Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Orthop. Oct 18, 2012; 3(10): 162-166
Published online Oct 18, 2012. doi: 10.5312/wjo.v3.i10.162
Intraprosthetic fixation techniques in the treatment of periprosthetic fractures-A biomechanical study
Stephan Brand, Johannes Klotz, Thomas Hassel, Maximilian Petri, Carl Haasper, Friedrich-Wilhelm Bach, Christian Krettek, Thomas Goesling
Stephan Brand, Maximilian Petri, Carl Haasper, Christian Krettek, Thomas Goesling, Department of Trauma, Medical School Hannover (MHH), D-30625 Hannover, Germany
Johannes Klotz, Thomas Hassel, Friedrich-Wilhelm Bach, Department of Material Sciences, Leibniz University Hannover, D-30625 Hannover, Germany
Author contributions: Brand S and Klotz J performed the majority of experiments; Hassel T, Petri M and Haasper C were involved in editing the manuscript to the standards required; Goesling T and Krettek C coordinated the support and equipment for this work; Brand S, Goesling T and Bach FW designed the study; Brand S wrote the manuscript.
Correspondence to: Dr, Stephan Brand, MD, Department of Trauma, Medical School Hannover (MHH), Carl-Neuberg-Street 1/OE 6230, D-30625 Hannover, Germany. brand.stephan@mh-hannover.de
Telephone: +49-511-5322050 Fax: +49-511-5325877
Received: June 22, 2012
Revised: August 25, 2012
Accepted: October 10, 2012
Published online: October 18, 2012
Abstract

AIM: To develop new fixation techniques for the treatment of periprosthetic fractures using intraprosthetic screw fixation with inserted threaded liners.

METHODS: A Vancouver B1 periprosthetic fracture was simulated in femur prosthesis constructs using sawbones and cemented regular straight hip stems. Fixation was then performed with either unicortical locked-screw plating using the less invasive stabilization system-plate or with intraprosthetic screw fixation using inserted liners. Two experimental groups were formed using either prostheses made of titanium alloy or prostheses made of cobalt chrome alloy. Fixation stability was compared in an axial load-to-failure model. Drilling was performed using a specially invented prosthesis drill with constantly applied internal cooling.

RESULTS: The intraprosthetic fixation model with titanium prostheses was superior to the unicortical locked-screw fixation in all tested devices. The intraprosthetic fixation model required 10 456 N ± 1892 N for failure and the unicortical locked-screw plating required 7649 N ± 653 N (P < 0.05). There was no significant difference between the second experimental group and the control group.

CONCLUSION: Intraprosthetic screw anchorage with special threaded liners enhances the primary stability in treating periprosthetic fractures by internal fixation.

Keywords: Periprosthetic fracture, Less invasive stabilization system, Plate fixation, Intraprosthetic screw fixation, Material science, Biomechanical testing, Axial load-to-failure