TY - JOUR
T1 - Bioabsorbable interference screws for bone-patellar tendon-bone anterior cruciate ligament reconstruction
T2 - Clinical and computerized tomography results of four different models. A prospective study
AU - Denti, M.
AU - Randelli, Pietro
AU - Lo Vetere, D.
AU - Moioli, M.
AU - Tagliabue, M.
PY - 2004/12
Y1 - 2004/12
N2 - We investigated the effectiveness of four bioabsorbable interference screws for bone block fixation in ACL reconstruction, and assessed their complete absorption and graft integration. We performed a prospective clinical evaluation with the IKDC form and computed tomography (CT) scans 3, 6, 9, 12, 18 and 24 months after arthroscopic ACL reconstruction with the bonepatellar tendon-bone (BPTB) technique. A total of 20 patients was divided into five groups according to the type of screw used for the femoral fixation (half-tunnel technique): group A, poly L-lactic acid; group B, polyglyconate copolymer; group C, lactic acid and glycolic acid copolymer; group D, polylactic acid; and group E (control), titanium. Proximal bone graft integration was always achieved within 6 and 12 months. Cystic bone absorption was observed in two group A patients. Ten screws were absorbed (9 completely; 1 partially): 1 completely and 1 partially in group A at 9 and 24 months; 4 in Group B between 12 and 18 months; 4 in Group C (2 each at 12 and 24 months); and none in Group D. The IKDC ratings were: group A, four patients with A; group B, 2 with A, 1 with B and 1 with C; group C, 2 with A, 2 with B; group D, 4 with A. Effusion that resolved within 6 months was noted in 2 group A and 2 group C patients. One patient in group B had a traumatic re-rupture of the graft; the screw was not found when he was re-operated at 18 months. The four bioabsorbable interference screws provided safe and effective bone block fixation during ACL reconstruction. Their 93.75% excellent and good overall IKDC results were in line with those achieved with metal interference screws. The fact that none of the group D screws (polylactic acid) were absorbed at 2 years indicates that absorption of polylactic acid is a slow biological process. This is also suggested by the absence of effusion in this group.
AB - We investigated the effectiveness of four bioabsorbable interference screws for bone block fixation in ACL reconstruction, and assessed their complete absorption and graft integration. We performed a prospective clinical evaluation with the IKDC form and computed tomography (CT) scans 3, 6, 9, 12, 18 and 24 months after arthroscopic ACL reconstruction with the bonepatellar tendon-bone (BPTB) technique. A total of 20 patients was divided into five groups according to the type of screw used for the femoral fixation (half-tunnel technique): group A, poly L-lactic acid; group B, polyglyconate copolymer; group C, lactic acid and glycolic acid copolymer; group D, polylactic acid; and group E (control), titanium. Proximal bone graft integration was always achieved within 6 and 12 months. Cystic bone absorption was observed in two group A patients. Ten screws were absorbed (9 completely; 1 partially): 1 completely and 1 partially in group A at 9 and 24 months; 4 in Group B between 12 and 18 months; 4 in Group C (2 each at 12 and 24 months); and none in Group D. The IKDC ratings were: group A, four patients with A; group B, 2 with A, 1 with B and 1 with C; group C, 2 with A, 2 with B; group D, 4 with A. Effusion that resolved within 6 months was noted in 2 group A and 2 group C patients. One patient in group B had a traumatic re-rupture of the graft; the screw was not found when he was re-operated at 18 months. The four bioabsorbable interference screws provided safe and effective bone block fixation during ACL reconstruction. Their 93.75% excellent and good overall IKDC results were in line with those achieved with metal interference screws. The fact that none of the group D screws (polylactic acid) were absorbed at 2 years indicates that absorption of polylactic acid is a slow biological process. This is also suggested by the absence of effusion in this group.
KW - Anterior cruciate ligament reconstruction
KW - Bioabsorbable screws
KW - Graft fixation
UR - http://www.scopus.com/inward/record.url?scp=12344275497&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=12344275497&partnerID=8YFLogxK
U2 - 10.1007/s10195-004-0062-5
DO - 10.1007/s10195-004-0062-5
M3 - Article
AN - SCOPUS:12344275497
VL - 5
SP - 151
EP - 155
JO - Journal of Orthopaedics and Traumatology
JF - Journal of Orthopaedics and Traumatology
SN - 1590-9921
IS - 3
ER -