A new augmentation method for improved screw fixation in fragile bone
| dc.contributor.author | Raina, Deepak Bushan | |
| dc.contributor.author | Stravinskas, Mindaugas | |
| dc.contributor.author | Markevi?i?t?, Vetra | |
| dc.contributor.author | Kok, Joeri | |
| dc.contributor.author | Jacobson, Ida | |
| dc.contributor.author | Liu, Yang | |
| dc.contributor.author | Sezgin, Erdem Aras | |
| dc.contributor.author | Isaksson, Hanna | |
| dc.contributor.author | Zwingenberger, Stefan | |
| dc.contributor.author | Tägil, Magnus | |
| dc.contributor.author | Tarasevi?ius, Šar?nas | |
| dc.contributor.author | Lidgren, Lars | |
| dc.date.accessioned | 2022-04-11T11:55:10Z | |
| dc.date.available | 2022-04-11T11:55:10Z | |
| dc.date.issued | 2022 | |
| dc.department | Tıp Fakültesi | |
| dc.description.abstract | Pertrochanteric fractures (TF) due to osteoporosis constitute nearly half of all proximal femur fractures. TFs are treated with a surgical approach and fracture fixation is achieved using metallic fixation devices. Poor quality cancellous bone in osteoporotic patients makes anchorage of a fixation device challenging, which can lead to failure of the fracture fixation. Methods to reinforce the bone-implant interface using bone cement (PMMA) and other calcium phosphate cements in TFs have been described earlier but a clear evidence on the advantage of using such biomaterials for augmentation is weak. Furthermore, there is no standardized technique for delivering these biomaterials at the bone-implant interface. In this study, we firstly describe a method to deliver a calcium sulphate/hydroxyapatite (CaS/HA) based biomaterial for the augmentation of a lag-screw commonly used for TF fixation. We then used an osteoporotic Sawbones model to study the consequence of CaS/HA augmentation on the immediate mechanical anchorage of the lag-screw to osteoporotic bone. Finally, as a proof-of-concept, the method of delivering the CaS/HA biomaterial at the bone-implant interface as well as spreading of the CaS/HA material at this interface was tested in patients undergoing treatment for TF as well as in donated femoral heads. The mechanical testing results indicated that the CaS/HA based biomaterial increased the peak extraction force of the lag-screw by 4 times compared with un-augmented lag-screws and the results were at par with PMMA. The X-ray images from the patient series showed that it was possible to inject the CaS/HA material at the bone-implant interface without applying additional pressure and the CaS/HA material spreading was observed at the interface of the lag-screw threads and the bone. Finally, the spreading of the CaS/HA material was also verified on donated femoral heads and micro-CT imaging indicated that the entire length of the lag-screw threads was covered with the CaS/HA biomaterial. In conclusion, we present a novel method for augmenting a lag-screw in TFs, which could potentially reduce the risk of fracture fixation failure and reoperation in fragile osteoporotic patients. | |
| dc.identifier.doi | 10.3389/fbioe.2022.816250 | |
| dc.identifier.endpage | - | en_US |
| dc.identifier.issn | 2296-4185 | |
| dc.identifier.issue | - | en_US |
| dc.identifier.pmid | 35309986 | |
| dc.identifier.scopusquality | Q1 | |
| dc.identifier.startpage | - | en_US |
| dc.identifier.uri | https:/dx.doi.org/10.3389/fbioe.2022.816250 | |
| dc.identifier.uri | https://hdl.handle.net/20.500.12451/9277 | |
| dc.identifier.volume | 10 | en_US |
| dc.identifier.wos | WOS:000773024800001 | |
| dc.identifier.wosquality | Q1 | |
| dc.indekslendigikaynak | Web of Science | |
| dc.indekslendigikaynak | Scopus | |
| dc.indekslendigikaynak | PubMed | |
| dc.language.iso | en | |
| dc.publisher | Frontiers Media S.A. | |
| dc.relation.ispartof | Frontiers in Bioengineering and Biotechnology | |
| dc.relation.publicationcategory | Makale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı | |
| dc.rights | info:eu-repo/semantics/openAccess | |
| dc.subject | Biomaterial | |
| dc.subject | Hip Fracture | |
| dc.subject | Implant Augmentation | |
| dc.subject | Implant Integration | |
| dc.subject | Osteoporosis | |
| dc.title | A new augmentation method for improved screw fixation in fragile bone | |
| dc.type | Article |
