BOOK
Biodegradable Implants In Fracture Fixation: Proceedings Of Hte Isfr Symposium
Leung Kwong-sak | Hung L-k | Leung Ping-chung
(1994)
Additional Information
Book Details
Abstract
This volume, which describes the most recent and important advances in the development of biodegradable implants in fracture fixation, presents specialists involved in fracture management with a picture of the current status of this exciting field of research and clinical applications. The articles in the volume were presented at the ISFR Symposium on Biodegradable Implants in Fracture Fixation 1993.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Preface | xiii | ||
| Acknowledgements | xvii | ||
| Contents | xix | ||
| Session I Introduction | xix | ||
| Session II In-Vitro Properties | xix | ||
| Session III In-Vivo Response | xx | ||
| Session IV Clinical Applications | xxi | ||
| Session V Future Perspectives | xxii | ||
| Session VI Discussion & Provocative Issues | xxii | ||
| Index | xxii | ||
| Session I Introduction | 1 | ||
| Chapter 1.1 Modulation of Fracture Healing and Bone Regeneration using Physical and Biological Means | 3 | ||
| Rationale for Basic Research on Mechanical Effect on Cellular Response | 5 | ||
| Modulation for Bone Fracture Healing and Remodeling Enhancement | 5 | ||
| Experimental Study of Fracture Repair and Remodeling | 7 | ||
| Effects of Biomechanical Environment on Fracture Healing Pathways | 10 | ||
| Prerequisites for Experimental Validation of Biomechanics and Molecular Biology Interaction | 13 | ||
| Difficulties Involved in Cross-Discipline Research | 14 | ||
| Modeling limitations | 14 | ||
| Molecular biology limitations | 14 | ||
| Experimental design limitations | 15 | ||
| Cross discipline collaboration limitations | 15 | ||
| Summary | 16 | ||
| References | 16 | ||
| Chapter 1.2 Is There an Ideal Biomaterial For Use As An Implant For Fracture Fixation ? | 19 | ||
| Introduction | 19 | ||
| Osteosynthesis | 19 | ||
| Matched Modulus Implants | 23 | ||
| Composite Materials | 24 | ||
| Biodegradable Polymers | 26 | ||
| Intelligence in Biomaterials | 28 | ||
| Interactive and Co-operative Biomaterials(ICBM's) for Osteosynthesis | 30 | ||
| Concluding Remarks | 32 | ||
| References | 32 | ||
| Chapter 1.3 Clinical Requirements for Bioresorbable Implants in Internal Fixation | 35 | ||
| Introduction | 35 | ||
| Metallic Implants | 36 | ||
| Bioresorbable Implants | 36 | ||
| Implant Design | 39 | ||
| Conclusion | 40 | ||
| Open Questions | 41 | ||
| Summary | 42 | ||
| References | 42 | ||
| Chapter 1.4 Chemical and Mechanical Considerations of Biodegradable Polymers for Orthopaedic Applications | 45 | ||
| Introduction | 45 | ||
| Synthetic considerations | 46 | ||
| Polyesters | 47 | ||
| Polyanhydrides | 49 | ||
| Polyorthoesters | 50 | ||
| Polyiminocarbonates | 51 | ||
| Polyphosphoesters | 51 | ||
| Mechanical Considerations | 52 | ||
| Challenges and Opportunities | 54 | ||
| References | 54 | ||
| Chapter 11.1 The Manufacturing Details and Mechanical Aspects of the PLLA Implants | 59 | ||
| Manufacturing Details | 63 | ||
| Discussion | 65 | ||
| References | 66 | ||
| Chapter 11.2 The Development and Testing of three Biodegradable Screw Plate-Systems for Maxillofacial Surgery | 67 | ||
| Introduction | 67 | ||
| Materials and Methods | 68 | ||
| Results | 70 | ||
| Discussion | 73 | ||
| References | 73 | ||
| Chapter 11.3 Hydrolytic Degradation of Ultra-High-Strength Self-Reinforced Poly-L-Lactide. A Temperature Dependence Study | 75 | ||
| Introduction | 75 | ||
| Materials and Methods | 76 | ||
| Rod manufacturing | 76 | ||
| Hydrolysis tests | 77 | ||
| Mechanical testing | 77 | ||
| Molecular weight measurements | 78 | ||
| Thermal analysis | 78 | ||
| Results and Discussion | 78 | ||
| Degradation kinetics | 78 | ||
| Thermal properties | 83 | ||
| Interaction with strength loss and Mv loss | 84 | ||
| Measured and calculated strength retention | 86 | ||
| Conclusions | 87 | ||
| References | 87 | ||
| Chapter 11.4 Recent Advances in the Understanding of the Bioresorption of PLA/GA Polymers with Respect to Bone Fracture Fixation | 89 | ||
| Abstract | 89 | ||
| Introduction | 89 | ||
| Selected Protocol for Comparative In-Vitro Investigations | 92 | ||
| Degradation Characteristics | 94 | ||
| Application to PLA polymers of interest for fracture fixation: the case of PLA1OO (Poly-L-lactic acid) | 96 | ||
| A stereocopolymer composed of 96% L-lactic acid units and 4% D-lactic acid units. the case of PLA96: | 97 | ||
| Conclusion | 98 | ||
| Acknowledgements | 99 | ||
| References | 99 | ||
| Chapter 11.5 The Hybrid Use of Bioabsorbable Components in Conventional Plating Systems for Long Bone Fractures - A Biomechanical Feasibility Exploration | 103 | ||
| Introduction | 103 | ||
| Methodology | 105 | ||
| Results | 107 | ||
| Conclusion and Further Studies | 114 | ||
| Acknowledegments | 115 | ||
| References | 115 | ||
| Session III In-Vivo Response | 117 | ||
| Chapter 111.1 Biodegradable Intramedullary Devices for Fracture Fixation | 119 | ||
| Introduction | 119 | ||
| Choice of Material | 120 | ||
| Aims of the Study | 120 | ||
| Materials and Methods | 121 | ||
| Results | 122 | ||
| References | 123 | ||
| Chapter 111.2 A Five-Year Study of Absorbable Screws Implanted in Canine Femora and Tibiae | 125 | ||
| Introduction | 125 | ||
| Materials and Methods | 126 | ||
| Results | 129 | ||
| Discussion | 133 | ||
| References | 134 | ||
| Chapter 111.3 Biodegradation of SR-Polyglycolide (SR-PGA) Rods In-vivo | 135 | ||
| Introduction | 135 | ||
| Materials | 135 | ||
| Methods | 136 | ||
| Histological investigation | 136 | ||
| Bending strength | 137 | ||
| Results | 137 | ||
| Discussion | 141 | ||
| Histological investigation | 141 | ||
| Bending strength | 141 | ||
| Summary | 141 | ||
| References | 142 | ||
| Chapter 111.4 Experimental In vivo Model to Evaluate Resorbable Implants into bone | 143 | ||
| Introduction | 143 | ||
| Materials and Methods | 145 | ||
| PLLA | 145 | ||
| Animal model | 146 | ||
| Results | 148 | ||
| Discussion and Conclusions | 149 | ||
| References | 150 | ||
| Chapter 111.5 Kinetics of Biodegradable Implant Resorption | 153 | ||
| Introduction | 153 | ||
| Materials and Methods | 154 | ||
| I. In-vitro cytotoxicity of polylactic acid extracts on lymphocyte cultures | 155 | ||
| 2. In-vivo histocompatibility and polylactic acid degradation kinetics. | 156 | ||
| Results | 157 | ||
| I. Cytotoxicity tests | 157 | ||
| 2. Histocompatibility tests | 158 | ||
| Discussion and Conclusion | 162 | ||
| Acknowledgements | 163 | ||
| References | 163 | ||
| Chapter 111.6 Ultrastructural Evaluation of bone/Poly-L-Lactic Acid Interactions | 165 | ||
| Introduction | 165 | ||
| Materials and Methods | 165 | ||
| Results and Discussion | 166 | ||
| Chapter III. 7 Immunocytochemical Analysis of Cellular Infiltrate in Poly-L-Lactic Acid Polymer Implants | 173 | ||
| References | 175 | ||
| Chapter 111.8 Fixation of Experimental Distal Femoral Physeal Fracture in Growing Rabbits and Cats with Transphyseal Absorbable Pins | 177 | ||
| Introduction | 177 | ||
| Materials and Methods | 178 | ||
| Results and Discussion | 178 | ||
| Acknowledgements | 184 | ||
| References | 184 | ||
| Session IV Clinical Applications | 187 | ||
| Chapter IV. I Absorbable Implants in the Fixation of Fractures and Osteotomies | 189 | ||
| Introduction | 189 | ||
| Clinical Experiences | 190 | ||
| References | 192 | ||
| Chapter IV.2 Absorbable Malleolar Screws:The Treatment of Ankle Fractures | 193 | ||
| Abstract | 193 | ||
| Introduction | 193 | ||
| Materials and Methods | 194 | ||
| Study Design | 195 | ||
| Results | 195 | ||
| Conclusions | 200 | ||
| References | 200 | ||
| Chapter IV.3 Bioreabsorbable Osteosynthesis Devices in Foot Fractures | 201 | ||
| Conclusion | 206 | ||
| References | 206 | ||
| Chapter IV.4 Absorbable Intramedullary Nails in Hand Surgery | 207 | ||
| Abstract | 207 | ||
| Introduction | 208 | ||
| Materials and Methods | 208 | ||
| 1) Materials | 208 | ||
| 2) Experimental study | 208 | ||
| A) Mechanical tests | 208 | ||
| B) Animal assessment | 209 | ||
| 3) Clinical study | 209 | ||
| A) Patient | 209 | ||
| B) Postoperative care | 210 | ||
| Results | 210 | ||
| 1) Experimental studies | 210 | ||
| A) Mechanical test | 210 | ||
| B) Assessment of animals | 210 | ||
| 2) Clinical study | 211 | ||
| Discussion | 212 | ||
| Conclusion | 214 | ||
| References | 214 | ||
| Chapter IV.5 Biodegradable Implants:Experimental and Clinical Studies | 217 | ||
| Introduction | 217 | ||
| Experimental studies | 217 | ||
| 1. Mechanical degradation tests | 218 | ||
| 2. Transepiphyseal degradable implants | 219 | ||
| Morphologic observations | 219 | ||
| Histology | 219 | ||
| 3. Fixation of osteochondral fractures | 221 | ||
| Clinical Experience with Biodegradable Polyglycolic Acid Implants | 221 | ||
| Results | 222 | ||
| Discussion | 223 | ||
| References | 224 | ||
| Chapter IV.6 Absorbable Polyglycolide Pins in the Fixation of Fractures in Children | 225 | ||
| Introduction | 225 | ||
| Experimental Background | 226 | ||
| Clinical Experiences | 227 | ||
| References | 231 | ||
| Session V Future Perspectives | 233 | ||
| Chapter V. 1 HA-PLLA Composite Materials for Fracture Fixation | 235 | ||
| Summary | 235 | ||
| Introduction | 235 | ||
| Materials | 236 | ||
| Methods | 237 | ||
| Results | 237 | ||
| Discussion | 239 | ||
| Conclusion | 240 | ||
| References | 240 | ||
| Chapter V. 2 The Development of Biodegradable Fracture Fixation Devices; Past, Present and Future | 243 | ||
| Introduction | 243 | ||
| References | 247 | ||
| Chapter V.3 Bioresorbable Internal Fixation Devices - Mechanical Properties and Future Trends in Production Technologies | 249 | ||
| Introduction | 249 | ||
| Machining | 250 | ||
| Melt-processing | 251 | ||
| Compression-moulding' below melting temperature Tm | 252 | ||
| Solution-processing (gel-processing) | 252 | ||
| Composites | 254 | ||
| New technologies\" ? | 254 | ||
| Sterilization of resorbable internal fixation devices | 255 | ||
| Implant design | 256 | ||
| Conclusions | 256 | ||
| References | 257 | ||
| Chapter V.4 Future Trends in the Development of Bioabsorbable Implants for Fracture Fixation | 259 | ||
| Introduction | 259 | ||
| Mechanism of Bioabsorption | 260 | ||
| New Surgical Techniques and New Implant Geometries | 261 | ||
| Bioactive Implants and Hybrid Artificial Organs | 262 | ||
| References | 264 | ||
| Session VI Discussion & Provocative Issues | 267 | ||
| 1) The Speed of Degradation | 269 | ||
| 2) The Mechanical Properties of the Implants | 270 | ||
| 3) The Biological Reactions to Biodegradable Materials | 271 | ||
| 4) The Structural and Functional Biointegration in Fracture Healing | 271 | ||
| 5) The Sterilisation and Storage | 272 | ||
| 6) The Economical Implication | 272 | ||
| Index | 273 |