Effectiveness of prophylactic double-looped wiring in cementless Hip arthroplasty: A biomechanical study in osteoporotic bone model using impaction simulation system
3
item.page.dc.date.issued
2022-07-01
item.page.dc.type
item.page.dc.identifier.issn
00201383
item.page.dc.identifier.eissn
18790267
item.page.dc.identifier.doi
item.page.dc.identifier.scopus
2-s2.0-85131397792
item.page.dc.identifier.pmid
35660012
item.page.oaire.citation.title
Injury
item.page.oaire.citation.volume
53
item.page.oaire.citation.issue
7
item.page.oaire.citation.startPage
2454
item.page.oaire.citation.endPage
2461
item.page.dc.rights.holder
SCOPUS
item.page.dc.identifier.citation
Injury Vol.53 No.7 (2022) , 2454-2461
punsarn.item.page.citation
Wongsak S., Sa-ngasoongsong P., Pinitkwamdee S., Thongchuea N., Prasai A.B., Warinsiriruk E., Jarungvittayakon C., Jaovisidha S., Chanplakorn P. Effectiveness of prophylactic double-looped wiring in cementless Hip arthroplasty: A biomechanical study in osteoporotic bone model using impaction simulation system. Injury Vol.53 No.7 (2022) , 2454-2461. 2461. doi:10.1016/j.injury.2022.05.034 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/85765
item.page.dc.title
Effectiveness of prophylactic double-looped wiring in cementless Hip arthroplasty: A biomechanical study in osteoporotic bone model using impaction simulation system
item.page.dc.contributor.author
item.page.oairecerif.author.affiliation
item.page.dc.contributor.other
item.page.dc.description.abstract
Background: Periprosthetic femoral fracture (PFF) is well-known complication in cementless hip arthroplasty (HA), especially in the elderly with osteoporosis. To prevent intraoperative PFFs during HA, prophylactic cerclage wiring on the calcar area during femoral broaching and implant insertion is recommended. However, biomechanical data on the benefits of cerclage wiring in osteoporotic bone during impaction are limited and controversial. This study aimed to assess the efficacy of prophylactic double-looped cerclage wiring (PDLCW) during femoral broaching in the osteoporotic bone model with an impaction simulation system. Methods: Fifteen osteoporotic femur models were prepared and allocated to three groups; control group (no cerclage), PW group (received PDLCW), and CC+PW group (prepared as having calcar crack and received PDLCW). All femurs were broached under impaction force that sequentially increased until the visible fracture or calcar crack propagation was visible. The primary outcomes were mallet impaction force (MIF-CF) and mallet velocity (MV-CF) at the time of calcar fracture. The secondary outcomes were calcar fracture pattern and subsidence during calcar fracture (S-CF). Results: PW group showed a significant increase in average MIF-CF, by 40.4% and 120.2% (p<0.001) compared to the control and CC+PW groups, respectively. The average MV-CF in PW group was also significantly greater, 13.1% and 64.6% (p<0.001), compared to the control and CC+PW groups, respectively. Control group revealed significantly greater incidence of complete calcar fracture (60% vs. 0% vs. 0%, p = 0.024), and the highest S-CF compared to those in the PW and CC+PW groups (10.6 ± 6.0 mm, 6.7 ± 4.4 mm, and 1.3 ± 2.0 mm, p = 0.020). Conclusions: This study showed that PDLCW significantly improved hoop stress resistance by increasing the calcar fracture threshold related to mallet impaction, decreasing the risk of complete calcar fracture.