Degradation and tissue replacement of a totally absorbable polyglycolide
screw, 4.5 millimeters in diameter and thirty millimeters in length, were
studied histologically, morphometrically, and radiographically at
sequential stages of resorption at as long as thirty-six weeks after
fixation of a transverse distal femoral osteotomy in rabbits. The initial
mean shear force to failure was 95.0 newtons for the specimens that had
been fixed with the polyglycolide screw compared with 257.0 newtons for the
distal part of the contralateral, intact femur. The physical appearance of
the screw was unaltered at three weeks. The first histological signs of
degradation were seen at six weeks, along the thread ridge. Premature
breakage of the screw resulted in gross displacement and non-union of the
osteotomy in one animal. The degradation of polyglycolide was accompanied
histologically by a typical non-specific foreign-body reaction. This kind
of tissue response seemed to be associated with an osteolytic proximal
expansion of the implant cavity that was suggestive of increased pressure
within the cavity during degradation of the screw. In eight specimens, a
wall of new bone formed around this area of osteolysis and demarcated the
implant cavity from the surrounding normal cancellous bone. Seventy-four
per cent of the periphery and 28 per cent of the central core of the screw
had been resorbed at twelve weeks. At thirty-six weeks, no polymeric
material could be discerned, and the predominant tissue component within
the implant cavity was loose connective tissue. The volume fractions of
trabecular bone and hematopoietic bone marrow were significantly lower (p
less than 0.01) than those of the intact, control side, but the degree of
restoration of tissue varied considerably from animal to animal.