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  4. Calcium phosphate cement augmentation of cancellous bone screws can compensate for the absence of cortical fixation
 
research article

Calcium phosphate cement augmentation of cancellous bone screws can compensate for the absence of cortical fixation

Stadelmann, Vincent
•
Bretton, Elise
•
Terrier, Alexandre  
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2010
Journal of Biomechanics

An obvious means to improve the fixation of a cancellous bone screw is to augment the surrounding bone with cement. Previous studies have shown that bone augmentation with Calcium Phosphate (CaP) cement significantly improves screw fixation. Nevertheless, quantitative data about the optimal distribution of CaP cement is not available. The present study aims to show the effect of cement distribution on the screw fixation strength for various cortical thicknesses and to determine the conditions at which cement augmentation can compensate for the absence of cortical fixation in osteoporotic bone. In this study, artificial bone materials were used to mimic osteoporotic cancellous bone and cortical bone of varying thickness. These bone constructs were used to test the fixation strength of cancellous bone screws in different cortical thicknesses and different cement augmentation depths. The cement distribution was measured with microCT. The maximum pullout force was measured experimentally. The microCT analysis revealed a pseudo-conic shape distribution of the cement around the screws. While the maximum pullout strength of the screws in foam only was 30±7 N, it could increase up to approximately 1000 N under optimal conditions. Cement augmentation significantly increased pullout force in all cases. The effect of cortical thickness on pullout force was reduced with increased cement augmentation depth. Indeed, cement augmentation without cortical fixation increased pullout forces over that of screws without cement augmentation but with cortical fixation. Since cement augmentation significantly increased pullout force in all cases, we conclude that the loss of cortical fixation can be compensated by cement augmentation.

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Type
research article
DOI
10.1016/j.jbiomech.2010.07.025
Web of Science ID

WOS:000285122900001

Author(s)
Stadelmann, Vincent
Bretton, Elise
Terrier, Alexandre  
Procter, Philippe
Pioletti, Dominique P.  
Date Issued

2010

Publisher

Elsevier

Published in
Journal of Biomechanics
Volume

43

Issue

15

Start page

2869

End page

2874

Subjects

screw fixation

•

pullout force

•

calcium phosphate cement

•

osteoporotic bone

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
LBO  
Available on Infoscience
July 28, 2010
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/51894
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