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Implant augmentation: adding bone cement to improve the treatment of osteoporotic distal femur fractures: a biomechanical study using human cadaver bones.

Wähnert D, Hofmann-Fliri L, Richards RG, Gueorguiev B, Raschke MJ, Windolf M - Medicine (Baltimore) (2014)

Bottom Line: Prior to mechanical testing, bone mineral density (BMD) and local bone strength were determined.Mechanical testing was performed by cyclic axial loading (100 N to 750 N + 0.05N/cycle) using a servo-hydraulic testing machine.As a result, the BMD as well as the axial stiffness did not significantly differ between the groups.The number of cycles to failure was significantly higher in the augmented group with the BMD as a significant covariate.In conclusion, cement augmentation can significantly improve implant anchorage in plating of osteoporotic distal femur fractures.

View Article: PubMed Central - PubMed

Affiliation: Department of Trauma, Hand, and Reconstructive Surgery (DW, MJR), University Hospital Münster, Münster, Germany; and Biomedical Services (LH-F, RGR, BG, MW), AO Research Institute Davos, Davos, Switzerland.

ABSTRACT
The increasing problems in the field of osteoporotic fracture fixation results in specialized implants as well as new operation methods, for example, implant augmentation with bone cement. The aim of this study was to determine the biomechanical impact of augmentation in the treatment of osteoporotic distal femur fractures.Seven pairs of osteoporotic fresh frozen distal femora were randomly assigned to either an augmented or nonaugmented group. In both groups, an Orthopaedic Trauma Association 33 A3 fractures was fixed using the locking compression plate distal femur and cannulated and perforated screws. In the augmented group, additionally, 1 mL of polymethylmethacrylate cement was injected through the screw. Prior to mechanical testing, bone mineral density (BMD) and local bone strength were determined. Mechanical testing was performed by cyclic axial loading (100 N to 750 N + 0.05N/cycle) using a servo-hydraulic testing machine.As a result, the BMD as well as the axial stiffness did not significantly differ between the groups. The number of cycles to failure was significantly higher in the augmented group with the BMD as a significant covariate.In conclusion, cement augmentation can significantly improve implant anchorage in plating of osteoporotic distal femur fractures.

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Box-plot diagram showing the number of cycles until failure for the augmented and nonaugmented group.
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Figure 5: Box-plot diagram showing the number of cycles until failure for the augmented and nonaugmented group.

Mentions: Mean number of cycles to failure was 23,483 (SD 5715) in the augmented group and 17,643 (SD 5483) in the nonaugmented group (Figure 5). This difference was significant (P = 0.011, power = 0.67). Figure 6 shows the cumulative survival from a cox-regression analysis, the difference between the 2 groups was found to be significant (P = 0.007) with the BMD as a significant covariate (P = 0.014).


Implant augmentation: adding bone cement to improve the treatment of osteoporotic distal femur fractures: a biomechanical study using human cadaver bones.

Wähnert D, Hofmann-Fliri L, Richards RG, Gueorguiev B, Raschke MJ, Windolf M - Medicine (Baltimore) (2014)

Box-plot diagram showing the number of cycles until failure for the augmented and nonaugmented group.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4616336&req=5

Figure 5: Box-plot diagram showing the number of cycles until failure for the augmented and nonaugmented group.
Mentions: Mean number of cycles to failure was 23,483 (SD 5715) in the augmented group and 17,643 (SD 5483) in the nonaugmented group (Figure 5). This difference was significant (P = 0.011, power = 0.67). Figure 6 shows the cumulative survival from a cox-regression analysis, the difference between the 2 groups was found to be significant (P = 0.007) with the BMD as a significant covariate (P = 0.014).

Bottom Line: Prior to mechanical testing, bone mineral density (BMD) and local bone strength were determined.Mechanical testing was performed by cyclic axial loading (100 N to 750 N + 0.05N/cycle) using a servo-hydraulic testing machine.As a result, the BMD as well as the axial stiffness did not significantly differ between the groups.The number of cycles to failure was significantly higher in the augmented group with the BMD as a significant covariate.In conclusion, cement augmentation can significantly improve implant anchorage in plating of osteoporotic distal femur fractures.

View Article: PubMed Central - PubMed

Affiliation: Department of Trauma, Hand, and Reconstructive Surgery (DW, MJR), University Hospital Münster, Münster, Germany; and Biomedical Services (LH-F, RGR, BG, MW), AO Research Institute Davos, Davos, Switzerland.

ABSTRACT
The increasing problems in the field of osteoporotic fracture fixation results in specialized implants as well as new operation methods, for example, implant augmentation with bone cement. The aim of this study was to determine the biomechanical impact of augmentation in the treatment of osteoporotic distal femur fractures.Seven pairs of osteoporotic fresh frozen distal femora were randomly assigned to either an augmented or nonaugmented group. In both groups, an Orthopaedic Trauma Association 33 A3 fractures was fixed using the locking compression plate distal femur and cannulated and perforated screws. In the augmented group, additionally, 1 mL of polymethylmethacrylate cement was injected through the screw. Prior to mechanical testing, bone mineral density (BMD) and local bone strength were determined. Mechanical testing was performed by cyclic axial loading (100 N to 750 N + 0.05N/cycle) using a servo-hydraulic testing machine.As a result, the BMD as well as the axial stiffness did not significantly differ between the groups. The number of cycles to failure was significantly higher in the augmented group with the BMD as a significant covariate.In conclusion, cement augmentation can significantly improve implant anchorage in plating of osteoporotic distal femur fractures.

Show MeSH
Related in: MedlinePlus