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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 11, 1575-1580.
doi: 10.1302/0301-620X.87B11.16520  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Tissue restoration after resorption of polyglycolide and poly-laevo-lactic acid screws

O. M. Böstman, MD, Orthopaedic Surgeon1; O. M. Laitinen, DVM, Veterinary Surgeon2; O. Tynninen, MD, Pathologist3; S. T. Salminen, MD, Orthopaedic Surgeon4; and H. K. Pihlajamäki, MD, Orthopaedic Surgeon5

1 Department of Orthopaedics and Trauma Surgery, Helsinki University Hospital, P. O. Box 266, FIN-00029, Helsinki, Finland.
2 Department of Clinical Veterinary Sciences, Faculty of Veterinary Medicine, P. O. Box 57, FIN-00014, University of Helsinki, Finland.
3 Department of Pathology, Helsinki University Hospital, P. O. Box 400, FIN-00029, HUS (Helsinki), Finland.
4 Department of Paediatric Orthopaedics, Helsinki University Hospital, P. O. Box 281, FIN-00029, HUS (Helsinki), Finland.
5 Department of Orthopaedic Surgery and Research, Institute of Military Medicine Central Military Hospital, P. O. Box 50, FIN-00301, Helsinki, Finland.

Correspondence should be sent to Dr O. M. Böstman at Tiirasaarentie 24 C, Helsinki, FIN-00200, Finland; e-mail: Ole.Bostman{at}Helsinki.fi

Despite worldwide clinical use of bio-absorbable devices for internal fixation in orthopaedic surgery, the degradation behaviour and tissue replacement of these implants are not fully understood.

In a long-term experimental study, we have determined the patterns of tissue restoration 36 and 54 months after implantation of polyglycolic acid and poly-laevo-lactic acid screws in the distal femur of the rabbit.

After 36 months in the polyglycolic acid group the specimens showed no remaining polymer and loose connective tissue occupied 80% of the screw track. Tissue restoration remained poor at 54 months, the amounts of trabecular bone and haematopoietic elements being significantly lower than those in the intact control group. The amount of trabecular bone within the screw track at 54 months in the polyglycolic acid group was less than in the empty drill holes (p = 0.04). In the poly-laevo-lactic acid group, polymeric material was present in abundance after 54 months, occupying 60% of the cross-section of the core area of the screw track.

When using absorbable internal fixation implants we should recognise that the degradation of the devices will probably not be accompanied by the restoration of normal trabecular bone.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General