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This study measured the bonding strength between alkyl-2-cyanoacrylates and bone, and examined how treatment of the bone surface with acid, and prolonged exposure to moisture, affected this strength. The initial strength of all cyanoacrylates was high (9.6-11.2 N/mm2). In long-term experiments under water, n- and i-butylcyanoacrylates lost their strength at a far slower rate than ethylcyanoacrylates. However, the butylcyanoacrylates also showed a decrease of 15% in strength after three weeks. Pretreatment of the bone surface with acid did not have a marked effect on bonding strength, although SEM investigation revealed that the acid treatment had increased the porosity of the bone surface. A study of the fracture surface proved that the adhesive film tended to loosen or break after 3 to 6 weeks under water. The decrease in the bonding strength was probably due to the degradation of the adhesive film in water which loosened mechanical bonds between the bone and adhesive. Considering clinical use it would be necessary to achieve better long-term strength.

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Two self-reinforced poly(L/DL)lactide 70:30 or self-reinforced poly (L/DL)lactide 70:30/ bioactive glass (SR-P(L/DL)LA/bioactive glass) composite rods (2 mm x 40 mm) were implanted into the dorsal subcutaneous tissue and osteotomies of the distal femur were fixed with these rods (2 mm x 26 mm) in 36 rabbits. The follow-up times varied from 3 to 100 weeks. After the animals were killed, three-point bending and shear tests and molecular weight measurements were performed for subcutaneously placed rods. Radiological, histological, histomorphometrical, microradiographic and oxytetracycline-fluorescence studies of the osteotomized and intact control femora were performed. After 12 weeks the SR-P(L/DL)LA rods had fragmented into pieces and the mechanical properties could not be measured. The SR-P(L/DL)LA/bioactive glass rods lost their mechanical properties slower, and at 24 weeks the bending strength had decreased by 39% and the shear strength by 50%. After that the mechanical properties of the SR-P(L/DL)LA/bioactive glass rods could not be measured. All osteotomies healed well, and no gross signs of inflammatory reactions were observed. One slight displacement was seen in the three-week follow-up group with SR-P(L/DL)LA rods. Signs of resorption of the implants were seen after 48 weeks in the SR-P(L/DL)LA group and after 24 weeks in the SR-P(L/DL)LA/bioactive glass group. The SR-P(L/DL)LA/bioactive glass rods were almost totally resorbed from the bone at 100 weeks. The present investigation showed that the mechanical strength and fixation properties of the SR-P(L/DL)LA and the SR-P(L/DL)LA/bioactive glass composite rods are suitable for fixation of cancellous bone osteotomies in rabbits.

Self-reinforced poly(L/DL)lactide 70:30/bioactive glass [SR-P(L/DL)LA/bioactive glass] composite rods, 2 mm in diameter and 36 mm in length, were implanted into the dorsal subcutaneous tissue of 16 rats. Osteotomies of the distal femur were fixed with these rods (2 x 15 mm) in 64 other rats. The follow-up times varied from one week to one year. After sacrifice, three-point bending and shear tests, and molecular weight measurements were performed for subcutaneously placed rods. Radiological, histological, histomorphometrical, microradiographic, and oxytetracycline-fluorescence studies of the osteotomized and intact control femora were performed. At 24 weeks the mechanical properties had decreased significantly. Thirty-nine osteotomies healed uneventfully. One of the 64 evaluated osteotomies showed signs of infection at six weeks, and there were 19 non-unions and six delayed unions. In 20 operations the fixation was loose and out of these 14 non-unions were observed. No gross signs of inflammatory or foreign-body reactions were observed. The present investigation showed that the mechanical strength and fixation properties of SR-P(L/DL)LA/bioactive glass composite rods are suitable for fixation of cancellous bone osteotomies in rats as long as the operative technique is correct. The present article is the first report on the application of SR-P(L/DL)LA/bioactive glass composite rods for fixation of cancellous bone osteotomies.

A total of 50 patients with osteoarthritis of the knee joint treated by proximal osteotomy of the tibia were followed up 1-5 years after operation. Fusion occurred within an average of 24 weeks. The subjective result of the treatment was good or fair in 44/50 patients. The results were the same 1-2 years and 4-5 years postoperatively. Half the patients showed some significant general disease, most usually hypertension or cardiac disease. Although the patients' subjective condition was significantly better after than before operation, the treatment did not improve or maintain their working capacity. Preoperatively 29 patients worked, while this number was reduced to 12 at the time of follow-up, and two of the latter patients had been trained for new occupation.