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  • Title: Poly-L-lactic acid - hydroxyapatite (PLLA-HA) bioabsorbable interference screws for tibial graft fixation in anterior cruciate ligament (ACL) reconstruction surgery: MR evaluation of osteointegration and degradation features.
    Author: Macarini L, Milillo P, Mocci A, Vinci R, Ettorre GC.
    Journal: Radiol Med; 2008 Dec; 113(8):1185-97. PubMed ID: 18956150.
    Abstract:
    PURPOSE: We evaluated with magnetic resonance imaging (MRI) the degradation and osteointegration features of a new type of bioabsorbable interference (BioRCI) screw composed of poly-L-lactic acid and hydroxyapatite (PLLA-HA) used for tibial graft fixation in anterior cruciate ligament (ACL) reconstruction. MATERIALS AND METHODS: Thirty-one patients underwent arthroscopic surgery for ACL reconstruction using doubled gracilis and semitendinosus tendons fixed to the tibial tunnel with PLLA-HA (BioRCI-HA) screws. Two groups of patients were evaluated, one group 10-13 months after surgery and the other after 30-40 months. The standard knee ligament evaluation form of the International Knee Documentation Committee (IKDC) was used for clinical assessment and MRI for the radiological assessment. RESULTS: MRI after 10-13 months revealed findings referable to healing and integration of the bone-graft-screw system, findings that disappeared at later follow-up examinations. The BioRCI-HA screw remained constantly visible in all patients, although with changes in signal intensity over time. CONCLUSIONS: BioRCI-HA screws allow adequate primary stability and superior osteoconduction and biocompatibility in comparison with plain PLLA screws. The absence of ferromagnetic artefacts allows accurate MRI follow-up and adequate evaluation of ligament synovialisation, screw degradation and graft osteointegration.
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