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A lean bioabsorbable magnesium-zinc-calcium alloy ZX00 used for operative treatment of medial malleolus fractures early clinical results of a prospective non-randomized first in man study

Holweg, P., Herber V., Ornig, M., Hohenberger, G., Donohue, N., Puchwein, P., Leithner, A. and Seibert, F.

Bone & Joint Research, 2020, 9(8), pp.477-483.

This study is a prospective, non-randomized trial for the treatment of fractures of the medial malleolus using lean, bioabsorbable, rare-earth element (REE)-free, magnesium (Mg)-based biodegradable screws in the adult skeleton. This first prospective clinical investigation of fracture reduction and fixation using lean, bioabsorbable, REE-free ZX00 screws showed excellent clinical and functional outcomes. The study by Holweg, P., Herber V., Ornig, M., Hohenberger, G., Donohue, N., Puchwein, P., Leithner, A. and Seibert, F.

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High-Strength Low-Alloy (HSLA) Mg-Zn-Ca Alloys with Excellent Biodegradation Performance

Hofstetter, J., Becker, M., Martinelli, E., Weinberg, A.-M., Mingler, B., Kilian, H., Pogatscher, S., Uggowitzer, P.J. and Loffler, J.F.

The Journal of The Minerals, Metals & Materials Society (TMS), 2014; 66(4): p. 566-572

This article deals with the development of fine-grained high-strength low-alloy (HSLA) magnesium alloys intended for use as biodegradable implant material. The alloys contain solely low amounts of Zn and Ca as alloying elements. The study by Hofstetter, J., Becker, M., Martinelli, E., Weinberg, A.-M., Mingler, B., Kilian, H., Pogatscher, S., Uggowitzer, P.J. and Loffler, J.F. 

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Assessing the degradation performance of ultrahigh-purity magnesium in vitro and in vivo

Hofstetter, J., Martinelli, E., Weinberg, A.-M., Becker, M. Mingler, B., Uggowitzer, P.J. and Loffler, J.F.

Corrosion Science, 2015, 91, pp.29-36.

The biodegradation of ultrahigh-purity Mg was tested in vitro in NaHCO3/CO2-buffered simulated body fluid and in vivo in the femur of rats. The less pure specimens exhibit significantly higher degradation rates due to the formation of Fe-containing precipitates during casting and annealing. The study by Hofstetter, J., Martinelli, E., Weinberg, A.-M., Becker, M. Mingler, B., Uggowitzer, P.J. and Loffler, J.F.

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A lean magnesium–zinc–calcium alloy ZX00 used for bone fracture stabilization in a large growing-animal model

Holweg, P., Berger, L., Cihova, M., Donohue, N., Clement, B., Schwarze, U., Sommer, N.G., Hohenberger, G., van den Beucken, J.J.J.P., Seibert, F., Leithner, A., Löffler, J.F., Weinberg, A.-M.

Acta Biomaterialia, Volume 113, 1 September 2020, Pages 646-659.

The aim of the study was to introduce the high-strength, lean Magnesium alloy and for the first time investigate the clinical applicability of screw osteosynthesis using this alloy that contains no rare-earth elements. The fracture healing process, including its effects on the surrounding area, had no significant influence on degradation behaviour. There was also no negative influence from hydrogen-gas formation on fracture healing. The study by Holweg, P., Berger, L., Cihova, M., Donohue, N., Clement, B., Schwarze, U., Sommer, N.G., Hohenberger, G., van den Beucken, J.J.J.P., Seibert, F., Leithner, A., Löffler, J.F., Weinberg, A.-M.

 

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MRI evaluation of resorbable poly lactic-co-glycolic acid (PLGA) screws used in pelvic osteotomies in children - a retrospective case series

H. Hedelin, H. Hebelka, H. Brisby & T. Laine

Journal of Orthopaedic Surgery and Research, 15, Article number: 329 (2020)

The orthopaedic use of resorbable poly lactic-co-glycolic acid (PLGA) implants carries multiple potential benefits. The aim of this study is to present an MRI-based evaluation of the resorption pattern and local tissue reactions in a paediatric case series after pelvic osteotomies fixated with PLGA screws. PLGA screws in the paediatric pelvis appear to be resorbed and replaced with solid bone in most cases but this process takes at least 2 years. The study by H. Hedelin, H. Hebelka, H. Brisby & T. Laine.

 

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Bioabsorbable Implants in Treatment of Ankle Fractures (Comparative Study)

V.G. Golubev, K.B. Zelenyak and A.N. Starostenkov
Department of Traumatology and Orthopedics, 2018 2(32), pp.66-73. In Russian. The study by V.G. Golubev, K.B. Zelenyak and A.N. Starostenkov.
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Patellar chondral defect treatment with a cell-free polyglycolic acid–hyaluronan-based implant and platelet-rich fibrin glue after previously failed microfracture

I. D. McDermott

SAGE Open Medical Case Reports, Volume 7: 1-4, 2019

Use of Bioretec ActivaNail™ with resorbable PGA–hyaluronan-based implant and platelet-rich autologous fibrin glue. The patient was treated with a polymer-based implant in combination with microfracture and autologous platelet-rich fibrin glue. Post-surgical follow-up after 6 months with magnetic resonance imaging revealed complete defect filling, which was confirmed by second-look arthroscopy after 9 months, showing the formation of cartilage repair tissue. The study by Mr. I. D. McDermott.

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Bony Fragment Excision Followed by Multiple Drilling and Fragment Fixation Using Bio-absorbable Pins for Bilateral Osteochondral Fracture of the Lateral Talar Dome: A Case Report

Y.J. Lee, J.S. Suh and J.Y. Choi

Journal of Korean Foot and Ankle Society, 2019 Dec; 23(4):201-207.

"An osteochondral fracture is considered to be an injury involving the cartilage and subchondral bone. Acute traumatic osteochondral fractures can be related to joint instability because abnormal joint motion causes shearing and rotatory stress. Acute osteochondral fractures are frequently missed or misdiagnosed as a pure soft tissue injury. Thus, surgeons' proactive attention is highly required as articular cartilage has limited potential for self-repair and these lesions may develop osteoarthritis. In order to minimize the progression of post-traumatic osteoarthritis, it is important to properly identify and treat osteochondral fractures. Yet, little is known about the operative management of acute osteochondral fractures of the talus. We report here on a case of a middle-aged male with acute osteochondral fractures of the bilateral lateral talar dome. We applied different operative methods on each side with regard to fragment size and stability. A favourable clinical outcome was obtained at 18 months follow-up." The study by Y.J. Lee, J.S. Suh and J.Y. Choi.

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Clinical Study on Percutaneous Intramedullary Bioresorbable Pin Fixation for Fourth and Fifth Metacarpal Bone Fracture

S.H. Lee, S.H. Kim, E.S. Parl, S.M. Nam and H.S. Shin

Journal of the Korean Society for Surgery of the Hand, 2017;22(2):105-111

"Metacarpal fracture of a ring and little finger occurs frequently. Percutaneous intramedullary fixation is a simple and effective method with a low incidence of complications. To date, Kirschner wire (K-wire) fixation has been widely used, but this has problems such as pin infection. Moreover, it is difficult to start early active motion exercise. So, we replaced the K-wire with a bioresorbable implant and evaluated the results. Replacement of a K-wire with a bioresorbable pin prevented soft tissue damage and dorsal scarring. And our percutaneous intramedullary bioresorbable pin fixation technique resulted in early recovery of range of motion and correction of deformity. The patients regained range of motion and returned to daily life early." The study by S.H. Lee, S.H. Kim, E.S. Parl, S.M. Nam and H.S. Shin.

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Our First Experience of Using Biodegradable Implants in Latarjet – Bristow Surgical Procedure at Chronic Posttraumatic Anterior Shoulder Instability

V.V. Monastryev, M.E. Puseva and N.S. Ponomarenko

Acta Biomedica Scientifica, 2018, Vol. 3, N 6

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Minimally invasive surgery for young female patients with mild-to -moderate juvenile hallux valgus deformity

J. Y. Choi, H. C. Ahn, S. H. Kim, S. Y. Lee and J. S. Suh

Foot and Ankle Surgery 25 (2019) 316–322

"We aimed to compare the clinical and radiographic outcomes of minimally invasive surgery (MIS) and distal chevron metatarsal osteotomy (DCMO) for young female patients with mild-to-moderate juvenile hallux valgus deformity. MIS for young female patients with mild-to-moderate juvenile hallux valgus deformity had similar radiographic and clinical outcomes compared to DCMO. Regarding additional fixation crossing the osteotomy site, both temporary Kirschner wires and absorbable pins showed no radiographic differences in terms of correction maintenance." The study by J. Y. Choi, H. C. Ahn, S. H. Kim, S. Y. Lee and J. S. Suh.

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Correct techniques for the use of bioabsorbable implants in orthopaedic trauma

Zamora, R., Jackson, A. and Seligson D.

Current Orthopaedic Practice, vol 27, 4, July/Aug 2016

"The materials and designs of bioabsorbable screws and rods have improved with better biocompatibility, absorbability, and biomechanics, thus reducing the rate of complications. This article describes the differences in the placement of bioabsorbable materials and conventional materials and how the differences affect applicability in orthopaedic procedures. Bioabsorbable screws and pins can be used for different types of fractures." The article by Zamora, R., Jackson, A. and Seligson D.

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Biodegradable poly-L-lactide-co-glycolide copolymer pin fixation of a traumatic patellar osteochondral fragment in a 11-year-old child: A novel surgical approach

J.-J. Sinikumpu and W. Serlo

Experimental and Therapeutic Medicine 13: 242-246, 2017

"The present report describes a novel operative technique using headless poly-L-lactide-co-glycolide (PLGA) pins in treating an 11-year-old girl with a patellar fracture from a cycling injury. The surgical technique of this procedure is described in detail in the current report. Excellent subjective outcomes were achieved from this surgery, with superb bone healing according to follow-up radiographic and computerized tomography scans. In conclusion, the results of this case indicate that similarly to osteochondritis, intra-articular osteochondral fractures in children may be fixed using biodegradable PLGA pins." The article by J.-J. Sinikumpu and W. Serlo.

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Innominate Salter osteotomy using resorbable screws: a retrospective case series and presentation of a new concept for fixation

H. Hedelin, P. Larnert, H. Hebelka, H. Brisby, K. Lagerstrand, T. Laine.

Journal of Children's Orthopaedics Vol. 13, No. 3., 2019

"The Salter innominate osteotomy (SIO) in children is traditionally stabilized by Kirschner-wires, which have issues regarding stability, infection and the need to be extracted. To counter these disadvantages, we present a surgical method to stabilize SIO with modern resorbable poly lactic-co-glycolic acid screws. Using a case series of 21 patients treated with SIO for developmental dysplasia of the hip or Legg-Calvé-Perthes disease we evaluate the feasibility of the method. Modern resorbable screws carry multiple benefits both for the patient and the surgeon. In our case series the implants provided sufficient stability and the implants caused no local reactions. The use of resorbable implants gave the surgeon a wider range of possible screw placements and avoided the need for implant removal." The study by H. Hedelin, P. Larnert, H. Hebelka, H. Brisby, K. Lagerstrand and T. Laine.

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Latarjet-Bristow Procedure Performed With Bioabsorbable Screws - Computed Tomography Evidence of Healing

Allan Andrew Young, MD, MBBS, MSpMed, PhD, FRACS (Orth), Roberto Maia, MD, Claudio Moraga, MD, Vaqar Latif, MD, Jean-Pierre Liotard, MD, and Gilles Walch, MD

Techniques in Shoulder & Elbow Surgery, vol 11, 3, Sep. 2010

"The Latarjet-Bristow procedure has been shown to be a safe and reliable method of treating recurrent anterior instability. We proposed using bioabsorbable screws for fixation of the coracoid graft to avoid the potential complications associated with metallic hardware. In all cases, there was radiologic evidence of bony graft healing in a satisfactory position. There were no intraoperative or postoperative complications observed. This study confirms that satisfactory bone healing in the Latarjet-Bristow procedure can be obtained with the use of bioabsorbable screws." The study by Allan Andrew Young, MD, MBBS, MSpMed, PhD, FRACS (Orth), Roberto Maia, MD, Claudio Moraga, MD, Vaqar Latif, MD, Jean-Pierre Liotard, MD, and Gilles Walch, MD.

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A New Mini-Invasive Technique in Treating Pediatric Diaphyseal Forearm Fractures by Bioabsorbable Elastic Stable Intramedullary Nailing: A Preliminary Technical Report

J.-J. Sinikumpu, J. Keränen, A.-M. Haltia, W. Serlo, J. Merikanto

Scandinavian Journal of Surgery, Vol 102, Issue 4, 2013

"We developed a new, two-stage mini-invasive surgical technique to stabilize the unstable diaphyseal fractures in children. The procedure is bioabsorbable elastic stable intramedullary nailing. Ultra-high-strength bioabsorbable intramedullary nails of poly(lactide-co-glycolide) were manufactured for our purpose. The material has been widely proven to be biocompatible and stable enough for fracture treatment as screws and pins. We have used the new technique in the unstable both-bone diaphyseal forearm fractures in children between the ages of 5 and 15 years. We report the technique and our clinical experience in the series of those three cases that have been followed up for at least 12 months. We report our preliminary experience of a new surgical mini-invasive procedure to stabilize the unstable pediatric forearm shaft fractures by bioabsorbable elastic stable intramedullary nailing. Our clinical experience suggests that the procedure combined with long-arm casting is feasible in treating the pediatric forearm fractures. The technique may bring benefits to handling these challenging fractures. The disadvantages of metallic implants may be avoided. In addition, removal of the implant will not be required." The study by J.-J. Sinikumpu, J. Keränen, A.-M. Haltia, W. Serlo, J. Merikanto.

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Operative Technique Features in Application Of Bioabsorbable Implants for Limb Fractures Treatment

V.G. Golubev, A.N. Starrostenkov

Surgeon Practice, No 2 / 2017; 617-089.844; 617.57; 617.58 Study translation from Russia to English.

Bioabsorbable screws and rods (pins) were used for the treatment of different types and locations of limb fractures in the Federal State-Funded Health Institution: Central Clinical Hospital of the Russian Academy of Sciences, Moscow in the orthopaedic trauma department between 2014 and 2016 for 120 patients. Interfragmentary fixation with bioabsorbable implants was applied as a single fixation method for 53 patients (44%), and in 67 (56%) cases it was combined with metallic plates and screws. Bioabsorbable implants were recognized as effective devices for interfragmentary fixation. Generally, bioabsorbable screws and rods (pins) did not require particular skills for the surgeon`s team and were in accordance with AO principles of fracture management. The article by V.G. Golubev, A.N. Starrostenkov.

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Absorbable Fixation in Forefoot Surgery A Viable Alternative to Metallic Hardware

D. L. Nielson, N. J. Young and C. M. Zelen

Clinics in Podiatric Medicine and Surgery, Volume 30, Issue 3, July 2013, Pages 283-293

KEY POINTS

  • Absorbable fixation has progressed to become a reliable, cost-effective alternative tometallic hardware.
  • Newer absorbable devices have been formulated to provide adequate strength for healingand a smooth degradation to limit the local inflammation typically associated with first-generation devices.
  • Historically, fixation with absorbable devices can be time-consuming due to a more diffi-cult insertion; however, new innovative technologies to aid in the insertion of these devicesare now becoming more common in the orthopedic realm.

The article by D. L. Nielson, N. J. Young and C. M. Zelen.

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