Bone cement augmentation of femoral nail head elements increases their cut-out resistance in poor bone quality– A biomechanical study

Sermon, An; Khatchadourian, Roberto; Scherrer, Simon; Knobe, Matthias; Stoffel, Karl; Gueorguiev, Boyko

doi:10.1016/j.jbiomech.2021.110301

Cited by 18 publications

(12 citation statements)

References 34 publications

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“…As this study is to evaluate by the Harris Hip Function, the results show two groups of patients with postoperative hip joint function improved, though six months after hip function had no significant difference in both the groups, but the study group 1 month after the surgery of the hip joint function was significantly better than control group, analyzes reasons for this recognition on the above as soon as possible after the activity and the benefits of exercise are fully understood. Therefore, in the short term after surgery, patients can actively cooperate with rehabilitation exercise, so that patients can improve the function of hip joint earlier [ 14 – 17 ]. In addition two kinds of treatment not only can improve the elderly patients with femoral fractures between rotor hip function, also can effectively improve the quality of life, and the team 1 months and 6 months after surgery improved quality of life of significantly higher, illustrate the team earlier recovery of hip function in patients with better blend in social activities, the ability to live independently, Therefore, the quality of life is higher [ 18 , 19 ].…”

Section: Related Workmentioning

confidence: 99%

[Retracted] Clinical Analysis of Surgical Treatment of Senile Intertrochanteric Fracture Based on Intelligent Knowledge of Health Care

Dong

et al. 2022

Contrast Media & Molecular Imaging

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In order to explore the clinical application value of intelligent health care knowledge combined with closed reduction intramedullary nail fixation in elderly patients with intertrochanteric fracture of the femur, a retrospective analysis is performed on 80 elderly patients who received intertrochanteric surgery from January 2019 to January 2021. All patients were divided into study group and control group based on intelligent medical knowledge received or not. During the phase of treatment, both the two groups were treated with closed reduction and intramedullary nailing. The control group received conventional knowledge training and rehabilitation before and after the surgery, and the research group received additional intelligent medical knowledge health care. Observations of patients after bed and ground time are compared and the VAS score is used to evaluate the pain degree at 12 h, 24 h, and 48 h after surgery. Besides, the incidence of postoperative complications in the two groups is observed. From the clinical follow-up results, it is clearly evident that intramedullary nail fixation based on medical care knowledge can effectively improve the hip function and quality of life in patients, reduce postoperative pain, and improve the prognosis of elderly patients with femoral trochanteric fracture.

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Section: Related Workmentioning

confidence: 99%

[Retracted] Clinical Analysis of Surgical Treatment of Senile Intertrochanteric Fracture Based on Intelligent Knowledge of Health Care

Dong

et al. 2022

Contrast Media & Molecular Imaging

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“…Cement augmentation for primary fixation of osteoporotic proximal femoral fractures has been studied and shows favorable biomechanical and clinical results. 20,[51][52][53][54][55][56][57] A recent review reported that cement augmentation lead to higher loads to failure, decreased implant migration, and decreased complications and reoperations compared to non-augmented fixation. 20 A randomized multicenter prospective study also reported no reoperations or symptomatic episodes of CMN migration in a cement-augmented group vs 6 cases in the nonaugmented group.…”

Section: Discussionmentioning

confidence: 99%

Outcomes After Revision Fixation With Cement Augmentation for Failed Intertrochanteric Fracture Fixation in Older Adult Patients

Huyke-Hernández

Only

Sorich

et al. 2022

Geriatr Orthop Surg Rehabil

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Introduction Intertrochanteric (IT) fractures that fail fixation are traditionally treated with arthroplasty, introducing significant risk of morbidity and mortality in frail older adult patients. Revision fixation with cement augmentation is a relatively novel technique that has been reported in several small scale international studies. Here we report a clinical series of 22 patients that underwent revision fixation with cement augmentation for IT fracture fixation failure. Methods This retrospective case series identified all patients that underwent revision intramedullary nailing from 2018 to 2021 at two institutions within a large metropolitan healthcare system. Demographics, injury characteristics, Charlson Comorbidity Index score, and surgical characteristics were extracted from the electronic medical record. Outcomes were extracted from the electronic medical record and included radiographic findings, pain, functional outcomes, complications, and mortality. Results Average follow-up after revision surgery was 15.2 ± 10.6 months. Twenty patients (90.9%) reported improved pain and achieved union or progressive healing after surgery. Most of these patients regained some degree of independent ambulation (19 patients, 86.4%), with only 5 patients (22.7%) requiring increased assistance for their activities of daily living (ADLs). One-year mortality was 13.6% (3 patients). Of the 5 patients (22.7%) that experienced complications, 2 patients (9.1%) required revision hemiarthroplasty for subsequent fixation failure. The other 3 patients did well when complications resolved. Conclusions Revision fixation with cement augmentation can be an effective, safe, cost-effective alternative to arthroplasty for the management of cases involving non-infected failed IT fracture fixation with implant cut-out or cut-through limited to the femoral head in older adult patients that have appropriate acetabular bone stock.

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“…Mechanical testing was performed on a servo-hydraulic test system (Mini Bionix II 858, MTS Systems Corp., Eden Prairie, MN, USA) equipped with a 25 kN load cell. An adopted test setup from previous work was used to test each specimen by simulating an unstable pertrochanteric fracture with a lack of posteromedial support and load sharing at the fracture gap ( Figure 3 ) [ 4 , 19 , 20 ].…”

Section: Methodsmentioning

confidence: 99%

“…unstable pertrochanteric fracture with a lack of posteromedial support and load sharing at the fracture gap (Figure 3) [4,19,20].…”

Section: Mechanical Testingmentioning

confidence: 99%

“…These fractures lead to an increasing percentage of hospital utilization for people over the age of 55 [ 1 ]. Due to the aging population, the socioeconomic impact of osteoporotic hip fractures becomes more relevant as more than 30% of the patients having sustained an osteoporotic hip fracture cannot return to their pre-fracture place of residence [ 2 , 3 , 4 , 5 , 6 ]. Despite the recent advances in implant design development, the reported rates of implant-related failures remain in the range of 2.0–16.5% [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Impact of Bone Cement Augmentation on the Fixation Strength of TFNA Blades and Screws

Sermon

Hofmann‐Fliri

Agarwal³

et al. 2021

Medicina

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Background and Objectives: Hip fractures constitute the most debilitating complication of osteoporosis with steadily increasing incidences in the aging population. Their intramedullary nailing can be challenging because of poor anchorage in the osteoporotic femoral head. Cement augmentation of Proximal Femoral Nail Antirotation (PFNA) blades demonstrated promising results by enhancing cut-out resistance in proximal femoral fractures. The aim of this study was to assess the impact of augmentation on the fixation strength of TFN-ADVANCEDTM Proximal Femoral Nailing System (TFNA) blades and screws within the femoral head and compare its effect when they are implanted in centre or anteroposterior off-centre position. Materials and Methods: Eight groups were formed out of 96 polyurethane low-density foam specimens simulating isolated femoral heads with poor bone quality. The specimens in each group were implanted with either non-augmented or cement-augmented TFNA blades or screws in centre or anteroposterior off-centre positions, 7 mm anterior or posterior. Mechanical testing was performed under progressively increasing cyclic loading until failure, in setup simulating an unstable pertrochanteric fracture with a lack of posteromedial support and load sharing at the fracture gap. Varus-valgus and head rotation angles were monitored. A varus collapse of 5° or 10° head rotation was defined as a clinically relevant failure. Results: Failure load (N) for specimens with augmented TFNA head elements (screw/blade centre: 3799 ± 326/3228 ± 478; screw/blade off-centre: 2680 ± 182/2591 ± 244) was significantly higher compared with respective non-augmented specimens (screw/blade centre: 1593 ± 120/1489 ± 41; screw/blade off-centre: 515 ± 73/1018 ± 48), p < 0.001. For both non-augmented and augmented specimens failure load in the centre position was significantly higher compared with the respective off-centre positions, regardless of the head element type, p < 0.001. Augmented off-centre TFNA head elements had significantly higher failure load compared with non-augmented centrally placed implants, p < 0.001. Conclusions: Cement augmentation clearly enhances the fixation stability of TFNA blades and screws. Non-augmented blades outperformed screws in the anteroposterior off-centre position. Positioning of TFNA blades in the femoral head is more forgiving than TFNA screws in terms of failure load.

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Bone cement augmentation of femoral nail head elements increases their cut-out resistance in poor bone quality– A biomechanical study

Cited by 18 publications

References 34 publications

[Retracted] Clinical Analysis of Surgical Treatment of Senile Intertrochanteric Fracture Based on Intelligent Knowledge of Health Care

[Retracted] Clinical Analysis of Surgical Treatment of Senile Intertrochanteric Fracture Based on Intelligent Knowledge of Health Care

Outcomes After Revision Fixation With Cement Augmentation for Failed Intertrochanteric Fracture Fixation in Older Adult Patients

Impact of Bone Cement Augmentation on the Fixation Strength of TFNA Blades and Screws

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