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Abstract
Suture anchors are playing an increasingly important role in attaching tendons or
ligaments to bone. Anchors are usually made of metallic or other nonbioabsorbable
materials. The development of an absorbable suture anchor would provide a valuable
tool for the surgeon; this characteristic would minimize the problems of anchor loosening,
migration, interference with imaging studies, and the potential requirement for later
implant removal. This study evaluated the in vivo histological response over time
of the first generation Arthrex Expanding Suture Plug (ESP) (Arthrex Inc, Naples,
FL). Suture anchors threaded with nonab- sorbable No. 2 braided polyester sutures
were implanted into ram femurs and removed at various intervals over a period of 12
weeks. After preparation, histological study showed a gradual healing response in
the bone tract. There was no evidence of an inflammatory infiltrate or foreign-body
reaction during the 12 weeks of implantation. A normal bone callus appeared at the
insertion tunnel site consistent with a fracture-healing response. Later, a fibrous
membrane appeared at the junction of the implant and the bone tunnel. Over the 12
week interval, there was a decrease in osteoblastic activity and the appearance of
cavernous vascular spaces in the superficial portions of the membrane near the periosteum.
The ESP anchor composed of poly-L-lactic acid was well tolerated in the in vivo setting.
Throughout the study, no substantial acute, chronic, or foreign-body reaction was
observed. These observations are consistent with the expected in vivo behavior of
poly-L-lactic acid. There is no reason to believe that the ESP composed of poly-L-lactic
acid should cause a foreign body reaction.
Keywords
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© 1995 Published by Elsevier Inc.
