The biomechanical analysis of three plating fixation systems for periprosthetic femoral fracture near the tip of a total hip arthroplasty

<p>Abstract</p> <p>Background</p> <p>A variety of techniques are available for fixation of femoral shaft fractures following total hip arthroplasty. The optimal surgical repair method still remains a point of controversy in the literature. However, few studies have quantified the performance of such repair constructs. This study biomechanically examined 3 different screw-plate and cable-plate systems for fixation of periprosthetic femoral fractures near the tip of a total hip arthroplasty.</p> <p>Methods</p> <p>Twelve pairs of human cadaveric femurs were utilized. Each left femur was prepared for the cemented insertion of the femoral component of a total hip implant. Femoral fractures were created in the femurs and subsequently repaired with Construct A (Zimmer Cable Ready System), Construct B (AO Cable-Plate System), or Construct C (Dall-Miles Cable Grip System). Right femora served as matched intact controls. Axial, torsional, and four-point bending tests were performed to obtain stiffness values.</p> <p>Results</p> <p>All repair systems showed 3.08 to 5.33 times greater axial stiffness over intact control specimens. Four-point normalized bending (0.69 to 0.85) and normalized torsional (0.55 to 0.69) stiffnesses were lower than intact controls for most comparisons. Screw-plates provided either greater or equal stiffness compared to cable-plates in almost all cases. There were no statistical differences between plating systems A, B, or C when compared to each other (p > 0.05).</p> <p>Conclusions</p> <p>Screw-plate systems provide more optimal mechanical stability than cable-plate systems for periprosthetic femur fractures near the tip of a total hip arthroplasty.</p

A biomechanical assessment of modular and monoblock revision hip implants using FE analysis and strain gage measurements

<p>Abstract</p> <p>Background</p> <p>The bone loss associated with revision surgery or pathology has been the impetus for developing modular revision total hip prostheses. Few studies have assessed these modular implants quantitatively from a mechanical standpoint.</p> <p>Methods</p> <p>Three-dimensional finite element (FE) models were developed to mimic a hip implant alone (Construct A) and a hip implant-femur configuration (Construct B). Bonded contact was assumed for all interfaces to simulate long-term bony ongrowth and stability. The hip implants modeled were a Modular stem having two interlocking parts (Zimmer Modular Revision Hip System, Zimmer, Warsaw, IN, USA) and a Monoblock stem made from a single piece of material (Stryker Restoration HA Hip System, Stryker, Mahwah, NJ, USA). Axial loads of 700 and 2000 N were applied to Construct A and 2000 N to Construct B models. Stiffness, strain, and stress were computed. Mechanical tests using axial loads were used for Construct A to validate the FE model. Strain gages were placed along the medial and lateral side of the hip implants at 8 locations to measure axial strain distribution.</p> <p>Results</p> <p>There was approximately a 3% average difference between FE and experimental strains for Construct A at all locations for the Modular implant and in the proximal region for the Monoblock implant. FE results for Construct B showed that both implants carried the majority (Modular, 76%; Monoblock, 66%) of the 2000 N load relative to the femur. FE analysis and experiments demonstrated that the Modular implant was 3 to 4.5 times mechanically stiffer than the Monoblock due primarily to geometric differences.</p> <p>Conclusions</p> <p>This study provides mechanical characteristics of revision hip implants at sub-clinical axial loads as an initial predictor of potential failure.</p

The effect of surface strands, angle of attack, and ice accretion on the flow field around electrical power cables

The influence of surface strands, angle of attack, and ice accumulation on the flow field around electrical power cables of various geometries is not clearly understood. The purpose of this study was to examine the effect of these factors on the near wake flow field of three stationary wind tunnel models, namely, Model 1 (smooth and heavily iced), Model 2 (stranded and lightly iced), and Model 3 (stranded and heavily iced). Some angles of attack, θ, significantly altered the flow field by encouraging a rise in Strouhal number for all models at θ=0°, for Model 2 at θ=150–160°, and for Model 3 at θ=180°. Under certain conditions (θ=0°, U >22 m/s, Re>42,000) for Model 3, dual vortex shedding frequency peaks were present. These changes in Strouhal number may potentially predispose models to low drag and high lift forces

The effect of muscle contusion on cortical bone and muscle perfusion following reamed, intramedullary nailing: a novel canine tibia fracture model

<p>Abstract</p> <p>Background</p> <p>Management of tibial fractures associated with soft tissue injury remains controversial. Previous studies have assessed perfusion of the fractured tibia and surrounding soft tissues in the setting of a normal soft tissue envelope. The purpose of this study was to determine the effects of muscle contusion on blood flow to the tibial cortex and muscle during reamed, intramedullary nailing of a tibial fracture.</p> <p>Methods</p> <p>Eleven adult canines were distributed into two groups, Contusion or No-Contusion. The left tibia of each canine underwent segmental osteotomy followed by limited reaming and locked intramedullary nailing. Six of the 11 canines had the anterior muscle compartment contused in a standardized fashion. Laser doppler flowmetry was used to measure cortical bone and muscle perfusion during the index procedure and at 11 weeks post-operatively.</p> <p>Results</p> <p>Following a standardized contusion, muscle perfusion in the Contusion group was higher compared to the No-Contusion group at post-osteotomy and post-reaming (p < 0.05). Bone perfusion decreased to a larger extent in the Contusion group compared to the No-Contusion group following osteotomy (p < 0.05), and the difference in bone perfusion between the two groups remained significant throughout the entire procedure (p < 0.05). At 11 weeks, muscle perfusion was similar in both groups (p > 0.05). There was a sustained decrease in overall bone perfusion in the Contusion group at 11 weeks, compared to the No-Contusion group (p < 0.05).</p> <p>Conclusions</p> <p>Injury to the soft tissue envelope may have some deleterious effects on intraosseous circulation. This could have some influence on the fixation method for tibia fractures linked with significant soft tissue injury.</p