One-Year Results of Use of Poly-L/D-Lactic Acid Joint Scaffolds and Bone Packing in Revision Metacarpophalangeal Arthroplasty

Ikävalko, Mikko; Skyttä, Eerik; Belt, Eero A.

doi:10.1016/j.jhse.2007.03.006

Cited by 14 publications

(15 citation statements)

References 10 publications

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“…Periarticularly bone absorbtion was noticed already at one-year after operation. This may have occurred as a result of insufficient blood supply or foreign body reaction caused by the PLDLA interposition implant (14).…”

Section: Discussionmentioning

confidence: 99%

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The Mean Seven Years' Results of the Use of Poly-L/D-Lactic Acid (PLDLA) Interposition Implant and Bone Packing in Revision Metacarpophalangeal Arthroplasty: A Prospective Cohort Study

Tiihonen

Honkanen

Belt³

et al. 2012

Scand J Surg

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Background and Aims: revision arthroplasty of metacarpophalangeal (mcp) joints in chronic inflammatory arthritis patients after silicone implants is challenging due of severe bone loss and soft tissue deficiencies. The aim of this study was to evaluate the outcome of revision mcp arthroplasty using poly-l/D-lactic acid 96:4 (plDla) interposition implant and morcelised allograft or autograft bone packing in patients with failed mcp arthroplasties and severe osteolysis.Material and Methods: The study group consisted of 15 patients (15 hands and 36 joints) at a mean follow-up of seven years (range 5-10 years). The radiographs were reviewed for osteolysis and incorporation of the grafted bone. The clinical assessments included active range of motion, evaluation of pain, subjective outcome and assessment of grip power.Results: plDla interposition arthroplasty combined with bone packing provided satisfactory pain relief, but function was limited. radiographic analysis showed complete incorporation of the grafted bone to the diaphyseal portion of the host metacarpal and phalangeal bones in 30 of the 36 joints. all the patients had very limited grip strength, both on the operated and non-operated side.Conclusions: Due to soft tissue deficiencies long-term function and alignment problems can not be resolved with plDla interposition implant.

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Section: Discussionmentioning

confidence: 99%

“…This implant has yielded promising results in both primary and revision MCP arthroplasties (11)(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

The Mean Seven Years' Results of the Use of Poly-L/D-Lactic Acid (PLDLA) Interposition Implant and Bone Packing in Revision Metacarpophalangeal Arthroplasty: A Prospective Cohort Study

Tiihonen

Honkanen

Belt³

et al. 2012

Scand J Surg

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“…MP joint arthroplasty using a silicone implant is the gold standard in advanced stages although silicone implants break easily and can stimulate periprosthetic bone lysis; the outcome deteriorates in the long term (Bass et al, 1996;Schmidt et al, 1999;Parkkila et al, 2005;Goldfarb and Stern, 2003;Trail et al, 2004). Revision of major osteolytic defects around silicone implants may require technically demanding bone grafting, and two-stage revision operations are sometimes needed (Burgess et al, 2007;Ikavalko et al, 2007). There is a need for more durable MP joint implants (Goldfarb and Dovan, 2006;Moller et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

“…The bioresorbable interposition implant aims to avoid the chronic foreign body evoked complications associated with silicone implants, especially in the long term. In addition, a stemless implant allows bone grafting at the time of implantation in a one-step procedure in revision of silicone arthroplasty (Ikavalko et al, 2007). The first bioabsorbable materials used in the MP joint arthroplasty trials were commercially available Vicryl Õ and Ethisorb Õ fleeces, which were folded into rectangular scaffolds.…”

Section: Introductionmentioning

confidence: 99%

Bioreconstructive Poly-L/D-Lactide Implant Compared With Swanson Prosthesis in Metacarpophalangeal Joint Arthroplasty in Rheumatoid Patients: a Randomized Clinical Trial

Honkanen

Tiihonen

Skyttä³

et al. 2010

J Hand Surg Eur Vol

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It was hypothesized that the bioresorbable interposition implant might offer a viable alternative to conventional silicone implant arthroplasty in rheumatoid metacarpophalangeal joint destruction. A randomized clinical study was performed to compare a stemless poly-L/D-lactide copolymer 96 : 4 (PLDLA) implant with the Swanson silicone implant. Results in 52 patients (53 hands and 175 joints) at a mean follow-up of 2 years (minimum 1 year) showed that the improvement in clinical assessments was comparable in both groups, except for better maintenance of palmar alignment in the Swanson group. The lack of implant fractures and intramedullary osteolysis were advantages of the PLDLA implant. The bioresorbable PLDLA interposition implant may offer an alternative tool for tailored reconstruction of rheumatoid metacarpophalangeal joints.

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“…PLDLA copolymer is compatible with 34 and suitable for use as a bone graft substitute [35][36][37][38] , meniscus replacement 39,40 , suture cords/threads 41 and axon regeneration 42 . Cellular adhesion to biomaterials is extremely important in material sciences.…”

Section: Discussionmentioning

confidence: 99%

Lithograph-moulded poly-L-co-D,L lactide porous membranes for osteoblastic culture

et al. 2013

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Pore size, shape, wall morphology, porosity, and interconnectivity are important characteristics of the scaffolds. Lithography is a manufacturing technique that allows the production of tridimensional scaffolds with a controllable and reproducible inner architecture. The aim of this study was to use lithography to create a poly-L-co-D,L lactide (PLDLA) scaffold with symmetrical pore size and distribution, and to evaluate its biocompatibility with osteoblasts in vitro. Lithographic moulds were used to produce porous PLDLA membranes by a casting procedure. Osteoblasts were removed from calvarial bones and seeded onto porous and smooth PLDLA membranes after which cell viability and adhesion assays, cytochemical analysis and scanning electron microscopy were used to characterize the cells. Cell viability and adhesion assays, cytochemical analysis, and scanning electron microscopy were carried out. Cell viability was similar on porous and smooth PLDLA membranes but higher than on a polystyrene substrate (positive control). Although osteoblasts adhered to the surface of all the materials tested, cell adhesion to lithographed PLDLA was greater than to smooth PLDLA membranes. In conclusion, osteoblasts interacted well with PLDLA membranes, as shown by the viability and adhesion assays and by the enhanced collagen production.

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One-Year Results of Use of Poly-L/D-Lactic Acid Joint Scaffolds and Bone Packing in Revision Metacarpophalangeal Arthroplasty

Cited by 14 publications

References 10 publications

The Mean Seven Years' Results of the Use of Poly-L/D-Lactic Acid (PLDLA) Interposition Implant and Bone Packing in Revision Metacarpophalangeal Arthroplasty: A Prospective Cohort Study

The Mean Seven Years' Results of the Use of Poly-L/D-Lactic Acid (PLDLA) Interposition Implant and Bone Packing in Revision Metacarpophalangeal Arthroplasty: A Prospective Cohort Study

Bioreconstructive Poly-L/D-Lactide Implant Compared With Swanson Prosthesis in Metacarpophalangeal Joint Arthroplasty in Rheumatoid Patients: a Randomized Clinical Trial

Lithograph-moulded poly-L-co-D,L lactide porous membranes for osteoblastic culture

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