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An in-vitro biomechanical study of different fixation techniques for the extended trochanteric osteotomy in revision THA.

Zhu Z, Ding H, Shao H, Zhou Y, Wang G - J Orthop Surg Res (2013)

Bottom Line: Ten cadaveric femurs were chosen in this study.The tension to the greater trochanter was from 0 to 500N in vertical and lateral direction, respectively.The translation and rotation of the greater trochanter with respect to the bony bed were captured by an optical tracking system.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Biomedical Engineering, Tsinghua University, Beijing, China.

ABSTRACT

Background: The wire fixation and the cable grip fixation have been developed for the extended trochanteric osteotomy (ETO) in the revision of total hip arthroplasty (THA). Many studies reported the postoperative performance of the patients, but with little quantitative biomechanical comparison of the two fixation systems.

Methods: An in-vitro testing approach was designed to record the loosening between the femoral bed and the greater trochanter after fixations. Ten cadaveric femurs were chosen in this study. Each femur underwent the THA, revision by ETO and fixations. The tension to the greater trochanter was from 0 to 500N in vertical and lateral direction, respectively. The translation and rotation of the greater trochanter with respect to the bony bed were captured by an optical tracking system.

Results: In the vertical tension tests, the overall translation of the greater trochanter was observed 0.4 mm in the cable fixations and 7.0 mm in the wire fixations. In the lateral tension tests, the overall motion of the greater trochanter was 2.0 mm and 1.2° in the cable fixations, while it was 6.2 mm and 5.3° in the wire fixations. The result was significantly different between the two fixation systems.

Conclusions: The stability of the proximal femur after ETO using different fixations in the revision THA was investigated. The cable grip fixation was significantly more stable than the wire fixation.

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Five fixations: 2-wires fixation (F1), 3-wires fixation (F2), a short claw plate fixation with 2 wires and 2 cables (F3), a short claw plate fixation with 4 cables (F4), and a long claw plate fixation with 4 cables (F5).
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Figure 1: Five fixations: 2-wires fixation (F1), 3-wires fixation (F2), a short claw plate fixation with 2 wires and 2 cables (F3), a short claw plate fixation with 4 cables (F4), and a long claw plate fixation with 4 cables (F5).

Mentions: 1) Osteotomy: The neck of the intact proximal femur was resected to implant the THA prosthesis. Then the greater trochanter was cut extendedly to remove the previous implant in a revision THA. The vertical cuts were 13 cm at the anterior and posterior side of the proximal femur (Figure 1). The horizontal cut was one third of the girth and joined both sides of the vertical cuts [7,20,22]. The piece of the extended greater trochanter was separated from the femoral bed. The THA prosthesis was replaced by an implant for revision.


An in-vitro biomechanical study of different fixation techniques for the extended trochanteric osteotomy in revision THA.

Zhu Z, Ding H, Shao H, Zhou Y, Wang G - J Orthop Surg Res (2013)

Five fixations: 2-wires fixation (F1), 3-wires fixation (F2), a short claw plate fixation with 2 wires and 2 cables (F3), a short claw plate fixation with 4 cables (F4), and a long claw plate fixation with 4 cables (F5).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3643827&req=5

Figure 1: Five fixations: 2-wires fixation (F1), 3-wires fixation (F2), a short claw plate fixation with 2 wires and 2 cables (F3), a short claw plate fixation with 4 cables (F4), and a long claw plate fixation with 4 cables (F5).
Mentions: 1) Osteotomy: The neck of the intact proximal femur was resected to implant the THA prosthesis. Then the greater trochanter was cut extendedly to remove the previous implant in a revision THA. The vertical cuts were 13 cm at the anterior and posterior side of the proximal femur (Figure 1). The horizontal cut was one third of the girth and joined both sides of the vertical cuts [7,20,22]. The piece of the extended greater trochanter was separated from the femoral bed. The THA prosthesis was replaced by an implant for revision.

Bottom Line: Ten cadaveric femurs were chosen in this study.The tension to the greater trochanter was from 0 to 500N in vertical and lateral direction, respectively.The translation and rotation of the greater trochanter with respect to the bony bed were captured by an optical tracking system.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Biomedical Engineering, Tsinghua University, Beijing, China.

ABSTRACT

Background: The wire fixation and the cable grip fixation have been developed for the extended trochanteric osteotomy (ETO) in the revision of total hip arthroplasty (THA). Many studies reported the postoperative performance of the patients, but with little quantitative biomechanical comparison of the two fixation systems.

Methods: An in-vitro testing approach was designed to record the loosening between the femoral bed and the greater trochanter after fixations. Ten cadaveric femurs were chosen in this study. Each femur underwent the THA, revision by ETO and fixations. The tension to the greater trochanter was from 0 to 500N in vertical and lateral direction, respectively. The translation and rotation of the greater trochanter with respect to the bony bed were captured by an optical tracking system.

Results: In the vertical tension tests, the overall translation of the greater trochanter was observed 0.4 mm in the cable fixations and 7.0 mm in the wire fixations. In the lateral tension tests, the overall motion of the greater trochanter was 2.0 mm and 1.2° in the cable fixations, while it was 6.2 mm and 5.3° in the wire fixations. The result was significantly different between the two fixation systems.

Conclusions: The stability of the proximal femur after ETO using different fixations in the revision THA was investigated. The cable grip fixation was significantly more stable than the wire fixation.

Show MeSH
Related in: MedlinePlus