title: Distal radius plate of CFR-PEEK has minimal effect compared to titanium plates on bone parameters in high-resolution peripheral quantitative computed tomography: a pilot study.
abstract: Carbon-fiber-reinforced poly-ether-ether-ketone (CFR-PEEK) has superior radiolucency compared to other orthopedic implant materials, e.g. titanium or stainless steel, thus allowing metal-artifact-free postoperative monitoring by computed tomography (CT). Recently, high-resolution peripheral quantitative CT (HRpQCT) proved to be a promising technique to monitor the recovery of volumetric bone mineral density (vBMD), micro-architecture and biomechanical parameters in stable conservatively treated distal radius fractures. When using HRpQCT to monitor unstable distal radius fractures that require volar distal radius plating for fixation, radiolucent CFR-PEEK plates may be a better alternative to currently used titanium plates to allow for reliable assessment. In this pilot study, we assessed the effect of a volar distal radius plate made from CFR-PEEK on bone parameters obtained from HRpQCT in comparison to two titanium plates.
  
  
  
  Plates were instrumented in separate cadaveric human fore-arms (n = 3). After instrumentation and after removal of the plates duplicate HRpQCT scans were made of the region covered by the plate. HRpQCT images were visually checked for artifacts. vBMD, micro-architectural and biomechanical parameters were calculated, and compared between the uninstrumented and instrumented radii.
  
  
  
  No visible image artifacts were observed in the CFR-PEEK plate instrumented radius, and errors in bone parameters ranged from -3.2 to 2.6%. In the radii instrumented with the titanium plates, severe image artifacts were observed and errors in bone parameters ranged between -30.2 and 67.0%.
  
  
  
  We recommend using CFR-PEEK plates in longitudinal in vivo studies that monitor the healing process of unstable distal radius fractures treated operatively by plating or bone graft ingrowth.
authors.affiliation: NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands. joost.dejong@maastrichtuniversity.nl.|Department of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands. joost.dejong@maastrichtuniversity.nl.
authors.forename: Joost J A
authors.initials: JJ
authors.lastname: de Jong
authors.affiliation: Department of Anatomy and Embryology, Maastricht University, Maastricht, The Netherlands.
authors.forename: Arno
authors.initials: A
authors.lastname: Lataster
authors.affiliation: Faculty of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
authors.forename: Bert
authors.initials: B
authors.lastname: van Rietbergen
authors.affiliation: Faculty of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.|Department of Orthopedic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.|CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
authors.forename: Jacobus J
authors.initials: JJ
authors.lastname: Arts
authors.affiliation: Department of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands.|CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.|Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
authors.forename: Piet P
authors.initials: PP
authors.lastname: Geusens
authors.affiliation: NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.|Department of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands.|Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.|Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands.
authors.forename: Joop P W
authors.initials: JP
authors.lastname: van den Bergh
authors.affiliation: Department of Orthopedic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.|CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Willems
mesh_terms: D001577:Benzophenones; D015519:Bone Density; D001860:Bone Plates / Q000145:classification*; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D007659:Ketones; D008297:Male; D010865:Pilot Projects; D011092:Polyethylene Glycols; D011108:Polymers; D011884:Radius / Q000503:physiopathology* / Q000601:surgery; D014025:Titanium; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D001577:Benzophenones; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols; D014025:Titanium
keywords: CFR-PEEK; Distal radius; HRpQCT; Implant; Injury/fracture healing