Sangroungrai Atiwich, Atipiboonsin Vorawit, Sukhonthamarn Kamolsak, Twinprai Nattaphon, Berkban Thewarid, Piyasin Surasith, Laonapakul Teerawat, Phruetthiphat Ong-Art, Apinyankul Rit
Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
Arthroplasty. 2025 Sep 25;7(1):47. doi: 10.1186/s42836-025-00331-0.
Intraoperative periprosthetic femur fracture is a serious complication in hip arthroplasty, affecting patient outcomes. This study explored the biomechanical properties of the proximal femur, specifically comparing prophylactic cerclage wiring to non-wiring techniques using finite element analysis (FEA) and cadaveric biomechanical testing.
A finite element model of the proximal femur was constructed using Ansys software, allowing systematic assessment of both wiring area and technique to identify biomechanically optimal locations and configurations for cerclage placement. Twenty fresh cadaveric femurs were prepared according to standard protocols; the left femurs received cerclage wiring, while the right served as controls. Each femur was fitted with a femoral stem and tested under axial loading until catastrophic failure. Outcomes measured included ultimate load, seating load, subsidence distance, and energy absorption. Statistical analysis included the Shapiro-Wilk test for normality and independent t-tests for group comparisons.
The wiring group demonstrated comparable biomechanical performance to the non-wiring group across all measured parameters. Energy absorption was similar between groups (41.9 ± 18.1 Nm vs. 41.0 ± 19.1 Nm, P = 0.918). No significant differences were observed in ultimate load (7.6 ± 2.1 kN vs. 7.7 ± 2.0 kN, P = 0.901) or seating load (3.1 ± 0.7 kN vs. 3.4 ± 1.4 kN, P = 0.589). Similarly, subsidence distance showed no intergroup difference (7.7 ± 2.6 mm vs. 7.7 ± 3.8 mm, P = 0.978).
Cerclage femoral wiring for prophylactic purposes during hip arthroplasty does not confer a significant biomechanical advantage over non-wiring techniques.
术中假体周围股骨骨折是髋关节置换术中的一种严重并发症，会影响患者的预后。本研究探讨了股骨近端的生物力学特性，特别是使用有限元分析（FEA）和尸体生物力学测试，将预防性环扎钢丝与非环扎技术进行比较。
使用Ansys软件构建股骨近端的有限元模型，以便系统评估环扎区域和技术，以确定环扎放置的生物力学最佳位置和配置。按照标准方案准备20根新鲜尸体股骨；左侧股骨接受环扎钢丝固定，右侧作为对照。每根股骨安装一个股骨柄，并在轴向载荷下进行测试，直至发生灾难性失效。测量的结果包括极限载荷、就位载荷、下沉距离和能量吸收。统计分析包括用于正态性检验的Shapiro-Wilk检验和用于组间比较的独立t检验。
在所有测量参数方面，环扎组与非环扎组的生物力学性能相当。两组之间的能量吸收相似（41.9±18.1 Nm对41.0±19.1 Nm，P = 0.918）。在极限载荷（7.6±2.1 kN对7.7±2.0 kN，P = 0.901）或就位载荷（3.1±0.7 kN对3.4±1.4 kN，P = 0.589）方面未观察到显著差异。同样，下沉距离在组间也没有差异（7.7±2.6 mm对7.7±3.8 mm，P = 0.978）。
髋关节置换术中预防性使用环扎钢丝固定股骨，与非环扎技术相比，在生物力学方面没有显著优势。
