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Related Experiment Videos

Broken poly-L-lactic acid interference screw after ligament reconstruction.

Brian L Shafer1, Peter T Simonian

  • 1Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington 98195-6500, USA. bshafer@u.washington.edu

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
|September 5, 2002
PubMed
Summary

Bioabsorbable interference screws are increasingly used in ligament reconstruction. This study presents rare cases of late screw breakage in anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstructions.

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Area of Science:

  • Orthopedic surgery
  • Biomaterials science
  • Sports medicine

Background:

  • Interference screws are crucial for graft fixation in ligament reconstruction.
  • Historically, metal screws were standard, but bioabsorbable alternatives are gaining traction.
  • Poly-L-lactic acid (PLLA) screws offer a biodegradable option for tendon-to-bone and bone-to-bone fixation.

Observation:

  • While bioabsorbable implants generally have a good safety profile, late screw breakage is an uncommon complication.
  • This report details two instances of late screw breakage involving bioabsorbable interference screws.
  • One case occurred after anterior cruciate ligament (ACL) reconstruction, and the other after combined posterior cruciate ligament (PCL) and posterolateral corner reconstruction.

Findings:

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  • The study highlights the occurrence of late screw breakage with PLLA interference screws, a complication previously considered rare.
  • These findings underscore the importance of monitoring patients even after successful ligament reconstruction with bioabsorbable implants.
  • The presented cases contribute to the understanding of potential long-term issues with biodegradable fixation devices.

    • Implications:

    • These findings may prompt further investigation into the long-term durability and failure modes of bioabsorbable interference screws.
    • Clinicians should remain vigilant for potential complications, including mechanical failure, even with seemingly well-integrated bioabsorbable implants.
    • This information is vital for patient counseling and optimizing surgical techniques in ligament reconstruction.