Bone fixation techniques for managing joint disorders and injuries: A review study
P Farjam1, E E G Hekman1, J Rouwkema1
1Department of Biomechanical Engineering, Faculty of Engineering Technology, University of Twente, Enschede, the Netherlands.
Abstract:
The majority of surgical procedures treating joint disorders require a technique to realize a firm implant-to-tissue and/or a tissue-to-tissue fixation. Fixation methods have direct effects on survival, performance and integration of orthopedic implants This review paper gives an overview of novel fixation techniques that have been evaluated and optimized for orthopaedic joint implants and could be alternatives for traditional implant fixation techniques or inspirations for future design of joint implantation procedures.
Method:
The articles were selected using the Scopus search engine. Key words referring to traditional fixation methods have been excluded to find potential innovative fixation techniques. In order to review the recent anchorage systems, only articles that been published during the period of 2010-2020 have been included.
Results:
A total of 57 studies were analyzed. The result revealed that three main fixation principles are being employed: using mechanical interlockings, employing adhesives, and performing tissue-bonding strategies.
Conclusion:
The development of fixation techniques demonstrates a transformation from the general anchoring tools like K-wires toward application-specific designs. Several new methods have been designed and evaluated, which highlight encouraging results as described in this review. It seems that mechanical fixations provide the strongest anchorage. Employing (bio)-adhesives as fixation tool could revolutionize the field of orthopedic surgery. However, the adhesives must be improved and optimized to meet the requirements of an anchorage system. Long-term fixation might be formed by tissue ingrowth approaches which showed promising results. In most cases further clinical studies are required to explore their outputs in clinical applications.
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