Department of Orthopedics, Jena University Hospital, Friedrich-Schiller-University of Jena, Campus Eisenberg, Klosterlausnitzer Straße 81, 07607, Eisenberg, Germany.
Department of Orthopedics, Laboratory of Biomechanics, Jena University Hospital, Friedrich-Schiller-University of Jena, Campus Eisenberg, Klosterlausnitzer Straße 81, 07607, Eisenberg, Germany.
Arch Orthop Trauma Surg. 2020 Jun;140(6):727-734. doi: 10.1007/s00402-019-03284-7. Epub 2019 Nov 6.
The increasing number of geriatric traumatology cases has intensified the need to reliably and objectively evaluate local bone quality, the latter poses a decisive factor for the choice of an optimal approach to treat osteoporotic fractures. Osteodensitometry imaging techniques are not routinely available in acute operative settings, nor do they provide objective information on local bone properties specifically needed for the prognosis of implant stability.
This study sought to verify ex vivo the feasibility and sensitivity of a novel method for the determination of local bone strength in the acute operative setting (intraoperative osseomechanical strength measurement; IOSM) that is based on the principle of material displacement resistance against the force of a rotary indenter. Samples consisted of human femoral heads obtained after total hip replacement. Comparisons were made with results obtained via conventional dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (qCT).
Regression analyses of the results showed a highly significant correlation between the IOSM and the control methods (r = 0.61 and r = 0.56; p < 0.01), indicating that this new approach qualifies as a reliable tool for the intraoperative evaluation of the intrinsic local bone strength.
The intraoperative integration of this method may support surgeon on taking proper decisions in terms of optimal surgical approaches and prevention of complications inherent to osteoporotic bone.
老年创伤学病例的数量不断增加，这使得我们必须能够可靠且客观地评估局部骨质量，而后者是选择治疗骨质疏松性骨折的最佳方法的决定性因素。骨密度成像技术在急性手术环境中并不常用，也无法提供对植入物稳定性预后特别重要的局部骨特性的客观信息。
本研究旨在验证一种新的方法在急性手术环境中（术中骨机械强度测量；IOSM）确定局部骨强度的可行性和敏感性，该方法基于抵抗旋转压头力的材料位移阻力的原理。样本由全髋关节置换术后获得的人股骨头组成。并与传统双能 X 射线吸收法（DXA）和定量计算机断层扫描（qCT）的结果进行了比较。
对结果进行回归分析显示，IOSM 与对照方法高度相关（r=0.61 和 r=0.56；p<0.01），这表明这种新方法是一种可靠的术中评估局部骨固有强度的工具。
术中整合该方法可以支持外科医生根据骨质疏松性骨骼固有的最佳手术方法和预防并发症做出适当的决策。
