Long-term tissue response to bioabsorbable poly-l-lactide and metallic screws: An experimental study

Pihlajamäki, Harri; Böstman, O; Tynninen, Olli; Laitinen, Outi

doi:10.1016/j.bone.2006.04.009

Cited by 55 publications

(40 citation statements)

References 32 publications

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“…Bostman reported a 5.3% incidence of aseptic foreign body reaction after PGA device implantation versus 0.2% rate with PLLA [3]. Studies in rabbit femurs failed to reveal widespread inflammatory reactions to PLLA implants [11]. Slowly degrading bioabsorbable composites, however, may decompose into smaller fractions that may incite delayed nonspecific foreign body reactions.…”

Section: Discussionmentioning

confidence: 99%

Is the Etiology of Pretibial Cyst Formation After Absorbable Interference Screw Use Related to a Foreign Body Reaction?

Gonzalez-Lomas¹,

Cassilly²,

Remotti

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Arthroscopically assisted anterior cruciate ligament reconstruction using a bioabsorbable tibial fixation screw is occasionally complicated by pretibial cyst formation. The few case reports describing pretibial cyst formation noted several graft types and fixation techniques, making it difficult to establish one etiology. Some literature suggests cysts form from communication between the joint and pretibial area leading to extravasation of joint fluid, maturing into a cyst. We propose the development of cysts after PLLA screw use may be related to a foreign body reaction. Questions/purposes We propose this foreign body reaction (1) relates to the biochemical breakdown of bioabsorbable materials; and (2) differs from cystic formations resulting from joint communication. Methods We retrospectively reviewed seven patients who developed pretibial cysts at least 2 years after original primary ACL reconstruction surgery. MRI was used to visualize the extent of cystic formation. Cysts were treated by débridement with specimens sent for histologic analysis. Cyst appearance had a 3-year incidence of 5%.

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Section: Discussionmentioning

confidence: 99%

Is the Etiology of Pretibial Cyst Formation After Absorbable Interference Screw Use Related to a Foreign Body Reaction?

Gonzalez-Lomas¹,

Cassilly²,

Remotti

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…tion due to the presence of the scaffold. It has been reported that polymer scaffolds such as PLA may induce an inflammatory reaction, as this polymer releases lactic acid during its degradation [21]. It is the accumulation of this acid which becomes toxic [22].…”

Section: Discussionmentioning

confidence: 99%

Augmentation of bone defect healing using a new biocomposite scaffold: An in vivo study in sheep

et al. 2010

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a b s t r a c tPrevious studies support resorbable biocomposites made of poly(L-lactic acid) (PLA) and b-tricalcium phosphate (TCP) produced by supercritical gas foaming as a suitable scaffold for tissue engineering. The present study was undertaken to demonstrate the biocompatibility and osteoconductive properties of such a scaffold in a large animal cancellous bone model. The biocomposite (PLA/TCP) was compared with a currently used b-TCP bone substitute (ChronOS™, Dr. Robert Mathys Foundation), representing a positive control, and empty defects, representing a negative control. Ten defects were created in sheep cancellous bone, three in the distal femur and two in the proximal tibia of each hind limb, with diameters of 5 mm and depths of 15 mm. New bone in-growth (osteoconductivity) and biocompatibility were evaluated using microcomputed tomography and histology at 2, 4 and 12 months after surgery. The in vivo study was validated by the positive control (good bone formation with ChronOS™) and the negative control (no healing with the empty defect). A major finding of this study was incorporation of the biocomposite in bone after 12 months. Bone in-growth was observed in the biocomposite scaffold, including its central part. Despite initial fibrous tissue formation observed at 2 and 4 months, but not at 12 months, this initial fibrous tissue does not preclude long-term application of the biocomposite, as demonstrated by its osteointegration after 12 months, as well as the absence of chronic or long-term inflammation at this time point.

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“…CONCLUSION: Studies of injectable PLLA support the hypothesized mode of operation, and the experience and clinical recommendations of the authors that suggest that three treatment sessions are an optimal regimen for use of injectable PLLA in the majority of patients. (23)(24)(25)(26)(27)(28). In humans, Lemperle et al (25) observed a cellular response (involving macrophages, lymphocytes and giant cells), which was similar to that seen in mice after reconstituted PLLA (New-Fill, Biotech Industry SA, Luxembourg) was injected into the volar skin of the forearm.…”

Section: Methodsmentioning

confidence: 81%

Optimizing injectable poly-L-lactic acid administration for soft tissue augmentation: The rationale for three treatment sessions

Bauer¹,

Graivier²

2011

J Plast Surg

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Long-term tissue response to bioabsorbable poly-l-lactide and metallic screws: An experimental study

Cited by 55 publications

References 32 publications

Is the Etiology of Pretibial Cyst Formation After Absorbable Interference Screw Use Related to a Foreign Body Reaction?

Is the Etiology of Pretibial Cyst Formation After Absorbable Interference Screw Use Related to a Foreign Body Reaction?

Augmentation of bone defect healing using a new biocomposite scaffold: An in vivo study in sheep

Optimizing injectable poly-L-lactic acid administration for soft tissue augmentation: The rationale for three treatment sessions

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