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Screw rotation tended to gradually increase to six degrees, after which the screw was grossly loose. Overall, the hollow screw required fewer loading cycles (P = 0.004) and less applied moment (P = 0.003) to achieve the same magnitude of screw rotation as the solid screw. To achieve 6 degrees of screw rotation, the number of loading cycles were 6301 +/- 2161 and 11151 +/- 4221 for hollow and solid screws, respectively. The corresponding applied moments were 3.5 +/- 1.0 Nm and 5.8 +/- 2.0 Nm. CONCLUSION.: The novel hollow screw was less resistant to loosening when compared with a conventional solid pedicle screw in this sacral model under cyclic loading.

Optimal parameters for many orthopaedic implants, such as stem length and material, are unknown. Geometry and mechanical properties of bone can vary greatly amongst cadaveric specimens, requiring a large number of specimens to test design variations. This study aimed to develop an experimental methodology to measure bone strains as a function of multiple implant stem designs in a single specimen, and evaluate its efficacy in the distal ulna. Eight fresh-frozen cadaveric ulnae were each instrumented with 12 uniaxial strain gauges on the medial and lateral surfaces of the bone. The proximal portion of each ulna was cemented in a custom-designed jig that allowed a medially directed force to be applied to the distal articular surface. An implant with a finely threaded stem was cemented into the canal by an experienced upper extremity orthopaedic surgeon. Six loads (5-30 N) were applied sequentially to the lateral surface of the prosthetic head using a materials testing machine. Testing was repeated after breaking the stem-cement bond, and after removing and reinserting the stem several times into the threaded cement mantle. Near the end of the testing period, the initial stem was reinserted and data were collected to determine if there was any change in bone properties or testing setup over time. Finally, a smooth stem was inserted for comparison to the threaded stem. Strain varied linearly with load (R(2)> or =0.99) for all testing scenarios. Bending strains were not affected by breaking the stem-cement bond (P=0.7), testing durations up to 18 h (P=0.7), nor the presence of threads when compared to a smooth stem (P>0.4). Furthermore, for all gauges, there was no interaction between the effect of the threads and level of applied load (P>0.1). This methodology should prove to be useful to compare stem designs of varying lengths and materials in the same bone, allowing for a direct comparison between implant designs for the ulna and other bones subjected primarily to bending loads. Furthermore, it will minimize the need for large numbers of specimens to test multiple implant designs. The ultimate goal of using this protocol is to optimize implant stem properties, such as length and material, with respect to load transfer.