Femoroplasty – augmentation of the proximal femur with a composite bone cement – feasibility, biomechanical properties and osteosynthesis potential

Beckmann, J.; Ferguson, S.J.; Gebauer, M.; Luering, C.; Gasser, B.; Heini, P.

doi:10.1016/j.medengphy.2006.08.006

« Previous Next »Medical Engineering & Physics
Volume 29, Issue 7 , Pages 755-764, September 2007

Femoroplasty – augmentation of the proximal femur with a composite bone cement – feasibility, biomechanical properties and osteosynthesis potential

J. Beckmann
- Orthopaedic Clinic and Policlinic of the University of Regensburg, Asklepios Klinik Bad Abbach, Kaiser-Karl-V-Allee 3, 93077 Bad Abbach, Germany
- R. Mathys RMS Foundation, Bettlach, Switzerland
- Department of Orthopedic Surgery, Inselspital Bern, University of Bern, Switzerland
- Corresponding author. Tel.: +49 1723513013.
S.J. Ferguson
- MEM Research Center, Institute for Surgical Technology and Biomechanics, University of Bern, Switzerland
M. Gebauer
- Department of Trauma Surgery, University Clinics Eppendorf, Germany
C. Luering
- Orthopaedic Clinic and Policlinic of the University of Regensburg, Asklepios Klinik Bad Abbach, Kaiser-Karl-V-Allee 3, 93077 Bad Abbach, Germany
B. Gasser
- R. Mathys RMS Foundation, Bettlach, Switzerland
P. Heini
- Department of Orthopedic Surgery, Inselspital Bern, University of Bern, Switzerland

Received 25 April 2006; received in revised form 23 August 2006; accepted 30 August 2006. published online 06 October 2006.

Abstract

Background

Analogous to vertebroplasty, cement-augmentation of the proximal femur (“femoroplasty”) could reinforce osteoporotic bones. This study was to evaluate (i) the feasibility of femoroplasty with a composite cement (Cortoss™), (ii) its influence on femoral strength by mechanical testing and (iii) the feasibility of stable osteosynthesis of the augmented fractured bones.

Methods

Nine human cadaveric femora were augmented with a composite bone cement, the surface heat generation monitored, and then tested biomechanically against their native contralateral control to determine fracture strength. Subsequently, thirteen reinforced and fractured femora were osteosynthetized by different implants and tested against their osteosynthetisized, non-augmented contralateral control.

Findings

Cement could be injected easily, with a moderate temperature rise. A positive correlation between BMD and fracture load and a significant increase in fracture load (+43%) of the augmented femora compared to their native controls (6324N and 4430N, respectively) as well as a significant increase in energy-to-failure (+187%, 86Nm and 30Nm, respectively) was found. Osteosynthesis was possible in cement-augmented femora. Osteosynthetisized femora showed equivalent strength to the intact controls.

Interpretation

Augmentation of the proximal femur with composite bone cement could be of use in prophylaxis of fractures in osteoporotic femurs. Osteosynthesis of the fractured augmented bones is a challenging procedure but has a good chance to restore strength.

Keywords: Hip, Fracture, Osteoporosis, Cement, Reinforcement, Augmentation, Femoroplasty