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Poor relation between biomechanical and clinical studies for the proximal femoral locking compression plate : A systematic review

Viberg, Bjarke; Rasmussen, Katrine M V; Overgaard, Søren and Rogmark, Cecilia LU (2017) In Acta Orthopaedica
Abstract

Background and purpose — The proximal femur locking compression plate (PF-LCP) is a new concept in the treatment of hip fractures. When releasing new implants onto the market, biomechanical studies are conducted to evaluate performance of the implant. We investigated the relation between biomechanical and clinical studies on PF-LCP. Methods — A systematic literature search of relevant biomechanical and clinical studies was conducted in PubMed on December 1, 2015. 7 biomechanical studies and 15 clinical studies were included. Results — Even though the biomechanical studies showed equivalent or higher failure loads for femoral neck fracture, the clinical results were far worse, with a 37% complication rate. There were no biomechanical... (More)

Background and purpose — The proximal femur locking compression plate (PF-LCP) is a new concept in the treatment of hip fractures. When releasing new implants onto the market, biomechanical studies are conducted to evaluate performance of the implant. We investigated the relation between biomechanical and clinical studies on PF-LCP. Methods — A systematic literature search of relevant biomechanical and clinical studies was conducted in PubMed on December 1, 2015. 7 biomechanical studies and 15 clinical studies were included. Results — Even though the biomechanical studies showed equivalent or higher failure loads for femoral neck fracture, the clinical results were far worse, with a 37% complication rate. There were no biomechanical studies on pertrochanteric fractures. Biomechanical studies on subtrochanteric fractures showed that PF-LCP had a lower failure load than with proximal femoral nail, but higher than with angled blade plate. 4 clinical studies had complication rates less than 8% and 9 studies had complication rates between 15% and 53%. Interpretation — There was no clear relation between biomechanical and clinical studies. Biomechanical studies are generally inherently different from clinical studies, as they examine the best possible theoretical use of the implant without considering the long-term outcome in a clinical setting. Properly designed clinical studies are mandatory when introducing new implants, and they cannot be replaced by biomechanical studies.

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author
organization
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type
Contribution to journal
publication status
epub
subject
in
Acta Orthopaedica
pages
7 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85015103427
  • wos:000404588400012
ISSN
1745-3674
DOI
10.1080/17453674.2017.1304207
language
English
LU publication?
yes
id
0bc006c8-8ebc-46d2-a31b-20833f6a121b
date added to LUP
2017-04-03 11:43:30
date last changed
2017-09-18 13:31:17
@article{0bc006c8-8ebc-46d2-a31b-20833f6a121b,
  abstract     = {<p>Background and purpose — The proximal femur locking compression plate (PF-LCP) is a new concept in the treatment of hip fractures. When releasing new implants onto the market, biomechanical studies are conducted to evaluate performance of the implant. We investigated the relation between biomechanical and clinical studies on PF-LCP. Methods — A systematic literature search of relevant biomechanical and clinical studies was conducted in PubMed on December 1, 2015. 7 biomechanical studies and 15 clinical studies were included. Results — Even though the biomechanical studies showed equivalent or higher failure loads for femoral neck fracture, the clinical results were far worse, with a 37% complication rate. There were no biomechanical studies on pertrochanteric fractures. Biomechanical studies on subtrochanteric fractures showed that PF-LCP had a lower failure load than with proximal femoral nail, but higher than with angled blade plate. 4 clinical studies had complication rates less than 8% and 9 studies had complication rates between 15% and 53%. Interpretation — There was no clear relation between biomechanical and clinical studies. Biomechanical studies are generally inherently different from clinical studies, as they examine the best possible theoretical use of the implant without considering the long-term outcome in a clinical setting. Properly designed clinical studies are mandatory when introducing new implants, and they cannot be replaced by biomechanical studies.</p>},
  author       = {Viberg, Bjarke and Rasmussen, Katrine M V and Overgaard, Søren and Rogmark, Cecilia},
  issn         = {1745-3674},
  language     = {eng},
  month        = {03},
  pages        = {7},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica},
  title        = {Poor relation between biomechanical and clinical studies for the proximal femoral locking compression plate : A systematic review},
  url          = {http://dx.doi.org/10.1080/17453674.2017.1304207},
  year         = {2017},
}