Efficacy of osteochondral fragment fixation using bioabsorbable pins for Hepple Ⅱ osteochondral lesions of the talus in adolescents / 国际外科学杂志

Objective:To investigate the efficacy of osteochondral fragment fixation using bioabsorbable pins for Hepple Ⅱ osteochondral lesions of the talus (OLT) in adolescents.Methods:Retrospective case analysis was used. The clinical data and follow-up results of 13 adolescent patients (13 feet) with Hepple Ⅱ OLT were all treated with osteochondral fragment fixation using bioabsorbable pins admitted to Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2017 to December 2021 were retrospectively analyzed. There were 7 males and 6 females, with 13 right feet. The age was (14.85±2.23) years old, ranged from 12 to 18 years old. According to the American orthopedic foot and ankle society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) and SF-36 score before operation and at the last follow-up were used to evaluate the efficacy and function of the patients. Measurement data with normal distribution were represented as mean ± standard deviation( ± s), and the comparison between groups was conducted using the t-test; The mearsurement data with skewness distribution were expressed by M( Q1, Q3), and rank-sum test was used for inter-group comparison. Results:Thirteen adolescent patients (13 feet) with Hepple Ⅱ OLT underwent surgery successfully and were followed up for (25.54±9.95) months. All wounds healed by first intention, and no complications such as wound infection and delayed healing occurred. Preoperative AOFAS ankle-posterior foot score, VAS and SF-36 score were 58.62±3.55, 7.00 (6.50, 8.00) and 68.38±4.81, respectively. At the last follow-up, the scores were 97.38±2.73, 1.00 (0.00, 1.00), 91.15±4.28, respectively, and the results were significantly improved at the last follow-up, with the difference between the two groups statistically significant( P<0.05). Conclusion:Osteochondral fragment fixation using bioabsorbable pins which can promote cartilage repair, significantly improve symptoms, and achieve better clinical satisfaction with fewer complications, is a safe and effective surgical treatment option for Hepple Ⅱ OLT in adolescents with satisfactory short-term clinical outcomes.

Characteristics and application of bioabsorbable materials in orthopedics / 中国组织工程研究

BACKGROUND: Bioabsorbable materials have shown obvious advantages in clinical application for more than ten years, and have been widely used in many biomedical fields. OBJECTIVE: To review characteristics of bioabsorbable materials and their application in orthopedics. METHODS: The articles published in Wanfang, CNKI, VIP, and PubMed databases were searched by computer. The key words were “bioabsorbable materials, bioabsorbable metal materials, bioabsorbable inorganic materials, polymer materials, biocomposites” in Chinese, and “bioabsorbable/bioabsorbable material, metal material, polymer material, biocomposites” in English. RESULTS AND CONCLUSION: Absorbable metal materials have good mechanical properties. The corrosion mechanism of polymer materials is clear, which can predict the corrosion behavior and corrosion rate in vivo and in vitro, but its load-bearing performance is not as good as that of absorbable metal materials. After certain treatment, bioceramics have good biocompatibility, bone conductivity and osseointegration, but they are brittle and difficult to be formed. Biocomposites have the properties of component materials, and can also obtain new properties that single component materials do not have, so it has a wide application prospect.

Biocerámicos: aspectos farmaco-tecnológicos y clínicos de uso odontológico / Bioceramics: pharmatechnological and clinical aspects of dental use

Se analizan aspectos fármaco-tecnológicos y clínicos de biocerámicos bioabsorbibles compuestos por biovidrios con capacidad osteogénica y microbicida, para ser utilizados como relleno bioactivo en el conducto radicular y como tratamiento terapéutico en el sitio de a lesión apicoperirradicular de origen endodóntico. Mediante un diagrama ternario se consideraron las diversas variables cuyos valores determinan las diferentes fases de los vidrios bioactivos, hasta alcanzar la formación de hidroxiapatita, cuando se someten a un medio biológico. Se analizaron composición y mecanismo de acción en la reparación posendodóntica, que parte de la integración del biomaterial al tejido duro sano, sin formación de fibrosis o proceso inflamatorio inmune (AU)

Pharmacotechnological and clinical aspects of bioabsorbable bioceramics composed of bioglasses with osteogenic and microbicidal capacity are analyzed, to be used as a bioactive filler in the root canal and as a therapeutic treatment at the site of an apicoperiradicular lesion of endodontic origin. By means of a ternary diagram, the various variables whose values determine the different phases of the bioactive glasses were considered, until reaching the formation of hydroxyapatite, when subjected to a biological medium. Composition and mechanism of action were analyzed in post-endodontic repair, which starts from the integration of the biomaterial into healthy hard tissue, without the formation of fibrosis or an immune inflammatory process (AU)

Development of biodegradable occluders in the treatment for congenital heart diseases / 中华实用儿科临床杂志

Percutaneous intervention with occluder has become the preferred radical therapy for most of common congenital heart diseases, such as atrial septal defect (ASD), ventricular septal defect and patent ductus arteriosus.At present, most occluders for clinical use are made of nitinol, which will permanently exist in human body after implantation, and lead to the risk of severe complications such as chronic inflammation, cardiac perforation and high-grade atrioventricular block.Biodegradable occluder will be gradually replaced by body tissues after implantation.Investigators are exploring to develop biodegradable occluder with different biodegradable materials.In particular, a completely biodegradable atrial septum occlusion system (Absnow™) developed by the team of professor Zhang Zhiwei has been approved for clinical trial by China Food and Drug Administration (CFDA) in 2018, which is the first completely biodegradable atrial septal defect occluder entered the clinical trial phase in the world.The results of human trial test demonstrated the initial safety and effectiveness of this occluder.However, multi-center clinical trials are needed for evaluation and verification.Currently, selecting suitable materials for developing new biodegradable occluders, and the effectiveness and safety of occluders are the focuses and development trend of studies on biodegradable occluders in the treatment of congenital heart diseases.

Guided bone regeneration using preformed titanium mesh combined with bioabsorbable membranes in aesthetic area / 中国组织工程研究

BACKGROUND: Absorbable and non-absorbable barrier membranes have their own merits and demerits in the guided bone regeneration. OBJECTIVE: To investigate the clinical effect of new preformed titanium mesh combined with different bone augmentation materials in anterior teeth with inadequate bone volume for dental implants. METHODS: Thirty-one patients with single maxillary anterior tooth loss were divided into three groups: Bio-Gide collagen membrane + Bio-oss bone group (C; n=12), titanium mesh + Bio-Gide collagen membrane + Bio-Oss bone group (TC; n=10), titanium mesh + concentrated growth factor + Bio-Gide collagen membrane + Bio-Oss bonegroup (TCC; n=9). Through clinical review, cone-beam CT and histological examination, osteogenic effects of the three treatment methods were compared and statistically analyzed at 0 day and 6 months after operation. The implementation of the study protocol complied with the relevant ethical requirements of Qingdao Stomatological Hospital, and each patient was fully informed of the trial process. RESULTS AND CONCLUSION: In the postoperative review, only two patients in the TC group had wound deformations, and the wound healed about 3 weeks postoperation. Six months after the operation, cone-beam CT results revealed significant differences in bone height between the TCC and TC groups and the C group (P < 0.05), as well as in bone width at the mark points of 2, 4 and 6 mm (P < 0.05). There was no significant difference in bone width between three groups at the mark point of 8 mm (P < 0.05). Hematoxylin-eosin staining of bone tissue around the implant showed that trabecular structure was visible in all three groups, but the structures was more mature and denser in the TCC group and sparser in the C group. These findings indicate that titanium mesh has good space maintenance function, better maintains the stability of bone graft material, and enhances the osteogenesis effect to a certain extent. Concentrated growth factors may promote soft tissue healing.

Development of biodegradable occluders in the treatment for congenital heart diseases / 中华实用儿科临床杂志

Percutaneous intervention with occluder has become the preferred radical therapy for most of common congenital heart diseases,such as atrial septal defect (ASD),ventricular septal defect and patent ductus arteriosus.At present,most occluders for clinical use are made of nitinol,which will permanently exist in human body after implantation,and lead to the risk of severe complications such as chronic inflammation,cardiac perforation and high-grade atrioventricular block.Biodegradable occluder will be gradually replaced by body tissues after implantation.Investigators are exploring to develop biodegradable occluder with different biodegradable materials.In particular,a completely biodegradable atrial septum occlusion system (AbsnowTM) developed by the team of professor Zhang Zhiwei has been approved for clinical trial by China Food and Drug Administration (CFDA) in 2018,which is the first completely biodegradable atrial septal defect occluder entered the clinical trial phase in the world.The results of human trial test demonstrated the initial safety and effectiveness of this occluder.However,multi-center clinical trials are needed for evaluation and verification.Currently,selecting suitable materials for developing new biodegradable occluders,and the effectiveness and safety of occluders are the focuses and development trend of studies on biodegradable occluders in the treatment of congenital heart diseases.

Comparison of bioabsorbable stents and drug-eluting stents for cardiovascular disease: Meta-analysis of clinical trial / 第二军医大学学报

Objective To compare the safety and effectiveness of bioabsorbable stents and drug-eluting stents for cardiovascular disease. Methods We searched SinoMed, Wanfang data, Chinese National Knowledge Infrastructure (CNKI), VIP, PubMed, Medline and Embase databases to obtain the clinical trial studies published between Jan. 1980 and Oct. 2018 according to inclusion criteria. The odds ratio (OR) and 95% confidence interval (95% CI) were calculated by the R 3.5.1 software to evaluate the safety and efficacy of bioabsorbable stents and drug-eluting stents in treatment of cardiovascular disease. Results A total of 22 studies with 33 570 subjects were included. Comparing the bioabsorbable stents with the drug-eluting stents, we found that OR (95% CI) for the main safety and effectiveness indicators were as follow: cardiac death (1.01 [0.88, 1.16], P0.05), all-caused death (0.97 [0.88, 1.08], P0.05), myocardial infarction (0.98 [0.87, 1.10], P0.05), target lesion revascularization (0.99 [0.89, 1.09], P0.05), and target vessel revascularization (1.03 [0.95, 1.13], P0.05). The OR (95% CI) was (0.80 [0.65, 0.99], P＝0.042) for the detection of confirmed or suspected stent thrombosis, (0.97 [0.69, 1.37], P＝0.906) for early stent thrombus, and (0.61 [0.43, 0.86], P＝0.004) for late stent thrombus. Conclusion In the treatment of coronary heart disease, the results of this meta-analysis indicate that there are no differences in safety or efficacy between bioabsorbable stents and drug-eluting stents. However, bioabsorbable stents can decrease the risk of stent thrombus, especially for the late stent thrombus.

A Case of Early Septal Reconstruction with Autogenous Cartilage Graft with Bioaborbable Plate in a 13-Year-Old Male of Nasal Septal Abscess / 대한이비인후과학회지

Nasal septal abscess is a serious condition that necessitates urgent surgical management, and it may lead to saddle nose deformity caused by the loss of cartilaginous support. To date, there is no consensus among clinicians with regard to early versus late surgical management of the saddle nose deformity. For the growing child, reconstructing the septum is essential for the normal development of the nose. We present a case of nasal septal abscess with a nearly total loss of septal cartilage of a 13-year-old male. His nasal septum was reconstructed immediately with autologous ear cartilage attached to a bioabsorbable plate through open approach. The aesthetic problems such as the saddle nose have not occurred during the follow-up period.

Long-term Follow-up of Extensive Peri-anchor (Poly-L/D-lactic Acid) Cyst Formation after Arthroscopic Rotator Cuff Repair: A Case Report

Suture anchors are commonly used in shoulder surgeries, especially for rotator cuff tears. Peri-anchor cyst formation, however, is sometimes detected on follow-up radiologic image after surgery. The purpose of this report is to discuss the case of a patient who presented with regression of extensive peri-anchor cyst on postoperative 4-year follow-up magnetic resonance imaging and had good clinical outcome despite peri-anchor cyst formation after arthroscopic rotator cuff repair.

Quiste sinovial en la tibia luego de la reconstrucción del ligamento cruzado anterior: evaluación de 14 pacientes / Synovial cyst in the tibia after reconstruction of the anterior cruciate ligament: evaluation of 14 patients

Introducción: La aparición de quiste sinovial pretibial posterior a cirugía de reconstrucción de LCA es una complicaciónpoco frecuente, de origen multifactorial que puede suceder incluso años luego de la cirugía. El objetivo del presentetrabajo fue analizar una serie de pacientes tratados por esta complicación. Material y métodos: Se evaluaron retrospectivamente 14 pacientes operados de resección de quiste pretibial posterior auna cirugia de LCA entre el año 2008 y 2016. Se analizó el tipo de injerto, técnica quirúrgica e implante utilizado, la clínicadel paciente y el tiempo de aparición de los síntomas. Se realizó una evaluación radiológica pre y post operatoria. Sedescribió la cirugía de resección del quiste y la anatomía patológica. Evaluamos el índice de recidiva. Resultados: Nueve hombres y 5 mujeres con edad promedio de 38 años. El seguimiento promedio fue de 35 meses.Todos operados con isquiotibiales cuádruple y técnica trans-tibial. El tiempo promedio entre la cirugía de LCA y aparicióndel quiste fue de 29 meses. Clínicamente presentaban una tumoración entre 1.1 y 3 cm sin signos de inestabilidad. Através de Rx y RM se evidenció ensanchamiento del túnel tibial en todos los casos. Se rellenó el túnel tibial con injertoóseo en 7 casos. La anatomía patológica informó: 12 quistes sinoviales (5 asociados a remanentes de sutura) y 2 casosúnicamente fibrosis. Un paciente evolucionó con recidiva...

Introduction: Among complications following ACL reconstruction, the formation of a pre-tibial cyst in the site of the tibialtunnel is very rare and might happen even years after surgery. The purpose of this study was to analyze 14 patients with tibialsynovial cyst after ACL reconstruction.Material and method: We retrospectively evaluated patients operated between 2008 and 2016. We analyzed the graftselection and surgical technique for ACL reconstruction, the time between primary surgery and the onset of symptoms andthe clinical presentation. A pre and postoperative radiological evaluation was performed for every patient. Surgical techniquefor cyst excision, histological analysis and culture results were also analyzed. The recurrence rate was evaluated at finalfollow-upResults: Nine patients were male, with an average age of 38 years. The average follow-up was of 35 months. All ACLreconstructions were performed using hamstring graft and a trans-tibial technique. The average time between primary ACLsurgery and onset of the cyst was 29 months. All patients presented a palpable tumor at proximal tibia and a stable knee.The cyst size varied between 1.1 and 3 cm. In all cases, Rx and MRI could appreciate a widening of the tibial tunnel. Thetibial tunnels were filled with cancellous bone in 7 cases. Pathological anatomy reported 12 synovial cysts (5 associated withremaining suture) and 2 fibrosis. One recurrence was reported...

Meta-analysis on the Safety and Efficacy of Absorb Bioresorbable Vascular Scaffold Versus Everolimus Eluting Stent for Percutaneous Coronary Intervention / 中国循环杂志

Objectives:To systemically review the safety and efficacy of bioresorbable vascular scaffold (BVS) versus everolimus eluting stent (EES) for percutaneous coronary intervention (PCI). Methods:The database searched includes PubMed, Medline, MEDILINE, EMBASE, Cochrane library, CNKI and Wanfang. Database retrieval time was between database establishment time to October 2017. During the same time, authors accessed the conference summary and related websites to collect published randomized controlled trials of published data. To evaluate the quality of the literature according to the modified Jadad scale and extracted the data. Meta-analysis was performed using Review Manager 5.3 software. Results:Nine trials were included; 6 721 patients were randomized to receive BVS (n=3 670) or EES (n=3 051). Time of follow-up was ranged from 6 to 36 months. Compared with metallic EES, risk of target lesion failure (RR=1.31, 95%CI:1.08-1.58; P=0.005) and in-stent thrombosis (RR=2.89, 95%CI:1.85-4.53; P＜0.0001), ischemia-driven target lesion revascularization (RR=1.44,95%CI:1.12-1.86, P=0.005)、target-vessel myocardial infarction (RR=1.74, 95%CI:1.33-2.27, P＜0.0001) and all myocardial infarction (RR=1.49, 95%CI:1.16-1.91, P=0.002) were all significantly higher in BVS group than in EES group. There were no significant differences in all-cause death (RR=0.87, 95 % CI:0.57-1.33, P=0.520), cardiovascular mortality (RR=0.78, 95%CI:0.54-1.11, P=0.160) and composite endpoints (RR=1.10, 95%CI:0.95-1.27, P=0.210) between the two groups. Conclusions:Compared with metallic EES, the BVS appears to be associated with both lower efficacy and higher thrombotic risk during the observation period.

Bioabsorbable Screws Used in Hallux Valgus Treatment Using Proximal Chevron Osteotomy / 대한족부족관절학회지

Hallux valgus is a deformity that causes pain in the first metatarsophalangeal joint. Surgical methods are quite diverse and a range of osteotomies are used at the proximal and distal part of the metatarsal bone and proximal phalange. Fixation methods, such as plate, screw, K-wire, and others have been used in various ways. The fixation device is often removed with various side effects due to the fixation devices. In the case of instruments that are absorbed in vivo, these procedures are not necessary to remove and there is an advantage of not performing the second operation. Three patients were treated, in which a proximal chevron osteotomy was used with a bioabsorbable screw (K-MET™; U&I Corporation).

Delayed formation of sterile abscess after zygomaticomaxillary complex fracture treatment with bioabsorbable plates

We present a patient who showed a sterile abscess after facial bone fixation with bioabsorbable plates and screws. He had zygomaticomaxillary complex and periorbital fracture due to falling down. The displaced bones were treated by open reduction and internal fixation successfully using bioabsorbable plate system. However, at postoperative 11 months, abrupt painless swelling was noted on the previous operation sites, left lateral eyebrow and lower eyelid. By surgical exploration, pus-like discharge and degraded materials were observed and debrided. The pathologic analysis revealed foreign body reaction with sterile abscess. This complication followed by bioabsorbable device implantation on maxillofacial bone surgery has been rarely reported in which we call attention to the maxillofacial plastic surgeons.

Ruptura de tornillo tibial interferencial biodegradable posterior a reconstrucción de ligamento cruzado anterior / Broken bioabsorbable interference tibial screw of anterior cruciate ligament reconstruction

Se presenta un reporte un caso con una ruptura de tornillo interferencial biodegradable tibial luego de la reconstrucción de ligamento cruzado anterior (LCA) con injerto cuádruple autólogo de semitendinoso y recto interno. Doce meses postoperatorios luego de una recuperación satisfactoria inicia con síntomas de bloqueo y dolor de rodilla. La Resonancia magnética (RM) mostró ruptura del tornillo tibial sin pérdida de la ubicación ni continuidad de la plástica de LCA. Se realizó extracción de la parte rota del tornillo por vía artroscópica. La paciente tuvo una recuperación completa de su rodilla. Éste caso describe posibles causas de ruptura del tornillo biodegradable y se sugiere tomar en cuenta los cuidados necesarios para evitar dicho problema.

We report a case of broken screw from the tibial site of anterior cruciate ligament reconstruction using an autologous ipsilateral semitendinosus-gracilis quadruple graft. Twelve months after initially successful ACL surgery the patient felt locking symptoms and knee pain. MRI showed a broken bioabsorbable interference tibial screw without loss of location or continuity of the ACL graft. At revision arthroscopy the broken part was removed. The patient had full recovery. This case describes possible causes of bioscrew rupture in ACL surgery and we suggest the necessary precautions to avoid this problem.

Arthroscopic Assisted Bioabsorbable Screw Fixation for Radial Head Fractures: A Report of Two Cases

Most radial head fractures occur as the result of low-energy mechanisms, such as a trip or fall on the outstretched hand. These fractures typically occur when an axial load is applied to the forearm, causing the radial head to hit the capitellum of the humerus. Good results are shown with nonsurgical treatments for Mason type 2 fractures. However, if there is a limitation of elbow joint exercise or displacement of more than 2 mm, an operative treatment should be considered. We treated two patients with arthroscopic assisted bioabsorbable screw (K-MET™; U&I Corporation, Uijeongbu, Korea) fixation for radial head fractures to prevent complications of open reduction and minimize radiation exposure.

Arthroscopic Assisted Bioabsorbable Screw Fixation for Radial Head Fractures: A Report of Two Cases

Most radial head fractures occur as the result of low-energy mechanisms, such as a trip or fall on the outstretched hand. These fractures typically occur when an axial load is applied to the forearm, causing the radial head to hit the capitellum of the humerus. Good results are shown with nonsurgical treatments for Mason type 2 fractures. However, if there is a limitation of elbow joint exercise or displacement of more than 2 mm, an operative treatment should be considered. We treated two patients with arthroscopic assisted bioabsorbable screw (K-MET™; U&I Corporation, Uijeongbu, Korea) fixation for radial head fractures to prevent complications of open reduction and minimize radiation exposure.

Comparison of Poly-L-Lactic Acid and Poly-L-Lactic Acid/Hydroxyapatite Bioabsorbable Screws for Tibial Fixation in ACL Reconstruction: Clinical and Magnetic Resonance Imaging Results

BACKGROUND: The purpose of this study was to compare the clinical and radiological results of 2 different tibial fixations performed using bioabsorbable screws with added hydroxyapatite (HA) and pure poly-L-lactic acid (PLLA) screws in anterior cruciate ligament (ACL) reconstruction. METHODS: A total of 394 patients who underwent arthroscopic ACL reconstruction between March 2009 and June 2012 were retrospectively reviewed. Of those, 172 patients who took the radiological and clinical evaluations at more than 2 years after surgery were enrolled and divided into 2 groups: PLLA group (n = 86) and PLLA-HA group (n = 86). Both groups were assessed by means of the Lysholm score, International Knee Documentation Committee (IKDC) subjective knee score, and Tegner activity score. Stability was evaluated using the KT-2000 arthrometer. Magnetic resonance imaging was performed to evaluate tibial tunnel widening, screw resorption, osteoingeration, and foreign body reactions. RESULTS: The PLLA-HA group showed significant reduction in the extent of tibial tunnel widening and foreign body reactions and significant increase in screw resorption compared to the pure PLLA group (p < 0.001 for both). In contrast, postoperative Lysholm score, Tegner activity score, IKDC score, and side-to-side difference on the KT-2000 arthrometer showed no significant differences between groups (p = 0.478, p = 0.906, p = 0.362, and p = 0.078, respectively). The PLLA group showed more significant widening in the proximal tibial tunnel than the PLLA-HA group (p = 0.001). In the correlation analysis, proximal tibial tunnel widening revealed a positive correlation with knee laxity (r = 0.866) and a negative correlation with Lysholm score (r = −0.753) (p < 0.01 for both). CONCLUSIONS: The HA added PLLA screws would be advantageous for tibial graft fixation by reducing tibial tunnel widening, improving osteointegration, and lowering foreign body reactions. Even though no clinically significant differences were noted between the pure PLLA group and PLLA-HA group, widening of the proximal area of the tibial tunnel showed a tendency to increase knee laxity measured using the KT-2000 arthrometer.

Fijación de tórax inestable con placas y tornillos bioabsorbibles. Presentación de serie de casos / Thoracic inestability fixed with bioabsorbable screws and plates

Resumen: Antecedentes: El tórax inestable se trata con ventilación mecánica o inhaloterapia y analgesia. Poco se ha publicado sobre el uso de material bioabsorbible y su evolución en la fijación de tórax inestable. Métodos: Estudio descriptivo de pacientes con tórax inestable sometidos a fijación con placas y tornillos bioabsorbibles en un período comprendido de Febrero de 2009 a Diciembre de 2011. Resultados: Presentamos 18 casos con edades entre 33 y 74 años (media de 53), tres con tórax inestable bilateral; la fijación costal se realizó entre 1 y 21 días del accidente (media de 1.5). Se inició deambulación al día siguiente en 14 casos; la estancia postoperatoria fue de cuatro días (rango de 3 a 14). La frecuencia cardíaca de los pacientes previa a la cirugía era de 90 por minuto (rango 82 a 100) y bajó a 84 después de la fijación (rango 82 a 92); la frecuencia respiratoria preoperatoria era 26 por minuto (rango 22 a 28) y bajó a 22 por minuto (rango 20 a 26) en el postoperatorio. Conclusiones: El uso de material bioabsorbible para osteosíntesis costal no tiene efectos secundarios atribuibles al material en el corto plazo.

Abstract: Background: Flail chest is managed with mechanical ventilation or inhaloteraphy and analgesia. Little has been published on the use of bioabsorbable material and its evolution in flail chest fixation. Methods: This is a descriptive study of patients with unstable chest undergoing fixation with bioabsorbable plates and screws in a period from February 2009 to December 2011. Results: We report 18 cases, aged 33-74 years (mean 53), three with bilateral involvement; rib fixation was performed between 1-21 days of the accident (mean 1.5). They started walking the next day in 14 cases; postoperative stay was four days (range 3-14). The heart rate of patients prior to surgery was 90 per minute (range 82-100) and lowered to 84 after fixation (range 82-92), preoperative respiratory rate was 26 per minute (range 22-28) and below 22 per minute (range 20 to 26) in postoperative period. Conclusions: The use of bioabsorbable material for osteosynthesis of costal fractures did not show side effects in our period of study.

Síndrome de fricción de la cintilla iliotibial posterior a reconstrucción del ligamento cruzado anterior con pines transversos bioabsorbibles / Iliotibial band friction syndrome due to bioabsorbable pins in ACL reconstruction

Resumen: Las lesiones del ligamento cruzado anterior (LCA) hoy en día son tratadas principalmente con injerto de isquiotibiales y una amplia gama de técnicas y sistemas de fijación del LCA en busca de una menor morbilidad del paciente. Se reporta un caso de una paciente de 42 años que sufrió ruptura de LCA, tratada con reconstrucción de LCA con injerto autólogo de isquiotibiales, fijación femoral con pines transversos bioabsorbibles y fijación tibial con tornillo bioabsorbible. La paciente evolucionó con presencia de dolor en región lateral de rodilla, diagnosticado como síndrome de fricción de la banda iliotibial un año posterior a la cirugía. Se realizaron estudios de imagen que incluyeron rayos X y resonancia magnética (RM) donde se observó adecuada fijación del LCA con presencia de migración y ruptura del pin proximal bioabsorbible. Se decidió extraer el fragmento del pin bioabsrobile en un segundo tiempo quirúrgico y la paciente regresó a sus actividades cotidianas y deportivas sin dolor y con una adecuada estabilidad.

Abstract: Injuries of the anterior cruciate ligament are currently treated primarily with the use of hamstring graft with a wide range of different techniques and fixation systems for anterior cruciate ligament in reducing patient morbidity. We report the case of a female patient aged 42 that suffered an anterior cruciate ligament rupture and was treated with anterior cruciate ligament reconstruction with hamstring autograft with femoral fixation with bio-absorbable cross-pin and tibial fixation with bio-absorbable screw. The patient presented lateral knee pain that was diagnosed one year after the operation as an iliotibial band friction syndrome. Imaging studies were performed. X-rays and magnetic resonance imaging demonstrated adequate fixation of the anterior cruciate ligament with the presence of migration and rupture of the proximal bio-absorbable cross-pin. It was decided to remove the bio-absorbable cross-pin fragment in a second surgical procedure after which the patient went back to her daily activities and sports without pain and with stability stable knee.

Percutaneous coronary intervention with bioabsorbable vascular scaffolds in anomalous origin of right coronary artery: case report / Intervención coronaria percutánea con stents bioabsorbibles en origen anómalo de la arteria coronaria derecha: reporte de caso

Abstract: Introduction: A case report describing the use of bio-absorbable vascular scaffolds in a patient with rare anomalous origin of right coronary artery. Case report: Male 71 years, ST-segment elevation myocardial infarction in the inferior region wall, thrombolysis with tenecteplase, with reperfusion criteria. Coronary angiography: left coronary system without angiographic lesions, right coronary artery with a significant lesion in the middle segment. An elective percutaneous coronary intervention was performed using 2 bio-absorbable vascular scaffolds (Absorb 3.5 x 28 mm joined in proximal segment with an Absorb 3.5 x 23 mm), posterior review with optical coherence tomography. Results: Discharged 24 hours later, remaining asymptomatic at 6 months follow-up. Conclusion: In this case, the significant stenosis of the artery involved was treated with the implantation of two bio-absorbable vascular scaffolds, obtaining an appropriate outcome after six months follow-up. This is the first report of a patient with anomalous origin of the right coronary artery treated with bio-absorbable vascular scaffolds in Mexico.

Resumen: Introducción: Se trata de un caso clínico que describe el uso de stents bioabsorbibles en un paciente con origen anómalo de arteria coronaria derecha de rara presen­tación. Caso clínico: Hombre de 71 años, con antecedente de infarto del miocardio con elevación del segmento ST en la cara inferior, sometido a trombolisis con tenecteplase, presentando criterios de reperfusión. El angiograma coronario reporta el sistema coronario izquierdo sin lesiones significativas, así como la arteria coronaria derecha con una lesión significativa en el segmento proximal a medio. Se realizó una intervención coronaria percutánea electiva con dos stents bioabsorbibles (Absorb 3.5 x 28 mm el cual se empalmó en el segmento proximal con un Absorb 3.5 x 23 mm), revisión posterior con tomografía de coherencia óptica con adecuada aposición. Resultados: Egresado 24 horas más tarde, permaneciendo asintomático a los seis meses de seguimiento. Conclusión: En este caso, la estenosis significativa de la arteria involucrada fue tratada con la implantación de dos stents bioabsorbibles, con la obtención de un resultado clínico apropiado después de seis meses de seguimiento. Éste es el primer informe de un paciente con un origen anómalo de la arteria coronaria derecha tratado con stents bioabsorbibles en México.