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Limited V-shaped cement augmentation of the proximal femur to prevent secondary hip fractures

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Patients with a femoral fracture due to osteoporosis are at high risk of sustaining a secondary fracture on the contralateral side. A prophylactic mechanical reinforcement of the contralateral side during operation of the initial fracture could be of interest for such patients. This biomechanical in vitro study investigates the potential of a limited V-shaped bone cement augmentation to prevent secondary hip fractures by targeting the areas of the proximal femur with the
highest stresses during a fall. Five pairs of human cadaveric proximal femora were tested in a configuration simulating a fall on the greater trochanter. The femoral neck of one specimen of each pair was augmented with 8–14 ml polymethylmethacrylate from the lateral cortex towards inferior and superior, spanning a V-shaped cement pattern. Clinical relevant fractures were generated with a 45 kg mass in controlled free fall. Load-displacement data were recorded and energy to fracture, fracture load, yield load and stiffness were statistically evaluated. Augmented samples absorbed 124% more energy until fracture compared to their controls (p¼0.043). No significant differences were found between the two groups for fracture load (p¼0.5), yield load (p¼0.35) and stiffness (p¼0.5). Biomechanically, a limited V-shaped prophylactic cement augmentation carries potential to prevent secondary hip fractures indicated by increased energy absorption until fracture. Further investigations are necessary to minimize interference with the biology and to maximize the mechanical benefit of prophylactic augmentation.

Keywords Secondary hip fracture, prophylactic, cement augmentation, osteoporosis, fall simulation, polymethylmethacrylate

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Informasi Detail

Judul Seri

Journal of Biomaterials Applications

No. Panggil

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Penerbit

: SAGE Publications Ltd., 2012

Deskripsi Fisik

Journal of Biomaterials Applications 28(1) 136–143

Bahasa

English

ISBN/ISSN

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Klasifikasi

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Tipe Isi

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Tipe Media

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Tipe Pembawa

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Edisi

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Subjek

BIOKIMIA

Info Detail Spesifik

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Pernyataan Tanggungjawab

hasnidar/agus

Versi lain/terkait

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