Degradation and tissue replacement of an absorbable polyglycolide screw in the fixation of rabbit femoral osteotomies.

Böstman, O; Päivärinta, Unto; Partio, Esa K.; Vasenius, Jarkko; Manninen, Mikko; Rokkanen, P

doi:10.2106/00004623-199274070-00008

Cited by 109 publications

(46 citation statements)

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“…The degradation products are reabsorbed by the body. 10 All carriers were used as blocks of 7 × 7 × 10-mm size. Table I shows the physical properties of tested materials, supported by the companies in their data sheets presented.…”

Section: Biodegradable Materialsmentioning

confidence: 99%

Adsorption and release properties of growth factors from biodegradable implants

Ziegler

Mayr-Wohlfart

Kessler

et al. 2001

J. Biomed. Mater. Res.

102

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The present investigation was performed to study the adsorption behavior of growth factors and their release characteristics from biodegradable implants in an in vitro study. We investigated the stability of growth factors administered on various scaffolds. We used porous tricalcium phosphate ceramics (alpha-TCP), a neutralized glass-ceramics (GB9N), a composite (polylactid/-glycolid/GB9N), and solvent dehydrated human bone as carriers. Block shaped scaffolds (sized: 7 x 7 x 10 mm) were loaded with 5 microg of either bone morphogenetic protein (rxBMP-4), basic fibroblast growth factor (rh-bFGF), or vascular endothelial growth factor (rh-VEGF) solved in 150 microL PBS. The growth factors were labeled with Iodine125 (I-125) for detecting the adsorbed and released amount of growth factors by counting the samples for total I-125 activity. We observed that the adsorption of these growth factors seems to depend on two different parameters: first on the nature of the tested material, and second on the growth factors on their own. The release kinetics of the growth factors from the biodegradable implants can be described as a two phase process-a very rapid release during the first hours by an elution of not adsorbed protein, followed by a specific release, which depends upon the chemical/physical interaction of the material and the growth factor used. Analyzing the eluted proteins on SDS-PAGEs rh-VEGF was degraded into a smaller fragment with a size of around 15 kDa, while rxBMP-4 and rh-bFGF showed a complete degradation into fragments smaller than 3 kDa after more than 3 days. Although this in vitro study suggests that biodegradable implants might be successfully used as carriers for osteogenic growth factors, the different release kinetics as well as the alteration of their molecular structure including loss of biological activity should be considered.

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Section: Biodegradable Materialsmentioning

confidence: 99%

Adsorption and release properties of growth factors from biodegradable implants

Ziegler

Mayr-Wohlfart

Kessler

et al. 2001

J. Biomed. Mater. Res.

102

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“…In other studies, a similar response has earlier been observed to PGA and PLLA. 8,27,34,35 Such an osteoconductive reaction seems to be related to, or result from, a walling-off response that creates bony trabeculae to surround the implant. The prior reports describing the osteoconductive properties of PDS are controversial.…”

Section: Discussionmentioning

confidence: 99%

“…In experimental studies in rabbits, PGA screws and rods have been shown to degrade in 24-36 weeks in cancellous bone. 8,27,44 PDS pins have been reported to biodegrade almost fully in the cortical bone of rabbits at 4 months. 45 The degradation time of PLLA, on the other hand, is much longer, a fact known on the basis of both experimental and clinical studies.…”

Section: Discussionmentioning

confidence: 99%

“…At present, the variety of biodegradable devices includes pins, rods, screws, plugs, and tacks, most of them made of polyglycolide (PGA) or polylevolactide (PLLA). [1][2][3][4][5][6] In previous experimental [7][8][9][10][11][12] and clinical studies, [13][14][15][16][17] devices made of PGA and PLLA have been shown to have the suitable mechanical properties for the fixation of cancellous bone fragments. Polydioxanone (PDS) is a wellknown suture material with good biocompatibility.…”

Section: Introductionmentioning

confidence: 99%

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Tissue response to polyglycolide, polydioxanone, polylevolactide, and metallic pins in cancellous bone: An experimental study on rabbits

Pihlajamäki

Salminen

Laitinen

et al. 2006

Journal Orthopaedic Research

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The purpose of this study was to investigate, qualitatively and histoquantitatively, the tissue response of rabbit femur cancellous bone to polyglycolide (PGA), polydioxanone (PDS), polylevolactide (PLLA), and stainless steel pins under identical conditions. Eighty knees in 50 rabbits were operated on by inserting bioabsorbable pins (PGA, PDS, or PLLA) together with metallic Kirschner wire in 60, and two metallic Kirschner wires alone in 20 knees, while 20 knees served as intact controls. Follow-up times were 3, 6, 12, 24, and 52 weeks. Cancellous bone tissue response to implants was studied using histological, histomorphometrical, microradiographical, and oxytetracycline fluorescence methods. Residual fragments of PGA and PDS were seen at 24 weeks. Complete degradation of these polymers had taken place before 52 weeks. No signs of degradation of the PLLA pins were observed within the entire follow-up period. The osteoid formation surfaces at tissue implant-interface were statistically larger in all test groups as compared to intact controls. The number of macrophages at tissue implant-interfaces increased in all bioabsorbable implant specimens until 6 weeks, and with PGA until 12 weeks. No differences in the osseous response emerged when comparing groups of bioabsorbable implants with each other or with stainless steel group. Bioabsorbable pins and metallic Kirschner wires evoked an osteoconductive response in the cancellous bone surrounding implant, but the response intensity between implants displayed no differences. This suggests a simple, nonspecific walling-off new-bone front type of response. Consequently, the polymers possessed no specific osteostimulatory or osteoinhibitory properties. Within the follow-up, no significant differences in biocompatibility between the implants appeared, and no frank inflammatory foreign-body reactions occurred. The smallvolume pins obviously did not exceed the local tissue tolerance and clearing capacity of the bone.

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“…Acute synovitis of the knee has been described in three patients after fixation of osteochondral fragments with PGA pins, 5,6 but there was no long-term follow-up. The association between osteolytic changes and foreign-body tissue responses to PGA has been well documented in experimental 20,21 and clinical studies, 8,10,11,22 but the natural history of such lesions is not clear. We have confirmed in our study that there is usually total regression of the osteolysis within three years.…”

Section: Discussionmentioning

confidence: 99%

Osteoarthritis of the ankle after foreign-body reaction to absorbable pins and screws

Böstman

1998

The Journal of Bone and Joint Surgery. British volume

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Between 1985 and 1994, 1223 patients with malleolar fractures of the ankle were treated by open reduction and internal fixation with absorbable pins and screws, of whom 74 (6.1%) had an obvious inflammatory foreign-body reaction to the implants. Of these 74, ten later developed moderate to severe osteoarthritis of the ankle despite no evidence of incongruity of the articular surface. The implants used in these patients were made from polyglycolide, polylactide or glycolide-lactide copolymer.The joint damage seemed to be due to polymeric debris entering the articular cavity through an osteolytic extension of an implant track. The ten patients had a long clinical course which included a vigorous local foreign-body reaction, synovial irritation and subsequent degeneration. At a follow-up of three to nine years, ankle arthrodesis had been necessary in two patients and is being considered for another two.The incidence of these changes in the whole series was 0.8%, which is not high, but awareness of this possible late complication is essential.

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Degradation and tissue replacement of an absorbable polyglycolide screw in the fixation of rabbit femoral osteotomies.

Cited by 109 publications

References 0 publications

Adsorption and release properties of growth factors from biodegradable implants

Adsorption and release properties of growth factors from biodegradable implants

Tissue response to polyglycolide, polydioxanone, polylevolactide, and metallic pins in cancellous bone: An experimental study on rabbits

Osteoarthritis of the ankle after foreign-body reaction to absorbable pins and screws

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