Predicting osteosynthesis screw failure by peri-implant bone morphology in multiple loading conditions

IF 3.3 2区医学 Q2 ENGINEERING, BIOMEDICAL

Journal of the Mechanical Behavior of Biomedical Materials Pub Date : 2025-05-02 DOI:10.1016/j.jmbbm.2025.107043

Juan D. Silva-Henao , Dieter H. Pahr , Andreas G. Reisinger

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引用次数: 0

Abstract

Osteosynthesis screws are critical in orthopaedic surgery for stabilizing and aligning bone fracture fragments. Despite their importance, screw failure remains a significant complication, often due to excessive movement at the implant-bone interface resulting from both physiological loading and external mechanical forces. This study aims to enhance understanding of screw failure mechanisms by investigating the relationship between peri-implant CT-based trabecular bone morphology and screw failure under axial-, shear-, and mixed loading conditions, including the effect of plate elevation. Using high-resolution micro-computed tomography (micro-CT) and mechanical testing, 100 porcine epiphyseal bone samples were extracted and analysed to measure key CT-based trabecular morphometric indices and correlate them with mechanical failure. The study tested screws under ten different loading configurations. Statistical analyses revealed that bone volume (BV) and bone volume over total volume (BV/TV) are strong predictors of screw failure force, explaining 70–90 % of the variance in failure forces across different loading scenarios. The findings suggest that BV and BV/TV can be used to determine optimal screw implantation sites based on local bone morphology, potentially improving surgical outcomes and reducing postoperative complications. This research contributes to a more comprehensive understanding of orthopaedic screw behaviour and offers a predictive model for clinical use.

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多种载荷条件下种植体周围骨形态预测骨合成螺钉失效

骨合成螺钉是骨科手术中稳定和对准骨折碎片的关键。尽管螺钉失效很重要，但它们仍然是一个重要的并发症，通常是由于生理负荷和外部机械力在种植体-骨界面处造成的过度运动。本研究旨在通过研究轴向、剪切和混合载荷条件下种植体周围ct骨小梁形态与螺钉破坏的关系，包括钢板抬高的影响，增强对螺钉破坏机制的理解。采用高分辨率微ct （micro- computer tomography, micro-CT）和力学测试技术，对100个猪骨骺样本进行了提取和分析，测量了基于ct的关键骨小梁形态计量指标，并将其与力学失效进行了关联。该研究测试了十种不同载荷配置下的螺钉。统计分析显示，骨体积（BV）和骨体积/总体积（BV/TV）是螺钉破坏力的重要预测因子，解释了不同加载情况下破坏力差异的70 - 90%。研究结果表明，BV和BV/TV可以根据局部骨形态确定最佳螺钉植入位置，有可能改善手术效果并减少术后并发症。该研究有助于更全面地了解骨科螺钉的行为，并为临床应用提供预测模型。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the Mechanical Behavior of Biomedical Materials 工程技术-材料科学：生物材料

CiteScore

7.20

自引率

7.70%

发文量

505

审稿时长

46 days

期刊介绍： The Journal of the Mechanical Behavior of Biomedical Materials is concerned with the mechanical deformation, damage and failure under applied forces, of biological material (at the tissue, cellular and molecular levels) and of biomaterials, i.e. those materials which are designed to mimic or replace biological materials. The primary focus of the journal is the synthesis of materials science, biology, and medical and dental science. Reports of fundamental scientific investigations are welcome, as are articles concerned with the practical application of materials in medical devices. Both experimental and theoretical work is of interest; theoretical papers will normally include comparison of predictions with experimental data, though we recognize that this may not always be appropriate. The journal also publishes technical notes concerned with emerging experimental or theoretical techniques, letters to the editor and, by invitation, review articles and papers describing existing techniques for the benefit of an interdisciplinary readership.