Osteolysis after biodegradable pin fixation of fractures in children

Fraser, RK; Wg, Cole

doi:10.1302/0301-620x.74b6.1332975

Cited by 70 publications

(25 citation statements)

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“…The osteolytic changes first described by Böstman (1991) should be viewed as the expected reaction to the PGA implant and not as a complication. The incidence of these changes varied from 14.3% to 60% in patients (Table I) and was as high as 100% in our animal experiments (Casteleyn et al 1992; Fraser and Cole 1992;Frokjaer and Moller 1992;Gerbert 1992). Mild osteolytic changes at the rod site probably have no effect on fracture healing or on the static properties of the bone.…”

Section: Discussionmentioning

confidence: 58%

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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Section: Discussionmentioning

confidence: 58%

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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“…In contrast, none of our patients exhibited osteolysis, which appears in approximately 50% of patients [1,12]. The clinical and histologic features of adverse tissue reactions to polyglycolide and polylactide implants appear to be quite similar, except that discharging sinuses are common with the former and rare with the latter implants [5].…”

Section: Discussionmentioning

confidence: 62%

Delayed Foreign-body Reaction to Absorbable Implants in Metacarpal Fracture Treatment

Givissis

Stavridis

Papagelopoulos

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background First-generation bioabsorbable implants have been associated with a high complication rate attributable to weak mechanical properties and rapid degradation. This has led to the development of stronger devices with improved durability. However, the modern implants have raised concerns about potential late-occurring adverse reactions. Questions/purposes This retrospective study addressed the following questions: Can absorbable implants consisting of trimethylene carbonate, L-lactide, and D,L-lactide provide adequate fixation for healing of a metacarpal fracture? Will these implants obviate a second removal operation? What complications can occur in the reaction to implant breakdown? Patients and Methods Twelve unstable, displaced, metacarpal fractures were studied in 10 consecutive patients (seven men, three women; mean age, 36.4 years; range, 18-75 years). The fractures were treated with absorbable plates and screws consisting of the aforementioned copolymers and designed to resorb in 2 to 4 years. Nine patients (10 fractures) were available for clinical and radiographic followups (mean, 45.7 months; range, 34-61 months).

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“…At each examination, the radiological assessment comprised a front view and lateral view centered on the lesion, to discern aspects and timing of the consolidation, the occurrence of a secondary displacement, and the development of an osteolytic response at the level of the osteosynthetic device, as has been described previously with certain polyglycolic acid materials [17,18]. Furthermore, patients being monitored for osteochondritis dissecans lesions received an MRI checkup in order to monitor the integration and vitality of the fragment.…”

Section: Methodsmentioning

confidence: 99%

Resorbable osteosynthetic devices in pediatric traumatology: a prospective series of 24 cases

Poircuitte

Popkov

Huber

et al. 2015

Eur J Orthop Surg Traumatol

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Osteolysis after biodegradable pin fixation of fractures in children

Cited by 70 publications

References 0 publications

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

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

Delayed Foreign-body Reaction to Absorbable Implants in Metacarpal Fracture Treatment

Resorbable osteosynthetic devices in pediatric traumatology: a prospective series of 24 cases

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