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Osteolytic changes after polyglycolide pin fixation in chevron osteotomy
K Pelto-Vasenius1, E Hirvensalo, J Vasenius
1Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Finland.
Foot & Ankle International
|January 1, 1997
Summary
Absorbable polyglycolide pins in foot surgery can cause temporary osteolytic changes in metatarsal heads. These changes typically resolve, indicating observation is sufficient for management.
Area of Science:
- Orthopaedic surgery
- Biomaterials science
- Radiology
Background:
- Absorbable implants are used in orthopaedic procedures.
- Polyglycolide pins were utilized for chevron osteotomies.
- Osteolytic changes are a potential complication of absorbable implants.
Purpose of the Study:
- To evaluate the incidence and outcomes of osteolytic changes after using absorbable polyglycolide pins for chevron osteotomies.
- To determine the clinical significance and resolution of these changes.
Main Methods:
- Retrospective review of 94 chevron osteotomies in 70 patients.
- Analysis of postoperative radiographs for osteolytic changes around polyglycolide pins.
- Assessment of implant type (polydioxanone-coated vs. non-coated) and follow-up observations.
Main Results:
- 22% of metatarsal heads showed postoperative osteolytic changes.
- 17 of 21 cases involved polydioxanone-coated pins, which are no longer in use.
- 16/21 osteolytic changes resolved completely, 4 partially, and 1 persisted.
- Other complications included cystic changes (7.4%), avascular necrosis (1.1%), foreign body reaction (6.3%), and infection (3.2%).
- No association found between osteolysis and foreign body reaction or infection.
Conclusions:
- Osteolytic changes associated with polyglycolide pins are generally transient and require only observation.
- The use of polydioxanone-coated pins was linked to a higher incidence of these changes.
- Symptoms associated with radiographic osteolysis are temporary, suggesting a benign course.