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How relevant is lumbar bone mineral density for the stability of symphyseal implants? A biomechanical cadaver study

PURPOSE: Osteoporotic bone tissue appears to be an important risk factor for implant loosening, compromising the stability of surgical implants. However, it is unclear whether lumbar measured bone mineral density (BMD) is of any predictive value for stability of surgical implants at the pubic symphy...

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Autores principales: Schwaabe, Fanny, Gleich, Johannes, Linhart, Christoph, Keppler, Alexander Martin, Woiczinski, Matthias, Kammerlander, Christian, Greiner, Axel, Böcker, Wolfgang, Cavalcanti Kußmaul, Adrian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9360150/
https://www.ncbi.nlm.nih.gov/pubmed/34881391
http://dx.doi.org/10.1007/s00068-021-01850-6
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author Schwaabe, Fanny
Gleich, Johannes
Linhart, Christoph
Keppler, Alexander Martin
Woiczinski, Matthias
Kammerlander, Christian
Greiner, Axel
Böcker, Wolfgang
Cavalcanti Kußmaul, Adrian
author_facet Schwaabe, Fanny
Gleich, Johannes
Linhart, Christoph
Keppler, Alexander Martin
Woiczinski, Matthias
Kammerlander, Christian
Greiner, Axel
Böcker, Wolfgang
Cavalcanti Kußmaul, Adrian
author_sort Schwaabe, Fanny
collection PubMed
description PURPOSE: Osteoporotic bone tissue appears to be an important risk factor for implant loosening, compromising the stability of surgical implants. However, it is unclear whether lumbar measured bone mineral density (BMD) is of any predictive value for stability of surgical implants at the pubic symphysis. This study examines the fixation strength of cortical screws in human cadaver specimens with different BMDs. METHODS: The lumbar BMD of ten human specimens was measured using quantitative computed tomography (qCT). A cut-off BMD was set at 120 mg Ca-Ha/mL, dividing the specimens into two groups. One cortical screw was drilled into each superior pubic ramus. The screw was withdrawn in an axial direction with a steady speed and considered failed when a force decrease was detected. Required force (N) and pull-out distance (mm) were constantly tracked. RESULTS: The median peak force of group 1 was 231.88 N and 228.08 N in group 2. While BMD values differed significantly (p < 0.01), a comparison of peak forces between both groups showed no significant difference (p = 0.481). CONCLUSION: Higher lumbar BMD did not result in significantly higher pull-out forces at the symphysis. The high proportion of cortical bone near the symphyseal joint allows an increased contact of pubic screws and could explain sufficient fixation. This condition is not reflected by a compromised lumbar BMD in a qCT scan. Therefore, site-specific BMD measurement could improve individual fracture management. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00068-021-01850-6.
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spelling pubmed-93601502022-08-10 How relevant is lumbar bone mineral density for the stability of symphyseal implants? A biomechanical cadaver study Schwaabe, Fanny Gleich, Johannes Linhart, Christoph Keppler, Alexander Martin Woiczinski, Matthias Kammerlander, Christian Greiner, Axel Böcker, Wolfgang Cavalcanti Kußmaul, Adrian Eur J Trauma Emerg Surg Original Article PURPOSE: Osteoporotic bone tissue appears to be an important risk factor for implant loosening, compromising the stability of surgical implants. However, it is unclear whether lumbar measured bone mineral density (BMD) is of any predictive value for stability of surgical implants at the pubic symphysis. This study examines the fixation strength of cortical screws in human cadaver specimens with different BMDs. METHODS: The lumbar BMD of ten human specimens was measured using quantitative computed tomography (qCT). A cut-off BMD was set at 120 mg Ca-Ha/mL, dividing the specimens into two groups. One cortical screw was drilled into each superior pubic ramus. The screw was withdrawn in an axial direction with a steady speed and considered failed when a force decrease was detected. Required force (N) and pull-out distance (mm) were constantly tracked. RESULTS: The median peak force of group 1 was 231.88 N and 228.08 N in group 2. While BMD values differed significantly (p < 0.01), a comparison of peak forces between both groups showed no significant difference (p = 0.481). CONCLUSION: Higher lumbar BMD did not result in significantly higher pull-out forces at the symphysis. The high proportion of cortical bone near the symphyseal joint allows an increased contact of pubic screws and could explain sufficient fixation. This condition is not reflected by a compromised lumbar BMD in a qCT scan. Therefore, site-specific BMD measurement could improve individual fracture management. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00068-021-01850-6. Springer Berlin Heidelberg 2021-12-08 2022 /pmc/articles/PMC9360150/ /pubmed/34881391 http://dx.doi.org/10.1007/s00068-021-01850-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Schwaabe, Fanny
Gleich, Johannes
Linhart, Christoph
Keppler, Alexander Martin
Woiczinski, Matthias
Kammerlander, Christian
Greiner, Axel
Böcker, Wolfgang
Cavalcanti Kußmaul, Adrian
How relevant is lumbar bone mineral density for the stability of symphyseal implants? A biomechanical cadaver study
title How relevant is lumbar bone mineral density for the stability of symphyseal implants? A biomechanical cadaver study
title_full How relevant is lumbar bone mineral density for the stability of symphyseal implants? A biomechanical cadaver study
title_fullStr How relevant is lumbar bone mineral density for the stability of symphyseal implants? A biomechanical cadaver study
title_full_unstemmed How relevant is lumbar bone mineral density for the stability of symphyseal implants? A biomechanical cadaver study
title_short How relevant is lumbar bone mineral density for the stability of symphyseal implants? A biomechanical cadaver study
title_sort how relevant is lumbar bone mineral density for the stability of symphyseal implants? a biomechanical cadaver study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9360150/
https://www.ncbi.nlm.nih.gov/pubmed/34881391
http://dx.doi.org/10.1007/s00068-021-01850-6
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