Can plate osteosynthesis of periprosthethic femoral fractures cause cement mantle failure around a stable hip stem? A biomechanical analysis.
Periprosthetic femoral fractures (PFF) are a serious complication after total hip arthroplasty. Plate fixation with screws perforating the cement mantle is a common treatment option. The study objective was to investigate hip stem stability and cement mantle integrity under dynamic loading. A cemented hip stem was implanted in 17 composite femur models. Nine bone models were osteotomised just distal to the stem and fixed with a polyaxial locking plate the other eight constructs served as the control group. All specimens were tested in a bi-axial material testing machine (100000 cycles). There were no statistically significant differences in axial nor in medial (varus) stem migration. No cement cracks were detected in both groups. Plate fixation of a PFF with a stable, cemented prosthesis did not lead to cement mantle failure in this in vitro study.
Department of Orthopaedic Surgery, St. Gallen, Switzerland.
Karlmeinrad
K
Giesinger
Department of Orthopaedic Surgery, St. Gallen, Switzerland.
Lukas
L
Ebneter
Department of Medical Engineering and Physics, Royal Perth Hospital, Perth, Australia.
Robert E
RE
Day
Murdoch Orthopaedic Clinic, Murdoch, Australia.
Karl K
KK
Stoffel
Fremantle University Hospital, Fremantle, Australia.
Piers J
PJ
Yates
Royal Perth Hospital, University of Western Australia, Perth, Australia.
Markus S
MS
Kuster
D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000295:instrumentation; D001696:Biomechanical Phenomena; D001843:Bone Cements; D001860:Bone Plates / Q000009:adverse effects*; D002484:Cementation; D005264:Femoral Fractures / Q000209:etiology / Q000601:surgery*; D005269:Femur / Q000601:surgery; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008954:Models, Biological; D010027:Osteotomy; D057068:Periprosthetic Fractures / Q000209:etiology / Q000601:surgery*; D011475:Prosthesis Failure
D001843:Bone Cements
cement mantle failure; hip stem stability; periprosthetic fracture fixation; polyaxial locking Plate; total hip arthroplasty