The purpose of this study was to assess the effects of biodegradable interference screw use in ACL reconstruction beyond the usual clinical historical and physical findings. The use of this material for interference screws has potential benefits if the problems of inflammation are minimal and the fixation properties are sufficient. There is no need for a second operation for removal and no complicating factor if revision surgery is necessary. A prospective study was initiated in May, 1993 to evaluate the use of biodegradable interference screws (Instrument Makar). Our patients were evaluated with the aid of the common OAK-score. The overall evaluation showed 89.5% excellent and good results, 7% fair results and 3.5% poor results. The average score was 90.7 points (63-100 points). The measurement with the arthrometer (KT 1000) showed a difference of up to 3 mm as compared to the knee joint not operated on in 24 (93%) of the patients. Four patients showed a 3 to 6 mm difference. A tibia translation of more than 4 mm was not measured in any case. The biodegradable interference screw is a safe and effective interference screw for fixation of the bone blocks for ACL reconstruction.
The use of degradable implants in recent years has brought not only good results. Foreign body reactions to implantation of degradable polymers clearly curtailed the initial expectations. Bioabsorbable polymers have been used for sutures, vascular clips, and fixation implants for both intra-articular fractures and malleolar fractures. In the literature these implants are controversial. Potential benefits remain for the use of this material for interference screws if the problems of inflammation are minimal and the fixation properties are sufficient. There is no need for a second operation for removal. In one patient, 4,5 years after to implantation of an degradable interference screw (Copolymer 85/15 D,L lactide glycolide; Biologically Quiet, Instrument Makar, Inc. Mount Hope, MI 48864, USA) we took an biopsy and made histological examinations. No foreign body reaction or inflammation signs could be detected.
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