Adverse tissue reactions to bioabsorbable fixation devices.

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Inflammatory Response

Background:

• Absorbable fixation devices like pins, rods, bolts, and screws made of polyglycolic acid (PGA) and polylactic acid (PLA) are used in orthopedic procedures.
• Local inflammatory, sterile tissue reactions can occur following the use of these bioresorbable implants.

Purpose of the Study:

• To investigate the incidence, characteristics, and risk factors of adverse tissue reactions associated with polyglycolic acid and polylactic acid orthopedic implants.
• To evaluate the clinical significance and histopathological findings of these reactions.

Main Methods:

• Retrospective analysis of 2528 patients who underwent surgery with PGA or PLA fixation devices.
• Review of clinical records, implant types, indications for use, and patient outcomes.
• Histopathological examination of tissue reactions.

Main Results:

• A total of 108 patients (4.3%) experienced clinically significant local inflammatory reactions.
• Reactions were predominantly associated with polyglycolic acid implants (5.3% incidence) compared to polylactic acid implants (0.2% incidence).
• Risk factors included poorly vascularized bone, quinone dye additives, and large implant surface area (screws).

Conclusions:

• Polyglycolic acid implants demonstrate a higher risk of adverse tissue reactions compared to polylactic acid implants.
• While polylactic acid shows better initial biocompatibility, its long-term effects require further investigation due to slow degradation.
• Identifying risk factors aids in predicting and potentially mitigating adverse tissue responses to bioresorbable orthopedic implants.