Spotlight on Naturally Absorbable Osteofixation Devices

Abstract

The practice of using implants is growing day by day, and more foreign materials are being inserted for various indications. The field of implantology thus deserves intensive research and careful evaluation of results. Solutions to overcome current problems and risks are necessary. It has taken a long time to arrive at where we are now. Bioabsorbable devices were explored in the 1960s for surgical bone fixation. Failures were followed by changes in ways of thinking and innovations. Improvements in the strength properties and biocompatibility were achieved. Bioabsorbable polymeric materials such as high-molecular-weight polymers were used and also reinforced with other material or, more recently, by self-reinforcement to produce small yet strong devices. New generations of implants include those that contain bioactive substances such as antibiotics and growth factors. Developments in bioabsorbable materials continue to accommodate the new way of thinking brought about by the emergence of the field of tissue engineering. Surgeons, conversely, are also inventing new surgical techniques and methods to exploit the plastic and bioabsorbability properties of these materials for the better future of our patients. Such a multidisciplinary approach that involves surgeons and materials scientists should help to find solutions to the current limitations of these devices.

Tissue response to partially in vitro predegraded poly-L-lactide implants

“…Polylactide (PLA) and polyglycolide (PGA) acid are the most commonly used biodegradable (co)polymers in surgery especially in osteosynthesis [1][2][3][4], and in general are considered safe for clinical use [5], although unexpected phenomena such as long degradation periods are not uncommon [6,7]. The aim for the use of these degradable polymers is the prevention of repeated surgery for the patient.…”

In vivotesting of a bioabsorbable magnesium alloy serving as total ossicular replacement prostheses

“…8,12,13 Furthermore, the foreign body has disappeared and the risk for infection is thereby reduced. 2 In this study, degradation of magnesium alloy implants and new bone formation was demonstrated in a living organism. The two study groups revealed different degradation stages in correlation with varying extents of ossification.…”

“…To avoid these problems and the need for a follow-up operation for implant removal in orthopedics, bioabsorbable materials which degrade after serving their purpose were investigated. 2,3 In orthopaedics, especially polymers like polyglycolic acid and polylactic acid were used as plates or screws, but showed adverse effects like local tissue reactions. 4 The same polymers were examined as cardiovascular devices such as coronary stents, but revealed excessive neointima proliferation with complete occlusion of vessels and inflammatory reactions.…”

Preliminary in vitro evaluation of an adjunctive therapy for extremity wound infection reduction: Rapidly resorbing local antibiotic delivery

“…Use of biodegradable drug delivery systems evades the need for additional surgery required by nonresorbable systems, such as polymethylmethacrylate (PMMA) beads. 6,10,11 Calcium sulfate, a biocompatible, biodegradable material, is an interesting candidate for local delivery in cases of trauma because extensive bone damage is common. Calcium sulfate improves bone healing and repair, even when loaded with an antibiotic.…”