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Adverse tissue reactions to bioabsorbable fixation devices.

O M Böstman1, H K Pihlajamäki

  • 1Department of Orthopaedic and Trauma Surgery, University Hospital, Helsinki, Finland.

Clinical Orthopaedics and Related Research
|February 29, 2000
PubMed
Summary

Polyglycolic acid implants caused inflammatory reactions in 5.3% of patients, unlike polylactic acid implants. Further research is needed to assess the long-term biocompatibility of polylactic acid in orthopedic surgery.

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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.

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  • 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.