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Cyclic Damage Accumulation in the Femoral Constructs Made With Cephalomedullary Nails

Background: The purpose of this study was to evaluate the risk of peri-prosthetic fracture of constructs made with cephalomedullary (CM) long and short nails. The nails were made with titanium alloy (Ti-6Al-4V) and stainless steel (SS 316L). Methods: Biomechanical evaluation of CM nail constructs wa...

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Autores principales: Hamandi, Farah, Whitney, Alyssa, Stouffer, Mark H., Prayson, Michael J., Rittweger, Jörn, Goswami, Tarun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7894258/
https://www.ncbi.nlm.nih.gov/pubmed/33614603
http://dx.doi.org/10.3389/fbioe.2020.593609
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author Hamandi, Farah
Whitney, Alyssa
Stouffer, Mark H.
Prayson, Michael J.
Rittweger, Jörn
Goswami, Tarun
author_facet Hamandi, Farah
Whitney, Alyssa
Stouffer, Mark H.
Prayson, Michael J.
Rittweger, Jörn
Goswami, Tarun
author_sort Hamandi, Farah
collection PubMed
description Background: The purpose of this study was to evaluate the risk of peri-prosthetic fracture of constructs made with cephalomedullary (CM) long and short nails. The nails were made with titanium alloy (Ti-6Al-4V) and stainless steel (SS 316L). Methods: Biomechanical evaluation of CM nail constructs was carried out with regard to post-primary healing to determine the risk of peri-implant/peri-prosthetic fractures. Therefore, this research comprised of, non-fractured, twenty-eight pairs of cadaveric femora that were randomized and implanted with four types of fixation CM nails resulting in four groups. These constructs were cyclically tested in bi-axial mode for up to 30,000 cycles. All the samples were then loaded to failure to measure failure loads. Three frameworks were carried out through this investigation, Michaelis–Menten, phenomenological, and probabilistic Monte Carlo simulation to model and predict damage accumulation. Findings: Damage accumulation resulting from bi-axial cyclic loading in terms of construct stiffness was represented by Michaelis–Menten equation, and the statistical analysis demonstrated that one model can explain the damage accumulation during cyclic load for all four groups of constructs (P > 0.05). A two-stage stiffness drop was observed. The short stainless steel had a significantly higher average damage (0.94) than the short titanium nails (0.90, P < 0.05). Long titanium nail group did not differ substantially from the short stainless steel nails (P > 0.05). Results showed gender had a significant effect on load to failure in both torsional and bending tests (P < 0.05 and P < 0.001, respectively). Interpretation: Kaplan–Meier survival analysis supports the use of short titanium CM nail. We recommend that clinical decisions should take age and gender into consideration in the selection of implants.
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spelling pubmed-78942582021-02-20 Cyclic Damage Accumulation in the Femoral Constructs Made With Cephalomedullary Nails Hamandi, Farah Whitney, Alyssa Stouffer, Mark H. Prayson, Michael J. Rittweger, Jörn Goswami, Tarun Front Bioeng Biotechnol Bioengineering and Biotechnology Background: The purpose of this study was to evaluate the risk of peri-prosthetic fracture of constructs made with cephalomedullary (CM) long and short nails. The nails were made with titanium alloy (Ti-6Al-4V) and stainless steel (SS 316L). Methods: Biomechanical evaluation of CM nail constructs was carried out with regard to post-primary healing to determine the risk of peri-implant/peri-prosthetic fractures. Therefore, this research comprised of, non-fractured, twenty-eight pairs of cadaveric femora that were randomized and implanted with four types of fixation CM nails resulting in four groups. These constructs were cyclically tested in bi-axial mode for up to 30,000 cycles. All the samples were then loaded to failure to measure failure loads. Three frameworks were carried out through this investigation, Michaelis–Menten, phenomenological, and probabilistic Monte Carlo simulation to model and predict damage accumulation. Findings: Damage accumulation resulting from bi-axial cyclic loading in terms of construct stiffness was represented by Michaelis–Menten equation, and the statistical analysis demonstrated that one model can explain the damage accumulation during cyclic load for all four groups of constructs (P > 0.05). A two-stage stiffness drop was observed. The short stainless steel had a significantly higher average damage (0.94) than the short titanium nails (0.90, P < 0.05). Long titanium nail group did not differ substantially from the short stainless steel nails (P > 0.05). Results showed gender had a significant effect on load to failure in both torsional and bending tests (P < 0.05 and P < 0.001, respectively). Interpretation: Kaplan–Meier survival analysis supports the use of short titanium CM nail. We recommend that clinical decisions should take age and gender into consideration in the selection of implants. Frontiers Media S.A. 2021-02-05 /pmc/articles/PMC7894258/ /pubmed/33614603 http://dx.doi.org/10.3389/fbioe.2020.593609 Text en Copyright © 2021 Hamandi, Whitney, Stouffer, Prayson, Rittweger and Goswami. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Bioengineering and Biotechnology
Hamandi, Farah
Whitney, Alyssa
Stouffer, Mark H.
Prayson, Michael J.
Rittweger, Jörn
Goswami, Tarun
Cyclic Damage Accumulation in the Femoral Constructs Made With Cephalomedullary Nails
title Cyclic Damage Accumulation in the Femoral Constructs Made With Cephalomedullary Nails
title_full Cyclic Damage Accumulation in the Femoral Constructs Made With Cephalomedullary Nails
title_fullStr Cyclic Damage Accumulation in the Femoral Constructs Made With Cephalomedullary Nails
title_full_unstemmed Cyclic Damage Accumulation in the Femoral Constructs Made With Cephalomedullary Nails
title_short Cyclic Damage Accumulation in the Femoral Constructs Made With Cephalomedullary Nails
title_sort cyclic damage accumulation in the femoral constructs made with cephalomedullary nails
topic Bioengineering and Biotechnology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7894258/
https://www.ncbi.nlm.nih.gov/pubmed/33614603
http://dx.doi.org/10.3389/fbioe.2020.593609
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