title: Fracture prevention by prophylactic femoroplasty of the proximal femur--metallic compared with cemented augmentation.
abstract: OBJECTIVE
  To compare 2 different femoral neck augmentation techniques at improving the mechanical strength of the femoral neck.
  
  
  METHODS
  Twenty pairs of human cadaveric femora were randomly divided into 2 groups. In 1 group, the femora were augmented with a steel spiral; the other group with the cemented technique. The untreated contralateral side served as an intraindividual control. Fracture strength was evaluated using an established biomechanical testing scenario mimicking a fall on the greater trochanter (Hayes fall).
  
  
  RESULTS
  The peak load to failure was significantly higher in the steel spiral group (P = 0.0024) and in the cemented group (P = 0.001) compared with the intraindividual controls. The peak load to failure showed a median of 3167 N (1825-5230 N) in the spiral group and 2485 N (1066-4395 N) in the spiral control group. The peak load to failure in the cemented group was 3698 N (SD ± 1249 N) compared with 2763 N (SD ± 1335 N) in the cement control group. Furthermore, fracture displacement was clearly reduced in the steel spiral group.
  
  
  CONCLUSIONS
  Femoral augmentations using steel spirals or cement-based femoroplasty are technically feasible procedures. Our results demonstrate that a prophylactic reinforced proximal femur has higher strength when compared with the untreated contralateral limb. Prophylactic augmentation has potential to become an auxiliary treatment option to protect the osteoporotic proximal femur against fracture.
authors.affiliation: *Department of Orthopaedics, University of Regensburg, Asklepios Klinik Bad Abbach, Regensburg, Germany; †Department of Osteology and Biomechanics, University Medical Center, Hamburg-Eppendorf, Germany; ‡ENDO-Klinik, Hamburg, Germany; §Department of Legal Medicine, University Medical Center, Hamburg-Eppendorf, Germany; and ‖Sportklinik Stuttgart, Stuttgart, Germany.
authors.forename: Hans-Robert
authors.initials: HR
authors.lastname: Springorum
authors.forename: Matthias
authors.initials: M
authors.lastname: Gebauer
authors.forename: Alexander
authors.initials: A
authors.lastname: Mehrl
authors.forename: Olaf
authors.initials: O
authors.lastname: Stark
authors.forename: Benjamin
authors.initials: B
authors.lastname: Craiovan
authors.forename: Klaus
authors.initials: K
authors.lastname: Püschel
authors.forename: Michael
authors.initials: M
authors.lastname: Amling
authors.forename: Joachim
authors.initials: J
authors.lastname: Grifka
authors.forename: Johannes
authors.initials: J
authors.lastname: Beckmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials; D002102:Cadaver; D002484:Cementation; D005260:Female; D005265:Femoral Neck Fractures / Q000517:prevention & control* / Q000601:surgery*; D005269:Femur / Q000601:surgery*; D006801:Humans; D008297:Male; D008670:Metals; D019736:Prostheses and Implants
chemical_list: D001672:Biocompatible Materials; D008670:Metals