Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Pediatric Orthopaedics, Children's Hospital Hamburg-Altona, Hamburg, Germany; Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Injury. 2021 Aug;52(8):2265-2271. doi: 10.1016/j.injury.2021.03.037. Epub 2021 Mar 18.
Biodegradable magnesium-based alloy implants represent a promising option in orthopedic surgery, as the clinical outcomes have been reported to be comparable to those of titanium implants and no surgical interventions are required for removal. To date, little is known about the results of the use of these implants in children and adolescents. Therefore, the aim of the present study was to analyze the safety and performance of these implants in children and adolescents.
Eighty-nine patients treated with magnesium-based implants for fracture stabilization, osteotomy and osteochondral refixation were analyzed; 38 were treated by osteosynthesis; 18, osteotomy; and 33, osteochondral refixation. The mean follow-up duration was 8.2 months (range, 1.5-30 months). Clinical and radiographical follow-up examinations were performed at 4-8 weeks and 3-6 months, respectively, to evaluate implant performance and osseous consolidation.
Clinical outcomes were rated as good to very good in all patients. Radiolucent zones were apparent after surgery in all patients but were noted to decrease in size during the follow-up period. Revision surgery was necessary in 1 of 89 patients who had a highly unstable osteochondritis dissecans lesion of the knee. None of the magnesium-based implants required surgical removal.
Magnesium-based implants in children and adolescents results in good clinical outcomes when used for fracture stabilization, osteotomy and osteochondral defect refixation. Future studies are needed to further analyze the significance of the transient appearance and temporal development of radiolucent zones in the growing skeleton as well as the long-term performance of these implants.
可生物降解的镁基合金植入物在骨科手术中具有很大的应用潜力,因为其临床结果已被报道与钛植入物相当,并且不需要进行手术干预即可取出。迄今为止,人们对这些植入物在儿童和青少年中的应用效果知之甚少。因此,本研究旨在分析这些植入物在儿童和青少年中的安全性和性能。
分析了 89 例接受镁基植入物治疗骨折固定、截骨和骨软骨复位的患者;38 例接受骨内固定治疗,18 例接受截骨术治疗,33 例接受骨软骨复位术治疗。平均随访时间为 8.2 个月(范围为 1.5-30 个月)。分别在术后 4-8 周和 3-6 个月进行临床和影像学随访检查,以评估植入物的性能和骨愈合情况。
所有患者的临床结果均评定为良好至非常好。所有患者术后均出现透光区,但在随访期间发现透光区逐渐缩小。1 例膝关节高度不稳定的剥脱性骨软骨炎患者需要进行翻修手术。无 1 例镁基植入物需要手术取出。
在儿童和青少年中,镁基植入物用于骨折固定、截骨和骨软骨缺损复位时,可获得良好的临床效果。需要进一步研究来分析在生长骨骼中,透光区的短暂出现和暂时发展以及这些植入物的长期性能的意义。