Use of Osteoplug polycaprolactone implants as novel burr-hole covers.

Introduction: The aim of this study was to evaluate the outcome of Osteoplug, a novel biodegradable polymer burr-hole cover implant, used in patients with burr holes done for drainage of chronic subdural haematoma.

Methods: 12 patients with chronic subdural haematoma had Osteoplug implants inserted into their burr holes after evacuation of the haematoma. Osteoplug is a biodegradable polycaprolactone implant with a mushroom-button shape, designed specifically to fit into a 14-mm diameter burr hole. It has an upper rim of 16-mm diameter and a body diameter of 14 mm, with a honeycomb-like architecture of 400-600 mum pore size. The Osteoplug snaps onto the 14-mm diameter burr hole snugly after the evacuation of the liquefied haematoma is done. All 12 patients were followed up for a period ranging from ten months to two years (mean 16 months) postoperatively. They were evaluated for their clinical, radiological and cosmetic outcomes.

Results: Osteoplug provided good cosmesis by preventing unsightly depressions over the skull postoperatively in all the 12 patients. Postoperative computed tomography, done at one year, showed signs of good osteointegration into the surrounding calvarial bone, with multifoci mineralisation throughout the scaffold in one patient. There was no case of infection or any adverse systemic reaction noted. Patient satisfaction was high.

Conclusion: The Osteoplug polycaprolactone burr-hole covers are suitable, biodegradable implants with good medium-term results. They provide an ideal scaffold for osteogenesis and excellent cosmesis. There were no adverse events in all 12 patients, with a mean follow-up of 16 months.