Cementless long-stem fixation in periprosthetic clamshell fracture: a biomechanical investigation.

IF 4.3 3区 工程技术 Q1 BIOTECHNOLOGY & APPLIED MICROBIOLOGY
Frontiers in Bioengineering and Biotechnology Pub Date : 2025-05-22 eCollection Date: 2025-01-01 DOI:10.3389/fbioe.2025.1604441
Lingqi Zhu, Li Xie, Mingchang He, Jianyun Miao, Liang Zhou, Lianshui Huang, Hui Liu, Wei Xie, Wenliang Zhai
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引用次数: 0

Abstract

Objective: To investigate the biomechanical strength of cementless long-stem fixation for the treatment of periprosthetic clamshell fracture.

Methods: Eighteen Sawbones artificial femur models were used and divided into three groups. Group A had an intact medial wall. Group B, the proximal periprosthetic femoral medial wall was osteotomized to simulate periprosthetic clamshell fractures. Group C, following identical osteotomy to Group B, cerclage wiring was applied to fix the medial wall fracture fragment. After molding, the cementless long-stem were implanted in all models, which were then evaluated through axial compression tests, torsion tests, and axial failure tests. The axial stiffness, axial displacement, torsional stiffness, torque, and maximum failure load were recorded and statistically analyzed.

Results: In the axial compression tests, no statistically significant differences were observed among Groups A, B, and C in terms of axial displacement, axial stiffness, or maximum failure load (the displacement greater than 3 mm). However, in the torsional tests, Group B showed significantly lower torsional stiffness or torque compared to Groups A and C (p < 0.05). No significant differences in torsional stiffness or torque were detected between Groups A and C.

Conclusion: The integrity of the femoral medial wall is crucial for femoral stem stability. In case of medial wall fracture, while cementless long-stem implantation can achieve satisfactory axial stability, its torsional stability remains inadequate. The application of supplemental cerclage wiring for medial wall fragment fixation provides reliable improvement in torsional stability of the stem.

假体周围翻盖骨折无骨水泥长柄固定:生物力学研究。
目的:探讨无骨水泥长柄内固定治疗假体周围翻盖骨折的生物力学强度。方法:采用锯骨人工股骨模型18只,分为3组。A组内侧壁完整。B组,近端假体周围股骨内侧壁截骨,模拟假体周围蛤状骨折。C组采用与B组相同的截骨术,应用环扎钢丝固定内侧壁骨折碎片。成型后,将无水泥长柄植入所有模型,通过轴向压缩试验、扭转试验和轴向破坏试验对模型进行评估。记录轴向刚度、轴向位移、扭转刚度、扭矩和最大失效载荷并进行统计分析。结果:在轴压试验中,A、B、C组在轴向位移、轴向刚度、最大破坏载荷(位移大于3mm)方面无统计学差异。然而,在扭转试验中,B组的扭转刚度或扭矩明显低于A组和C组(p < 0.05)。A组和c组在扭转刚度和扭矩方面无显著差异。结论:股内侧壁的完整性对股骨干的稳定性至关重要。在内侧壁骨折情况下,无骨水泥长柄植入虽然可以获得满意的轴向稳定性,但其扭转稳定性仍然不足。应用补充环系钢丝内侧壁碎片固定提供可靠的改善扭转稳定的干。
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
Frontiers in Bioengineering and Biotechnology
Frontiers in Bioengineering and Biotechnology Chemical Engineering-Bioengineering
CiteScore
8.30
自引率
5.30%
发文量
2270
审稿时长
12 weeks
期刊介绍: The translation of new discoveries in medicine to clinical routine has never been easy. During the second half of the last century, thanks to the progress in chemistry, biochemistry and pharmacology, we have seen the development and the application of a large number of drugs and devices aimed at the treatment of symptoms, blocking unwanted pathways and, in the case of infectious diseases, fighting the micro-organisms responsible. However, we are facing, today, a dramatic change in the therapeutic approach to pathologies and diseases. Indeed, the challenge of the present and the next decade is to fully restore the physiological status of the diseased organism and to completely regenerate tissue and organs when they are so seriously affected that treatments cannot be limited to the repression of symptoms or to the repair of damage. This is being made possible thanks to the major developments made in basic cell and molecular biology, including stem cell science, growth factor delivery, gene isolation and transfection, the advances in bioengineering and nanotechnology, including development of new biomaterials, biofabrication technologies and use of bioreactors, and the big improvements in diagnostic tools and imaging of cells, tissues and organs. In today`s world, an enhancement of communication between multidisciplinary experts, together with the promotion of joint projects and close collaborations among scientists, engineers, industry people, regulatory agencies and physicians are absolute requirements for the success of any attempt to develop and clinically apply a new biological therapy or an innovative device involving the collective use of biomaterials, cells and/or bioactive molecules. “Frontiers in Bioengineering and Biotechnology” aspires to be a forum for all people involved in the process by bridging the gap too often existing between a discovery in the basic sciences and its clinical application.
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