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Evaluation of the fatigue performance and degradability of resorbable PLDLLA-TMC osteofixations

: Landes, C.; Ballon, A.; Ghanaati, S.; Ebel, D.; Ulrich, D.; Spohn, U.; Heunemann, U.; Sader, R.; Jaeger, R.

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Open Biomedical Engineering Journal 12 (2013), pp.133-146
ISSN: 1874-1207
Journal Article, Electronic Publication
Fraunhofer IWM ()
Fraunhofer IWM ( Fraunhofer IWM-H) ()
polylactic acid; resorbable osteosyntheses; resorbable osteofixation; PLLA; PLDLLA-TMC; in-situ degradation; in-patient degradation; strength retention; resorbable craniofacial implants; fatigue

The fatigue performance of explanted in-situ degraded osteofixations/osteosyntheses, fabricated from poly (70L-lactide-co-24DL-lactide-6-trimethylane-carbonate or PLDLLA-TMC) copolymer was compared to that of virgin products. The fatigue test was performed on 21 explants retrieved from 12 women and 6 men; 16-46 years by a custom-designed three-point bend apparatus using a staircase method and a specified failure criterion (an increase of the deflec-tion of the specimen > 1 mm) with run-out designated as “no failure” after 150,000 loading cycles. While all the virgin products showed run-out at 38N, all of the specimens fabricated from explants failed at this load level. For the explant specimens, although there was a trend of decreased failure load with increased in-situ time, this decrease was pronounced after 4 months in-situ, however, not yet statistically significant, while a 6-month in-situ explant had significantly less fail-ure load. Three and four month in-situ explants had highly significant differences in failure load between measurements close and distant to the osteotomy line: p=0.0017 (the region of maximum load in-situ). In the virgin products, there were only traces of melt joining and cooling, left from a stage in the manufacturing process. For the implants retrieved after 4.5 months in-situ, the fracture surfaces showed signs of degradation of the implants, possibly caused by hydrolysis, and for those retrieved after 9 months in-situ, there were cracks and pores. Thus, the morphological results are consistent with those obtained in the fatigue test. The present results suggest that resorbable osteofixations fabricated from PLDLLA-TMC are stable enough to allow loading of the healing bone and degrade reliably.