Differentially Loaded Radiostereometric Analysis to Monitor Fracture Stiffness: A Feasibility Study

Abstract

Inability to accurately and objectively assess the mechanical properties of healing fractures in vivo hampers clinical fracture management and research. We describe a method to monitor fracture stiffness during healing in a clinical research setting by detecting changes in fracture displacement using radiostereometric analysis and simultaneously measuring applied axial loads. A method was developed for load application, positioning of the patient, and radiographic setup to establish the technique of differentially loaded radiostereometric analysis (DLRSA). A DLRSA examination consists of radiostereometric analysis radiographs taken without load (preload), under different increments of load, and without load (postload). Six patients with distal femur fractures had DLRSA examinations at 6, 12, 18, and 26 weeks postoperatively. The DLRSA method was feasible in a clinical setting. The method provides objective and quantifiable data for internally fixed fractures and may be used in clinical research as a tool to monitor the in vivo stiffness of healing femoral fractures managed with nonrigid internal fixation.

Impaction bone grafting has potential as an adjunct to the surgical stabilisation of osteoporotic tibial plateau fractures: Early results of a case series

“…Clusters of at least 4 beads were inserted in the reduced articular fragment and the un-fractured tibial metaphysis as previously described [30,32,33]. Radiographs for RSA were performed postoperatively and at each follow-up.…”

Peak loading during walking is not associated with fracture migration following tibial plateau fracture: A preliminary case series

“…Six medial condyle fractures were fixed with small LC‐DCP locking plates (Synthes Inc). Clusters of at least four, non‐collinear tantalum beads (1.0 mm diameter, RSA Biomedical, Umea, Sweden) were inserted in the reduced articular fragments and the un‐fractured tibial metaphysis as previously described to allow for RSA analysis. Any traumatic meniscal tear identified at the time of surgery was repaired with an outside‐in technique.…”

Does Cup-cage Reconstruction With Oversized Cups Provide Initial Stability in THA for Osteoporotic Acetabular Fractures?

“…For all RSA radiographic examinations, a uniplanar RSA setup with two radiographic tubes was used [3]. A room-mounted unit (Siemens Ysio Digital System; Siemens AG, Berlin, Germany) and a mobile radiographic unit (Shimadzu Art analog mobile F = female; M = male; LE = low-energy (fall from standing height); HE = high energy (mechanism provided); MVA = motor vehicle accident; ACPTH = anterior column + posterior hemitransverse; ABC = associated both column; AC = anterior column.…”