Abstract
Aims: Bioabsorbable self-reinforced polylevolactide (SR-PLLA) fixation devices have been used for several indications within orthopaedics and traumatology since the eighties, but their long-term effects in clinical use and in patients with rheumatoid arthritis (RA), however, are not wellknown, and were evaluated at the present study. Methods: Arthrodeses were fixed with SR-PLLA devices in 27 patients with RA (32 procedures: 22 of the wrist with rods, 7 of the talocal-caneal-calcaneocuboid-talonavicular (triple) and 3 of the talocrural (ankle) with screws and rods) and 16 ankle fractures with screws and/or rods. Outcomes were assessed clinically and radiographically in the long-term (mean 6.0, range 1.1–11.7 years). Computed tomography (CT) evaluation of the implants in a subgroup of 33 patients was performed. Results: All but one wrist fusion, 5/7 of triple fusions, 1 of 3 ankle fusions and all ankle fractures united. Functional results were generally good. In 5 ankle fractures degrading polymer material originating from uncut screw heads led to tissue reactions, and in 2 cases to exceptionally slow degradation. Conclusions: SR-PLLA implants served well as fixation devices for wristand triple arthrodeses in patients with RA and for ankle fractures. Difficulties occurred in bony healing of ankle arthrodeses. The SR-PLLA implants showed high biocompatibility as long as the correct operative technique was followed. Inside the bone, SR-PLLA implants degraded in 4 to 6 years. Slight bone resorption occurred.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
