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Biomechanical in vitro examination of a standardized low-volume tubular femoroplasty

  • Background Osteoporosis is associated with the risk of fractures near the hip. Age and comorbidities increase the perioperative risk. Due to the ageing population, fracture of the proximal femur also proves to be a socio-economic problem. Preventive surgical measures have hardly been used so far. Methods 10 pairs of human femora from fresh cadavers were divided into control and low-volume femoroplasty groups and subjected to a Hayes fall-loading fracture test. The results of the respective localization and classification of the fracture site, the Singh index determined by computed tomography (CT) examination and the parameters in terms of fracture force, work to fracture and stiffness were evaluated statistically and with the finite element method. In addition, a finite element parametric study with different position angles and variants of the tubular geometry of the femoroplasty was performed. Findings Compared to the control group, the work to fracture could be increased by 33.2%. The fracture force increased by 19.9%. The used technique and instrumentation proved to be standardized and reproducible with an average poly(methyl methacrylate) volume of 10.5 ml. The parametric study showed the best results for the selected angle and geometry. Interpretation The cadaver studies demonstrated the biomechanical efficacy of the low-volume tubular femoroplasty. The numerical calculations confirmed the optimal choice of positioning as well as the inner and outer diameter of the tube in this setting. The standardized minimally invasive technique with the instruments developed for it could be used in further comparative studies to confirm the measured biomechanical results.

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Metadaten
Author:Andreas HorbachORCiD, Manfred StaatORCiD, Daniel Perez-Viana, Hans-Peter Simmen, Valentin Neuhaus, Hans-Christoph Pape, Andreas Prescher, Bernhard Ciritsis
DOI:https://doi.org/10.1016/j.clinbiomech.2020.105104
Parent Title (English):Clinical Biomechanics
Publisher:Elsevier
Place of publication:Amsterdam
Document Type:Article
Language:English
Year of Completion:2020
Date of the Publication (Server):2020/07/20
Volume:80
Issue:Art. 105104
Link:https://doi.org/10.1016/j.clinbiomech.2020.105104
Zugriffsart:bezahl
Institutes:FH Aachen / Fachbereich Medizintechnik und Technomathematik
FH Aachen / IfB - Institut für Bioengineering
collections:Verlag / Elsevier