Subject-specific planning of femoroplasty: An experimental verification study

JOURNAL OF BIOMECHANICS

卷:48

Article

Basafa, Ehsan¹  Murphy, Ryan J.^1,2  Otake, Yoshito³  Kutzer, Michael D.⁴  Belkoff, Stephen M.⁵  Mears, Simon C.⁶  Armand, Mehran^1,2 

[1] Johns Hopkins Univ, Lab Computat Sensing & Robot, Baltimore, MD USA

[2] Johns Hopkins Univ, Appl Phys Lab, Res & Exploratory Dev Dept, Laurel, MD USA

[3] Nara Inst Sci & Technol, Grad Sch Informat Sci, Nara 6300101, Japan

[4] US Naval Acad, Annapolis, MD 21402 USA

[5] Johns Hopkins Univ, Bayview Med Ctr, Int Ctr Orthopaed Adv, Baltimore, MD USA

[6] Baylor Reg Med Ctr, Total Joint Replacement Ctr, Plano, TX USA

关键词: Femoroplasty;    Cement augmentation;    Planning;    Mechanical test;   

DOI  :  10.1016/j.jbiomech.2014.11.002

来源: Elsevier

【 摘 要 】

The risk of osteoporotic hip fractures may be reduced by augmenting susceptible femora with acrylic polymethylmethacrylate (PMMA) bone cement. Grossly filling the proximal femur with PMMA has shown promise, but the augmented bones can suffer from thermal necrosis or cement leakage, among other side effects. We hypothesized that, using subject-specific planning and computer-assisted augmentation, we can minimize cement volume while increasing bone strength and reducing the risk of fracture. We mechanically tested eight pairs of osteoporotic femora, after augmenting one from each pair following patient-specific planning reported earlier, which optimized cement distribution and strength increase. An average of 9.5( +/- 1.7) ml of cement was injected in the augmented set. Augmentation significantly (P < 0.05) increased the yield load by 33%, maximum load by 30%, yield energy by 118%, and maximum energy by 94% relative to the non-augmented controls. Also predicted yield loads correlated well (R-2=0.74) with the experiments and, for augmented specimens, cement profiles were predicted with an average surface error of <2 mm, further validating our simulation techniques. Results of the current study suggest that subject-specific planning of femoroplasty reduces the risk of hip fracture while minimizing the amount of cement required. (C) 2014 Elsevier Ltd. All rights reserved.

【 授权许可】

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