Biomechanical evaluation of a new system to improve screw fixation in osteoporotic bones

Yáñez, Alejandro J.; Carta, José A.; Garcés, Gerardo L.

doi:10.1016/j.medengphy.2010.02.014

Cited by 27 publications

(31 citation statements)

References 62 publications

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“…Placing screws too closely together may lead to uniting of cracks and extensive regions of bone damage, adding significant complications to revision surgery. Additionally, the techniques presented in this study provide a powerful design tool for the investigation of new materials and screw geometries (Goldhahn et al, 2006;Yá nez et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Cortical bone failure mechanisms during screw pullout

Feerick¹,

McGarry²

2012

Journal of Biomechanics

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Section: Discussionmentioning

confidence: 99%

Cortical bone failure mechanisms during screw pullout

Feerick¹,

McGarry²

2012

Journal of Biomechanics

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“…In the cyclic compression tests, the constructs were subjected to a sinusoidal cyclic load at a frequency of 2 Hz [17,22], between 0 N and 350 N [11,17]. This type of test was characterised by a reference load of 175 N with an alternating load amplitude of 175 N. The displacement and load values obtained by the machine's sensor system were used to determine stiffness.…”

Section: Cyclic Testsmentioning

confidence: 99%

“…To improve NS fixation the use of the so-called screw locking element (SLE), which acts like a lock-nut at the tip of the screw [16,17], has been proposed. Screw pull-out resistance is considerably increased using these SLE, giving stability to the system regardless of bone quality [16].…”

Section: Introductionmentioning

confidence: 99%

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Experimental analysis of the minimally invasive plate osteosynthesis technique applied with non-locking screws and screw locking elements

Yáñez

Cuadrado

Cabrera

et al. 2014

Medical Engineering & Physics

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“…Screw pullout strength is often predicted using pullout tests from bone models such as Sawbones™ (Ramaswamy et al, 2010;Flahiff et al, 1995;Yánez et al, 2010;Augat et al, 2002;Brown et al, 2000;Schoenfeld et al, 2008;Patel et al, 2010), and tests reported by Asnis et al (1996) suggest that good agreement is reached in porous foams of various densities. However Chapman et al (1996) found the strength range for the tests in a homogenous Sawbones™ material and those data available for human bone differ considerably.…”

Section: Introductionmentioning

confidence: 99%

Variability of the pullout strength of cancellous bone screws with cement augmentation

Procter

Bennani

Brown

et al. 2015

Clinical Biomechanics

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Background: Orthopaedic surgeons often face clinical situations where improved screw holding power in cancellous bone is needed. Injectable calcium phosphate cements are one option to enhance fixation. Methods: Paired screw pullout tests were undertaken in which human cadaver bone was augmented with calcium phosphate cement. A finite element model was used to investigate sensitivity to screw positional placement. Findings: Statistical analysis of the data concluded that the pullout strength was generally increased by cement augmentation in the in vitro human cadaver tests. However, when comparing the individual paired samples there were surprising results with lower strength than anticipated after augmentation, in apparent contradiction to the generally expected conclusion. Investigation using the finite element model showed that these strength reductions could be accounted for by small screw positional changes. A change of 0.5 mm might result in predicted pullout force changes of up to 28%. Interpretation: Small changes in screw position might lead to significant changes in pullout strength sufficient to explain the lower than expected individual pullout values in augmented cancellous bone. Consequently whilst the addition of cement at a position of low strength would increase the pullout strength at that point, it might not reach the pullout strength of the un-augmented paired test site. However, the overall effect of cement augmentation produces a significant improvement at whatever point in the bone the screw is placed. The use of polymeric bone-substitute materials for tests may not reveal the natural variation encountered in tests using real bone structures.

show abstract

Biomechanical evaluation of a new system to improve screw fixation in osteoporotic bones

Cited by 27 publications

References 62 publications

Cortical bone failure mechanisms during screw pullout

Cortical bone failure mechanisms during screw pullout

Experimental analysis of the minimally invasive plate osteosynthesis technique applied with non-locking screws and screw locking elements

Variability of the pullout strength of cancellous bone screws with cement augmentation

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