Titanium Versus Bioabsorbable Magnesium Headless Compression Screw Fixation for Tibial Tubercle Osteotomy

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Sports medicine

Background:

• Tibial tubercle osteotomy (TTO) is a common surgical procedure.
• Fixation methods for TTO include titanium (Ti) and bioabsorbable magnesium (Mg) screws.
• The long-term outcomes and necessity of implant removal for Mg screws in TTO are not well-established.

Purpose of the Study:

• To compare clinical and radiological outcomes of TTO fixed with Mg versus Ti headless compression screws.
• To evaluate the need for implant removal in both fixation groups.
• To assess patient satisfaction and complication rates following TTO.

Main Methods:

• Retrospective study of 29 patients undergoing TTO between 2013 and 2023.
• Comparison of outcomes between patients with Ti screws (n=19) and Mg screws (n=10).
• Primary outcome: implant removal; Secondary outcomes: Kujala and Lysholm scores, complication rates, radiographic union, and patient satisfaction.

Main Results:

• Both Ti and Mg screw groups showed significant improvements in Kujala and Lysholm scores postoperatively, with no significant differences between groups.
• No implant removal, fixation failure, nonunion, or significant range of motion loss occurred in either group.
• Persistent Mg screw remnants were observed radiographically after five years, indicating incomplete bioabsorption, while Ti screws maintained stability.

Conclusions:

• Bioabsorbable Mg screws did not provide superior clinical or radiological benefits compared to Ti headless compression screws for TTO.
• The routine use of Mg screws is not recommended due to higher cost and incomplete long-term resorption.
• Ti headless compression screws are a cost-effective and reliable fixation method for TTO, ensuring stable healing without secondary surgery.