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Biomechanical evaluation of novel ultrasound-activated bioresorbable pins for the treatment of osteochondral fractures compared to established methods

  • Benjamin Kienast ORCID logo EMAIL logo , Hellal Mohsen , Robert Wendlandt , Nils Reimers , Arndt P. Schulz , Hinrich Heuer , Justus Gille and Hanjo Neumann
Published/Copyright: September 14, 2016

Abstract

Background:

Osteochondral injuries often lead to osteoarthritis of the affected joint. All established systems for refixation of osteochondral defects show certain disadvantages. To address the problem of reduced stability in resorbable implants, ultrasound-activated pins were developed. By ultrasound-activated melting of the tip of these implants, a more secure anchoring is assumed.

Materials and methods:

The aim of the study was to investigate if ultrasound-activated pins can provide secure fixation of osteochondral fragments compared to screws and conventional resorbable pins. In a biomechanical laboratory setting, osteochondral fragments of the medial femoral condyle of sheep were refixated with ultrasound-activated pins [US fused poly(L-lactide-co-D,L-lactide) (PLDLLA) pins], polydioxanone (PDA) pins and conventional titanium screws. Anchoring forces of the different fixation methods were examined, registered and compared concerning shear force and tensile force.

Results:

Concerning the pull out test, the US fused PLDLLA pins and titanium screws (~122 N and ~203 N) showed comparable good results, while the PDA pins showed significantly lower anchoring forces (~18 N). Examination of shear forces showed a significantly higher anchoring of the screws (~248 N) than the US fused PLDLLA pins (~218 N). Nevertheless, the US fused PLDLLA pins could significantly outperform the PDA pins (~68 N) concerning shear forces.

Conclusion:

The US fused PLDLLA pins demonstrated a comparable anchorage to the fixation with screws, but were free from the disadvantages of metal implants, i.e. the need for implant removal. The PDA pin application showed inferior biomechanical properties.


Corresponding author: Priv.-Doz. Dr. Benjamin Kienast, BG Trauma Hospital Hamburg, Department of Traumatology, Orthopaedics and Sports Traumatology, Bergedorfer Strasse 10, 21033 Hamburg, Germany, Phone: +49-40-7306-2226, Fax: +49-40-41466969

  1. Conflict of interest statement: The co-author Nils Reimers was working as a research fellow for the University of Lübeck Medical Faculty in another project during the study period. He is also employed at the Stryker Trauma GmbH, Schönkirchen, Germany. Mr Reimers did not influence any of the results we obtained during this study. He gave helpful advice concerning the usage of the innovative US fused PLDLLA pin system and the established titanium screws. The University Medical Center Schleswig-Holstein, Campus Lübeck, Germany, was partially funded by the Stryker Trauma GmbH, Schönkirchen, Germany.

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Received: 2016-2-26
Accepted: 2016-7-27
Published Online: 2016-9-14
Published in Print: 2017-8-28

©2017 Walter de Gruyter GmbH, Berlin/Boston

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