Preliminary Clinical and Radiographic Evaluation of a Novel Resorbable Implant of Polylactic Acid (PLA) for Tibial Tuberosity Advancement (TTA) by Modified Maquet Technique (MMT)

Abstract

Our objectives were to determine whether PLA implants can be used in TTA with successful results; secondly, to observe whether they provide a faster bone healing; finally, to determine whether weight or age influences bone healing scores. PLA cages were created with a 3D printer. TTA by MMT with PLA implants was performed in 24 patients. Follow-ups were carried out pre-surgical, at 1, 2, and 5 months and consisted of a radiographic study and a lameness assessment. A comparison was performed in terms of weight and age. Patients data, time between follow-up examinations, healing score, and lameness score were compared between patients using commercial software for statistically significant differences p < 0.05. Eighteen dogs finished the study. The ossification degrees presented statistically significant differences between each other. PLA implants maintained the advancement in 100% of cases. Comparing weight and age did not present any statistically significant differences between groups. Lameness presented statistically significant differences between follow-up examinations. Complications were observed in 20.8%. PLA implants for TTA provide good functional results, presenting an acceptable rate of complications. They provide a faster bone healing of the osteotomy gap, which was not affected by age or body weight, and have a clinical recovery time similar to metallic implants.

Does PRGF Work? A Prospective Clinical Study in Dogs with A Novel Polylactic Acid Scaffold Injected with PRGF Using the Modified Maquet Technique

“…The results in our study demonstrated that PLA scaffolds are an acceptable alternative to metallic implants, agreeing with our preliminary study [ 37 ]. In addition, the results in our control group were better than the results obtained in other studies with the same scale in biodegradable implants [ 4 , 44 ]; moreover, our ossification results were also better than another published study with metallic implants [ 41 ].…”

“…The fractures had no displacement, thus they were solved by strict rest of the patient for a month, as recommended in several studies [ 3 , 52 , 62 , 63 ]; in all cases, the evolution was good and they did not require further treatment. Another minor complication was the appearance of vesicles in the area of the incision at the last follow-up, already described in our preliminary study [ 37 ]. The treatment was the application of local medication and the administration of antibiotics; the vesicles disappeared with the treatment.…”

“…As we described in our preliminary study, the maintenance of the advancement with biodegradable implants is controversial [ 37 ]. In our study, all the patients maintain the advancement, including the patients with a complete implant biodegradation.…”

“…An anamnesis, physical and traumatological exploration, diagnostic radiographies, complete blood count and biochemistry profiles were determined for each patient. The inclusion and exclusion criteria were previously published [ 37 ].…”

“…The anaesthetic and analgesic protocol, the antibiotic therapy and the postsurgical therapy were described in a previous paper [ 37 ]. The day of the surgery, the premedication for anaesthesia were 10 μg/kg intramuscular (IM) medetomidine and 0.3 mg/kg IM morphine.…”