The use of biodegradable scaffold as an alternative to silicone implant arthroplasty for small joint reconstruction: An experimental study in minipigs

Waris, Eero; Ashammakhi, Nureddin; Lehtimäki, Mauri Y; Tulamo, Riitta‐Mari; Kellomäki, Minna; Törmälä, Pertti; Konttinen, Yrjö T.

doi:10.1016/j.biomaterials.2007.10.037

Cited by 30 publications

(38 citation statements)

References 21 publications

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“…Under rat skin P(L/D)LA 96/4 copolymer rods displayed only minor changes for the first 24 weeks and the implant disappeared almost totally within 3 years: histology showed only a minor foreign body reaction (Kelloma¨ki et al, 2000;Lansman et al, 2006;Saikku-Backstrom et al, 2001). In minipig joints the PLDLA implants were almost completely degraded at 3 years and had been replaced by longitudinally organized dense connective tissue (Waris et al, 2008).…”

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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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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“…A porous, bioabsorbable poly-L/D-lactic acid 96:4 (PLDLA) interposition implant is designed to retain its shape long enough to allow the ingrowth of host tissue and then gradually be replaced with fibrous tissue in approximately 2-3 years (8)(9)(10). 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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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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“…[1][2][3][4] Generally, joint fusions are generally used to treat pain and deformity of arthritis. [3] This involves tissue reconstruction and repair via tissue substitute transplantation.…”

mentioning

confidence: 99%

“…[13] In spite of the aforementioned benefits, the silicone elastomer with expected lifespan of 15 years or more, experiences buckling and prematurely fractures. Possible explanations, but not limited to are: (i) low tensile strength, [3,4] (ii) inadequate bone build-up around the implants, (iii) loosening at the bone-implant interface induced by damaging impact of reactive oxygen species (superoxide: O À 2 and peroxynitrate: OONO À ) produced by activated microphages, (iv) dislocation of the implant and infection and recurrent deformation. [14] In a biomedical application, success is achieved when the different mechanisms associated with the failure are attended.…”

mentioning

confidence: 99%

Enhanced Fibroblasts Functions in a New Family of Hierarchically Organized Nanohybrid Elastomers

2011

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Fibroblasts functions in a new family of nanohybrid network elastomers with high strength‐at‐break involving pressure‐induced curing and short chain cross‐links of inorganic nanostructures have been investigated. The concept of chemical design and synthesis involves covalently linking nanometer‐sized titania with a bi‐functional agent, acrylic acid, which has a carboxylic group to coordinate with titania and a vinyl group to form short chain cross‐links as an integral part of the silicone network structure elastomer. Interestingly, the cell–substrate interactions in the hybrid network structure elastomer are significantly different from those observed in stand alone silicone. The origin of intriguing differences in cell–substrate interactions in terms of cell attachment, viability, and proliferation and assessment of proteins actin, vinculin, and fibronectin are addressed and attributed to physico‐chemical properties (topography and hydrophilicity) and to the presence of nanocrystalline titania. The end outcome of the study is a new family of soft tissue implants with desired (enhanced cell functions) and bulk properties (long term stability–high strength‐at‐break). The integration of cellular and molecular biology with material science and engineering described here provides an insight into the ability to modulate cellular and molecular reactions in promoting osteoinductive signaling of surface adherent cells, in the present case, fibroblasts for soft tissue reconstruction.

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The use of biodegradable scaffold as an alternative to silicone implant arthroplasty for small joint reconstruction: An experimental study in minipigs

Cited by 30 publications

References 21 publications

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

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

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

Enhanced Fibroblasts Functions in a New Family of Hierarchically Organized Nanohybrid Elastomers

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