Comparison of Poly-L-Lactide and Polylactide Carbonate Interference Screws in an Ovine Anterior Cruciate Ligament Reconstruction Model

Walsh, William R.; Cotton, Nicholas J.; Stephens, Paul; Brunelle, John E.; Langdown, Andy; Auld, J.; Vizesi, Frank; Bruce, Warwick

doi:10.1016/j.arthro.2007.01.030

Cited by 28 publications

(24 citation statements)

References 34 publications

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“…5,24–28 Sheep were selected for this study because their bone density and weight are similar to humans. 29 Pena et al 6 reported that bone density had an influence on determining peak loads at failure in human cadaveric specimens, so the use of sheep specimens can help to minimize specimen-related bias.…”

Section: Discussionmentioning

confidence: 99%

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Influence of Hydroxyapatite-Coated and Growth Factor–Releasing Interference Screws on Tendon-Bone Healing in an Ovine Model

Markel

Nemke

et al. 2009

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Purpose Our purpose was to determine whether a bioresorbable interference screw coated with a hydroxyapatite-based mineral layer designed to release an engineered peptide growth factor (linkBMP-2 [where “BMP-2” indicates bone morphogenetic protein 2]) improved tendon-bone healing compared with a screw without coating. Methods Tagged linkBMP-2 peptides were used to quantify binding efficiency and release kinetics on 9 mineral-coated BIORCI screws (Smith & Nephew, Andover, MA). Fourteen mature female sheep were used in this study. In each of the 14 sheep, each stifle was randomized to either receive a linkBMP-2–coated or uncoated interference screw (n ± 14 per treatment). The sheep were euthanized at 6 weeks after surgery. Eight sheep were subjected to biomechanical testing for peak load at failure and stiffness, and six sheep were used for histologic analysis according to a semiquantitative scoring scale. Results The linkBMP-2 molecule bound efficiently to the surface of mineral-coated interference screws. Over 80% of the initially bound linkBMP-2 was released during a 6-week time frame in vitro. Peak load at failure in the linkBMP-2–coated interference screw group (mean ± SD, 449.3 ± 84.7 N) was not significantly different from that in the uncoated group (421.0 ± 61.8 N) (P = .22). Stiffness in the linkBMP-2–coated interference screw group (157.3 ± 39.6 N/mm) was not significantly different from that in the uncoated group (140.6 ± 20.3 N/mm) (P = .12). Histologic analysis showed that the tendons in the linkBMP-2–coated interference screw group had higher scores (better) than the uncoated group. In the linkBMP-2–coated interference screw group, mesenchymal cells were present at the interface between screw and tendon, whereas these cells were not present in the uncoated group. Conclusions We found that linkBMP-2 can be bound onto a mineral-coated BIORCI interference screw surface and subsequently released from the screw surface in a sustained manner. The histologic result of this study showed that the linkBMP-2–coated interference screw significantly improved the histologic scores of early tendon-bone healing in this sheep model. Clinical Relevance This linkBMP-2 coating material may improve early tendon/ligament fixation.

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Section: Discussionmentioning

confidence: 99%

“…A modified semiquantitative scale, based on a previous study, was used to evaluate tendon-bone healing (Table 1). 24 The sections from each specimen were examined by 3 senior researchers blinded to group assignments, and the mean scores of the 3 researchers were used for statistical comparisons.…”

Section: Methodsmentioning

confidence: 99%

Influence of Hydroxyapatite-Coated and Growth Factor–Releasing Interference Screws on Tendon-Bone Healing in an Ovine Model

Markel

Nemke

et al. 2009

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…This bioabsorbable screw was composed of polylactide carbonate (PLC), an amorphous polymer consisting of 65% poly(D,L-lactic-co-glycolic acid) and 35% calcium carbonate 7,8 . It was hypothesized that this bioabsorbable material would also display osteoconductive properties, thereby providing a scaffold for new bone formation during its degradation.…”

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confidence: 99%

Do Newer-Generation Bioabsorbable Screws Become Incorporated into Bone at Two Years After ACL Reconstruction with Patellar Tendon Graft?

Cox

Spindler

Leonard

et al. 2014

Journal of Bone and Joint Surgery

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CALAXO screws in the tibial tunnel were more likely to be rated as degraded or partially degraded compared with MILAGRO screws at a mean of three years after implantation for ACL reconstruction. Although these newer-generation bioabsorbable screws were designed to promote osseointegration, no tunnel narrowing was noted, and in the majority of cases the remains of the screws were present at approximately three years.

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“…In ovine models [3], the PLC screws have shown gradual and controlled degradation, stimulating ossification of the graft within the bone tunnel. New bone thus formed was noted around the margin of the screw as early as 6–12 weeks.…”

Section: Discussionmentioning

confidence: 99%

“…Polylactide carbonate (PLC) is a combination of an amorphous bioabsorbable polymer, poly DL -lactide-coglycolide (PDLG), with calcium carbonate, a bone-stimulating material and neutralizing agent [3]. PLC was used to develop the “Calaxo” (Smith & Nephew, Andover, MA, USA) interference screw for knee ligament reconstruction surgery.…”

Section: Introductionmentioning

confidence: 99%

Femoral fracture following knee ligament reconstruction surgery due to an unpredictable complication of bioabsorbable screw fixation: a case report and review of literature

Konan

Haddad

2009

J Orthopaed Traumatol

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Comparison of Poly-L-Lactide and Polylactide Carbonate Interference Screws in an Ovine Anterior Cruciate Ligament Reconstruction Model

Cited by 28 publications

References 34 publications

Influence of Hydroxyapatite-Coated and Growth Factor–Releasing Interference Screws on Tendon-Bone Healing in an Ovine Model

Influence of Hydroxyapatite-Coated and Growth Factor–Releasing Interference Screws on Tendon-Bone Healing in an Ovine Model

Do Newer-Generation Bioabsorbable Screws Become Incorporated into Bone at Two Years After ACL Reconstruction with Patellar Tendon Graft?

Femoral fracture following knee ligament reconstruction surgery due to an unpredictable complication of bioabsorbable screw fixation: a case report and review of literature

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