Journal of Joint Surgery and Research · Published 2026-07-01 · DOI 10.1016/j.jjoisr.2026.06.001
Masanori Fujii, Shiori Tanaka, Yosuke Oba, Masaya Ueno, Shunsuke Kawano, Tadatsugu Morimoto
ABSTRACT: Purpose: The aim of this study was to determine whether poly-l-lactic acid (PLLA) screw fixation is associated with fixation-related complications after transposition osteotomy of the acetabulum (TOA). Methods: A total of 616 patients (800 hips) with hip dysplasia who underwent TOA between 1998 and 2019 were retrospectively reviewed. Acetabular fixation was performed using metal screws in 405 hips and PLLA screws in 395 hips. Surgery-related complications, fixation-related osseous complications, and re-operation were compared between groups. A subanalysis was performed according to greater trochanter fixation material. Logistic regression analysis was used to identify factors associated with acetabular fragment osseous complications among hips treated with PLLA acetabular fixation. Results: Any surgery-related complication was more frequent in the PLLA group than in the metal group (10% vs. 3.5%; p < 0.001). Fixation-related osseous complications (6.3% vs. 1.2%; p < 0.001), acetabular fragment osseous complications (2.0% vs. 0%; p = 0.003), and re-operation for fixation-related osseous complications (3.0% vs. 0.5%; p = 0.006) were also more frequent in the PLLA group. Greater trochanter PLLA fixation was associated with higher rates of greater trochanter-related complications than metal fixation (20% vs. 1.6%; p < 0.001). Among hips treated with PLLA acetabular fixation, male hips, higher body mass index, and lower lateral center-edge angle were independently associated with acetabular fragment osseous complications. Conclusions: Absorbable screw fixation was associated with increased fixation-related complications after TOA. Metal fixation should be considered for acetabular fixation in mechanically demanding hips, and single-screw PLLA fixation without supplemental wire is not recommended for greater trochanter reattachment.
Abstract from DOAJ. Public domain (CC0 1.0).
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Fujii, M., Tanaka, S., Oba, Y., et al. (2026). Absorbable screw fixation is associated with increased fixation-related complications after transposition osteotomy of the acetabulum. Journal of Joint Surgery and Research. https://doi.org/10.1016/j.jjoisr.2026.06.001