Absorbable implants in sport medicine and arthroscopic surgery:A narrative review of recent development

Over the past two decades,advances in arthroscopic and minimally invasive surgical techniques have led to significant growth in sports medicine surgery.Implants such as suture anchors,interference screws,and endo-buttons are commonly used in these procedures.However,traditional implants made of metal or inert materials are not absorbable,leading to complications that affect treatment outcomes.To address this issue,absorbable materials with excellent mechanical properties,good biocompatibility,and controlled degradation rates have been developed and applied in clinical practice.These materials include absorbable polymers,absorbable bioceramics,and absorbable metals.In this paper,we will provide a comprehensive summary of these absorbable materials from the perspective of clinicians,and discuss their clinical applications and related research in sport medicine.

Catgut Point-Embedding Therapy in Treatment of 76 Cases of Ulcerative Colitis

In recent years, our department has adopted a catgut point-embedding therapy in the treatment of 76 cases of chronic ulcerative colitis, with quite good therapeutic effects. The following is a report of it.Clinical DataOf 76 cases we treated, 32 were male, and 44 female, with the ages ranging from 23 to 65 years and the duration of illness from 6 months to 20 years.All the cases complained of chronic diarrhea, most of them had mucous and blood stool, and some had tenesmus. Sigmoscopic findings showed that all the cases had varying degrees of colic mucosal congestion and edema, fragile mucosa easy to bleed upon touching, or rough mucosa with multiple ulcers varying in size, shape, and depth.

Observation on 105 Cases of Duodenal Bulbar Ulcer Treated by Combined Therapy of Catgut Embe0ding and Chinese Drugs

Duodenal bulbar ulcer is a frequently encountered disease. Clinically, it manifests itself by regular epigastric pain accompanied by belching and acid regurgitation, corresponding to epigastralgia and stomach distending pain in traditional Chinese medicine (TCM). Based on the TCM type-differentiation, the author has treated 105 cases of duodenal bulbar ulcer by the combined therapy of catgut embedding at point Zusanli (ST 36) and Chinese drugs with satisfactory results. A summary is as follows. Clinical Data1. Case selection: The cases selected all had the clinical symptoms and signs of duodenal bulbar ulcer, and had been diagnosed by GI examination at this or other hospitals with no obvious therapeutic effects obtained after relevant treatment, and still symptoms and signs and repeated attacks of pain.

Treatment of displaced radial head fractures by internal fixation with absorbable pins

Objective： To study the effect of internal fixation with absorbable pins on treatment of displaced radial head fractures. Methods： From May 1999 to May 2004, 16 patients with displaced radial head fractures （Mason types Ⅱ and Ⅲ） were treated with internal fixation by absorbable pins. The duration of follow-up averaged 22.6 months （12-58 months）. The outcome was assessed on the basis of elbow motion, radiographic findings and the functional rating score delineated by Broberg and Morrey. Results： All fractures healed within 10 months without avascular necrosis of radial head. The mean elbow flexion loss was 15°（0°-35°） , and pronation and supination decreased by 10°（ 0°-30°） on average compared with those of the contralateral elbow. Five patients had an excellent result, 6 a good result, and 3 a fair result according to the criteria of Borberg and Morrey. Conclusions： Internal fixation with absorbable pins is an effective method in treating displaced radial head fractures. It can maintain the biomechanical stability of forearm, improve the elbow function and avoid second operation.

Surgical Fixation of Fourth and Fifth Metacarpal Shaft Fractures with Flexible Intramedullary Absorbable Rods： Early Clinical Outcomes and Implications

Background： To avoid the irritation of tendons and soft tissues as well as hardware-related problems, we designed an intramedullary fixation with bioabsorbable rods for the treatment of the metacarpal shaft fractures. Methods： Five patients with nine shaft fractures of the fourth and fifth metacarpi were treated with intramedullary absorbable implants and followed up with an average of 4.2 months postoperatively. Results： At final follow-up, all patients achieved fracture union with no signs of inflammatory or subcutaneous effusion. There was no shortening, angulatory, or rotatory deformity. There was almost full active extension range of motion （ROM） of the metacarpophalangeal joints while the active flexion ROM of these joints was 80.7 ± 9.6°. hand was 94.0 ± 9.6%. X-rays showed that the arch of the second Compared with the contralateral hand, the grip strength of the injured to fifth metacarpal heads was smooth. There were no intramedullary lytic changes and soft tissue swellings. Conclusion： The intramedullary absorbable implants are a safe, simple, and practical treatment for fourth and filth metacarpal fractures with good early clinical outcomes and no significant complications.

Biocompatibility and degradation comparisons of four biodegradable copolymeric osteosynthesis systems used in maxillofacial surgery: A goat model with four years follow-up

pplying biodegradable osteosyntheses avoids the disadvantages of titanium osteosyntheses. However, foreign-body reactions remain a major concern and evidence of complete resorption is lacking. This study compared the physico-chemical properties, histological response and radiographs of four copolymeric biodegradable osteo-synthesis systems in a goat model with 48-months follow-up. The systems were implanted subperiosteally in both tibia and radius of 12 Dutch White goats. The BioSorb FX [poly(70LLA-co-30DLLA)], Inion CPS [poly([70–78.5] LLA-co-[16–24]DLLA-co-4TMC)], SonicWeld Rx [poly(DLLA)], LactoSorb [poly(82LLA-co-18GA)] systems and a negative control were randomly implanted in each extremity. Samples were assessed at 6-, 12-, 18-, 24-, 36-, and 48-month follow-up. Surface topography was performed using scanning electron microscopy (SEM). Differential scanning calorimetry and gel permeation chromatography were performed on initial and explanted samples. Histological sections were systematically assessed by two blinded researchers using (polarized) light microscopy, SEM and energy-dispersive X-ray analysis. The SonicWeld Rx system was amorphous while the others were semi-crystalline. Foreign-body reactions were not observed during the complete follow-up. The SonicWeld Rx and LactoSorb systems reached bone percentages of negative controls after 18 months while the BioSorb Fx and Inion CPS systems reached these levels after 36 months. The SonicWeld Rx system showed the most predictable degradation profile. All the biodegradable systems were safe to use and well-tolerated (i.e., complete implant replacement by bone, no clinical or histological foreign body reactions, no [sterile] abscess formation, no re-interventions needed), but nanoscale residual polymeric fragments were observed at every system’s assessment.