Osteolytic Changes After Polyglycolide Pin Fixation in Chevron Osteotomy

Abstract

Absorbable polyglycolide pins were used for fixation of 94 chevron osteotomies in 70 patients at the Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, between 1986 and 1992. Postoperative osteolytic changes around the degrading pin occurred in 21 of 94 (22%) metatarsal heads. In 17 of 21 metatarsal heads, polydioxanone-coated polyglycolide pins were used. This type of pin has not been used since 1988. At follow-up, 16 of 21 osteolytic changes resolved completely and four partially resolved. In the remaining one, the osteolytic area remained visible after 6 years. Cystic changes in the metatarsal head, not attributable to the location of the absorbable implants, occurred in seven (7.4%) metatarsal heads and avascular necrosis of the entire metatarsal head in one (1.1%). Foreign body reaction occurred in six (6.3%) metatarsal heads and wound infection in three (3.2%) metatarsal heads. No association was observed between osteolytic changes and foreign body reaction or infection. Osteolysis in patients receiving polyglycolide implants only require observation, because associated symptoms with the radiographic findings are transient.