A Comparison of the Results of Anterior Cruciate Ligament Reconstruction Using Bioabsorbable Versus Metal Interference Screws

Emond, Christopher; Woelber, Erik; Kurd, Shanu K; Ciccotti, Michael G.; Cohen, Steven B.

doi:10.2106/jbjs.j.00269

Cited by 75 publications

(56 citation statements)

References 54 publications

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“…to 46.7% in the orthopaedic literature [44]. It is likely to result from hydrolysed polymeric debris that was beyond the clearance capacity of the surrounding tissue.…”

Section: 3fracture Fixation and Healingmentioning

confidence: 97%

In vitro and in vivo studies on the degradation of high-purity Mg (99.99wt.%) screw with femoral intracondylar fractured rabbit model

et al. 2015

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“…to 46.7% in the orthopaedic literature [44]. It is likely to result from hydrolysed polymeric debris that was beyond the clearance capacity of the surrounding tissue.…”

Section: 3fracture Fixation and Healingmentioning

confidence: 97%

In vitro and in vivo studies on the degradation of high-purity Mg (99.99wt.%) screw with femoral intracondylar fractured rabbit model

et al. 2015

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“…No significant differences in clinical outcomes were found between aperture and other fixation methods in a meta-analysis that included eight studies, although there was a nonsignificant trend toward a lower failure rate with the use of IS (P00.15) [9]. Metallic IS is the longtime gold standard of graft fixation [8,14,23] and it was the most preferable choice of surgeons until 1999 [11]. Bioabsorbable and bio-composite materials have been used to make the screws and those materials typically provide adequate strength over the three to four months required for graft incorporation.…”

Section: Graft Fixationmentioning

confidence: 99%

“…They are also better handled during revision surgery [23]. On the other hand, bio-absorbable IS have been reported to break intraoperatively and to possibly initiate an inflammatory response, contributing to tunnel widening [14]. In some cases these screws provoke inflammatory response and pain and require surgical removal [15].…”

Section: Graft Fixationmentioning

confidence: 99%

An international survey on anterior cruciate ligament reconstruction practices

Chechik

Amar

Khashan

et al. 2012

International Orthopaedics (SICOT)

163

134

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Purpose Bone-patellar-tendon-bone (BPTB) autografting fixed with metal interference screws (IS) is the gold standard for anterior cruciate ligament (ACL) reconstruction. Advances in surgical technology provide a wide choice of grafts, fixation devices and surgical approaches. Methods Two-hundred and sixty-one orthopedic surgeons of ten subspecialties from 57 countries were surveyed on their choice of graft and fixation device, the number of reconstructed bundles, and arthroscopic portal. Their preferences were analyzed according to country of origin, field of expertise and seniority, and compared to current publications. Results Hamstring autografting was the most popular choice (63 %), then BPTB (26 %) and allograft (11 %). The anteromedial portal was preferred over the traditional transtibial portal (68 % versus 31 %). Two-thirds reported routinely performing a single-bundle graft reconstruction, compared to one-third who used the double-bundle technique. The Endo-button was the most common graft fixation method (40 %), followed by the bioabsorbable IS (34 %), metallic IS (12 %), rigidfix (10 %) and others (4 %). The preferences of hamstring tendon grafting and the anteromedial portal are not supported in the literature. Responses from North American and European surgeons were different from all the others.Conclusions Surgeon preferences in ACL reconstruction differ considerably worldwide. Common practice is not always supported by evidence-based publications.

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“…2 Intraoperative and postoperative implant breakages of a resorbable polylactid acid screw have been reported, 3,4 as well as implant displacement into the joint, 5,6 joint swelling, 7 and tunnel widening around the implant. 8 In recent years, magnesium alloys have been investigated intensively as an alternative biodegradable material for orthopedic implants. 9 Magnesium is the fourth most common cation in the human body, and it is essential for many aspects of human physiology.…”

Section: Introductionmentioning

confidence: 99%

Biodegradation of a magnesium alloy implant in the intercondylar femoral notch showed an appropriate response to the synovial membrane in a rabbit model in vivo

et al. 2014

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Degradable magnesium alloys are promising biomaterials for orthopedic applications. The aim of this study was to evaluate the potential effects on both the synovial membrane (synovialis) and the synovial fluid (synovia) of the degradation products of a MgYREZr-pin implanted in the intercondylar femoral notch in a rabbit model. Thirty-six animals were randomized into two groups (MgYREZr or Ti6Al4V alloy) of 18 animals each. Each group was then divided into three subgroups with implantation periods of 1, 4, and 12 weeks, with six animals in each subgroup. The initial inflammatory reaction caused by the surgical trauma declined after 12 weeks of implantation, and elucidated a progressive recovery of the synovial membrane. Compared with control Ti6Al4V pins, there were no significant differences between the groups. However, after 12 weeks, recovery of the synovial membrane was more advanced in the titanium group, in which 92% showed no signs of synovitis, than in the magnesium group. A cytotoxicity test with L929 cells and human osteoblasts (HOB) was also conducted, according to EN ISO 10993-5/12, and no toxic leachable products were observed after 24 h of incubation. In conclusion, the MgYREZr alloy seems to be a suitable material for intra-articular degradable implants.

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A Comparison of the Results of Anterior Cruciate Ligament Reconstruction Using Bioabsorbable Versus Metal Interference Screws

Abstract: Therapeutic Level II. See Instructions to Authors for a complete description of levels of evidence.

Cited by 75 publications

References 54 publications

In vitro and in vivo studies on the degradation of high-purity Mg (99.99wt.%) screw with femoral intracondylar fractured rabbit model

In vitro and in vivo studies on the degradation of high-purity Mg (99.99wt.%) screw with femoral intracondylar fractured rabbit model

An international survey on anterior cruciate ligament reconstruction practices

Biodegradation of a magnesium alloy implant in the intercondylar femoral notch showed an appropriate response to the synovial membrane in a rabbit model in vivo

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