Walsh William R, Cotton Nick J, Stephens Paul, Brunelle John E, Langdown Andy, Auld Jason, Vizesi Frank, Bruce Warwick
Surgical & Orthopaedic Research Laboratories, University of New South Wales, Prince of Wales Hospital, Sydney, Australia.
Arthroscopy. 2007 Jul;23(7):757-65, 765.e1-2. doi: 10.1016/j.arthro.2007.01.030.
The purpose of this study was to compare polylactide carbonate (PLC) interference screws with poly-L-lactide (PLLA) screws in an ovine anterior cruciate ligament reconstruction model.
A PLC screw or PLLA screw was placed in the center of a 4-strand soft-tissue autograft fixating the graft within the tibial tunnel. Assessments were made at 6 and 12 weeks for fixation strength and at time points of 6, 12, 26, and 52 weeks via computed tomography and histology.
No adverse or inflammatory reactions were noted for either material at any time point. Mechanical fixation strength increased from 6 to 12 weeks for both the PLC and PLLA screws, with no significant differences in fixation strength being found between the 2 groups. By 26 weeks, the PLC screw was partially replaced by new bone, a process that was completed by 52 weeks. The PLLA screws were intact and surrounded by a fibrous layer at 52 weeks with no obvious resorption. New bone formation within the tendon construct located in the bone tunnel proximal to the interference screw was also noted in the PLC screw group but was not observed in the PLLA group.
This study has supported the hypothesis that this bioabsorbable composite has sufficient mechanical properties and strength retention to function successfully as an interference screw but also stimulates a biologic healing response, enabling replacement by bone and tunnel healing.
This study shows both the satisfactory mechanical characteristics and osteoconductive nature of PLC used in an interference screw in an ovine anterior cruciate ligament reconstruction model.
本研究旨在比较聚乳酸碳酸酯(PLC)干涉螺钉与聚-L-乳酸(PLLA)螺钉在羊前交叉韧带重建模型中的效果。
将一枚PLC螺钉或PLLA螺钉置于四股自体软组织移植物中心,将移植物固定于胫骨隧道内。在6周和12周时评估固定强度,并在6周、12周、26周和52周时间点通过计算机断层扫描和组织学进行评估。
在任何时间点,两种材料均未观察到不良或炎症反应。PLC和PLLA螺钉的机械固定强度从6周增加到12周,两组之间的固定强度无显著差异。到26周时,PLC螺钉部分被新骨替代,这一过程在52周时完成。PLLA螺钉在52周时保持完整,周围有一层纤维层,无明显吸收。PLC螺钉组在干涉螺钉近端骨隧道内的肌腱结构中也观察到新骨形成,但PLLA组未观察到。
本研究支持了以下假设,即这种可生物吸收复合材料具有足够的机械性能和强度保持能力,能够成功地作为干涉螺钉发挥作用,同时还能刺激生物愈合反应,实现骨替代和隧道愈合。
本研究显示了PLC在羊前交叉韧带重建模型中作为干涉螺钉使用时令人满意的机械特性和骨传导性质。