Komatsu Teruya, Sato Toshihiko, Sakaguchi Yasuto, Muranishi Yusuke, Yutaka Yojiro, Date Hiroshi, Nakamura Tatsuo
Department of Bioartificial Organs, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan.
Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan.
J Thorac Dis. 2018 Apr;10(4):2213-2222. doi: 10.21037/jtd.2018.03.75.
Costal coaptation pins made of poly-L-lactide (PLA) are clinically available for fixing surgically divided ribs. However, the clinical results of such rib fixation have not been completely satisfactory. We aimed to develop a new rib coaptation socket system and explore its clinical applicability.
We surgically divided three consecutive ribs of each beagle dog, and rib coaptation sockets were implanted to stabilize each rib. Fifteen 3-dimensional (3D)-printed and 30 PLA fiber knitted sockets were implanted in five and ten dogs, respectively, to stabilize the artificially divided ribs. Mechanical analysis of the sockets and radiographical examination of costal fixation were performed to evaluate the effectiveness of the newly developed socket system for rib stabilization.
All 15 ribs with 3D-printed sockets had displaced 1 month after the operation. Three ribs in one dog with implanted PLA fiber knitted sockets were displaced radiographically after 1 month, and the grade of displacement remained unchanged after 6 months. The remaining 27 ribs fixed with PLA fiber knitted sockets did not show any displacement.
The PLA fiber knitted rib coaptation socket system was sufficiently durable for the stabilization of divided ribs with biocompatibility. This promising finding can be applied for clinical stabilization of divided ribs.
聚-L-丙交酯(PLA)制成的肋骨固定针在临床上可用于固定手术切断的肋骨。然而,这种肋骨固定的临床效果并不完全令人满意。我们旨在开发一种新的肋骨对接套接系统,并探索其临床适用性。
我们对每只比格犬的三根连续肋骨进行手术切断,并植入肋骨对接套接以稳定每根肋骨。分别将15个三维(3D)打印的套接和30个PLA纤维编织的套接植入5只和10只犬体内,以稳定人为切断的肋骨。对套接进行力学分析,并对肋骨固定进行影像学检查,以评估新开发的套接系统对肋骨稳定的有效性。
所有植入3D打印套接的15根肋骨在术后1个月均发生移位。1只植入PLA纤维编织套接的犬的3根肋骨在1个月后经影像学检查发生移位,6个月后移位程度未变。其余27根用PLA纤维编织套接固定的肋骨未出现任何移位。
PLA纤维编织的肋骨对接套接系统对切断肋骨的稳定具有足够的耐久性和生物相容性。这一有前景的发现可应用于临床切断肋骨的稳定。