Incidence of infections associated with use of bioabsorbable implants in orthopedic surgeries

Background: The incidence of placement of osteosynthetic materials has grown worldwide. Bioabsorbable materials are more commonly used now days in Orthopedic surgeries. Implants modify the risk of infection by bacterial adhesion, tissue integration, and immunomodulation. Bacterial adhesion to implant leads to interaction between bacteria and implant. Aim: To evaluate the incidence of infections associated with use of bioabsorbable implants in Orthopedic surgeries. Materials and methods: The infection rates among 1057 patients were treated with bioabsorbable osteosynthesis devices was investigated. The implant material used was PGA in approximately three fourths of the patients. Results: Depending on the bioabsorbable material used, the infection rates varied from 0.7% (SR-PLLA) to 6.5% (SR-PGA and SR-PLLA together). In a comparison with metallic osteosynthesis devices, a total 522 ankle fracture patients were studied. There was no significant difference between the infection rates of the bioabsorbable fixation group (3.2%) and metallic fixation group (4.1%). The effect of bioabsorbable implants volume on wound infections showing a significant positive correlation between the incidence of infection and the implant volume when non-stained SR-PGA or SR-PLLA implants were used. In fracture patients the raising of the implant-bone volume ratio correlated with the rising incidence of infection. Conclusion: Increasing the implant volume causes a higher incidence of wound infection when modern, non-stained implants are used. The increase in the incidence of infection is most prominent when SR-PLLA implants are used. Increasing the implant-bone volume ratio causes a higher incidence of wound infection on the tibial side.