Search

The case of a 44-year-old male patient is reported, who was operated 4 years after a cruciate ligament replacement. A nearly completely intact biodegradable screw was removed arthroscopically. The screw dislocated from the tibial canal into the joint and caused damage to the retropatellar cartilage which was treated by debridement and lateral release. A material analysis was done on the explanted screw which showed no material fault. A review of the literature reporting adverse events connected to biodegradable implants was carried out. Nine papers reporting about adverse event are cited. There seem to be three main problems: delayed degradation, foreign body reaction and the filling of graft tunnels with non-ossified tissue. Instructions for the use of biodegradable interference screws were requested from seven manufacturers to compare the given information about the degradation behaviour. The information given on the period of time until the screws would be completely resorbed were heterogeneous, ranging from no specific information about the time span at all up to 24 months. More research is needed to identify the degradation behaviour more precisely and clarify the potential risks connected to biodegradable implants. Their use should be reconsidered critically., (Copyright (c) Georg Thieme Verlag KG Stuttgart-New York.)

Acute skin lesions following radiotherapy are uncomfortable and unacceptable side effects. They are observed predominantly after high surface doses as in conventional roentgen or electron beam therapy. To accelerate the wound healing we tested a bandage consisting of hydrocolloids and polymers, which is permeable for gas and water. Handling, compatibility and effectiveness of this plaster were tested in this study. According to the RTOG scoring system 19 irradiated fields with grade II to IV lesions were treated. Densitometric measurements of verification films with and without Biofilm showed no energy absorption. The bandage was comfortable for the patients and easy to handle.

This new synthetic absorbable suture material has been tested in 90 animal experiments (Wistar rats) with regard to tissue reaction, absorption and breaking strength. The data obtained were compared with Polyglactin 910 (Vicryl), Catgut plain and polyester fibres. PDS-sutures produced only a minimal tissue reaction and were completely resorbed after 168 days. They retained 50% of its breaking strength until the 40th day after implantation.

Twenty-two human eyes and one rejected Silastic sponge were examined histopathologically for the reaction of ocular tissues to buckling and encircling materials. The eyes were enucleated 22 days to 14 years following retinal detachment surgery. Silicone implants, Silastic sponges, and Mersilene bands were very well tolerated by the eye, whereas nylon threads caused a moderate and prolonged granulomatous inflammation due to their susceptability to enzymatic decomposition. This reaction, however, does not seem to be of major clinical importance, as the amount of nylon used in detachment operations is low. Atrophy of the underlying sclera can happen with any of the above-mentioned materials and depends mostly on mechanical factors of the implant and on the intraocular pressure. Even with total transcleral erosion of the buckling or encircling material, no severe histopathologic changes could be found in the overlying choroid and retina.