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A New Augmentation Method for Improved Screw Fixation in Fragile Bone.
Raina, Deepak Bushan; Markeviciute, Vetra; Stravinskas, Mindaugas; Kok, Joeri; Jacobson, Ida; Liu, Yang; Sezgin, Erdem Aras; Isaksson, Hanna; Zwingenberger, Stefan; Tägil, Magnus; Tarasevicius, Sarunas; Lidgren, Lars.
Afiliación
  • Raina DB; Department of Clinical Sciences Lund, Orthopedics, The Faculty of Medicine, Lund University, Lund, Sweden.
  • Markeviciute V; Department of Orthopedics and Traumatology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
  • Stravinskas M; Department of Orthopedics and Traumatology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
  • Kok J; Department of Biomedical Engineering, Lund University, Lund, Sweden.
  • Jacobson I; Department of Clinical Sciences Lund, Orthopedics, The Faculty of Medicine, Lund University, Lund, Sweden.
  • Liu Y; Department of Clinical Sciences Lund, Orthopedics, The Faculty of Medicine, Lund University, Lund, Sweden.
  • Sezgin EA; Department of Orthopedics and Traumatology, Faculty of Medicine, Aksaray University, Aksaray, Turkey.
  • Isaksson H; Department of Biomedical Engineering, Lund University, Lund, Sweden.
  • Zwingenberger S; University Hospital Carl Gustav Carus at Technische Universität Dresden, University Center of Orthopedic, Trauma and Plastic Surgery, Dresden, Germany.
  • Tägil M; Department of Clinical Sciences Lund, Orthopedics, The Faculty of Medicine, Lund University, Lund, Sweden.
  • Tarasevicius S; Department of Orthopedics and Traumatology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
  • Lidgren L; Department of Clinical Sciences Lund, Orthopedics, The Faculty of Medicine, Lund University, Lund, Sweden.
Front Bioeng Biotechnol ; 10: 816250, 2022.
Article en En | MEDLINE | ID: mdl-35309986
Pertrochanteric fractures (TF) due to osteoporosis constitute nearly half of all proximal femur fractures. TFs are treated with a surgical approach and fracture fixation is achieved using metallic fixation devices. Poor quality cancellous bone in osteoporotic patients makes anchorage of a fixation device challenging, which can lead to failure of the fracture fixation. Methods to reinforce the bone-implant interface using bone cement (PMMA) and other calcium phosphate cements in TFs have been described earlier but a clear evidence on the advantage of using such biomaterials for augmentation is weak. Furthermore, there is no standardized technique for delivering these biomaterials at the bone-implant interface. In this study, we firstly describe a method to deliver a calcium sulphate/hydroxyapatite (CaS/HA) based biomaterial for the augmentation of a lag-screw commonly used for TF fixation. We then used an osteoporotic Sawbones model to study the consequence of CaS/HA augmentation on the immediate mechanical anchorage of the lag-screw to osteoporotic bone. Finally, as a proof-of-concept, the method of delivering the CaS/HA biomaterial at the bone-implant interface as well as spreading of the CaS/HA material at this interface was tested in patients undergoing treatment for TF as well as in donated femoral heads. The mechanical testing results indicated that the CaS/HA based biomaterial increased the peak extraction force of the lag-screw by 4 times compared with un-augmented lag-screws and the results were at par with PMMA. The X-ray images from the patient series showed that it was possible to inject the CaS/HA material at the bone-implant interface without applying additional pressure and the CaS/HA material spreading was observed at the interface of the lag-screw threads and the bone. Finally, the spreading of the CaS/HA material was also verified on donated femoral heads and micro-CT imaging indicated that the entire length of the lag-screw threads was covered with the CaS/HA biomaterial. In conclusion, we present a novel method for augmenting a lag-screw in TFs, which could potentially reduce the risk of fracture fixation failure and reoperation in fragile osteoporotic patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Front Bioeng Biotechnol Año: 2022 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Front Bioeng Biotechnol Año: 2022 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Suiza