Barber F Alan
Plano Orthopedic Sports Medicine and Spine Center, Plano, TX.
Sports Med Arthrosc Rev. 2015 Sep;23(3):149-55. doi: 10.1097/JSA.0000000000000076.
Metal, plastic, and biodegradable implants can all cause problems. The advantage of the biodegradable implant is clarity in postoperative imaging, easier revision, and fewer concerns about associated tissue damage. Although biodegradable implants do degrade over time, this time varies considerably, depends upon the polymer present, and is often measured in years. Before that occurring, the implant is a rigid device. Problems in the operative or immediate postoperative period include implant breakage during insertion, loss of initial fixation, incompletely buried or "proud" implants within a joint that could damage articular cartilage, and possible implant migration. Later occurring problems include the development of inflammatory reactions leading to lytic changes, cyst formation, intra-articular granuloma formation along with swelling, and sterile pretibial abscesses. Despite this list of potential problems on balance biodegradable implants are safe and effective and present no greater concerns (and arguably fewer ones) than metal or plastic implants.
金属、塑料和可生物降解植入物都可能引发问题。可生物降解植入物的优点在于术后成像清晰、翻修更容易，且对相关组织损伤的担忧较少。尽管可生物降解植入物确实会随时间降解，但这段时间差异很大，取决于所使用的聚合物，且通常以年为单位衡量。在降解发生之前，植入物是一个刚性装置。手术期或术后即刻出现的问题包括插入过程中植入物断裂、初始固定丧失、关节内植入物未完全埋入或“外露”，这可能会损伤关节软骨，以及植入物可能移位。后期出现的问题包括炎症反应的发展，导致溶解改变、囊肿形成、关节内肉芽肿形成以及肿胀，还有无菌性胫前脓肿。尽管存在这一系列潜在问题，但总体而言，可生物降解植入物是安全有效的，与金属或塑料植入物相比，不存在更大的担忧（甚至可以说担忧更少）。
