Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Department of Engineering and Physics, Harding University, Searcy, AR, USA.
Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
J Mech Behav Biomed Mater. 2021 Mar;115:104263. doi: 10.1016/j.jmbbm.2020.104263. Epub 2020 Dec 11.
Core decompression is a minimally invasive surgical technique used to treat patients with avascular necrosis of the femoral head. The procedure requires an entry hole in the lateral cortex of the femur which potentially leaves patients susceptible to subtrochanteric fractures. The purpose of this study was to determine if filling the core decompression tract with synthetic bone-graft mechanically strengthens the proximal femur. Twenty composite synthetic femurs underwent a core decompression procedure; ten were augmented with synthetic bone-graft (PRO-DENSE™, Wright Medical) and ten femurs were left unfilled as a control group. Compressive testing to failure was performed using a mechanical testing machine. Stiffness, fracture load, and toughness did not significantly differ between groups. More subtrochanteric fractures were seen in the control group (6 of 10 specimens) compared to the bone-graft augmented group (2 of 10 specimens). In conclusion, augmentation of a core decompression tract does not improve mechanical properties in a synthetic bone model but may be protective of subtrochanteric fracture.
核心减压术是一种微创外科技术，用于治疗股骨头缺血性坏死患者。该手术需要在股骨外侧皮质上开一个入口孔，这可能使患者容易发生转子下骨折。本研究的目的是确定用合成骨移植物填充核心减压通道是否能使股骨近端机械强化。20 个复合合成股骨接受了核心减压手术；其中 10 个用合成骨移植物（PRO-DENSE™， Wright Medical）增强，10 个股骨作为对照组不填充。使用机械试验机进行抗压至失效测试。两组间的刚度、骨折载荷和韧性没有显著差异。与骨移植物增强组（10 个标本中有 2 个）相比，对照组（10 个标本中有 6 个）出现更多的转子下骨折。总之，在合成骨模型中，核心减压通道的增强并不能改善力学性能，但可能对转子下骨折有保护作用。
