The RIVET: a novel technique involving absorbable fixation for hydroxyapatite osteosynthesis

Area of Science:

• Biomaterials Science
• Neurosurgery
• Medical Device Engineering

Background:

• Cranioplasty commonly uses custom-made hydroxyapatite (HAP) ceramic implants for skull defect repair due to their biocompatibility and osteoconductive properties.
• Current fixation methods for HAP implants often involve titanium screws and plates, which are metallic and may have limitations.
• Developing alternative fixation methods is crucial for improving cranioplasty outcomes.

Observation:

• A new technique, Resorbable Immobilization for Vacuolar En Bloc Technique (RIVET), was developed for implant fixation using bioabsorbable screws and plates.
• The RIVET technique involves customizing HAP implants based on CT data and attaching bioabsorbable plates using a unique screw-melting process to form a rivet.
• This technique was successfully applied in two patients for cranial reconstruction.

Findings:

• The RIVET technique demonstrated satisfying and functional results in the two patient cases.
• No complications were reported during or after the application of the RIVET technique.
• The developed method provides more rigid fixation of implants and plates compared to previous approaches.

Implications:

• The RIVET technique offers a promising alternative for rigid fixation in cranioplasty using HAP implants.
• This advancement may lead to improved surgical outcomes and reduced complications in patients with skull defects.
• Further research and clinical application of the RIVET technique could enhance the standard of care in reconstructive surgery.