Use Of Resorbable Screws Research Articles

Graft osteolysis and recurrent instability after the Latarjet procedure performed with bioabsorbable screw fixation

The Latarjet procedure is a reliable treatment of recurrent anterior shoulder instability. The coracoid process is usually fixed with metallic screws; however, these can lead to irritation and the necessity for hardware removal and also can produce artifacts on imaging studies. The use of resorbable screws could avoid these complications. The purpose of this study was to assess the clinical results of the Latarjet procedure performed with bioabsorbable screws in addition to healing of the graft and resorption of the screws. In 2009, we performed a prospective study (case series, IV) of 11 patients (12 shoulders) who underwent a Latarjet procedure fixed with resorbable screws. Each patient was observed clinically and had a computed tomography scan at 3 months and 2 years of follow-up. Every graft healed at 3-month follow-up. At 2-year follow-up, 4 patients had at least one instability episode, and one underwent a revision surgery. Three of these 4 patients were unhappy or disappointed. The Walch-Duplay score was excellent or good for 7 shoulders and medium or poor for 5. Screw resorption appeared complete in every case. No drill hole enlargement was observed. Every drill hole was partially filled with bone. Of 12 shoulders, 8 (66.67%) were associated with a severe osteolysis and an almost complete disappearance of the graft. Coracoid graft osteolysis, previously reported after the Latarjet procedure, appears to be exacerbated with a risk of complete disappearance of the graft when the procedure is performed with the bioabsorbable screws used in this study.

Randomized Prospective Clinical Trial on Use of Resorbable Screws in Fixating Bilateral Sagittal Split Osteotomies for Mandibular Advancement

The use of metal rigid fixation in maxillofacial surgery is now standard in trauma of the maxillofacial skeleton, orthognathic surgery and craniofacial surgery.1 Resorbable fixation material is an attractive option for those patients undergoing orthognathic surgery. Besides the obvious benefit of not having permanent implants, it decreases the possible need for surgical implant removal that will be an additional cost and risk to the patient.2

Use of Resorbable Screws for Autogenous Onlay Block Graft Fixation: A Histological Analysis in Rabbits

The aim of the present in vivo study is to histologically evaluate and compare the use of resorbable screws based on poly(L-co-D,L lactide) 70:30 for fixation of autogenous bone grafts in rabbit tibiae. As control group, titanium (Ti-6Al-4V Grade V) screws were used. For this purpose, 15 white New Zealand male rabbits, aged 6 months and weighing between 3.8 and 4.5 kg, were used. From each animal, 2 total-thickness bone grafts were removed from the cranial vault: one was stabilized with a resorbable screw while the other was stabilized with a metallic one. Animals were divided into 3 groups, according to the sacrifice period: 3, 8, and 16 weeks postoperatively. After histological processing, cuts were stained with hematoxylin and eosin and submitted for descriptive histological analysis under light microscopy. It was found that the fixation system based on the polymer showed a histological behavior similar to metallic screws. For both groups, the bone graft was incorporated, with the presence of bone formation between the graft and receptor site. In none of the groups were undesirable inflammatory responses or foreign body reactions observed. Based on histological findings and on this experimental model, it is possible to conclude that the internal fixation system based on the poly(L-co-D,L lactide) 70:30 polymer is effective for fixation of autogenous bone grafts, with results that are comparable to the titanium fixation system.

Use of resorbable screws for autogenous onlay block graft fixation: a histological analysis in rabbits

Use of resorbable screws for autogenous onlay block graft fixation: a histological analysis in rabbits

Modifizierte Azetabuloplastik unter Verwendung von bioresorbierbaren Schrauben und lyophilisiertem allogenem Knochen

Various pericapsular procedures are available to surgically improve the acetabular coverage of the femoral head prior to closure of the triradiate cartilage. In this study the acetabuloplasty with the modification according to Westin (Pember-Sal) was applied. Indications for surgery were congenital hip dysplasia or luxation as well as Perthes' disease. To date, the standard procedures for acetabuloplasty include the transplantation of an autologous iliac crest bone graft and the fixation with K-wires. The aim of this study was to investigate if a modification of the operative procedure with the use of resorbable screws and allogenic bone transplants can minimise the operative trauma, avoid a second procedure, and permit MRI follow-ups without increasing the risk of the operation. 15 patients with a mean age of 6.7 years were included in this case series and treated with a modified acetabuloplasty for the indication hip dysplasia or Perthes' disease. The modification of the standard procedure included the transplantation of allogenic bone wedges customised from lyophilised femoral grafts. The fixation was performed with bioresorbable polylactide screws. Clinical and radiographical follow-ups were conducted. Procedure-related complications occurred neither in the intra- nor the postoperative period. The allogenic bone graft was remodelled successively as seen on radiographic controls. Dislocations of the bone wedges were not detectable. Subsiding of the allograft did not occur to a noticeable extent as the acetabular index showed no increase during follow-up. This study presents a gentle method of acetabuloplasty which avoids iliac crest bone harvesting with its known complications as well as a second procedure under anaesthesia for the removal of implants.