Serial Magnetic Resonance Imaging Evaluation of Operative Site After Fixation of Patellar Tendon Graft With Bioabsorbable Interference Screws in Anterior Cruciate Ligament Reconstruction

Lajtai, G.; Noszian, Irene; Humer, K.; Unger, Franz; Aitzetmüller, G.; Orthner, E.

doi:10.1016/s0749-8063(99)70002-2

Cited by 54 publications

(15 citation statements)

References 20 publications

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“…It is, thus, conceivable that composite materials, such as those we studied, have a "hybrid" biological behavior that becomes closer to Pure lactic acid polymer implants are absorbed slowly, over several years, depending on the volume of the implant. 17,41 The main mechanism is internal hydrolysis, 42 resulting in the sudden release of partially degraded polymer and monomer particles 3 at the end of the resorption process, which acidifies the peri-implant region.…”

Section: Discussionmentioning

confidence: 99%

Biological performance of a new β‐TCP/PLLA composite material for applications in spine surgery: In vitro and in vivo studies

Aunoble¹,

Clément²,

Frayssinet³

et al. 2006

J Biomedical Materials Res

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The objective of this research was to carry out an in vitro and in vivo study of the biological performance of PLLA/beta-TCP composite materials, to estimate the scope of their potential applications in bone surgery. Samples with increasing beta-TCP (0-60% w/w) contents were processed by injection molding. The in vitro study consisted of an evaluation of inflammatory potential by assaying the IL-1alpha secreted by monocytes, and then cell proliferation (counting) and phenotype expression (PAL and I collagen) in human osteogenous cells. The in vivo study was carried out using cylindrical implants of composite materials composed of composite materials containing 0 or 60% beta-TCP and pure beta-TCP, respectively. The implants were inserted in femoral sites in rabbits, using the Kathagen protocol. Each animal received a 60% implant, with either a 0 or a 100% implant in the contralateral femur, so that the materials could be compared with one another. Five animals were examined for each material and implantation period, giving a total of 30 animals. This study showed that adding increasing percentages of beta-TCP to a lactic acid polymer matrix stimulated the proliferation of human osteogenous cells and synthesis of the extracellular bone matrix in a dose-dependent manner. In vivo results indicate that, in comparison with pure PLA, tricalcium phosphate-containing composite materials had faster degradation kinetics, caused less inflammatory reaction, and promoted contact osteogenesis. The composite material containing 60% beta-TCP demonstrated a similar performance to pure tricalcium phosphate bone grafts in terms of osteogenesis, and is apparently compatible with the production of intra-osseous implants for situations representing high levels of mechanical strain.

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Section: Discussionmentioning

confidence: 99%

Biological performance of a new β‐TCP/PLLA composite material for applications in spine surgery: In vitro and in vivo studies

Aunoble¹,

Clément²,

Frayssinet³

et al. 2006

J Biomedical Materials Res

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“…In addition to the tunnel widening value, degradation and osteointegration of the bioabsorbable screw and foreign body reactions within the tunnel were checked. 11 16 17 18 19) The resorption rate of the bioabsorbable screw was calculated with the following formula: 16) Resorption rate: V1−V2/V1 × 100 (%) V1: original screw volume = 3.14 × 1/2 r 2 × L (r: screw diameter, L: screw length) V2: postoperative screw volume = 3.14 × (1/2 (d1/2 + d2/2)) 2 × L (d1: minimum diameter, d2: maximum diameter, L: calculated maximum screw length) …”

Section: Methodsmentioning

confidence: 99%

Comparison of Poly-L-Lactic Acid and Poly-L-Lactic Acid/Hydroxyapatite Bioabsorbable Screws for Tibial Fixation in ACL Reconstruction: Clinical and Magnetic Resonance Imaging Results

Lee

Kim

et al. 2017

Clin Orthop Surg

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BackgroundThe purpose of this study was to compare the clinical and radiological results of 2 different tibial fixations performed using bioabsorbable screws with added hydroxyapatite (HA) and pure poly-L-lactic acid (PLLA) screws in anterior cruciate ligament (ACL) reconstruction.MethodsA total of 394 patients who underwent arthroscopic ACL reconstruction between March 2009 and June 2012 were retrospectively reviewed. Of those, 172 patients who took the radiological and clinical evaluations at more than 2 years after surgery were enrolled and divided into 2 groups: PLLA group (n = 86) and PLLA-HA group (n = 86). Both groups were assessed by means of the Lysholm score, International Knee Documentation Committee (IKDC) subjective knee score, and Tegner activity score. Stability was evaluated using the KT-2000 arthrometer. Magnetic resonance imaging was performed to evaluate tibial tunnel widening, screw resorption, osteoingeration, and foreign body reactions.ResultsThe PLLA-HA group showed significant reduction in the extent of tibial tunnel widening and foreign body reactions and significant increase in screw resorption compared to the pure PLLA group (p < 0.001 for both). In contrast, postoperative Lysholm score, Tegner activity score, IKDC score, and side-to-side difference on the KT-2000 arthrometer showed no significant differences between groups (p = 0.478, p = 0.906, p = 0.362, and p = 0.078, respectively). The PLLA group showed more significant widening in the proximal tibial tunnel than the PLLA-HA group (p = 0.001). In the correlation analysis, proximal tibial tunnel widening revealed a positive correlation with knee laxity (r = 0.866) and a negative correlation with Lysholm score (r = −0.753) (p < 0.01 for both).ConclusionsThe HA added PLLA screws would be advantageous for tibial graft fixation by reducing tibial tunnel widening, improving osteointegration, and lowering foreign body reactions. Even though no clinically significant differences were noted between the pure PLLA group and PLLA-HA group, widening of the proximal area of the tibial tunnel showed a tendency to increase knee laxity measured using the KT-2000 arthrometer.

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“…PGA composites were reported to be fully resorbed at 12 months [5], however other reports stated that this was in fact more likely to be at 6 months or earlier [6]. This led to concerns regarding the rate of absorption of PGA, which turned increasing attention to biocomposites with a slower degradation.…”

Section: Introductionmentioning

confidence: 99%

Bio-interference screw cyst formation in anterior cruciate ligament reconstruction—10-year follow up

et al. 2012

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Serial Magnetic Resonance Imaging Evaluation of Operative Site After Fixation of Patellar Tendon Graft With Bioabsorbable Interference Screws in Anterior Cruciate Ligament Reconstruction

Cited by 54 publications

References 20 publications

Biological performance of a new β‐TCP/PLLA composite material for applications in spine surgery: In vitro and in vivo studies

Biological performance of a new β‐TCP/PLLA composite material for applications in spine surgery: In vitro and in vivo studies

Comparison of Poly-L-Lactic Acid and Poly-L-Lactic Acid/Hydroxyapatite Bioabsorbable Screws for Tibial Fixation in ACL Reconstruction: Clinical and Magnetic Resonance Imaging Results

Bio-interference screw cyst formation in anterior cruciate ligament reconstruction—10-year follow up

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