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Refixation of Osteochondral Fractures by an Ultrasound-Activated Pin System - An Ovine In Vivo Examination Using CT and Scanning Electron Microscope.

H N, A P S, S B, A U, B K - Open Orthop J (2015)

Bottom Line: By ultrasound-activated melting of the tip of these implants a higher anchoring is assumed.The scanning electron microscopy showed no major surface damage by the three implants, especially any postulated cartilage damage induced by the heat of the ultrasound-activated pin.The screws protruded above the cartilage surface, which may affect the opposingtibial surface.

View Article: PubMed Central - PubMed

Affiliation: Department of Traumatology, Orthopaedics and Sports Medicine, BG Trauma Centre Hamburg, Germany.

ABSTRACT

Background: Osteochondral injuries, if not treated appropriately, often lead to severe osteoarthritis of the affected joint. Without refixation of the osteochondral fragment, human cartilage only repairs these defects imperfectly. All existing refixation systems for chondral defects have disadvantages, for instance bad MRI quality in the postoperative follow-up or low anchoring forces. 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 higher anchoring is assumed. Aim of the study was to investigate, if ultrasound-activated pins can provide a secure refixation of osteochondral fractures comparing to conventional screw and conventional, resorbable pin osteosynthesis. CT scans and scanning electron microscopy should proovegood refixation results with no further tissue damage by the melting of the ultrasound-activated pins in comparison to conventional osteosynthesis.

Methods: Femoral osteochondral fragments in sheep were refixated with ultrasound-activated pins (SonicPin™), Ethipins(®) and screws (Asnis™). The quality of the refixated fragments was examined after three month of full weight bearing by CT scans and scanning electron microscopy of the cartilage surface.

Results: The CT examination found almost no statistically significant difference in the quality of refixation between the three different implants used. Concerning the CT morphology, ultrasound-activated pins demonstrated at least the same quality in refixation of osteochondral fragments as conventional resorbable pins or screws. The scanning electron microscopy showed no major surface damage by the three implants, especially any postulated cartilage damage induced by the heat of the ultrasound-activated pin. The screws protruded above the cartilage surface, which may affect the opposingtibial surface.

Conclusion: Using CT scans and scanning electron microscopy, the SonicPin™, the Ethipin(®) and screws were at least equivalent in refixation quality of osteochondral fragments.

No MeSH data available.


Related in: MedlinePlus

Scanning electron microscopy view of the Ethipin®osteosynthesis screw showing intact cartilage surfaces around the implant. Thescar-like parallel damages evolve from the surgical cutting of the implant during implantation are still visible after three month.
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Figure 5: Scanning electron microscopy view of the Ethipin®osteosynthesis screw showing intact cartilage surfaces around the implant. Thescar-like parallel damages evolve from the surgical cutting of the implant during implantation are still visible after three month.

Mentions: The Ethipin® consists of Polydioxanone and has a length of 40 mm and a thickness of 1.3 mm. In comparison to the SonicPin™, the Ethipin® had no cone or change of diameter. The ostoechondral fragment is fixed by the included K-wire. Afterwards the K-wire was removed and the Ethipin®was introduced into the hole using the included application shell. If the rest of the Ethipin®was raisedabove the surface of the cartilage into the joint, it was cut away with a surgical knife at the level of the cartilage. This procedure can lead to superficial cartilage damage, if not performed carefully and constitutes a difference to the competing implants (see Fig. 5). The Ethipin® is a provenimplant for refixation of osteochondral fragments. The handling of the Ethipin® is simpleand the resorption is good, but the stability, especially for traction forces, is only moderate [24-26].


Refixation of Osteochondral Fractures by an Ultrasound-Activated Pin System - An Ovine In Vivo Examination Using CT and Scanning Electron Microscope.

H N, A P S, S B, A U, B K - Open Orthop J (2015)

Scanning electron microscopy view of the Ethipin®osteosynthesis screw showing intact cartilage surfaces around the implant. Thescar-like parallel damages evolve from the surgical cutting of the implant during implantation are still visible after three month.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4321208&req=5

Figure 5: Scanning electron microscopy view of the Ethipin®osteosynthesis screw showing intact cartilage surfaces around the implant. Thescar-like parallel damages evolve from the surgical cutting of the implant during implantation are still visible after three month.
Mentions: The Ethipin® consists of Polydioxanone and has a length of 40 mm and a thickness of 1.3 mm. In comparison to the SonicPin™, the Ethipin® had no cone or change of diameter. The ostoechondral fragment is fixed by the included K-wire. Afterwards the K-wire was removed and the Ethipin®was introduced into the hole using the included application shell. If the rest of the Ethipin®was raisedabove the surface of the cartilage into the joint, it was cut away with a surgical knife at the level of the cartilage. This procedure can lead to superficial cartilage damage, if not performed carefully and constitutes a difference to the competing implants (see Fig. 5). The Ethipin® is a provenimplant for refixation of osteochondral fragments. The handling of the Ethipin® is simpleand the resorption is good, but the stability, especially for traction forces, is only moderate [24-26].

Bottom Line: By ultrasound-activated melting of the tip of these implants a higher anchoring is assumed.The scanning electron microscopy showed no major surface damage by the three implants, especially any postulated cartilage damage induced by the heat of the ultrasound-activated pin.The screws protruded above the cartilage surface, which may affect the opposingtibial surface.

View Article: PubMed Central - PubMed

Affiliation: Department of Traumatology, Orthopaedics and Sports Medicine, BG Trauma Centre Hamburg, Germany.

ABSTRACT

Background: Osteochondral injuries, if not treated appropriately, often lead to severe osteoarthritis of the affected joint. Without refixation of the osteochondral fragment, human cartilage only repairs these defects imperfectly. All existing refixation systems for chondral defects have disadvantages, for instance bad MRI quality in the postoperative follow-up or low anchoring forces. 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 higher anchoring is assumed. Aim of the study was to investigate, if ultrasound-activated pins can provide a secure refixation of osteochondral fractures comparing to conventional screw and conventional, resorbable pin osteosynthesis. CT scans and scanning electron microscopy should proovegood refixation results with no further tissue damage by the melting of the ultrasound-activated pins in comparison to conventional osteosynthesis.

Methods: Femoral osteochondral fragments in sheep were refixated with ultrasound-activated pins (SonicPin™), Ethipins(®) and screws (Asnis™). The quality of the refixated fragments was examined after three month of full weight bearing by CT scans and scanning electron microscopy of the cartilage surface.

Results: The CT examination found almost no statistically significant difference in the quality of refixation between the three different implants used. Concerning the CT morphology, ultrasound-activated pins demonstrated at least the same quality in refixation of osteochondral fragments as conventional resorbable pins or screws. The scanning electron microscopy showed no major surface damage by the three implants, especially any postulated cartilage damage induced by the heat of the ultrasound-activated pin. The screws protruded above the cartilage surface, which may affect the opposingtibial surface.

Conclusion: Using CT scans and scanning electron microscopy, the SonicPin™, the Ethipin(®) and screws were at least equivalent in refixation quality of osteochondral fragments.

No MeSH data available.


Related in: MedlinePlus