Radiolucent zones of biodegradable magnesium-based screws in children and adolescents-a radiographic analysis

Delsmann, Maximilian M. and Sturznickel, Julian and Kertai, Michael and Stucker, Ralf and Rolvien, Tim and Rupprecht, Martin (2023) Radiolucent zones of biodegradable magnesium-based screws in children and adolescents-a radiographic analysis. ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, 143 (5). pp. 2297-2305. ISSN 0936-8051, 1434-3916

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Abstract

Introduction Albeit the implantation of magnesium-based biodegradable implants can avoid a second surgery for implant removal, the postoperative occurrence of radiolucent zones around these implants based on corrosion processes has not been previously investigated in children and adolescents. We sought to characterize the distinct temporal and spatial dynamics for magnesium-based implants based on standard clinical routine radiographs. Materials and methods We retrospectively analyzed 29 patients, treated with magnesium-based compression screws (MAGNEZIX(R) CS 2.7 mm, CS 3.2 mm, CS(C) 4.8 mm; Syntellix AG) for fracture fixation, osteotomy, or osteochondral refixation. During a follow-up examination, the clinical and functional status was evaluated. Based on digital radiographs, the ratio of the area of the radiolucent zone and that of the screw was evaluated to assess implant degradation at two follow-up visits (i.e., after 6-8 weeks and 12-24 weeks). Results In 29 patients (16/29 females, 14.03 +/- 2.13 years), a total of 57 implants were evaluated that were used for osteotomy (n = 13, screws n = 26), fracture fixation (n = 9, screws n = 18), or osteochondral refixation (n = 7, screws n = 13). All patients healed without complications and regained full function. Radiolucent zones were observed in 27/29 patients at the first follow-up, with significantly decreased ratios at the second follow-up (2.10 +/- 0.55 vs 1.64 +/- 0.60, p = 0.0006). Regression analyses were performed to assess the temporal dynamics of radiolucent zones and revealed significant logarithmic developments for the 2.7 mm and 3.2 mm screws, marked by a strong ratio decrease during the first weeks and an almost complete disappearance after approximately 100 days and 200 days, respectively. In contrast, the ceramic-coated 4.8 mm screws presented a significant linear and slower decrease of radiolucent zones. Conclusion Radiolucent zones are a common phenomenon in the course of implant degradation. However, they represent a self-limiting phenomenon. Remarkably, neither implant failure nor affected implant function is noted in this context. Yet, the microstructural changes accompanying the presence of radiolucent zones remain to be analyzed by three-dimensional high-resolution imaging.

Item Type: Article
Uncontrolled Keywords: COMPRESSION SCREWS; FRACTURES; FIXATION; HYDROGEN; IMPLANTS; REMOVAL; Magnesium screws; Radiolucent zones; Children; Osteosynthesis; Osteotomy; Osteochondral refixation
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Kinder- und Jugendmedizin
Depositing User: Dr. Gernot Deinzer
Date Deposited: 07 Mar 2024 10:37
Last Modified: 07 Mar 2024 10:37
URI: https://pred.uni-regensburg.de/id/eprint/58233

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