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Augmenting a dynamic hip screw with a calcium sulfate/hydroxyapatite biomaterial

Kok, Joeri LU orcid ; Širka, Aurimas ; Liu, Yang LU ; Tarasevičius, Šarūnas LU ; Belickas, Juozas ; Tägil, Magnus LU ; Lidgren, Lars LU ; Isaksson, Hanna LU orcid and Raina, Deepak Bushan LU (2021) In Medical Engineering and Physics 92. p.102-109
Abstract

Internal fixation failure in hip fractures can lead to reoperation. Calcium sulfate/hydroxyapatite (CaS/HA) is a biomaterial that can be used for augmenting fracture fixation. We aimed to determine whether an injection of 2 ml CaS/HA increases the fixation of a dynamic hip screw inserted in synthetic and human trabecular bone. The study consists of two parts: 1) synthetic bone blocks (n = 74), with three subgroups: empty (cannulated screw, no injection), cannulated, and fenestrated; and 2) osteoporotic human femoral heads (n = 29), with the same subgroups. The heads were imaged using µCT. Bone volume fraction, insertion angle, and head diameter were measured. Pullout tests were performed and peak force, stiffness, and work were... (More)

Internal fixation failure in hip fractures can lead to reoperation. Calcium sulfate/hydroxyapatite (CaS/HA) is a biomaterial that can be used for augmenting fracture fixation. We aimed to determine whether an injection of 2 ml CaS/HA increases the fixation of a dynamic hip screw inserted in synthetic and human trabecular bone. The study consists of two parts: 1) synthetic bone blocks (n = 74), with three subgroups: empty (cannulated screw, no injection), cannulated, and fenestrated; and 2) osteoporotic human femoral heads (n = 29), with the same subgroups. The heads were imaged using µCT. Bone volume fraction, insertion angle, and head diameter were measured. Pullout tests were performed and peak force, stiffness, and work were measured. The fenestrated group showed increases in pullout strength compared to no injection in the synthetic blocks. The cannulated group showed a higher pullout strength in low-density blocks. In the femoral heads, the variation was larger and there were no significant differences between groups. The bone volume fraction correlated with the peak force and work, and the insertion angle correlated with the stiffness. CaS/HA can improve the fixation of a dynamic hip screw. For clinical use, spreading of the material around the threads of the screw must be ensured.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bone, Bone cement, Hip fracture, Pullout, Stability
in
Medical Engineering and Physics
volume
92
pages
8 pages
publisher
Elsevier
external identifiers
  • scopus:85107091322
  • pmid:34167704
ISSN
1350-4533
DOI
10.1016/j.medengphy.2021.05.006
language
English
LU publication?
yes
id
2cc50a90-95e2-4530-81b9-804a2cac8609
date added to LUP
2021-06-22 14:51:41
date last changed
2024-06-15 12:48:24
@article{2cc50a90-95e2-4530-81b9-804a2cac8609,
  abstract     = {{<p>Internal fixation failure in hip fractures can lead to reoperation. Calcium sulfate/hydroxyapatite (CaS/HA) is a biomaterial that can be used for augmenting fracture fixation. We aimed to determine whether an injection of 2 ml CaS/HA increases the fixation of a dynamic hip screw inserted in synthetic and human trabecular bone. The study consists of two parts: 1) synthetic bone blocks (n = 74), with three subgroups: empty (cannulated screw, no injection), cannulated, and fenestrated; and 2) osteoporotic human femoral heads (n = 29), with the same subgroups. The heads were imaged using µCT. Bone volume fraction, insertion angle, and head diameter were measured. Pullout tests were performed and peak force, stiffness, and work were measured. The fenestrated group showed increases in pullout strength compared to no injection in the synthetic blocks. The cannulated group showed a higher pullout strength in low-density blocks. In the femoral heads, the variation was larger and there were no significant differences between groups. The bone volume fraction correlated with the peak force and work, and the insertion angle correlated with the stiffness. CaS/HA can improve the fixation of a dynamic hip screw. For clinical use, spreading of the material around the threads of the screw must be ensured.</p>}},
  author       = {{Kok, Joeri and Širka, Aurimas and Liu, Yang and Tarasevičius, Šarūnas and Belickas, Juozas and Tägil, Magnus and Lidgren, Lars and Isaksson, Hanna and Raina, Deepak Bushan}},
  issn         = {{1350-4533}},
  keywords     = {{Bone; Bone cement; Hip fracture; Pullout; Stability}},
  language     = {{eng}},
  pages        = {{102--109}},
  publisher    = {{Elsevier}},
  series       = {{Medical Engineering and Physics}},
  title        = {{Augmenting a dynamic hip screw with a calcium sulfate/hydroxyapatite biomaterial}},
  url          = {{http://dx.doi.org/10.1016/j.medengphy.2021.05.006}},
  doi          = {{10.1016/j.medengphy.2021.05.006}},
  volume       = {{92}},
  year         = {{2021}},
}