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- Larsson, Sune, et al.
(author)
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Injectable calcium phosphate cement for augmentation around cancellous bone screws : In vivo biomechanical studies
- 2012
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In: Journal of Biomechanics. - : Elsevier BV. - 0021-9290 .- 1873-2380. ; 45:7, s. 1156-1160
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Journal article (peer-reviewed)abstract
- In lower cancellous apparent bone density, it can be difficult to achieve adequate screw fixation and hence stable fracture fixation. Different strategies have been proposed, one of them is through augmentation using calcium phosphate cement in the region at or close to the screw thread itself. To support the hypothesis of an improved screw fixation technique by augmentation of the bone surrounding the implanted screw, in vivo biomechanical and densitometric studies are performed on rabbit specimen where normal and simulated weak bone quality are considered. In particular, the evolution of screw stability till 12 weeks following the implantation is quantified. A statistical significance in the pull out force for augmented versus non-augmented screws was found for the shorter time periods tested of <= 5 days whilst the pull out force was found to increase with time for both augmented and non-augmented screws during the 12 week course of the study. The results of the study demonstrate that the use of an injectable calcium phosphate cement which sets in vivo can significantly improve screw pull out strength at and after implantation for normal and simulated weak bone quality.
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3. |
- Roshan-Ghias, A, et al.
(author)
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In vivo assessment of local effects after application of bone screws delivering bisphosphonates into a compromised cancellous bone site
- 2011
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In: CLINICAL BIOMECHANICS. - : Elsevier BV. - 0268-0033. ; 26:10, s. 1039-1043
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Journal article (peer-reviewed)abstract
- BACKGROUND: The primary stability of cancellous screw is difficult to obtain in bone of compromised quality and failure of screw fixation is common. To overcome this problem, it is proposed to locally deliver bisphosphonate from the screw. An in vivo validation of the increase in fixation of the cancellous screw is then needed in compromised bone. METHODS: In this study, we used an overdrilling procedure, which enables consistent modeling of reduced screw stability comparable to compromised cancellous bone. Forty eight adult NZW rabbits were used in this study and all animals underwent bilateral femur implantation. One leg was implanted with the screw containing the bisphosphonate (biocoated group) while the other was used as control (control group) with the screw only. Mechanical testing and micro-CT imaging were used to assess the effect of local drug delivery of Zoledronate on screws fixation at 5 time points. FINDINGS: At the early time points (1, 5, and 10 days), no significant difference could be seen between the biocoated and control groups. At 6 weeks, the bone volume fraction was significantly higher in the trabecular region of the biocoated group. However, this increase did not have a significant effect on the pull-out force. At the last time point, 11 weeks, both the bone volume fraction and the pull-out force were significantly higher in the biocoated group. INTERPRETATION: The results of this study suggest that, in compromised bone, local delivery of bisphosphonate enhances the stability of bone screws.
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