control femora were performed. The initial mechanical properties were higher with the SR-poly(DTE carbonate) rods, but the SR-poly(DTE carbonate)/bioactive glass rods lost their mechanical properties slower. At 100 weeks the bending strength had decreased to 21% of the initial value with the SR-poly(DTE carbonate) rods and to 49% with the SR-poly(DTE carbonate)/bioactive glass rods. The shear strength had decreased to 10% with the SR-poly(DTE carbonate) rods and to 23% of the initial value with the SR-poly(DTE carbonate)/bioactive glass rods. Two slight displacements and one delayed union and one failure of fixation were seen in the SR-poly(DTE carbonate) group. In the SR-poly(DTE carbonate)/bioactive glass group five delayed unions and seven slight displacements were seen. No signs of osteolysis or foreign body reactions were observed. Signs of resorption of the implants were seen at 100 weeks in the SR-poly(DTE carbonate)/bioactive glass group. The present investigation showed that the mechanical strength and fixation properties of SR-poly(DTE carbonate) and SR-poly(DTE carbonate)/bioactive glass rods are suitable for fixation of cancellous bone osteotomies in rabbits.
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Affiliation(s)
- Tuomo Pyhältö
- Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, PO Box 266 (Topeliuksenkatu 5), FIN-00029 HUS, Helsinki, Finland.
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Stallmann HP, Faber C, Plokker HM, Wuisman PIJM. Biodegradable X-ray markers of controlled radio-opacity. Temporary position measurements in bone. Acta Orthop 2005; 76:122-7. [PMID: 15788320 DOI: 10.1080/00016470510030445] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
In order to analyze X-ray markers for potential use in biodegradable implants or radiostereogrammatic analysis (RSA), we combined iopromide contrast fluid with biodegradable calcium phosphate cement. The radio-opacity of 10 x 10 mm markers containing different iodine concentrations (0, 120, 240, 360 and 720 mg per gram cement) was compared to an aluminium wedge of increasing (1-10 mm) thickness. The addition of iopromide increased the radio-opacity in a dose-dependent manner, which was comparable to 9-mm aluminium at concentrations of 240-720 mg/g. Radiographs of markers placed in explanted rabbit and in human femora were made to investigate the clinical accuracy for position determination. Markers of 1 x 1 mm (120 mg/g) were clearly discernable in all femora, and could be used to adequately measure distances of 5-45 mm (accuracy 0.10-2.19 mm). These markers might be embedded in biodegradable implants or used as temporary markers in the bone to analyze postoperative position on radiographs.
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Affiliation(s)
- Hein P Stallmann
- Department of Orthopaedic Surgery, VU Medical Center, NL-1007 MB Amsterdam, The Netherlands
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Saikku-Bäckström A, Räihä JE, Välimaa T, Tulamo RM. Repair of Radial Fractures in Toy Breed Dogs with Self-Reinforced Biodegradable Bone Plates, Metal Screws, and Light-Weight External Coaptation. Vet Surg 2005; 34:11-7. [PMID: 15720591 DOI: 10.1111/j.1532-950x.2005.00003.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe a surgical technique for, and outcome after, treatment of radial fractures with biodegradable self-reinforced polylactide plates and metal screws, and external coaptation. STUDY DESIGN Prospective clinical study. SAMPLE POPULATION Eleven Toy breed dogs. METHODS Radial fractures were repaired by application of a single or 2 stacked biodegradable self-reinforced polylactide plates (poly-L/D, L-lactide, stereocopolymer [LL-and DL-lactide ratio 70/30]; SR-PLA (70/30) implants) secured with metal screws, and light-weight external coaptation. Healing was evaluated clinically and by radiography at 2, 4, 6, 8, 9, 12, 24-26 weeks, and at 1 and 2 years. Owners were interviewed 3 years after surgery. RESULTS Radial fracture lines disappeared within 4-14 weeks in 10 dogs; an implant failed in 1 dog. Ambulation was excellent for healed fractures. Excessive skin tension led to removal of implants in 1 dog and suture repair in another dog. No foreign body reaction from implant degradation was observed and the plate was usually no longer palpable at 2 years. One dog had a fracture through a screw hole at 1 year. CONCLUSION Healing and complication rates after repair of radial fractures with SR-PLA (70/30) plates were considered similar or better than reported after repair with metallic plates or external fixation in Toy breed dogs. No radiographic signs of osteopenia were identified under the plate during follow-up. CLINICAL RELEVANCE Biodegradable polylactide plates could be considered as an alternative to metal plates for radial fracture repair in Toy breed dogs, however available plates are likely not strong enough when used as a single plate. Implant removal is usually not needed.
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Prokop A, Höfl A, Hellmich M, Jubel A, Andermahr J, Emil Rehm K, Hahn U. Degradation of poly-L/DL-lactide versus TCP composite pins: A three-year animal study. J Biomed Mater Res B Appl Biomater 2005; 75:304-10. [PMID: 16037964 DOI: 10.1002/jbm.b.30300] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Biodegradable polylactide implants allow secure fixation of osteochondral fractures. This quasirandomized parallel-group animal study investigates whether a composite implant of poly-L/DL-lactide (PLDLLA) with additional 10% beta-tricalcium phosphate produces an osteoconductive effect, whether the admixture positively influences implant degradation (assessed by comparing time to implant degradation), and whether the pin sites of degraded implants are replaced with bone tissue. On 36 medial femoral condyles of sheep, osteotomies were fixed with either three PLDLLA pins or three composite pins. At 3, 18, and 36 months, the pin sites were measured histologically and the state of degradation assessed according to Pistner's classification. All fractures healed without clinically relevant complications and without displacement. Both pin types led to asymptomatic pin-site enlargement at 18 months, which disappeared by 36 months. At 18 months, 14 of 18 PLDLLA pins were no longer evident, whereas 16 of 18 composite pins showed only peripheral degradation. By 36 months, all implants from both groups were completely degraded and replaced with scar (2/18) or bone tissue (16/18). At 36 months there was no evidence for significant improvement of either degradation performance or osseointegration through use of the 10% TCP composite mixture.
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Affiliation(s)
- Axel Prokop
- Department of Trauma and Reconstructive Surgery, University of Cologne, Joseph-Stelzmann-Strasse 9, D-50924, Cologne, Germany.
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Berkland C, Cox A, Kim K, Pack DW. Three-month, zero-order piroxicam release from monodispersed double-walled microspheres of controlled shell thickness. ACTA ACUST UNITED AC 2004; 70:576-84. [PMID: 15307162 DOI: 10.1002/jbm.a.30114] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Double-walled microspheres represent an increasingly important class of drug delivery devices that provide enhanced control of drug delivery schedules. Clearly, the overall particle size and shell thickness are important parameters in modulating the drug release rates. Precision particle fabrication technology has been used to fabricate double-walled microspheres of predefined uniform diameters of 40-60 microm exhibiting a poly(D,L-lactide-co-glycolide) (PLG) core and poly(L-lactide) (PL) shell of controllable thickness from approximately 2 to 10 microm. The release of a model small-molecule drug, piroxicam, from uniform microspheres of pure PLG and PL is compared to the release from double-walled microspheres exhibiting different PL shell thicknesses. The presence of the PL shell enveloping a PLG core essentially eliminated the initial "burst" of piroxicam that was observed when the drug was released from pure PLG microspheres. In addition, increasing the PL shell thickness shifted the release profile from a biphasic shape for pure PLG microspheres to zero-order piroxicam release over 3 months for the thickest (approximately 10 microm) PL shell.
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Affiliation(s)
- Cory Berkland
- Department of Chemical and Biomolecular Engineering, University of Illinois, Urbana, Illinois 61801, USA
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