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1️⃣ Bioabsorbable Screw
- The primary role of the bioabsorbable screw is to secure the graft and maintain stable fixation long enough for the graft to integrate fully before the screw begins to degrade.
2️⃣ Graft Incorporation vs. Screw Degradation
- Timing Mismatch: A disparity between the time needed for graft incorporation and the rate of screw degradation can lead to complications.
- Rapid degradation: → Cyst development
- Delayed → Lack of bony integration
3️⃣ Delayed Foreign Body Reactions to Bioabsorbable Pins
✅ Reactions to Poly-L-lactic Acid (PLLA) Implants
- Pretibial Complications: Sterile abscess and subcutaneous pretibial ganglion formation.
- Inflammatory Responses: Delayed intra-articular inflammatory reactions, leading to tibial and pretibial cyst formation.
- Synovial Reactions: Aseptic synovitis and foreign body gonitis (knee inflammation).
- Bone Reactions: Osteolytic foreign body reaction, where the body's reaction to the implant leads to bone dissolution.
✅ Reactions to Polyglycolic Acid (PGA) Implants
- Bone Reactions: Osteolytic foreign body reaction similar to PLLA implants.
- Synovial Reactions: Aseptic synovitis, involving the synovial membrane.
- Immune Responses: Specific immune responses to the PGA material, potentially leading to inflammation and other complications.
BMJ Case Rep 2019;12:e229927
Am J Sports Med. 2010 Jan;38(1):176-80
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