Comparison of absorbable poly-l-lactide and metallic intramedullary rods in the fixation of femoral shaft osteotomies: an experimental study in rabbits

Viljanen, Janne; Pihlajamäki, Harri; Kinnunen, J.; Bondestam, S.; Rokkanen, P

doi:10.1007/s007760100065

Cited by 32 publications

(26 citation statements)

References 12 publications

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“…49 Positioning of slices and ROIs was standardized throughout the follow-up. For the present study, five representative slices, equally spaced within the median third of the second metamer were chosen for each animal.…”

Section: Computed Tomography (Ct)mentioning

confidence: 99%

Electrospun Hydroxyapatite-Functionalized PLLA Scaffold: Potential Applications in Sternal Bone Healing

et al. 2011

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Sternal synthesis after median sternotomy, a conventional access practice in thoracic and cardiac surgery, is at the basis of severe complications, often impairing the clinical outcome of surgical interventions. In this work, we propose the use of an acellular biomaterial scaffold, to be interposed across the fracture rime during closure operations, directly exposing the biomaterial to bone marrow, in order to expedite healing process. A rabbit model of median sternotomy was performed and an electrospun scaffold composed of a hydroxyapatite-loaded absorbable biopolymer (poly-L: -lactide), shaped into a fibrillar structure, was used. CT follow-up confirmed a complete healing in the scaffold-treated group 1 week before the control. Histological evaluation demonstrated presence of newly formed bone trabeculae among scaffold fibers showing a higher degree of maturity with respect to the control untreated group. The proposed approach is able to both guide a more rapid healing and modulate inflammatory response across the wound site, resulting in improved healing and tissue remodeling with respect to conventional closure technique.

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Section: Computed Tomography (Ct)mentioning

confidence: 99%

Electrospun Hydroxyapatite-Functionalized PLLA Scaffold: Potential Applications in Sternal Bone Healing

et al. 2011

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“…Difficulties can be encountered during the removal operation, such as refracture due to bone formation around the rods [5,6]. Moreover, metallic bone fixation devices have disadvantages such as corrosion and higher stiffness than the bone, which could cause bone resorption [7,8]. Bioresorbable IM rods could potentially overcome these complications as they would be totally resorbable (therefore, removal surgery would not be required), biocompatible, able to accelerate or facilitate tissue healing and their mechanical properties could be engineered to gradually transfer stress allowing for progressive healing [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

“…Relatively poor mechanical properties for load-bearing applications are the main limitation for use of these bioresorbable polymers [13]. Thus, reinforcement is required to produce a device with mechanical properties matching that of cortical bone [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] GPa for Young's modulus and 90-140 MPa for flexural strength] [14,15]. Various methods have been explored to enhance the mechanical properties of polymers, such as self-reinforcement [16][17][18][19][20], particulate reinforcement [Hydroxyapatite (HA), Calcium phosphate (CaP)] [21][22][23][24][25] and drawing [26][27][28].…”

Section: Introductionmentioning

confidence: 99%

Initial mechanical properties of phosphate-glass fibre-reinforced rods for use as resorbable intramedullary nails

et al. 2012

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This paper investigates the use of novel phosphate-glass fibre-reinforced rods as resorbable intramedullary nails. Random and unidirectional fibres were moulded into composite rods by forging at *100°C. Rods produced using non-woven random mats (RM) showed little improvement in mechanical strength over the unreinforced polylactic acid (PLA) rods. This was suggested to be due to the breakdown of the fibres during the manufacturing process; the length of the fibres decreased from 10-mm (initial) to *1.2 mm. Modulus and stiffness values for P50 RM rods were higher than those for the PLA rods which could be due to the orientation of the fibres during the rod manufacture process. Rods produced using long fibres parallel to the length of the rod displayed superior mechanical properties, not only against the PLA rods but also cortical bone. Maximum flexural, shear and compressive strengths were 242, 87 and 400 MPa, respectively. A flexural modulus of 25 GPa was achieved, with shear and compressive stiffness values of 6 and 21.5 kN mm -1 , respectively. These unidirectionally reinforced phosphate glass fibre PLA composites have huge potential to be used as IM fixation devices.

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“…Bioresorbable devices may be useful for promoting healing in fixated ribs because of the gradual transfer of load from the fixation device to the healing bone over time (in contrast to the stress-shielding scenario associated with permanently rigid metal fixation devices) (Viljanen et al 2001). The obvious utility of such devices is tempered by the relative infancy of the technology.…”

Section: Introductionmentioning

confidence: 99%

“…A novel concept for rib fixation involves the use of bioresorbable (absorbable) polymer intramedullary rib splints, for which the need for implant removal post-healing is eliminated, and which are compatible to magnetic resonance imaging (Viljanen et al 2001;Marasco 2010). Bioresorbable devices may be useful for promoting healing in fixated ribs because of the gradual transfer of load from the fixation device to the healing bone over time (in contrast to the stress-shielding scenario associated with permanently rigid metal fixation devices) (Viljanen et al 2001).…”

Section: Introductionmentioning

confidence: 99%

Stress analysis of a centrally fractured rib fixated by an intramedullary screw

Liovic

Šutalo

Marasco

2012

Computer Methods in Biomechanics and Biomedical Engineering

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The stress on an intramedullary screw rib fixation device holding together a centrally fractured human rib under in vivo force loadings was studied using finite element analysis (FEA). Validation of the FEA modelling using pullout from porcine ribs proved FEA to be suitable for assessing the structural integrity of screw/bone systems such as rib fixated by a screw. In the human rib fixation investigation, it was found that intramedullary bioresorbable Bioretec screws can fixate centrally fractured human ribs under normal breathing conditions. However, under coughing conditions, simulation showed Bioretec fixating screws to bend substantially. High stresses in the screw are mainly the result of flexion induced by the force loading, and are restricted to thin regions on the outside of the screw shaft. Stiffer screws result in less locally intense stress concentrations in bone, indicating that bone failure in the bone/screw contact regions can be averted with improvements in screw stiffness.

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Comparison of absorbable poly-l-lactide and metallic intramedullary rods in the fixation of femoral shaft osteotomies: an experimental study in rabbits

Cited by 32 publications

References 12 publications

Electrospun Hydroxyapatite-Functionalized PLLA Scaffold: Potential Applications in Sternal Bone Healing

Electrospun Hydroxyapatite-Functionalized PLLA Scaffold: Potential Applications in Sternal Bone Healing

Initial mechanical properties of phosphate-glass fibre-reinforced rods for use as resorbable intramedullary nails

Stress analysis of a centrally fractured rib fixated by an intramedullary screw

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