A novel minimally invasive and press‐fit method for symphysiodesis — a biomechanical analysis

Abstract

Purpose Does the cylindrical shaped bone block allow a stable construct for the arthrodesis of the pubic symphysis compared to a rectangular shaped bone block. The cylindrical shaped bone block stabilized by a 3.5 symphyseal plate is inferior to the stabilization with an internal fixator. Methods This study analyzed the arthrodesis of the pubic symphysis on 24 synthetic pelvises, using a rectangular shaped bone block (control group) or a cylindrical shaped bone block, stabilized with a symphysis locking plate (n = 8) as the standard clinical procedure. Additionally we analyzed the stability using an internal fixator. Results This study showed that utilizing a cylindrical shaped synthetic bone graft results in a significant higher contact area and compression force compared to the classical rectangular shaped graft. Furthermore, the stabilization with an internal fixator had the tendency for increases of compression force and contact area, yet without a statistical significance, when compared to the plate fixation. Conclusion The novel method of cylindrical symphysis resection and cylindrical bone block implantation allowed an increased biomechanical stability compared to using a classical rectangular bone graft, also resulting in higher contact area. Moreover, this technique would also allow a minimally invasive approach for this purpose, which in turn could preserve perisymphyseal ligaments, thereby improving healing in a clinical context.

Tratamiento de la osteítis del pubis: artrodesis con nueva técnica a propósito de dos casos y revisión de la literatura

“…Sin embargo, en posición unipodal, la placa SLDCP exhibió un área de contacto mayor con injerto de cilindro, concluyendo que ésta última suponía una opción a tener en cuenta. 15 A pesar de obtener resultados favorables con nuestra técnica de fijación propuesta, otros autores han explorado alternativas que, aunque probadas en modelos cadavéricos, también parecen abordar la patología en sínfisis púbica con éxito. Un reciente estudio que realizaron Calvalcanti y asociados 16 evaluó un innovador método de osteosíntesis con suturas de cinta para tratar estas alteraciones; demostraron estabilidad biomecánica adecuada sin restricciones en la movilidad fisiológica.…”