Najmuddin J Gunja | PubMed Health

PubMed2006

Biodegradable materials in arthroscopy.

The use of biodegradable materials as implants has revolutionized the way medicine is practiced today. This review provides a general description of salient biodegradable polymeric materials currently used in arthroscopy. These materials include polyglycolic acid, self-reinforced polyglycolic acid, poly-L-lactic acid, self-reinforced polylactic-L-acid, poly-D-L-lactic acid, copolymer of poly-D-L-lactic acid polyglycolic acid, and polyglyconate. The mechanical strength, degradation properties, and widespread use of these materials, especially in the knee and shoulder, are discussed individually. Also discussed are the relatively few complications that are related to these materials' arthroscopic use. Future directions in biodegradable materials, including smart polymers, are also considered. In the future, novel techniques to identify the ideal polymer for a particular application will need to be developed to minimize the risk for implant complications.

Absorbable Implants↗

PubMed2005

In vitro comparison of wire and plate fixation for midline sternotomies.

BACKGROUND: The incidence of severe sternal wound complications in high-risk cardiac patients presents a significant need for more stabile sternal fixation techniques after median sternotomy procedures. Rigid metal plates, a potential alternative to wire fixation, are thought to promote faster sternal healing by reducing motion at the wound site. The goal of this study was to compare the stability provided by commercially available sternal plates with standard wires using an in vitro model. METHODS: Lateral distraction tests were conducted on bisected polyurethane sternal models fixed with either a standard 7 wire configuration (n = 5) or a 3 plate configuration (n = 3). To assure controlled loading, the sternal models were attached to a computer-controlled test machine by a novel tethering system that distributes the total force (180N) equally to eight locations on the sternum. Stability was defined as the ability to restrict sternal separation at seven locations along the midline quantified using digital image analysis. RESULTS: Our results indicate that rigid plate fixation significantly reduced lateral motion relative to wire fixation. The lower sternal region most noticeably benefited from plate fixation as the splaying observed for wire fixation was reduced. CONCLUSIONS: Under these loading conditions, plating increased stability at the midline compared to wires; this increased stability may facilitate the recovery of high-risk patients undergoing cardiac operation. To enhance in vitro testing methods, future studies should incorporate additional in vivo loading conditions applied to the sternum. Alternate plating configurations should also be examined to further increase stability.

Biomechanical Phenomena↗