The role of inter-prosthetic distance, cortical thickness and bone mineral density in the development of inter-prosthetic fractures of the femur: a biomechanical cadaver study
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The role of inter-prosthetic distance, cortical thickness and bone mineral density in the development of inter-prosthetic fractures of the femur: a biomechanical cadaver study. / Weiser, L; Korecki, M A; Sellenschloh, Kay; Fensky, F; Püschel, K; Morlock, M M; Rueger, J M; Lehmann, W.
in: BONE JOINT J, Jahrgang 96-B, Nr. 10, 01.10.2014, S. 1378-84.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - The role of inter-prosthetic distance, cortical thickness and bone mineral density in the development of inter-prosthetic fractures of the femur: a biomechanical cadaver study
AU - Weiser, L
AU - Korecki, M A
AU - Sellenschloh, Kay
AU - Fensky, F
AU - Püschel, K
AU - Morlock, M M
AU - Rueger, J M
AU - Lehmann, W
N1 - ©2014 The British Editorial Society of Bone & Joint Surgery.
PY - 2014/10/1
Y1 - 2014/10/1
N2 - It is becoming increasingly common for a patient to have ipsilateral hip and knee replacements. The inter-prosthetic (IP) distance, the distance between the tips of hip and knee prostheses, has been thought to be associated with an increased risk of IP fracture. Small gap distances are generally assumed to act as stress risers, although there is no real biomechanical evidence to support this. The purpose of this study was to evaluate the influence of IP distance, cortical thickness and bone mineral density on the likelihood of an IP femoral fracture. A total of 18 human femur specimens were randomised into three groups by bone density and cortical thickness. For each group, a defined IP distance of 35 mm, 80 mm or 160 mm was created by choosing the appropriate lengths of component. The maximum fracture strength was determined using a four-point bending test. The fracture force of all three groups was similar (p = 0.498). There was a highly significant correlation between the cortical area and the fracture strength (r = 0.804, p < 0.001), whereas bone density showed no influence. This study suggests that the IP distance has little influence on fracture strength in IP femoral fractures: the thickness of the cortex seems to be the decisive factor.
AB - It is becoming increasingly common for a patient to have ipsilateral hip and knee replacements. The inter-prosthetic (IP) distance, the distance between the tips of hip and knee prostheses, has been thought to be associated with an increased risk of IP fracture. Small gap distances are generally assumed to act as stress risers, although there is no real biomechanical evidence to support this. The purpose of this study was to evaluate the influence of IP distance, cortical thickness and bone mineral density on the likelihood of an IP femoral fracture. A total of 18 human femur specimens were randomised into three groups by bone density and cortical thickness. For each group, a defined IP distance of 35 mm, 80 mm or 160 mm was created by choosing the appropriate lengths of component. The maximum fracture strength was determined using a four-point bending test. The fracture force of all three groups was similar (p = 0.498). There was a highly significant correlation between the cortical area and the fracture strength (r = 0.804, p < 0.001), whereas bone density showed no influence. This study suggests that the IP distance has little influence on fracture strength in IP femoral fractures: the thickness of the cortex seems to be the decisive factor.
KW - Aged
KW - Arthroplasty, Replacement, Hip
KW - Arthroplasty, Replacement, Knee
KW - Biomechanical Phenomena
KW - Bone Density
KW - Cadaver
KW - Female
KW - Femoral Fractures
KW - Femur
KW - Hip Prosthesis
KW - Humans
KW - Knee Prosthesis
KW - Male
KW - Middle Aged
KW - Models, Biological
KW - Osteoporotic Fractures
KW - Prosthesis Failure
KW - Stress, Mechanical
KW - Tomography, X-Ray Computed
U2 - 10.1302/0301-620X.96B10.33461
DO - 10.1302/0301-620X.96B10.33461
M3 - SCORING: Journal article
C2 - 25274925
VL - 96-B
SP - 1378
EP - 1384
JO - BONE JOINT J
JF - BONE JOINT J
SN - 2049-4394
IS - 10
ER -