Biodegradable implant materials in fracture fixation

Illi, O. E.; Weigum, H; Misteli, F.

doi:10.1016/0267-6605(92)90087-a

Cited by 14 publications

(8 citation statements)

References 3 publications

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“…Waris et al (2002) tested the fixation properties of SR-P(L/DL) LA 70/30 screws (outer diameter 2.0 mm, core diameter 1.5 mm) (Fig 1) in oblique pig metacarpal osteotomies, and demonstrated that they provided rigidity comparable with that of 1.5 mm Kirschner wires, both in bending and torsion tests, but the rigidity was lower than that of titanium lag screws. Illi et al (1992) compared PLLA and stainless-steel screws for fixation of oblique metacarpal diaphyseal osteotomies in growing calves. The clinical, radiological and histological results were similar at follow-up times of 1 to 6 weeks, whereas conservative treatment yielded less successful results.…”

Section: Experimental Studiesmentioning

confidence: 99%

Use of Bioabsorbable Osteofixation Devices in the Hand

Waris

Ashammakhi

Kaarela

et al. 2004

Journal of Hand Surgery

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Bioabsorbable internal fixation by means of pins, tacks, screws and miniplates offers an alternative to metallic osteofixation for the stabilization of small bone fractures, osteotomies, ligament injuries and fusions in the hand. The advantages of using them include avoidance of metallic-implant-related long-term complications and a secondary removal operation. Currently the most commonly used devices are made of poly L-lactide (PLLA) and copolymers of polylactides (P(L/DL)LA) and polyglycolide (PLGA). In areas of mechanical stress, the use of ultra-high-strength self-reinforced devices is recommended. Biomechanical studies on fresh frozen bones have shown that the fixation rigidity achieved with self-reinforced devices approaches that of metallic osteofixation methods. The reliability of modern implants has been confirmed in several experimental and clinical studies.

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Section: Experimental Studiesmentioning

confidence: 99%

Use of Bioabsorbable Osteofixation Devices in the Hand

Waris

Ashammakhi

Kaarela

et al. 2004

Journal of Hand Surgery

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“…Operation time with resorbable materials may be a little longer than with conventional techniques, however, the advantage of not having to remove part of the wires, screws and plates is nowadays a real advantage. The resorbable implants have never interfered with later operations [1,5]. Radiological follow-up controls showed the absence of the PLLA material 12 to 18 months after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…This not only leads to a larger overall surface but also promotes ingrowth of soft and, later on, calcified tissue. Another advantage of our implants may be the breaking into pieces after 6-8 weeks, as found in the histological work-up of the cranioplasties in the trial with juvenile minipigs [1].…”

Section: Discussionmentioning

confidence: 99%

“…It was decided to do the first clinical trial in children at the Department of Pediatric Surgery, University Children's Hospital, Zurich. The type of PLLA material and the manufacturing process was not changed from those used in the 1987 animal research [1,2]. The surgical procedures without and with the use of biodegradable fixation devices remained unchanged for the entire group of children in craniofacial operations and also in neurosurgery.…”

Section: Introductionmentioning

confidence: 98%

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Five years of experience with biodegradable implants in paediatric surgery

Illi

Gitzelmann

Gasser

et al. 1994

J Mater Sci: Mater Med

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After successful animal research on minipigs and calves, it was decided in January 1988 to begin the clinical application of PLLA (poly-L-lactide) threaded plugs, nuts and woven bands made of PDS (poly-dioxanon). The implants were made of pure crystalline 1-1-PLLA with an average molecular weight between 220000 and 500000 I.E. Mechanical testing revealed a Young's modulus of 4000 N mm -2, a fracture elongation of 2%, and strength values under tension and compression and bending of 55, 110 and 120 N mm -2, respectively. The PDS bands (Ethicon Corp., type XX40) are commercially available items. Operations were carried out on 32 children, aged 11 months to 17 years, in 15 cases for craniofacial malformations, in 16 patients for neurotraumatological lesions and in 1 girl for refixation of an osteochondral flake of the patella. The follow-up time ranged from 3 months up to 5.6 years, with an average of 3 years. The stability achieved was comparable to that of metal implants. No foreign-body reaction or local infections were observed, and it did not become necessary to remove any of the resorbable implants. Furthermore, there was no interference with skull growth. In accordance with these results, PLLA implants fulfill the needs of skull surgery, and it is intended to increase the application of this type of material to orthopaedic traumatology in children.

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“…There are, however, several complications with the use of degradable polymers for orthopedic applications. PLA when used on its own has a low absorption rate 8. This is advantageous in that the slow release of degradation products can be accommodated by a patient's metabolism9 but means that a device made of PLA may not transfer loading to the supported tissue at a sufficiently fast rate for healing purposes.…”

Section: Introductionmentioning

confidence: 99%

The modification of PLA and PLGA using electron‐beam radiation

Leonard

Pick

Farrar

et al. 2008

J Biomedical Materials Res

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The degradable polymers polylactide (PLA) and polylactide-co-glycolide (PLGA) have found widespread use in modern medical practice. However, their slow degradation rates and tendency to lose strength before mass have caused problems. The aim of this study was to ascertain whether treatment with e-beam radiation could address these problems. Samples of PLA and PLGA were manufactured and placed in layered stacks, 8.1 mm deep, before exposure to 50 kGy of e-beam radiation from a 1.5 MeV accelerator. Gel permeation chromatography testing showed that the molecular weight of both materials was depth-dependent following irradiation, with samples nearest to the treated surface showing a reduced molecular weight. Samples deeper than 5.4 mm were unaffected. Computer modeling of the transmission of a 1.5 MeV e-beam in these materials corresponded well with these findings. An accelerated mass-loss study of the treated materials found that the samples nearest the irradiated surface initiated mass loss earlier, and at later stages showed an increased percentage mass loss. It was concluded that e-beam radiation could modify the degradation of bioabsorbable polymers to potentially improve their performance in medical devices, specifically for improved orthopedic fixation.

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Biodegradable implant materials in fracture fixation

Cited by 14 publications

References 3 publications

Use of Bioabsorbable Osteofixation Devices in the Hand

Use of Bioabsorbable Osteofixation Devices in the Hand

Five years of experience with biodegradable implants in paediatric surgery

The modification of PLA and PLGA using electron‐beam radiation

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