Subchondral fracture caused by unevenly stiffened meniscus after radiofrequency-assisted arthroscopic knee meniscectomy: A case report and review of the literature

Fukui, Kiyokazu; Shioya, Akihiro; Tachi, Yoshiyuki; Yonezawa, Katsutaka; Harai, Hiroaki; Kawahara, Norio

doi:10.1016/j.ijscr.2019.10.049

Cited by 3 publications

(1 citation statement)

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“…Subchondral insu ciency-type stress fracture (SIF) of the femoral head has been suggested as a predominant etiology of RPOH[6, 7,16], but the paucity of information on SIF etiology complicates efforts toward early diagnosis and treatment. Fukui et al suggested a relationship between inversion of the acetabular labrum and subchondral insu ciency fracture with subsequent rapidly progressive hip OA [17][18][19][20]. In that study, inversion of the anterosuperior portion of the labrum was found in 9 patients with RPOH, 8 of whom showed SIF in the anterosuperior portion of the femoral heads beneath the inverted acetabular labrum.…”

Section: Introductionmentioning

confidence: 94%

Inverted Acetabular Labrum Causes Insufficiency-type Stress Fracture of the Femoral Head: A Biomechanical Study

Fukui

Chen

Kaneuji

et al. 2022

Preprint

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Purpose: Subchondral insufficiency-type fracture is associated with rapidly progressive osteoarthritis of the hip, but are these fractures caused by a single load event such as an injury from a fall or by stress (fatigue) from repeated loading during the activities of daily life? Our biomechanical study applied repeated loading to a simulated osteoporotic bone model to investigate the relationship between an inverted acetabular labrum and the incidence of subchondral insufficiency-type fracture of the femoral head.Methods: We performed fatigue load testing on 15 osteoporotic composite femurs, applying 2000 N at 1 Hz, 1 million times or to failure, on 5 composite femurs without silicone rubber and 10 with 10x5 mm silicone rubber. Silicone rubber was inserted as a surrogate for inversion of the acetabular labrum between the acetabulum and femoral head.Results: No breakage was noted in the 5 specimens without silicone rubber, even after the application of 1 million individual loads at 1 Hz. Fractures appeared in the anterior femoral head in all 10 specimens with 10×5 mm silicone rubber, and mean number of loads to fracture was 6389. Conclusion: Our research selected an osteoporotic bone model to investigate the effects of loading tests that were designed to mimic typical repeated loads in daily activities, using silicone rubber as a surrogate for inversion of the acetabular labrum and resulting in the development of insufficiency-type stress fracture on the femoral head.Concept diagram or graphical abstract

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