In vitro evaluation of free-form biodegradable bone plates for fixation of distal femoral physeal fractures in dogs

Denis J. Marcellin-LittleDepartment of Clinical Sciences, College of Veterinary Medicine, College of Engineering, North Carolina State University, Raleigh, NC 27606

Search for other papers by Denis J. Marcellin-Little in
Current site
Google Scholar
PubMed
Close
 DEDV
,
Brian J. SutherlandDepartment of Clinical Sciences, College of Veterinary Medicine, College of Engineering, North Carolina State University, Raleigh, NC 27606

Search for other papers by Brian J. Sutherland in
Current site
Google Scholar
PubMed
Close
 DVM
,
Ola L. A. HarryssonEdward P. Fitts Department of Industrial and Systems Engineering, College of Engineering, North Carolina State University, Raleigh, NC 27606

Search for other papers by Ola L. A. Harrysson in
Current site
Google Scholar
PubMed
Close
 PhD
, and
Erica S. LeeDepartment of Biomedical Engineering, College of Engineering, North Carolina State University, Raleigh, NC 27606

Search for other papers by Erica S. Lee in
Current site
Google Scholar
PubMed
Close
 MS
View More View Less

Abstract

Objective—To design and manufacture free-form biodegradable polycaprolactone (PCL) bone plates and to compare mechanical properties of femoral constructs with a distal physeal fracture repaired by use of 5 stabilization methods.

Sample Population—40 canine femoral replicas created by use of additive manufacturing and rapid tooling.

Procedures—Surgery duration, mediolateral and craniocaudal bending stiffness, and torsional stiffness of femoral physeal fracture repair constructs made by use of 5 stabilization methods were assessed. The implants included 2 Kirschner wires inserted medially and 2 inserted laterally (4KW), a commercial stainless steel plate (CSP), a custom free-form titanium plate (CTP), thin (2-mm-thick) biodegradable PCL plates (TNP) placed medially and laterally, and thick (4-mm-thick) PCL plates (TKP) placed medially and laterally.

Results—Surgical placement of 4KW was more rapid than placement of other implants The mean caudal cantilever bending stiffness of CTP and CSP constructs was greater than that for TNP TKP and 4KW constructs, and the mean caudal cantilever bending stiffness of TNP and TKP constructs was greater than that for 4KW constructs. The mean lateral cantilever bending stiffness of TKP constructs was greater than that for 4KW constructs. Differences among construct types were not significant in yield strength, ultimate strength, yield torque, and ultimate torque.

Conclusions and Clinical Relevance—The mechanical properties of fracture repair constructs made from free-form PCL biodegradable plates compared favorably with those of constructs made from Kirschner wires. The impact of PCL plates on musculoskeletal soft tissues, bone healing, and bone growth should be evaluated before clinical use.

Abstract

Objective—To design and manufacture free-form biodegradable polycaprolactone (PCL) bone plates and to compare mechanical properties of femoral constructs with a distal physeal fracture repaired by use of 5 stabilization methods.

Sample Population—40 canine femoral replicas created by use of additive manufacturing and rapid tooling.

Procedures—Surgery duration, mediolateral and craniocaudal bending stiffness, and torsional stiffness of femoral physeal fracture repair constructs made by use of 5 stabilization methods were assessed. The implants included 2 Kirschner wires inserted medially and 2 inserted laterally (4KW), a commercial stainless steel plate (CSP), a custom free-form titanium plate (CTP), thin (2-mm-thick) biodegradable PCL plates (TNP) placed medially and laterally, and thick (4-mm-thick) PCL plates (TKP) placed medially and laterally.

Results—Surgical placement of 4KW was more rapid than placement of other implants The mean caudal cantilever bending stiffness of CTP and CSP constructs was greater than that for TNP TKP and 4KW constructs, and the mean caudal cantilever bending stiffness of TNP and TKP constructs was greater than that for 4KW constructs. The mean lateral cantilever bending stiffness of TKP constructs was greater than that for 4KW constructs. Differences among construct types were not significant in yield strength, ultimate strength, yield torque, and ultimate torque.

Conclusions and Clinical Relevance—The mechanical properties of fracture repair constructs made from free-form PCL biodegradable plates compared favorably with those of constructs made from Kirschner wires. The impact of PCL plates on musculoskeletal soft tissues, bone healing, and bone growth should be evaluated before clinical use.

Contributor Notes

Ms. Lee's present address is US Patent and Trademark Office, 600 Dulany St, Alexandria, VA 22314.

Supported by the University of North Carolina/NCSU Joint Department of Biomedical Engineering.

Address correspondence to Dr. Marcellin-Little (denis_marcellin@ncsu.edu).
  • 1

    Whitney WO, Schrader SC. Dynamic intramedullary crosspinning technique for repair of distal femoral fractures in dogs and cats: 71 cases (1981–1985). J Am Vet Med Assoc 1987; 191:11331138.

    • Search Google Scholar
    • Export Citation
  • 2

    Edgard-Rosa G, Launay F, Glard Y, et al. Salter and Harris type-II distal femoral physeal fracture-separations at adolescent age: a new therapeutic approach (preliminary study) [in French]. Rev Chir Orthop Réparatrice Appar Mot 2008; 94:546551.

    • Search Google Scholar
    • Export Citation
  • 3

    Stone EA, Betts CW, Rowland GN. Effect of Rush pins on the distal femoral growth plate of young dogs. Am J Vet Res 1981; 42:261265.

  • 4

    Mazzonetto R, Paza AO, Spagnoli DB. A retrospective evaluation of rigid fixation in orthognathic surgery using a biodegradable self-reinforced (70L:30DL) polylactide. Int J Oral Maxillofac Surg 2004; 33:664669.

    • Search Google Scholar
    • Export Citation
  • 5

    Eppley BL, Morales L, Wood R, et al. Resorbable PLLA-PGA plate and screw fixation in pediatric craniofacial surgery: clinical experience in 1883 patients. Plast Reconstr Surg 2004; 114:850856.

    • Search Google Scholar
    • Export Citation
  • 6

    Saikku-Bäckström A, Räihä JE, Välimaa T, et al. Repair of radial fractures in toy breed dogs with self-reinforced biodegradable bone plates, metal screws, and light-weight external coaptation. Vet Surg 2005; 34:1117.

    • Search Google Scholar
    • Export Citation
  • 7

    Marcellin-Little DJ, Harrysson OL & Cansizoglu O. In vitro evaluation of a custom cutting jig and custom plate for canine tibial plateau leveling. Am J Vet Res 2008; 69:961966.

    • Search Google Scholar
    • Export Citation
  • 8

    Marretta SM, Schrader SC. Physeal injuries in the dog: a review of 135 cases. J Am Vet Med Assoc 1983; 182:708710.

  • 9

    Gomes LS, Volpon JB. Experimental physeal fracture-separations treated with rigid internal fixation. J Bone Joint Surg Am 1993; 75:17561764.

    • Search Google Scholar
    • Export Citation
  • 10

    Hara Y, Tagawa M, Ejima H, et al. Application of oriented poly-L-lactide screws for experimental Salter-Harris type 4 fracture in distal femoral condyle of the dog. J Vet Med Sci 1994; 56:817822.

    • Search Google Scholar
    • Export Citation
  • 11

    Kowalski MJ, Schemitsch EH, Kregor PJ, et al. Effect of periosteal stripping on cortical bone perfusion: a laser doppler study in sheep. Calcif Tissue Int 1996; 59:2426.

    • Search Google Scholar
    • Export Citation
  • 12

    Perren SM, Cordey J, Rahn BA, et al. Early temporary porosis of bone induced by internal fixation implants. A reaction to necrosis, not to stress protection? Clin Orthop Relat Res 1988;(232):139151.

    • Search Google Scholar
    • Export Citation
  • 13

    Kregor PJ, Senft D, Parvin D, et al. Cortical bone perfusion in plated fractured sheep tibiae. J Orthop Res 1995; 13:715724.

  • 14

    Greenberg BM, Schneider SJ. Trigonocephaly: surgical considerations and long term evaluation. J Craniofac Surg 2006; 17:528535.

  • 15

    Sukhiani HR, Holmberg DL. Ex vivo biomechanical comparison of pin fixation techniques for canine distal femoral physeal fractures. Vet Surg 1997; 26:398407.

    • Search Google Scholar
    • Export Citation
  • 16

    Peltoniemi H, Ashammakhi N, Kontio R, et al. The use of bio-absorbable osteofixation devices in craniomaxillofacial surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002; 94:514.

    • Search Google Scholar
    • Export Citation
  • 17

    Buijs GJ, van der Houwen EB, Stegenga B, et al. Torsion strength of biodegradable and titanium screws: a comparison. J Oral Maxillofac Surg 2007; 65:21422147.

    • Search Google Scholar
    • Export Citation
  • 18

    Edwards WB, Gillette JC, Thomas JM, et al. Internal femoral forces and moments during running: implications for stress fracture development. Clin Biomech (Bristol, Avon) 2008; 23:12691278.

    • Search Google Scholar
    • Export Citation
  • 19

    Cox T, Kohn MW & Impelluso T. Computerized analysis of resorbable polymer plates and screws for the rigid fixation of mandibular angle fractures. J Oral Maxillojac Surg 2003; 61:481487.

    • Search Google Scholar
    • Export Citation
  • 20

    Eppley BL, Sadove AM. Effects of resorbable fixation on craniofacial skeletal growth: a pilot experimental study. J Craniofac Surg 1992; 3:190196.

    • Search Google Scholar
    • Export Citation
  • 21

    Lam CX, Hutmacher DW, Schantz JT, et al. Evaluation of poly-caprolactone scaffold degradation for 6 months in vitro and in vivo. J Biomed Mater Res A 2009; 90:906919.

    • Search Google Scholar
    • Export Citation
  • 22

    Sun H, Mei L, Song C, et al. The in vivo degradation, absorption and excretion of PCL-based implant. Biomaterials 2006; 27:17351740.

  • 23

    Yeo A, Rai B, Sju E, et al. The degradation profile of novel, bioresorbable PCL-TCP scaffolds: an in vitro and in vivo study J Biomed Mater Res A 2008; 84:208218.

    • Search Google Scholar
    • Export Citation
  • 24

    Yeo A, Sju E, Rai B, et al. Customizing the degradation and load-bearing profile of 3D polycaprolactone-tricalcium phosphate scaffolds under enzymatic and hydrolytic conditions. J Biomed Mater Res B Appl Biomater 2008; 87:562569.

    • Search Google Scholar
    • Export Citation
  • 25

    Lowry KJ, Hamson KR, Bear L, et al. Polycaprolactone/glass bioabsorbable implant in a rabbit humerus fracture model. J Biomed Mater Res 1997; 36:536541.

    • Search Google Scholar
    • Export Citation
  • 26

    Guarino V, Causa F, Netti PA, et al. The role of hydroxyapatite as solid signal on performance of PCL porous scaffolds for bone tissue regeneration. J Biomed Mater Res B Appl Biomater 2008; 86B:548557.

    • Search Google Scholar
    • Export Citation
  • 27

    Väänänen P, Koistinen A, Nurmi J, et al. Biomechanical in vitro evaluation of the effect of cyclic loading on the postoperative fixation stability and degradation of a biodegradable ankle plate. J Orthop Res 2008; 26:14851488.

    • Search Google Scholar
    • Export Citation
  • 28

    Daniels AU, Chang MK, Andriano KP. Mechanical properties of biodegradable polymers and composites proposed for internal fixation of bone. J Appl Biomater 1990; 1:5778.

    • Search Google Scholar
    • Export Citation
  • 29

    Liptak JM, Edwards MR, James SP, et al. Biomechanical characteristics of allogeneic cortical bone pins designed for fracture fixation. Vet Comp Orthop Traumatol 2008; 21:140146.

    • Search Google Scholar
    • Export Citation
  • 30

    Koleske JV. Poly(ε-caprolactone) overview. In: Salamone JC, ed. Polymeric materials encyclopedia. Boca Raton, Fla: CRC Press, 1996;56845688.

    • Search Google Scholar
    • Export Citation
  • 31

    Altpeter H, Bevis MJ, Grijpma DW, et al. Non-conventional injection molding of poly(lactide) and poly(epsilon-caprolactone) intended for orthopedic applications. J Mater Sci Mater Med 2004; 15:175184.

    • Search Google Scholar
    • Export Citation
  • 32

    Giordano RA, Wu BM, Borland SW, et al. Mechanical properties of dense polylactic acid structures fabricated by three dimensional printing. J Biomater Sci Polym Ed 1996; 8:6375.

    • Search Google Scholar
    • Export Citation

Advertisement