Transcutaneous migration of a tibial bioabsorbable interference screw after anterior cruciate ligament reconstruction

Sassmannshausen, Greg; Carr, Charles F.

doi:10.1016/j.arthro.2003.09.017

Cited by 29 publications

(30 citation statements)

References 14 publications

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“…These phenomena may be contributing factors in the reports of implant movement/migration [18][19][20][21][22][23][24][25]. The use of a calcium composite material having an improved hard tissue response may help reduce these problems and hence reduce the risk of implant migration.…”

Section: Discussionmentioning

confidence: 99%

Polymer-hydroxyapatite composite versus polymer interference screws in anterior cruciate ligament reconstruction in a large animal model

Hunt

Callaghan

2008

Knee Surg Sports Traumatol Arthr

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The aim of the study was to assess the hard tissue response of a composite hydroxyapatite/poly L-lactic acid (HA/PLLA) interference screw for anterior cruciate ligament (ACL) reconstruction compared to a standard PLLA screw. Twelve skeletally mature rams underwent unilateral ACL reconstruction using an autologous bone-patellar tendon graft. Each animal received either two test HA/PLLA interference screws or two control PLLA interference screws. Animals were sacrificed at 6 and 12 months post-implantation and the operated knees excised. Undecalcified sections of the screw and surrounding tissues were cut from resin embedded samples and stained; sections were approximately parallel to the longitudinal axis of the screws. A quantitative assessment of bone formation between each screw type (PLLA vs. HA/PLLA) and adjacent tissue in both the tibia and femur was undertaken using automated image analysis (KS400, Zeiss, UK). The inflammatory response of each screw type was assessed by histological evaluation. New bone formation along the perimeter of the screw threads was statistically significantly higher with the HA/PLLA than the PLLA alone. The inflammatory response as assessed semi-quantitatively by histologically determining the number of inflammatory cells present in the tissue adjacent to the implant, was higher for PLLA than HA/PLLA. Significantly increased new bone formation and decreased inflammatory cells were observed in vivo with the composite screw in comparison with the standard polymer. A novel HA/PLLA composite biomaterial in the form of an interference screw demonstrated an improved hard-tissue response compared to PLLA in a large animal ACL reconstruction. This study determined the differences in the tissue response between PLLA and a composite material of HA/PLLA. The improved tissue related outcomes observed in vivo, may be of benefit clinically in ACL reconstruction.

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Section: Discussionmentioning

confidence: 99%

Polymer-hydroxyapatite composite versus polymer interference screws in anterior cruciate ligament reconstruction in a large animal model

Hunt

Callaghan

2008

Knee Surg Sports Traumatol Arthr

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“…The reported complications of biodegradable screws are osteolysis around the screw [17], allergic reaction [15], and extraarticular pretibial sterile abscess [4]. Other reported complications are transcutaneous [18] and intraarticular migration [2], recurrent pretibial ganglion cyst formation [19], and intraarticular granuloma formation [7]. There is disagreement among pathologists regarding whether a fibroxanthoma represents a true neoplasm [3,6], developmental defect [5], or reactive process [14].…”

Section: Discussionmentioning

confidence: 99%

“…They have similar or superior fixation strength in comparison to metallic interference screws [11,21]. However, they have complications such as cyst and abscess formation [4,7,19,20], breakage, and intraarticular migration [2,18]. Although no fibroxanthoma as a complication of biodegradable screws has been reported in the English literature, a literature search shows sarcoma [9] and malignant fibrous histiocytoma [1,8] in response to other orthopaedic implants.…”

Section: Introductionmentioning

confidence: 99%

Case Report: Fibroxanthoma

Sadat-Ali

Azzam

Bluwi

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Biodegradable interference screws in anterior cruciate ligament (ACL) reconstruction have gained popularity because of their similar or superior fixation strength in comparison to metallic interference screws and because they do not cause imaging artifacts and do not need to be removed. Case Description We report the case of a 23-year-old man who presented with slowly progressive firm swelling of 2 months' duration at the site of the tibial tunnel 3 years after ACL reconstruction using a biodegradable interference screw. After curettage and débridement, the material was sent for histopathologic examination, which was reported as a fibroxanthoma. Literature Review Reported complications are osteolysis around the screw, allergic reaction, sterile abscess formation, ganglion cyst formation, and intraarticular migration.

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“…Poly-l-lactic acid (PLLA) is well known as a bioabsorbable material and has been clinically used as bioabsorbable mini-plate, screw and pin [2,13,14,30,33]. On the other hand, PLLA is known as a piezoelectric material.…”

mentioning

confidence: 99%

“…Various types of artificial ligaments including bioabsorbable material have been studied to reconstruct the injured ligament [3,27,31]. It has been suggested that early osteointegration of the grafted artificial ligament to the bone is important to improve the ligament function and durability [39].Poly-l-lactic acid (PLLA) is well known as a bioabsorbable material and has been clinically used as bioabsorbable mini-plate, screw and pin [2,13,14,30,33]. On the other hand, PLLA is known as a piezoelectric material.…”

mentioning

confidence: 99%

Helical Conformation Endows Poly-<span style="font-variant: small-caps;">l</span>-Lactic Acid Fibers with a Piezoelectric Charge under Tensile Stress

Harada

Kadono

Terao

et al. 2013

The Journal of Veterinary Medical Science

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ABSTRACT. Poly-l-lactic acid (PLLA) has been clinically used as a bioabsorbable material and attains a piezoelectric charge upon molecular orientation by the application of a shear force to the C-axis of the crystal line region. Previous studies showed that implanted drawn PLLA films or rods accelerate the ossification due to piezoelectric effect. In this study, we originally designed helically-twisted PLLA fiber to produce piezoelectricity in bioabsorbable suture upon tensile stress. The piezoelectricity of the helical PLLA fibers was evaluated using a lock-in amplifier system in vitro. The ossification induced by helical PLLA fibers was examined by implanting them in the rat patellar ligament supporting a physiological tensile load. We observed that 57° and 45° twisted PLLA fibers generated a higher piezoelectric potential than did 27° twisted fibers. The animal experiment showed that the formation of osseous tissue around helical PLLA fibers was more significant than around non-helical control fibers at 4 weeks after their implantation. These results suggest that helical PLLA fiber may be useful for the surgical suture or artificial ligament, which connects to the bone. KEW WORDS: animal model, helical conformation, ossification, piezoelectricity, poly-l-lactic acid.doi: 10.1292/jvms.12-0323; J. Vet. Med. Sci. 75(9): 1187-1192, 2013 Ligament injury, such as anterior cruciate ligament rupture, is a common cause of lameness in small animal practice [6,15]. Various types of artificial ligaments including bioabsorbable material have been studied to reconstruct the injured ligament [3,27,31]. It has been suggested that early osteointegration of the grafted artificial ligament to the bone is important to improve the ligament function and durability [39].Poly-l-lactic acid (PLLA) is well known as a bioabsorbable material and has been clinically used as bioabsorbable mini-plate, screw and pin [2,13,14,30,33]. On the other hand, PLLA is known as a piezoelectric material. Fukada reported that an external mechanical stress to a drawn PLLA film gives rise to electrical polarization [10], and this piezoelectric effect is ascribed to the change in the microscopic orientation of crystals with a fundamentally asymmetrical structure [5,10,22,23]. Animal experiments showed that the piezoelectricity of drawn PLLA films and rods accelerated callus formation on bone [10,22,35]. Shimono et al. prepared three types of PLLA piezoelectric films with different oriented directions (0°, 45° or 90° to the drawing direction) and implanted them on the periosteum of the rabbit tibia [35]. These drawn PLLA films promoted ossification to a greater extent than undrawn PLLA films, and the effect of drawn PLLA films in promoting ossification was greatest when a shearing stress was applied at 45° to the axis of orientation. Ikada et al. prepared drawn PLLA rods with different draw ratios and implanted these rods intramedullary in the osteotomized tibia of cats [22]. Fracture healing was clearly promoted with increased callus formation as the draw...

show abstract

Transcutaneous migration of a tibial bioabsorbable interference screw after anterior cruciate ligament reconstruction

Cited by 29 publications

References 14 publications

Polymer-hydroxyapatite composite versus polymer interference screws in anterior cruciate ligament reconstruction in a large animal model

Polymer-hydroxyapatite composite versus polymer interference screws in anterior cruciate ligament reconstruction in a large animal model

Case Report: Fibroxanthoma

Helical Conformation Endows Poly-<span style="font-variant: small-caps;">l</span>-Lactic Acid Fibers with a Piezoelectric Charge under Tensile Stress

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