Subscribe to RSS
DOI: 10.1055/s-2002-30634
© Georg Thieme Verlag Stuttgart · New York
Failure Types of Bioabsorbable Fixation
A Classification SystemPublication History
Publication Date:
17 May 2002 (online)

Abstract
Bioabsorbable implants are becoming more widely used in fracture fixation. Like metallic
implants, bioabsorbable fixation devices are subject to failures such as infection,
but they also have their own inherent failure types. Unlike metallic implants, bioabsorbable
implants are radiolucent, making the determination of correct placement difficult.
Each type of bioabsorbable material has its own degradation rate, which influences
the formation of a granuloma or sterile sinus tract. Additionally, the in vivo time
to complete absorbtion has yet to be determined for several types of bioabsorbable
implants. As the uses of bioabsorbable fracture fixation expand, a classification
system of failure types will provide a useful framework with which to compare new
outcomes.
Our study examines 346 patients who underwent fracture fixation with bioabsorbable
implants. Through a retrospective analysis of patient records, four distinct failure
types emerged:Type I -
Iatrogenic Failure, Type II - Mechanical Failure, Type III - Biologic Failure, Type
IV - Infection. Categorizing the failures under this classification system facilitates
discussion about success and failure with these new fixation devices.
Key words
Failure types - Bioabsorbable fixation
References
- 1 Athanasiou K A, Agrawal C M, Barber F A, Burkhart S S. Orthopaedic applications for PLA-PGA biodegradable polymers. Arthroscopy. 1998; 14 726-737
- 2 Böstman O M, Pihlajmaki H K, Partio E K, Rokkanen P U. Clinical biocompatibility and degradation of polylevolactide screws in the ankle. Clin Orthop. 1995; 320 101-109
- 3 Böstman O M, Pihlajmaki H K. Adverse tissue reactions to bioabsorbable fixation devices. Clin Orthop. 2000; 371 216-227
- 4 Böstman O M, Pihlajmaki H K. Late foreign-body reaction to an intraosseous bioabsorbable polylactic acid screw: A case report. J Bone Joint Surg [Am]. 1998; 80 1791-1794
- 5 George K, Becker D, Seligson D. Absorbable fasteners for the fixation of ankle fractures. J Kentucky Med Assoc. 1999; 97 105-108
- 6 Kankare J. Operative treatment of displaced intra-articular fractures of the calcaneus using absorbable internal fixation: A prospective study of twenty-five fractures. J Orthop Trauma. 1998; 12 413-419
- 7 Nakamura S, Takatori Y, Morimoto S. et al . Rotational acetabular osteotomy using biodegradable internal fixation. Int Orthop. 1999; 23 148-149
- 8 Rokkanen P, Bostman O, Vainionpaa S. et al . Absorbable devices in the fixation of fractures. J Trauma Inj Infect & Crit Care. 1996; 40 S123-127
- 9 Suuronen R, Puhjonen T, Hietanen J, Lindqvist C. A 5-year in vitro and in vivo study of the biodegradation of polylactide plates. J Oral Maxillofac Surg. 1998; 56 604-614
- 10 Veikko V V, Lindholm T S. Background of the early development of absorbable fixation devices. Techniques in Orthop. 1998; 13 117-122
- 11 Weiler A, Hoffmann R FG, Stahelin A C, Helling H J, Sudkamp N P. Biodegradable implants in sports medicine: The biological base. Arthroscopy. 2000; 16 305-321
- 12 Weiler A, Helling H J, Kirch U, Zirbes T K, Rehm K E. Foreign-body reaction and the course of osteolysis after polyglycolide implants for fracture fixation: Experimental study in sheep. J Bone Joint Surg [Br]. 1996; 78 369-376
Shannon B. AntekeierM.D.
Department of Orthopaedic Surgery
University of Louisville School of Medicine
530 S. Jackson St
Louisville, KY 40202
USA
Phone: +1-502-852-6902
Fax: +1-502-852-7227