Histologic findings with a bioabsorbable anterior cruciate ligament interference screw explant after 2.5 years in vivo

Morgan, Craig D.; Gehrmann, Robin M.; Jayo, Manuel J.; Johnson, Christopher

doi:10.1053/jars.2002.36466

Cited by 35 publications

(18 citation statements)

References 23 publications

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“…29 The material is broken down by hydrolic chain scission and eliminated as carbon dioxide and water by respiration. 29 Major advantages of the use of bioabsorbable implants include decreased interference during magnetic resonance imaging and absence of need for a second surgical procedure for hardware removal. [25][26][27][28][30][31][32][33] Disadvantages and possible complications include screw breakage, inflammatory and foreign body reactions, cyst formation, and local bone lysis.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Analysis of the Survivability of Absorbable Versus Nonabsorbable Subtalar Joint Arthroereisis Implants

Baker

Klein

Weil

et al. 2012

Foot & Ankle Specialist

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Subtalar joint arthroereisis is a surgical modality that has been shown to be an effective procedure for flexible flatfoot in both pediatric and adult populations. Despite advances in understanding its mechanics and function, complication and implant removal rates remain as high as 30% to 40%. Analysis was performed to determine the survivability of 2 subtalar joint arthroereisis implants, absorbable and nonabsorbable, used alone and in combination with other procedures in both the adult and pediatric populations. The 95 total arthroereisis procedures were analyzed in several major categories: absorbable implants versus nonabsorbable implants and adult versus pediatric patients. Each major group was then further subdivided to create further subgroups: absorbable isolated procedures, absorbable combined procedures, nonabsorbable isolated procedures, and nonabsorbable combined procedures. The overall survival rates were 83% for absorbable implants and 81% for nonabsorbable implants. A total of 11 (17%) absorbable implants and 6 (19%) nonabsorbable implants were removed, respectively, at an average of 9 months and 23 months postoperatively. When used alone and in combination with other procedures, 36% and 13% of absorbable implants and 18% and 19% of nonabsorbable implants, respectively, were removed. When comparing adult versus pediatric populations, the overall survival rates of the absorbable and nonabsorbable implants were 81% for absorbable implants and 79% for nonabsorbable implants in the adult population and 85% for absorbable implants and 100% for nonabsorbable implants in the pediatric population.

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Section: Discussionmentioning

confidence: 99%

Retrospective Analysis of the Survivability of Absorbable Versus Nonabsorbable Subtalar Joint Arthroereisis Implants

Baker

Klein

Weil

et al. 2012

Foot & Ankle Specialist

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show abstract

“…This assumption is based on the fact that ingrowing tissue in the screws can be detected by MRI scans [ 14 , 16 ]. However, Morgan et al [ 21 ] demonstrated that a screw that appeared to have a clear outline on MRI was actually undergoing degradation. They explanted en bloc a PLA screw used in a patient with ACL/bone–patellar tendon–bone after 2.5 years.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging analysis of the bioabsorbable Milagro™ interference screw for graft fixation in anterior cruciate ligament reconstruction

Frosch¹,

Sawallich²,

Schütze³

et al. 2009

Strategies in Trauma and Limb Reconstruction

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Ligament graft fixation with bioabsorbable interference screws is a standard procedure in cruciate ligament replacement. Previous screw designs may resorb incompletely, and can cause osteolysis and sterile cysts despite being implanted for several years. The aim of this study was to examine the in vivo degradation and biocompatibility of the new Milagro TM interference screw (Mitek, Norderstedt, Germany). The Milagro TM interference screw is made of 30% ß-TCP (TriCalcium phosphate) and 70% PLGA (Poly-lactic-co-glycolic acid). In the period between June 2005 and February 2006, 38 patients underwent graft fixation with Milagro TM screws in our hospital. Arthroscopic ACL reconstruction was performed using hamstring tendon grafts in all the patients. MR imaging was performed on 12 randomly selected patients out of the total of 38 at 3, 6 and 12 months after surgery. During the examination, the volume loss of the screw, tunnel enlargement, presence of osteolysis, fluid lines, edema and postoperative screw replacement by bone tissue were evaluated. There was no edema or signs of inflammation around the bone tunnels. At 3, 6 and 12 months, the tibial screws showed an average volume loss of 0, 8.1% (±7.9%) and 82.6% (±17.2%, P \ 0.05), respectively. The femoral screws showed volume losses of 2.5% (±2.1%), 31.3% (±21.6%) and 92.02% (±6.3%, P \ 0.05), respectively. The femoral tunnel enlargement was 47.4% (±43.8%) of the original bone tunnel volume after 12 months, and the mean tunnel volume of the tibial tunnel was -9.5% (±58.1%) compared to the original tunnel. Bone ingrowth was observed in all the patients. In conclusion, the resorption behaviour of the Milagro TM screw is closely linked to the graft healing process. The screws were rapidly resorbed after 6 months and, at 12 months, only the screw remnants were detectable. Moreover, the Milagro TM screw is biocompatible and osteoconductive, promoting bone ingrowth during resorption. Tunnel enlargement is not prevented in the first months but is reduced by bone ingrowth after 12 months.

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“…15 Biodegradable interference screw fixation has been used with success in knee ligament reconstruction. 8,18,21 Romeo and colleagues 19 have recently published preliminary data on biomechanical analysis of interference screw fixation. In a comparison of load to failure of repair via a bone tunnel versus a 7 ϫ 12-mm screw versus a 8 ϫ 12-mm screw, there was no statistical difference among the techniques.…”

Section: Discussionmentioning

confidence: 99%

Distal biceps tendon rupture: Biomechanical analysis of repair strength of the Bio-Tenodesis screw versus suture anchors

Krushinski

Brown

Murthi

2007

Journal of Shoulder and Elbow Surgery

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Histologic findings with a bioabsorbable anterior cruciate ligament interference screw explant after 2.5 years in vivo

Cited by 35 publications

References 23 publications

Retrospective Analysis of the Survivability of Absorbable Versus Nonabsorbable Subtalar Joint Arthroereisis Implants

Retrospective Analysis of the Survivability of Absorbable Versus Nonabsorbable Subtalar Joint Arthroereisis Implants

Magnetic resonance imaging analysis of the bioabsorbable Milagro™ interference screw for graft fixation in anterior cruciate ligament reconstruction

Distal biceps tendon rupture: Biomechanical analysis of repair strength of the Bio-Tenodesis screw versus suture anchors

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