Examination of efferent lymph nodes after 2 years of transcortical implantation of poly(<scp>L</scp>‐lactide) containing plugs: A case report

Verheyen, Cees C. P. M.; Wijn, J.R. de; Blitterswijk, Clemens A. van; Rozing, P. M.; Groot, K. de

doi:10.1002/jbm.820270817

Cited by 48 publications

(17 citation statements)

References 8 publications

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“…In general, lymph node swelling was limited, even for the completely degraded samples which were not recovered. This confirms previous findings for transport of PLA particles to the lymph node [33,34]. For the predegraded PLA96 168 implants similar results were obtained for 0.5, 1.0, and 2.0 thick implants, with an increase in the number of affected lymph nodes in time.…”

Section: Discussionsupporting

confidence: 91%

Tissue response to partially in vitro predegraded poly-L-lactide implants

Jong

Bergsma²,

Robinson

et al. 2005

Biomaterials

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Section: Discussionsupporting

confidence: 91%

Tissue response to partially in vitro predegraded poly-L-lactide implants

Jong

Bergsma²,

Robinson

et al. 2005

Biomaterials

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“…Even at 24 months after surgery we found polymer debris in the lymph nodes although there was no more at the implant site. This appearance was first described by Verheyen et al in 1993 for poly(L-lactide). Daniels et al (1992) and Taylor et al (1994) suggested that the local decrease in pH at the implant site during the degradation is one of the main reasons for the inflammatory tissue response and further data are now available on biocompatibility from investigations in vitro on the toxicity of Inguinal lymph node after six months of implantation showing a macrophage with intracellularly deposited polymer particles (arrows) (haematoxylin and eosin, polarised light, X160).…”

Section: Discussionmentioning

confidence: 74%

Foreign-Body Reaction and the Course of Osteolysis After Polyglycolide Implants for Fracture Fixation

Weiler

Helling

Kirch

et al. 1996

The Journal of Bone and Joint Surgery. British volume

147

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Foreign-body reaction to polyglycolide (PGA) implants has been described in man. Many animal experiments have verified the mechanical properties of fixation devices made from PGA, but a significant foreign-body reaction has not been described. We studied the effect of PGA rods in 12 sheep with standardized osteochondral fractures of the medial femoral condyle fixed with uncoloured, self-reinforced PGA rods (Biofix). Radiographs were taken at intervals ranging from two weeks to two years, and the sheep were killed at intervals ranging from six to 24 months. All knees were examined histologically.Eleven of the 12 fractures healed radiologically and histologically. Moderate to severe osteolysis was seen at four to six weeks with maximum changes at 12 weeks in ten animals. Six knees showed fistula-like connections between the implant site and the joint space. Three developed synovitis, one with inflammatory changes involving the whole cartilage and one with destruction of the medial condyle.Although in our study osteochondral fractures fixed with PGA rods healed reliably, there were frequent, significant foreign-body reactions. Caution is needed when considering the use of PGA fixation devices in vulnerable regions such as the knee.

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“…36 Implantation of L-PLA implants into the femur is associated with polymer particles colocated in the region of the inguinal lymph nodes. 37 Therefore, evidence is already available to suggest that particulation is an intermediate in the degradation scheme of PAEs. A further understanding of the degradation scheme for PAEs is complicated by the fact that the retrieval of particulate debris formed during the degradative process has not been possible.…”

Section: Discussionmentioning

confidence: 99%

Particulate retrieval of hydrolytically degraded poly(lactide-co-glycolide) polymers

Cordewener

Dijkgraaf

Ong

et al. 2000

J. Biomed. Mater. Res.

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This article describes a technique for the retrieval of polymeric particulate debris following advanced hydrolytic in vitro degradation of a biodegradable polymer and presents the results of the subsequent particle analysis. Granular 80/20 poly(L-lactide-co-glycolide) (PLG) was degraded in distilled, deionized water in Pyrextrade mark test tubes at 80 degrees C for 6 weeks. Subsequently, a density gradient was created by layering isopropanol over the water, followed by a 48-h incubation. Two opaque layers formed in the PLG tubes, which were removed and filtered through 0.2-micrometer polycarbonate membrane filters. In addition, Fourier transform IR spectroscopy (FTIR) was performed to confirm the presence of polymer in the removed layers. The filters were gold sputter coated, and scanning electron microscopy (SEM) images were made. FTIR analysis confirmed that the removed material was PLG. SEM images of the extracts from the upper (lowest density) opaque layer showed a fine, powderlike substance and globular structures of 500-750 nm. The SEM images of the lower (highest density) opaque layer showed particles with a crystalline-like morphology ranging in size from 4 to 30 micrometer. Particulate PLG debris generated with the described technique can be useful for further studies of its biological role in complications associated with poly(alpha-hydroxy)ester implants. This study shows the presence of very persistent nano- and microparticles in the degradation pathway of PLG.

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Examination of efferent lymph nodes after 2 years of transcortical implantation of poly(L‐lactide) containing plugs: A case report

Cited by 48 publications

References 8 publications

Tissue response to partially in vitro predegraded poly-L-lactide implants

Tissue response to partially in vitro predegraded poly-L-lactide implants

Foreign-Body Reaction and the Course of Osteolysis After Polyglycolide Implants for Fracture Fixation

Particulate retrieval of hydrolytically degraded poly(lactide-co-glycolide) polymers

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