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Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2015

Open Access 01-12-2015 | Research article

Osteosynthesis-screw augmentation by ultrasound-activated biopolymer - an ovine in vivo study assessing biocompatibility and bone-to-implant contact

Authors: Hanjo Neumann, Stefan Breer, Nils Reimers, Richard Kasch, Arndt-Peter Schulz, Benjamin Kienast

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2015

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Abstract

Objectives

Screw fixation and fragment anchoring in osteoporotic bones is often difficult. Problems like the cut out phenomenon and implant migration in osteoporotic bones have been reported. One possibility of improving the anchoring force of screws is augmentation of the screw. Cement-augmented screws in spinal surgery could exhibit a better anchoring in osteoporotic bones.

Methods

The purpose of this study was to examine the effect of screw augmentation using a resorbable polymer. Ultrasound-activated biodegradable pins were used for the purpose of a resorbable augmentation technique. Cannulated screws were inserted into the femur of 12 sheep and augmented by an ultrasound-activated polylactic acid (PLDLA) pin. In a paired approach, four screws were implanted in each animal: 2× a 10-mm thread and 2× a 20-mm thread, both of which were augmented with polymer. Both screws, named A and B, were also applied without augmentation (control group) and implanted into the contralateral hind limb. After 4, 8, and 12 weeks, the sheep were euthanized and a macroscopical and histological examination followed.

Results

The polymer spread well out of the screws into the cancellous lacunae. Around the polymer, the peripheral bone showed signs of healthy and active bone tissue. No evidence of inflammation or infection was observed. The boneto-implant contact was significantly higher in the augmented screws. Biocompatibility was proven in histopathological examination. After 12 weeks, no pathological changes were found.

Conclusion

Ultrasound-activated polymer augmentation of cannulated screws may improve the anchoring in osteoporotic bone.

Article focus

  • Can screw augmentation using a resorbable polymer improve the bone-to-implant contact in case of screw osteosynthesis?
  • Is there any effect on the surrounding tissue by the induced temperature and liquefied polymer?
  • Can biocompatibility be proven by this new osteosynthesis?

Key messages

  • Screw augmentation by ultrasound-activated biopolymer leads to a significant higher bone-to-implant contact than pure screw osteosynthesis.
  • No tissue damage could be observed by the application of the SonicFusion™.

Strength and limitations of this study

  • The ovine in vivo study concept can simulate physiological conditions.
  • First examination of screw augmentation by ultrasound-activated biopolymer.
  • No biomechanical testing of the higher bone-to-implant contact by now.
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Metadata
Title
Osteosynthesis-screw augmentation by ultrasound-activated biopolymer - an ovine in vivo study assessing biocompatibility and bone-to-implant contact
Authors
Hanjo Neumann
Stefan Breer
Nils Reimers
Richard Kasch
Arndt-Peter Schulz
Benjamin Kienast
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2015
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-015-0156-1

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