Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Str,1-7, 30625 Hannover, Germany.
Biomed Eng Online. 2013 Jul 3;12:62. doi: 10.1186/1475-925X-12-62.
Nondegradable steel-and titanium-based implants are commonly used in orthopedic surgery. Although they provide maximal stability, they are also associated with interference on imaging modalities, may induce stress shielding, and additional explantation procedures may be necessary. Alternatively, degradable polymer implants are mechanically weaker and induce foreign body reactions. Degradable magnesium-based stents are currently being investigated in clinical trials for use in cardiovascular medicine. The magnesium alloy MgYREZr demonstrates good biocompatibility and osteoconductive properties. The aim of this prospective, randomized, clinical pilot trial was to determine if magnesium-based MgYREZr screws are equivalent to standard titanium screws for fixation during chevron osteotomy in patients with a mild hallux valgus.
Patients (n=26) were randomly assigned to undergo osteosynthesis using either titanium or degradable magnesium-based implants of the same design. The 6 month follow-up period included clinical, laboratory, and radiographic assessments.
No significant differences were found in terms of the American Orthopaedic Foot and Ankle Society (AOFAS) score for hallux, visual analog scale for pain assessment, or range of motion (ROM) of the first metatarsophalangeal joint (MTPJ). No foreign body reactions, osteolysis, or systemic inflammatory reactions were detected. The groups were not significantly different in terms of radiographic or laboratory results.
The radiographic and clinical results of this prospective controlled study demonstrate that degradable magnesium-based screws are equivalent to titanium screws for the treatment of mild hallux valgus deformities.
在骨科手术中,通常使用不可降解的钢和钛基植入物。虽然它们提供了最大的稳定性,但也会干扰成像模式,可能导致应力遮挡,并可能需要额外的取出程序。相比之下,可降解聚合物植入物的机械强度较弱,并会引起异物反应。可降解镁基支架目前正在临床试验中用于心血管医学。镁合金 MgYREZr 表现出良好的生物相容性和骨诱导特性。本前瞻性、随机、临床初步试验的目的是确定在轻度拇外翻患者的 Chevron 截骨术中,使用可降解镁基 MgYREZr 螺钉作为固定物是否与标准钛螺钉等效。
将患者(n=26)随机分为两组,分别采用相同设计的钛或可降解镁基植入物进行骨合成。6 个月的随访期包括临床、实验室和影像学评估。
在拇趾 AOFAS 评分、疼痛评估的视觉模拟量表或第一跖趾关节(MTPJ)的活动范围方面,两组之间没有显著差异。未发现异物反应、骨溶解或全身炎症反应。两组在影像学或实验室结果方面无显著差异。
这项前瞻性对照研究的影像学和临床结果表明,可降解镁基螺钉在治疗轻度拇外翻畸形方面与钛螺钉等效。