A biomechanically-guided planning and execution paradigm for osteoporotic hip augmentation: Experimental evaluation of the biomechanics and temperature-rise.
A biomechanically-guided planning and execution paradigm for osteoporotic hip augmentation: Experimental evaluation of the biomechanics and temperature-rise.
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DOI：
10.1016/j.clinbiomech.2021.105392
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Armand M
中科院分区：
文献类型：
--
作者：
Farvardin A;Bakhtiarinejad M;Murphy RJ;Basafa E;Khanuja H;Oni JK;Armand M
骨水泥强化股骨近端（股骨成形术）已被确定为一种降低骨折风险的潜在预防方法。然而，当大量骨水泥注入骨内时，股骨成形术会有热损伤风险，以及骨水泥渗漏或血液供应受阻的风险。
使用一种新提出的规划范例和内部导航系统对6对尸体股骨进行强化，以控制注入骨水泥的位置和体积。为了评估热损伤的风险，我们记录了三个感兴趣区域的骨峰值温度，以及这些区域温度升高8°C、10°C和12°C的暴露时间。强化后进行模拟大转子侧方摔倒的力学破坏试验。
骨折试验结果与屈服载荷模拟结果相关（R² = 0.77），并且表明股骨成形术可显著提高标本的屈服载荷（42%，P<0.001）和屈服能量（139%，P = 0.062）。同时，骨表面温度记录显示，靠近大转子的区域比转子嵴和股骨颈区域会面临更严重的温度升高。
新的规划范例提供了一种更有效的注射策略，平均注射体积为9.1毫升。同时，骨表面温度记录表明，使用聚甲基丙烯酸甲酯进行股骨成形术时，热坏死的风险仍然是一个令人担忧的问题。
Augmentation of the proximal femur with bone cement (femoroplasty) has been identified as a potential preventive approach to reduce the risk of fracture. Femoroplasty, however, is associated with a risk of thermal damage as well as the leakage of bone cement or blockage of blood supply when large volumes of cement are introduced inside the bone. Six pairs of cadaveric femora were augmented using a newly proposed planning paradigm and an in-house navigation system to control the location and volume of the injected cement. To evaluate the risk of thermal damage, we recorded the peak temperature of bone at three regions of interest as well as the exposure time for temperature rise of 8°C, 10°C, and 12°C in these regions. Augmentation was followed by mechanical testing to failure resembling a sideway fall on the greater trochanter. Results of the fracture tests correlated with those of simulations for the yield load (R2 = 0.77) and showed that femoroplasty can significantly improve the yield load (42%, P<0.001) and yield energy (139%, P=0.062) of the specimens. Meanwhile, temperature recordings of the bone surface showed that the areas close to the greater trochanter will be exposed to more critical temperature rise than the trochanteric crest and femoral neck areas. The new planning paradigm offers a more efficient injection strategy with injection volume of 9.1 ml on average. Meanwhile, temperature recordings of bone surfaces suggest that risk of thermal necrosis remains as a concern with femoroplasty using Polymethylmethacrylate.
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DOI：
10.1109/34.121791
发表时间：
1992-02-01
影响因子：
23.6
作者：
BESL, PJ;MCKAY, ND
通讯作者：
MCKAY, ND
影响因子：
2.2
作者：
Basafa, Ehsan;Armiger, Robert S.;Armand, Mehran
通讯作者：
Armand, Mehran
影响因子：
2.4
作者：
Basafa, Ehsan;Murphy, Ryan J.;Armand, Mehran
通讯作者：
Armand, Mehran
影响因子：
120.7
作者：
SCHNEIDER, EL;GURALNIK, JM
通讯作者：
GURALNIK, JM
影响因子：
1.8
作者：
Varga, Peter;Inzana, Jason A.;Windolf, Markus
通讯作者：
Windolf, Markus