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The Development of Biodegradable Metallic Screws and Suture Anchors for Soft Tissue Fixation in Orthopaedic Surgery

Kim, Kwang E (2014) The Development of Biodegradable Metallic Screws and Suture Anchors for Soft Tissue Fixation in Orthopaedic Surgery. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

Surgical treatment for injuries to soft connective tissues are estimated at about 800,000 cases each year in the US. For these surgical procedures, interference screws or suture anchors are needed. Currently, materials used for the devices are non-degradable metals or bioresorbable polymers. However, these materials do lead to complications. Metallic materials suffer from difficulties encountered during revision surgery and interference with magnetic resonance imaging; whereas, polymeric materials lead to device fracture during implantation, inconsistent degradation rates, and poor osteointegration.
The overall goal of this dissertation was to explore the use of Mg-based materials as an alternative to the existing materials. Specifically, the studies focused on Mg-based interference screws for ACL reconstruction and suture anchors for rotator cuff repair. First, a Mg-based interference screw was designed and optimized through in-vitro testing and finite element analysis (FEA). At time zero, ACL reconstruction with Mg-based interference screws was found to restore initial joint stability as well as the in-situ load in the ACL close to the levels of the intact. Also, structural properties of the femur-graft-tibia complex (FGTC) with a Mg-based interference screw were comparable as those with a titanium control. In a follow-up study, joint stability and graft function after 12 weeks of healing were found to be comparable to past studies of ACL reconstruction in a goat model using the robotic/UFS testing system. The stiffness and ultimate load of the FGTC at 12 weeks were comparable to those at time zero. These results indicate that Mg-based interference screws allow for proper healing of the graft.
Similarly, a Mg-based suture anchor was also designed and developed. Using FEA, the thread depth and pitch of the anchor could be optimized. It was then demonstrated that Mg-based suture anchors could achieve superior fixation over commercially available polymer suture anchors as it could provide a higher stiffness and ultimate load.
In summary, the potential of Mg-based alloys for fixation of soft tissues to bone has been clearly demonstrated. We hope that the current findings would help the development of a novel class of biodegradable metallic implants that would ultimately help patients with improved outcomes.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Kim, Kwang Ekek68@pitt.eduKEK68
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee MemberVorp, David Avorp@pitt.eduVORP
Committee MemberKumta, Prashantpkumta@pitt.eduPKUMTA
Committee MemberMcMahon, Patrick Jmcmahonp@upmc.edu
Committee MemberMcCullough, Matthew BAmattbm@ncat.edu
Thesis AdvisorWoo, Savio L-Yslyw@pitt.eduSLYW
Date: 22 September 2014
Date Type: Publication
Defense Date: 19 March 2014
Approval Date: 22 September 2014
Submission Date: 3 April 2014
Access Restriction: 1 year -- Restrict access to University of Pittsburgh for a period of 1 year.
Number of Pages: 109
Institution: University of Pittsburgh
Schools and Programs: Swanson School of Engineering > Bioengineering
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Magnesium alloy, ACL reconstruction, interference screw, suture anchor, rotator cuff repair
Date Deposited: 22 Sep 2015 05:00
Last Modified: 15 Nov 2016 14:18
URI: http://d-scholarship.pitt.edu/id/eprint/20872

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