Augmenting a dynamic hip screw with a calcium sulfate/hydroxyapatite biomaterial

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Augmenting a dynamic hip screw with a calcium sulfate/hydroxyapatite biomaterial. / Kok, Joeri; Širka, Aurimas; Liu, Yang; Tarasevičius, Šarūnas; Belickas, Juozas; Tägil, Magnus; Lidgren, Lars; Isaksson, Hanna; Raina, Deepak Bushan.

In: Medical Engineering and Physics, Vol. 92, 06.2021, p. 102-109.

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TY - JOUR

T1 - Augmenting a dynamic hip screw with a calcium sulfate/hydroxyapatite biomaterial

AU - Kok, Joeri

AU - Širka, Aurimas

AU - Liu, Yang

AU - Tarasevičius, Šarūnas

AU - Belickas, Juozas

AU - Tägil, Magnus

AU - Lidgren, Lars

AU - Isaksson, Hanna

AU - Raina, Deepak Bushan

PY - 2021/6

Y1 - 2021/6

N2 - Internal fixation failure in hip fractures can lead to reoperation. Calcium sulfate/hydroxyapatite (CaS/HA) is a biomaterial that can be used for augmenting fracture fixation. We aimed to determine whether an injection of 2 ml CaS/HA increases the fixation of a dynamic hip screw inserted in synthetic and human trabecular bone. The study consists of two parts: 1) synthetic bone blocks (n = 74), with three subgroups: empty (cannulated screw, no injection), cannulated, and fenestrated; and 2) osteoporotic human femoral heads (n = 29), with the same subgroups. The heads were imaged using µCT. Bone volume fraction, insertion angle, and head diameter were measured. Pullout tests were performed and peak force, stiffness, and work were measured. The fenestrated group showed increases in pullout strength compared to no injection in the synthetic blocks. The cannulated group showed a higher pullout strength in low-density blocks. In the femoral heads, the variation was larger and there were no significant differences between groups. The bone volume fraction correlated with the peak force and work, and the insertion angle correlated with the stiffness. CaS/HA can improve the fixation of a dynamic hip screw. For clinical use, spreading of the material around the threads of the screw must be ensured.

AB - Internal fixation failure in hip fractures can lead to reoperation. Calcium sulfate/hydroxyapatite (CaS/HA) is a biomaterial that can be used for augmenting fracture fixation. We aimed to determine whether an injection of 2 ml CaS/HA increases the fixation of a dynamic hip screw inserted in synthetic and human trabecular bone. The study consists of two parts: 1) synthetic bone blocks (n = 74), with three subgroups: empty (cannulated screw, no injection), cannulated, and fenestrated; and 2) osteoporotic human femoral heads (n = 29), with the same subgroups. The heads were imaged using µCT. Bone volume fraction, insertion angle, and head diameter were measured. Pullout tests were performed and peak force, stiffness, and work were measured. The fenestrated group showed increases in pullout strength compared to no injection in the synthetic blocks. The cannulated group showed a higher pullout strength in low-density blocks. In the femoral heads, the variation was larger and there were no significant differences between groups. The bone volume fraction correlated with the peak force and work, and the insertion angle correlated with the stiffness. CaS/HA can improve the fixation of a dynamic hip screw. For clinical use, spreading of the material around the threads of the screw must be ensured.

KW - Bone

KW - Bone cement

KW - Hip fracture

KW - Pullout

KW - Stability

U2 - 10.1016/j.medengphy.2021.05.006

DO - 10.1016/j.medengphy.2021.05.006

M3 - Article

C2 - 34167704

AN - SCOPUS:85107091322

VL - 92

SP - 102

EP - 109

JO - Medical Engineering and Physics

JF - Medical Engineering and Physics

SN - 1873-4030

ER -