Norian SRS cement augmentation in hip fracture treatment. Laboratory and initial clinical results.
Bone quality, initial fracture displacement, severity of fracture comminution, accuracy of fracture reduction, and the placement of the internal fixation device are important factors that affect fixation stability. New high strength cements that are susceptible to remodeling and replacement for fracture fixation may lead to improved clinical outcome in the treatment of hip fractures. Norian SRS is an injectable, fast setting cement that cures in vivo to form an osteoconductive carbonated apatite of high compressive strength (55 MPa) with chemical and physical characteristics similar to the mineral phase of bone. It can be used as a space filling internal fixation device to facilitate the geometric reconstruction, load transfer, and healing of bone with defects and/or fractures in regions of cancellous bone. Furthermore, this cement can improve the mechanical holding strength of conventional fixation devices. Use of this material potentially could improve fracture stability, retain anatomy during fracture healing and improve hip function, thus achieving better clinical outcomes. In vivo animal studies have shown the material's biocompatibility, and cadaveric studies have shown the biomechanical advantage of its use in hip fractures. Initial clinical experience (in 52 femoral neck fractures and 39 intertrochanteric fractures) showed the potential clinical use of this innovative cement in the treatment of hip fractures.
Goodman
S B
SB
Division of Orthopaedic Surgery, Stanford University School of Medicine, CA 94305-5341, USA.
Bauer
T W
TW
Carter
D
D
Casteleyn
P P
PP
Goldstein
S A
SA
Kyle
R F
RF
Larsson
S
S
Stankewich
C J
CJ
Swiontkowski
M F
MF
Tencer
A F
AF
Yetkinler
D N
DN
Poser
R D
RD
D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001031:Apatites / Q000737:chemistry; D001672:Biocompatible Materials / Q000737:chemistry; D001843:Bone Cements / Q000737:chemistry; D001863:Bone Screws; D002102:Cadaver; D002484:Cementation; D055598:Chemical Phenomena; D002627:Chemistry, Physical; D019245:Compressive Strength; D004285:Dogs; D004735:Energy Transfer; D005260:Female; D005265:Femoral Neck Fractures / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D017102:Fracture Healing; D018460:Fractures, Comminuted / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D006620:Hip Fractures / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010012:Osteogenesis; D012756:Sheep; D013314:Stress, Mechanical; D016896:Treatment Outcome
D001031:Apatites; D001672:Biocompatible Materials; D001843:Bone Cements; C030782:carboapatite