Response of articular cartilage and subchondral bone to internal fixation devices made of poly-L-lactide: a histomorphometric and microradiographic study on rabbits

To study the tissue response of articular cartilage and subchondral bone to biodegradable fixation devices, pins and rods made of poly-L-lactide with a fibers-in-matrix texture were implanted through the articular surface of the intercondylar portion of the distal rabbit femur. The initial raw mater ial viscosity average molecular weight of the polymer was 660,000. One pin or screw was implanted per animal. The pins were cylindrical and measured 4 .5 mm in transverse diameter. The screws had a core diameter of 3.2 mm and an outer diameter of 4.5 mm. At insertion, the implants were cut flush with the articular surface. After follow-up times of 36 and 48 weeks, the speci mens were examined histomorphometrically and microradiographically. The int act contralateral femur served as a control for comparison. No signs of ero sion or degradation of the polymer could be seen in the specimens. A brim o f reparative tissue was formed at the entrance of the implant channel. The width of the reparative tissue from the tissue-implant boundary towards the center of the entrance hole varied greatly between the specimens, from 30 to 950 mu m. In most specimens this bridging tissue consisted of undifferen tiated mesenchymal tissue. Only two out of 24 specimens showed a near-norma l metachromatic toluidine-blue staining of the matrix. Degenerative chondro cyte clustering occurred in the pre-existing cartilage within a 400 mu m wi de zone from the tissue-implant interface into the recipient tissues. Some new-bone formation was seen to envelop the implant in all specimens, but th e fractional osteoid formation surface of the trabeculae showed a value sig nificantly higher than that of the intact control side only in the screw-im planted 36-week specimens. Because of the long degradation time of poly-L-l actide, the restoration process of the articular cartilage was slow, and wi th regard to the quality and quantity of the reparative tissue, very variab le. Large implants made of poly-L-lactide may not be suitable for insertion through intra-articular surfaces. (C) 2000 Elsevier Science Ltd. All right s reserved.