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Osteosynthesis and Trauma Care 2006; 14(1): 54-59
DOI: 10.1055/s-2005-872553
Original Article

© Georg Thieme Verlag Stuttgart · New York

Bone Mineral Density after Bioresorbable or Stainless Steel Intramedullary Osteosynthesis of the Sheep Femoral Bone

T. E. Otto1 , M. van der Elst3 , A. van Lingen2 , P. Patka1 , H. J. T. M. Haarman1
  • 1Department of Trauma Surgery, VU University Medical Center, Amsterdam, The Netherlands
  • 2Department of Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
  • 3Department of Surgery, Reinier de Graaf Hospital, Delft, The Netherlands
Further Information

Publication History

Publication Date:
02 March 2006 (online)

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Abstract

Bioresorbable osteosynthesis materials have theoretical advantages over stainless steel osteosynthesis materials like reduction of stress shielding and the absence of the need for a removal operation. Large volumes of bioresorbable material will be needed for intramedullary osteosynthesis in humans. A long-term follow-up study in a sheep femoral osteotomy model was performed to preclude a possible negative influence of the large volume of bioresorbable osteosynthesis material on the bone healing process. Bone mineral density (BMD) in different regions of interest (ROI) of both femur and tibia was measured with dual energy X-ray absorptiometry (DXA) 30 months after intramedullary nailing of a femoral osteotomy. Ten sheep with a bioresorbable nail after femoral osteotomy were compared to six sheep with a stainless steel nail after femoral osteotomy. In both groups, BMD was increased in the osteotomy and proximal regions of the femur and decreased in the distal femoral and tibial regions. However, BMD decreases were always smaller while increases were mostly larger after bioresorbable osteosynthesis. Stress shielding and inactivity osteoporosis seemed to be less in the bioresorbable group. No osteolysis around the large-volume intramedullary bioresorbable implants was observed. Therefore, we conclude that bioresorbable intramedullary osteosynthesis has an advantage over stainless steel osteosynthesis with regard to BMD. It seems to be a safe alternative for stainless steel osteosynthesis.

Key words

polylactic acid - bioabsorbable implants - fracture fixation - bone density - inactivity osteoporosis - stress shielding

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T. E. OttoM. D. 

Department of Trauma Surgery · VU University Medical Center

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The Netherlands

Phone: +31/20/4 44 02 68

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Email: pam.vleeuwen@vumc.nl