Concepts and Potential Future Developments for Treatment of Periprosthetic Proximal Femoral Fractures

Brand, Stephan; Ettinger, Max; Omar, Mohamed; Hawi, Nael; Krettek, Christian; Petri, Maximilian

doi:10.2174/1874325001509010405

Cited by 12 publications

(14 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Most of the biomechanical studies still concentrate on Vancouver type B1 fractures, with no studies conducted on Vancouver type A; and only one experimental and one computational study (Walcher et al, 2016;Moazen et al, 2012;) on Vancouver type C fractures. This may be due to the fact they are clinically less prevalent, and more easily treated (Brand et al, 2015;Capone et al, 2017;Fleischman and Chen, 2015;Lever et al, 2010). Vancouver type B2 and B3 fractures are more challenging to conduct experimentally, with some studies using a fracture gap to mimic an unstable fracture (Choi et al, 2010;Giesinger et al, 2014;Graham et al, 2015;Griffiths et al, 2015;Konstantinidis et al, 2010;Lochab et al, 2017;Sariyilmaz et al, 2014;Shah et al, 2011;Wähnert et al, 2014Wähnert et al, , 2017.…”

Section: Discussionmentioning

confidence: 99%

Periprosthetic fracture fixation of the femur following total hip arthroplasty: A review of biomechanical testing – Part II

Wang

Kenanidis

Miodownik

et al. 2019

Clinical Biomechanics

View full text Add to dashboard Cite

Background: Periprosthetic femoral fracture is a severe complication of total hip arthroplasty. A previous review published in 2011 summarised the biomechanical studies regarding periprosthetic femoral fracture and its fixation techniques. Since then, there have been several commercially available fracture plates designed specifically for the treatment of these fractures. However, several clinical studies still report failure of fixation treatments used for these fractures. Methods: The current literature on biomechanical models of periprosthetic femoral fracture fixation since 2010 to present is reviewed. The methodologies involved in the experimental and computational studies of periprosthetic femoral fracture fixation are described and compared with particular focus on the recent developments. Findings: Several issues raised in the previous review paper have been addressed by current studies; such as validating computational results with experimental data. Current experimental studies are more sophisticated in design. Computational studies have been useful in studying fixation methods or conditions (such as bone healing) that are difficult to study in vivo or in vitro. However, a few issues still remain and are highlighted. Interpretation: The increased use of computational studies in investigating periprosthetic femoral fracture fixation techniques has proven valuable. Existing protocols for testing periprosthetic femoral fracture fixation need to be standardised in order to make more direct and conclusive comparisons between studies. A consensus on the 'optimum' treatment method for periprosthetic femoral fracture fixation needs to be achieved.

show abstract

Section: Discussionmentioning

confidence: 99%

Periprosthetic fracture fixation of the femur following total hip arthroplasty: A review of biomechanical testing – Part II

Wang

Kenanidis

Miodownik

et al. 2019

Clinical Biomechanics

View full text Add to dashboard Cite

show abstract

“…But due to a continuously increasing number of primary hip arthroplasties, the incidence of periprosthetic fractures is also increasing [3]. At present, up to 4-5 % of all patients with implanted primary hip arthroplasties will suffer from a periprosthetic fracture at least once in their life, most commonly caused by a fall on the implanted hip [1,4]. Main reasons for these periprosthetic fractures are implant loosening, alteration of the femur's physiological properties and increasing patient's age [2,4].…”

Section: Introductionmentioning

confidence: 99%

“…1). For surgical decision-making, the Vancouver classification has been proven most useful, and it is widely in use [1,4]. The Vancouver B1 periprosthetic femoral fracture (tab.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical analysis of tension-compression asymmetry, anisotropy and heterogeneity of bone reconstruction in response to periprosthetic fracture repair

2019

The Journal of v. N. Karazin Kharkiv National University, Series "Medicine"

View full text Add to dashboard Cite

Introduction. Bone repair after periprosthetic fracture is a critical issue in orthopedics. Objectives. So there is a need for research to provide new medical solutions, especially in the context of population ageing in the Ukraine. The importance of biomechanics which is concerned with the application of principles, concepts and methods of mechanics of solid and fluid to the human body in motion and at rest is well recognized as a foundation for further experimental and theoretical research in the skeletal tissues. Materials and methods. Different aspects of biomechanics require different concepts and methods of mechanics of solid and fluid to be used. Remodeling occurs significantly throughout lifetime of bone that is why it can be regarded as a primary determinant of the mechanical properties of bone and implant. Biomechanical analysis given in this review has been concerned with understanding on how mechanical signals and molecular mechanisms affect the healing of Vancouver periprosthetic femoral fracture of B1 and C-type with the use of internal fixation through a less invasive stabilization system (LISS)-plate, which is screwed into the artificial hip joint. Results. Identification of such parameters as mechanical properties of bone, titanium alloys (hip prosthesis, coating, LISS-plate, screws) and implant/biomaterial interface with bone under mechanical and biochemical loading that are very essential for predicting arthroplasty outcomes were investigated experimentally considering elastoplastic deformation, creep, fatigue and ratcheting, as well as, damage development in materials under discussion. Among the basic deformation features were tension-compression asymmetry, anisotropy and heterogeneity of mechanical properties. We used the three-dimensional finite element model derived from the reconstruction of treatment and magnetic resonance (tomographic) images. Conclusions. As a result of this model analysis, it was found that treatment rate of periprosthetic femoral fractures after total hip arthroplasty with the use of LISS-plates and screws for internal fixation may be controlled by means of ABAQUS (or ANSYS) software package to reproduce the characteristic features of bone and implant in bone reconstruction in order to improve the fracture healing rate and shorten treatment duration Introduction. Bone repair after periprosthetic fracture is a critical issue in orthopedics. Objectives. So there is a need for research to provide new medical solutions, especially in the context of population ageing in the Ukraine. The importance of biomechanics which is concerned with the application of principles, concepts and methods of mechanics of solid and fluid to the human body in motion and at rest is well recognized as a foundation for further experimental and theoretical research in the skeletal tissues. Materials and methods. Different aspects of biomechanics require different concepts and methods of mechanics of solid and fluid to be used. Remodeling occurs significantly throughout lifetime of bone that is why it can be regarded as a primary determinant of the mechanical properties of bone and implant. Biomechanical analysis given in this review has been concerned with understanding on how mechanical signals and molecular mechanisms affect the healing of Vancouver periprosthetic femoral fracture of B1 and C-type with the use of internal fixation through a less invasive stabilization system (LISS)-plate, which is screwed into the artificial hip joint. Results. Identification of such parameters as mechanical properties of bone, titanium alloys (hip prosthesis, coating, LISS-plate, screws) and implant/biomaterial interface with bone under mechanical and biochemical loading that are very essential for predicting arthroplasty outcomes were investigated experimentally considering elastoplastic deformation, creep, fatigue and ratcheting, as well as, damage development in materials under discussion. Among the basic deformation features were tension-compression asymmetry, anisotropy and heterogeneity of mechanical properties. We used the three-dimensional finite element model derived from the reconstruction of treatment and magnetic resonance (tomographic) images. Conclusions. As a result of this model analysis, it was found that treatment rate of periprosthetic femoral fractures after total hip arthroplasty with the use of LISS-plates and screws for internal fixation may be controlled by means of ABAQUS (or ANSYS) software package to reproduce the characteristic features of bone and implant in bone reconstruction in order to improve the fracture healing rate and shorten treatment duration.

show abstract

“…Inwieweit zusätzlich kortikale Allografts, die an einigen Zentren zur Anwendung kommen, notwendig sind, hängt von der Verfügbarkeit, der Defektsituation, aber auch von der Erfahrung und dem Zugang des Chirurgen ab. Zudem sind diese Allografts kritisch zu bewerten, sie führen zu einer Erhöhung der kortikalen Dicke und erhöhen auch das Infektionsrisiko[20,[50][51][52][53][54][55][56][57][58][59].Mögliche weitere Entwicklungen zur Versorgung von periprothetischen FrakturenSpeziell die periprothetischen Frakturen beim alten Patienten mit Osteoporose, aber stabilen Vancouver-B1-und -C-Frakturen zeigen oft nur eine eierschalenartige, dünne Knochenschicht im Bereich der Prothese. In dieser Situation ist es sehr schwierig, stabile Schrauben zu setzen, Cerclagen alleinwie zuvor ausgeführtsind oft unzureichend.…”

unclassified

“…Das Bohren durch Titan-oder Metallimplantate ist mit großer Wärmeentwicklung verbundenso können Temperaturen von 200°C erreicht werden. Deshalb ist es wichtig, ein Kühlsystem zu entwickeln, um den Temperaturschaden für das umgebende Gewebe so gering wie möglich zu halten[58,59]. Des Weiteren gibt es die Entwicklung von kanülierten zementierbaren Schrauben, ähnlich wie in der Wirbelsäulenchirurgie, um eine verbesserte Fixierung im osteoporotischen Knochen zu erreichen.…”

unclassified

Proximale periprothetische Femurfrakturen: Klassifikation und Therapie

Trieb

Fialka

2016

Z Orthop Unfall

View full text Add to dashboard Cite

Periprosthetic femoral fractures can be categorized into proximal fractures around a hip stem or distally around a knee arthroplasty. This paper focuses on the proximal periprosthetic fractures. It is important to classify the fracture at diagnosis and to perform accurate planning of the surgery. Basically it is necessary to decide if the implant is fixed or loose, in the latter case a revision surgery including the change of the endoprosthesis is neccessary. If the implant is fixed an open reduction and internal fixation can be done. All implants have to be available on site because in the course of the intervention the plan could change. Due to rising numbers of primary arthroplasties and more elderly patients an increase of periprosthetic fractures can be expected. The treatment of periprosthetic fractures is an economic and surgical challenge. It is important to provide competence for these cases concerning both operative techniques and interdisciplinary treatment.

show abstract

Concepts and Potential Future Developments for Treatment of Periprosthetic Proximal Femoral Fractures

Cited by 12 publications

References 43 publications

Periprosthetic fracture fixation of the femur following total hip arthroplasty: A review of biomechanical testing – Part II

Periprosthetic fracture fixation of the femur following total hip arthroplasty: A review of biomechanical testing – Part II

Biomechanical analysis of tension-compression asymmetry, anisotropy and heterogeneity of bone reconstruction in response to periprosthetic fracture repair

Proximale periprothetische Femurfrakturen: Klassifikation und Therapie

Contact Info

Product

Resources

About