Potential complication of bioabsorbable screw fixation for osteochondritis dissecans of the knee

Autologous osteochondral mosaicplasty in osteochondritis dissecans of the patella in adolescents

“…Resection of the osteochondral fragment followed by perforation [9] or curettage [8,10] of the subchondral bone often results in poor outcomes [8,25]. The fixation of loose fragments with Herbert screws [11] or resorbable pins [12] is not free from complications such as synovitis or fractures of the screws with a loose body in the joint, which leads to joint degradation [26][27][28]. Most recently, the results of autologous chondrocyte implantation which produces a cartilage similar to the hyaline cartilage was reported [29].…”

Chondral fragment of the lateral femoral trochlea of the knee in adolescents

“…However, care must be taken to back-out the pins used in this procedure. There have been several reports of articular cartilage damage caused by protruding bioabsorbable pins, accompanied by joint effusion, pain or catching, after the pins were used for fixation of osteochondral fragments [2,7]. Finally, this series of cases suggested that a chondral fragment of articular cartilage of the lateral femoral trochlea of the knee joint in active adolescents, successfully treated with open reduction and fixation using bio-absorbable pins, should be recognized as a clear entity, although a rare injury.…”

Comparison of bioabsorbable interference screws and posts for distal fixation in anterior cruciate ligament reconstruction

“…Many reports concerning cyst formation, tunnel enlargement, inflammatory reactions and mechanical failures have been published [3,19,20,22,23]. Doubts still exist about whether PLLA degrades completely at all [16].…”

“…However, although the manufacturers claim optimal performance and full bioabsorption, the fixation device might cause several problems. Broken screws, joint cavity material migration, excessive inflammatory response, cyst formation, osteolytic changes and, most commonly, delayed absorption are mentioned in this issue [5,19,20,23].…”