The Use of Plla Screws for the Fixation of Bone Graft in Total Hip Arthroplasty

Abstract

We used Poly-L-lactic Acid (PLLA) screws for fixation of bone graft during THA operation in 22 patients (22 hips) with terminal stage coxarthrosis accompanied by marked acetabular dysplasia. Fixation with PLLA screws alone was performed in 6 of the first 7 cases. A metal washer was also used for better stability in one hip in which the bone graft was soft. In order to achieve adequate fixation between graft bone and acetabulum, a PLLA washer was produced and used at the time of PLLA screw fixation in the other 15 cases. Good bone union and good remodelling of the graft bone were observed in all hips. Since the follow-up period was short, the long term state of the grafted bone in the absorption process of the PLLA screws is still unclear. However, at present, PLLA screws appear to be a promising material that can replace metal or ceramic screws which may have some problems.

Keywords

Poly-L-lactic acid Bone graft Total hip arthroplasty Acetabular dysplasia

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References

Yamamuro

, Matsusue

, Uchida

, Shimada

, Shimazaki

, Kitaoka

. Bioabsorbable osteosynthetic implants of ultra high strength poly-L-lactide; A clinical study. International Orthopaedics 1994; 18: 332–40.

Knight

J.L.

, Fujii

, Atwater

, Grothaus

. Bone-grafting for acetabular deficiency during primary and revision total hip arthroplasty; A radiographic and clinical analysis. J Arthroplasty 1993; 8: 371–82.

Marti

R.K.

, Schuller

H.M.

, Van Steijn

M.J.A.

. Superolateral bone grafting for acetabular deficiency in primaly total hip replacement and revision. J Bone Joint Surg 1994; 76-B: 728–34.

Inao

, Gotoh

, Ando

. Total hip replacement using femoral neck bone to graft the dysplastic acetabulum; Follow-up study of 18 patients with old congenital dislocation of the hip. J Bone Joint Surg 1994; 76-B: 728–34.

Rodriguez

J.A.

, Huk

O.L.

, Pellicci

P.M.

, Wilson

P.D.

Jr . Autogenous bone grafts from the femoral head for the treatment of acetabular deficiency in primary total hip arthroplasty with cement. J Bone Joint Surg 1995; 77-A: 1227–33.

Mulroy

R.D.

, Harris

W.H.

. Failure of acetabular autogenous grafts in total hip arthroplasty. J Bone Joint Surg 1990; 72-A: 1536–40.