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Biomedical subjects

T Pohjonen

Publications and source records attributed to T Pohjonen.

47 records · Page 3Linked to original sources

Processing and characterization of absorbable polylactide polymers for use in surgical implants.

Absorbable fibers of linear poly-alpha-hydroxy acids have been used successfully in providing temporary scaffolds for tissue regeneration. In some surgical applications, degradation rates for poly(glycolide) (PGA) are too high, but implants of poly(L-lactide) (PLLA) fibers may degrade too slowly for optimal function. Polymers produced by copolymerization of L-lactide with varying amounts of D-lactide may offer an alternative choice for absorbable fiber based implants. Poly(L/D-lactide) stereocopolymers with L/D lactide molar ratios of 95/5, 90/10, and 85/15 were considered. Melt-spun/hot-drawn fibers with L/D molar ratios of 90/10 and 85/15 and draw ratios ranging from 3.0 to 8.9 were further evaluated by mechanical testing, differential scanning calorimetry, birefringence, x-ray diffraction, and in vitro exposure to pH 7.4 phosphate buffered saline at 37 degrees C. Fabrication was reproducible and results indicated that tensile strength, modulus, an birefringence all increased with increasing draw ratio up to a draw ratio of 6.7 and declined thereafter; elongation to failure decreased for the entire range studied. For fibers with a draw ratio of 6.7, there was a 10% relative difference in crystallinity between the 90/10 and 85/15 lactide fibers (90/10 was higher). Wet strength retention after 12 weeks in vitro exposure was approximately 10% for the 90/10 fibers and 30% for the 85/15 fibers. The intermediate wet strength retention of lactide stereocopolymer fibers when compared to reported values for PGA and PLLA fibers, suggests these materials may be useful in absorbable surgical implants for tissue repair and regeneration.

Biocompatible Materials↗

Sagittal ramus osteotomies fixed with biodegradable screws: a preliminary report.

Nine patients underwent bilateral sagittal split osteotomies of the mandible. The osteotomies were fixed using two self-reinforced poly-L-lactide screws. No maxillomandibular fixation was used postoperatively. The preliminary results with the shortest follow-up of 15 months show that primary healing was normal. No late-term clinical complications were encountered during the follow-up, the longest of which is now 23 months.

Adult↗

Polyglycolic acid membrane interpositioning for the prevention of skull deformity following experimental craniosynostosis.

The interpositioning of various materials to complete suturectomy for the treatment of craniosynostosis has been used by many surgeons to prevent early postoperative reunion. Clear scientific proof for this procedure has not yet been obtained with any material, however. A previously described model of experimental craniosynostosis was employed to examine the effects of an interpositioned biodegradable polyglycolic acid (PGA) membrane on the growing skull of 14 newborn rabbits. Additional 11 newborn rabbits served as controls, as on their skulls only unilateral resection of the coronal suture was performed (experimental craniosynostosis). The skulls were examined for shape and histology up to 6 months of age. The 11 rabbits in the control group developed a unilateral deformity on their calvaria as demonstrated by dry-skull osteometry. The 14 rabbit skulls having the interpositioning of a PGA membrane done into the resection site at the time of unilateral suturectomy were found to have grown in a remarkably symmetrical fashion. The interpositioning of a PGA membrane therefore seems to prevent the formation of a skull deformity during growth as compared with early suturectomy alone.

Animals↗

Fixation of subcapital femoral osteotomies by poly-L-lactic acid pins. An experimental study in sheep.

In an experimental study in nine sheep, self-reinforced poly-L-lactic pins were used to fix subcapital femoral osteotomies. One out of three was consolidated at 3 weeks. At 6 weeks, one out of 3 had failed, and the other two were united by bone. At 12 weeks all the osteotomies had healed. These results showed that absorbable SR-PLLA pins could be used to fix this type of osteotomy.

Animals↗

Mechanical properties of biodegradable poly-L-lactide ligament augmentation device in experimental anterior cruciate ligament reconstruction.

The mechanical properties, including maximum load, elongation, and axial rigidity, of the biodegradable poly-L-lactic acid (PLLA) ligament augmentation device were investigated, 6, 12, 24, and 48 weeks after experimental anterior cruciate ligament (ACL) repair in 32 sheep. In 16 sheep the cut ACL was removed and reconstructed with the fascia lata augmented with a braided PLLA implant 3.2 mm in diameter. In 16 sheep the ACL was cut from its midportion, sutured, and then augmented with a PLLA implant. The contralateral knee served as a control. At 6 weeks the maximum loads of the reconstructed ACL in the fascia lata-PLLA and primary suture-PLLA groups were 9% and 6%, respectively, of the contralateral ACL, but they increased with time and at 48 weeks were 21% and 12%, respectively, of the control. In the fascia lata-PLLA group the increase in maximum load was evident (P < 0.05) during the follow-up period. During the first 12 weeks the axial rigidity (expressing the elasticity of the reconstruction) was poor, especially in the high-stress region corresponding to the tensile load close to the maximum load. Thereafter the axial rigidity increased, being 48% of the control in the fascia lata-PLLA group and 29% in the primary suture-PLLA group at 48 weeks. In the low-stress region between 10 N and 100 N the increase in axial rigidity in the fascia lata-PLLA group was apparent (P < 0.05) throughout the follow-up, with values of 72% of the control in the fascia lata-PLLA and 47% in the primary suture-PLLA group at 48 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

A bioresorbable urethral stent. An experimental study.

The aim of the present study was to examine the suitability of biodegradable polymers as materials for a urethral stent. A new urethral stent made of biodegradable self-reinforced poly-L-lactide (SR-PLLA) was implanted in 16 male rabbits after urethrotomy. Seven stents of stainless steel served as controls. The dimensions of the two types of stents were identical: length 15 mm, diameter 8.2 mm. The mechanical construction was a helical spiral. The SR-PLLA spiral was sustained with three microspirals, and the whole device was coated with DL-lactide to achieve an active initial tissue reaction and better tissue penetration. The SR-PLLA stent showed more favourable implantation properties than the steel one. Within 6 months all PLLA stents had implanted, and the tissue reaction around the stent material was minimal. The helical spiral of stainless steel induced a remarkable inflammatory reaction due to poor implantation properties. We suggest that biodegradable SR-PLLA is a promising material for a urethral stent to prevent re-stenosis of urethral strictures.

Absorption↗

Intramedullary nailing of the cortical bone osteotomies in rabbits with self-reinforced poly-L-lactide rods manufactured by the fibrillation method.

Right femoral, cortical bone osteotomies of 42 rabbits were fixed with fibrillated, self-reinforced (SR) poly-L-lactide (PLLA) rods, 4.5 mm in diameter. Follow-up times were from 3 to 48 wk. None of the rods broke during this period. There was one non-union at three weeks and one non-union at 12 weeks. Radiographic, histologic, microradiographic and oxytetracyclic fluorescence studies showed normal healing. Shear load carrying capacity of the osteotomy plane was measured from 30 bone samples; the shear force at breaking increased during the follow-up time to 450 N, while the mean shear force of intact, left-side control femurs was 440 N. Before shear tests of the bones, the SR-PLLA rods were taken away from the medullary cavities of the femurs. The rods were also tested mechanically. About 25% of the initial 136 MPa shear-strength of the rods was left after 24 wk. The results show that fibrillated SR-PLLA rods are strong enough to be used in intramedullary nailing of femoral cortical bone osteotomies in rabbits.

Animals↗

New generation biodegradable plate for fracture fixation: comparison of bending strengths of mandibular osteotomies fixed with absorbable self-reinforced multi-layer poly-l-lactide plates and metallic plates--an experimental study in sheep.

Eighteen osteotomies of sheep's mandibular corpus were fixed: nine with self-reinforced multi-layer poly-l-lactide (SR-PLLA) plates and nine with metallic plates. Both plates were fixed with similar metallic screws. The right corpus of each sheep acted as a control. Radiographic analysis was carried out at 3 weeks and at sacrifice (6, 12 or 24 weeks) when the bending force needed to break the osteotomy site was measured. At 6 and 12 weeks of follow-up the osteotomy fixed with the PLA-plate seemed to tolerate the bending force better but no significant differences were detected at 3 or 24 weeks. The results have been satisfactory and have led the authors to continue with the development of a SR-PLLA plate-and-screw device for fracture fixation.

Absorption↗

Comparison of absorbable self-reinforced multilayer poly-l-lactide and metallic plates for the fixation of mandibular body osteotomies: an experimental study in sheep.

Eighteen unfavorable transverse osteotomies were created in the mandibular body of sheep. Nine were fixed with self-reinforced poly-l-lactide and nine with metallic dynamic compression plates. Both plates were fixed with similar titanium screws. The follow-up times for radiographic, histologic, and microradiographic studies were 6, 12, and 24 weeks. With both methods, bony union with callus formation was accomplished by 6 weeks in all but one osteotomy in the metallic fixation group. There were no signs of plate failure.

Animals↗

Sagittal split osteotomy fixed with biodegradable, self-reinforced poly-L-lactide screws. A pilot study in sheep.

Self-reinforced poly-L-lactide (SR-PLLA) screws were used to fix bilateral mandibular sagittal split osteotomies (SSO) in six sheep. No intermaxillary fixation was used postoperatively. The follow-up time was 16 weeks, after which the sheep were killed. Both sides of the mandible were photographed and radiographed. The bending strength of the osteotomy was measured on the left side of the mandible. Histological and microradiographic studies were performed on the right side of the mandible. The results showed that the SR-PLLA screws were strong enough to fix the SSO rigidly. The bending force needed to break the bone was greater than that for the average unoperated mandible. The histological and microradiographic studies showed uneventful healing of the osteotomies in all six sheep. The results indicate that this method should be suitable for rigid fixation of SSO and fractures of the mandible in human beings.

Animals↗

Ultra-high-strength absorbable self-reinforced polyglycolide (SR-PGA) composite rods for internal fixation of bone fractures: in vitro and in vivo study.

The ultra-high-strength, self-reinforced (SR) absorbable polymeric composites, consisting of reinforcement elements, like fibers, and of matrix polymer which have the same chemical element composition as reinforcement, were defined. A method to manufacture self-reinforced, absorbable polyglycolide (SR-PGA) rods of polyglycolide sutures (Dexon) by sintering them partially together at elevated temperature and pressure was presented. The rods with nominal diameters of 1.5 mm, 2.0 mm, 3.2 mm, and 4.5 mm showed initial bending modulus and strength values of 8-15 GPa and 220-405 MPa, respectively. Their initial shear strengths were 165-255 MPa. The smallest rods (diam. 1.5 mm) lost their mechanical strength after implantation in the subcutis of rabbits in 4-5 weeks while the thickest rods retained their strength over 8 weeks. The ultra-high-strength SR-PGA rods were concluded to be suitable for fixation of cancellous bone fractures, osteotomies, and epiphyseal plate fractures where the fixation is not exposed to excessive mechanical stresses and where the loads are predominantly of a shear nature.

Animals↗