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Surface polishing positively influences ease of plate and screw removal

Hayes, J. S., Seidenglanz, U., Pearce, A. I., Pearce, S. G., Archer, Charles William and Richards, R. G. 2010. Surface polishing positively influences ease of plate and screw removal. European Cells and Materials 19 , pp. 117-126.

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Difficulties removing temporary fracture fixation devices due to excessive bony on-growth results in extended surgical time leading to excessive blood loss, debris contamination and potentially refracture. Commercially available locking plates and screws are manufactured for clinics with a micro-rough surface, which contributes to the excessive bony on-growth reported. We have applied polishing technology to commercially pure titanium locking compression plates (LCP) and titanium-6%aluminium-7%niobium (TAN) plates and screws to assess if it can alleviate problems with strong bony overgrowth. Samples were implanted for 6, 12 and 18 months in a bilateral sheep tibia non fracture model and assessed for screw removal torque, percentage of bone contact and tissue-material response. Both electropolishing (p=0.001) and paste polishing (p=0.010) of TAN screws significantly reduced the mean torque required for removal compared to their micro-rough counterparts. This was accompanied by a trend for a lower percentage of bone contact for polished screws. This difference in bone contact was significant for paste polished TAN screws (p<0.001) but not electropolished TAN screws (p=0.066). Ex vivo, soft tissue removal was much easier (~five minutes) for polished constructs, which was difficult and at least four times longer for standard micro-rough constructs. We suggest that polishing of locked plate/screw systems will improve ease of removal and reduce implant related removal complications encountered due to excessive strong bony on-growth while maintaining biocompatibility and implant stability. Future studies aim to assess the potential of this technology in the next level of complication, a fracture model.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Biosciences
Subjects: Q Science > Q Science (General)
Uncontrolled Keywords: implant removal; in vivo; locking compression plate; screw removal; commercially pure titanium; titanium-6%aluminium-7%niobium
Publisher: AO Foundation
ISSN: 1473-2262
Last Modified: 19 Mar 2016 22:48

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