Development of Bioabsorbable Interference Screws: How Biomaterials Composition and Clinical and Retrieval Studies Influence the Innovative Screw Design and Manufacturing Processes - Biologically Responsive Biomaterials for Tissue Engineering - page 106

Chapter 6
Development of Bioabsorbable Interference
Screws: How Biomaterials Composition
and Clinical and Retrieval Studies
Influence the Innovative Screw Design
and Manufacturing Processes

Iulian Antoniac , Dan Laptoiu , Diana Popescu , Cosmin Cotrut ,
and Radu Parpala

6.1 Introduction

Worldwide annual reconstructive surgery for ligament injury is quoted as hundreds
of thousands of interventions estimated up to 100,000 cases only of arthroscopic-
assisted anterior cruciate ligament (ACL) reconstruction [ 1 ] .
The system of interference fixation with screws is a widely accepted technique
during knee-ligament reconstruction; it is important for the current accelerated
rehabilitation protocols to secure grafts both in the femur and tibia.
Kurosaka et al. [ 2 ] described some of the concepts of interference screw fixation
with a custom designed, fully threaded 9.0-mm cancellous screw with increased
stiffness and linear load compared with initial Lambert's 6.5-mm cancellous AO
screw [ 3 ] .
First generation of the interference screws used for graft fixation were made by
metallic biomaterials but they generate early and late postoperative complications
like pain requiring implant removal [ 4 ] , intra-articular migration [ 5 ] , and dif fi culty
in evaluating the postoperative evolution because metal screws distort postopera-
tive imaging. These problems led to the development of bioabsorbable screws
which provide similar fixation strength to that of metal interference screws. Many
clinical reports compare bioabsorbable and metallic interference screws and show
similar results in clinical performance like range of motion, knee effusion, and
activity level [ 6- 13 ] .

I. Antoniac ( * ) • D. Popescu • C. Cotrut • R. Parpala
University Politehnica of Bucharest , Spl. Independentei 313, sect. 6 , Bucharest , Romania
e-mail: [e-mail] ; [e-mail] ;
[e-mail] ; [e-mail]
D. Laptoiu
Colentina Clinical Hospital Bucharest, Street Stefan cel Mare 19-21, sector 2,
Bucharest , Romania
e-mail: [e-mail]