Femoroplasty--augmentation of the proximal femur with a composite bone cement--feasibility, biomechanical properties and osteosynthesis potential.
BACKGROUND
Analogous to vertebroplasty, cement-augmentation of the proximal femur ("femoroplasty") could reinforce osteoporotic bones. This study was to evaluate (i) the feasibility of femoroplasty with a composite cement (Cortoss), (ii) its influence on femoral strength by mechanical testing and (iii) the feasibility of stable osteosynthesis of the augmented fractured bones.


METHODS
Nine human cadaveric femora were augmented with a composite bone cement, the surface heat generation monitored, and then tested biomechanically against their native contralateral control to determine fracture strength. Subsequently, thirteen reinforced and fractured femora were osteosynthetized by different implants and tested against their osteosynthetisized, non-augmented contralateral control.


RESULTS
Cement could be injected easily, with a moderate temperature rise. A positive correlation between BMD and fracture load and a significant increase in fracture load (+43%) of the augmented femora compared to their native controls (6324 N and 4430 N, respectively) as well as a significant increase in energy-to-failure (+187%, 86 N m and 30 N m, respectively) was found. Osteosynthesis was possible in cement-augmented femora. Osteosynthetisized femora showed equivalent strength to the intact controls.


CONCLUSIONS
Augmentation of the proximal femur with composite bone cement could be of use in prophylaxis of fractures in osteoporotic femurs. Osteosynthesis of the fractured augmented bones is a challenging procedure but has a good chance to restore strength.
Beckmann
J
J
Orthopaedic Clinic and Policlinic of the University of Regensburg, Asklepios Klinik Bad Abbach, Kaiser-Karl-V-Allee 3, 93077 Bad Abbach, Germany. j.beckmann@asklepios.com
Ferguson
S J
SJ
Gebauer
M
M
Luering
C
C
Gasser
B
B
Heini
P
P
D001696:Biomechanical Phenomena / Q000379:methods; D001843:Bone Cements / Q000737:chemistry* / Q000627:therapeutic use; D019245:Compressive Strength / Q000187:drug effects / Q000502:physiology; D004548:Elasticity; D005240:Feasibility Studies; D005260:Female; D005270:Femur Head / Q000737:chemistry* / Q000187:drug effects / Q000502:physiology*; D006244:Hardness; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D010012:Osteogenesis / Q000187:drug effects / Q000502:physiology*; D013314:Stress, Mechanical; D016474:Weight-Bearing
D001843:Bone Cements