Despite the wide-spread opinion, that early stabilisation of femur fractures in multiply injured patients is of advantage, there are no publications that unambiguously prove this statement. In contrast, primary fracture stabilisation of the femur with concomitant thoracic trauma seems to increase the rate of complications. The biochemical data of the prospective study presented here suggest, that operative stabilisation of femoral fractures imposes an additional trauma on the already compromised organism. The period between days 2 to 4, when the primary activation of humoral and cellular mediators has returned to normal levels, seems to be the best time for osteosyntheses of these fractures. The operation in this period allows intramedullary fixation--the biologically and biomechanically best fixation procedure--with low risk.
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J Biomech
January 2025
Radboudumc, Orthopaedic Research Lab, PO Box 9101, 6500 HB Nijmegen, the Netherlands.
Aseptic loosening is the primary cause of revision in cementless total knee arthroplasty (TKA), emphasizing the importance of strong initial stability for long-term implant success. Pre-clinical evaluations are crucial for understanding implant fixation mechanics and improving implant designs. Finite element (FE) analysis models often use linear elastic bone material models, which do not accurately reflect bone's mechanical behavior.
View Article and Find Full Text PDFKnee
December 2024
Orthopedic Surgery and Traumatology, Hospital Clínic de Barcelona, Barcelona, Spain.
Distal femoral replacement (DFR) with megaprostheses is a salvage revision total knee arthroplasty (rTKA) procedure indicated in cases with massive bone defects in the distal femur. As long as these implants achieve fixation only in the diaphysis, the high aseptic loosening rate reported in some series is probably related to a lack of rotational stability. Two patients with extensive distal femoral bone defects with preservation of the metaphyseal-diaphyseal junction underwent rTKA.
View Article and Find Full Text PDFActa Orthop Traumatol Turc
December 2024
Department of Orthopaedics and Traumatology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Türkiye.
Objective: The aim of this study was to evaluate whether the locking femoral neck plate (LFNP) can be an alternative fixation method to the cannulated screws with a medial buttress plate. For this purpose, we compared biomechanically the LFNP and cannulated screws with or without a medial buttress plate in Pauwels type 3 femoral neck fractures.
Methods: A vertical fracture model was created at an 80-degree angle to the femoral neck in 28 synthetic bone models.
J Orthop Surg Res
January 2025
Department of Industrial Engineering, Alma Mater Studiorum-University of Bologna, Bologna, Italy.
Background: Transfemoral osseointegrated prostheses, like other uncemented prostheses experience the risk of aseptic loosening and post-operative periprosthetic fractures, with an incidence between 3% and 30%. To date, however, osseointegrated off-the-shelf prostheses are manufactured in a limited number of sizes, and some patients do not meet the strict eligibility criteria of commercial devices. A customized osseointegrated stem was developed and a pre-clinical in vitro investigation of the stem was performed, to evaluate its biomechanical performance.
View Article and Find Full Text PDFInjury
January 2025
Department of Orthopedic Surgery, McGovern Medical School, UTHealth Science Center at Houston, 5420 West Loop S. Suite 1300, Bellaire, TX, 77401, USA. Electronic address:
Introduction: Clinical data on osseointegration (OI) for limb replacement indicates a concerning increase in mechanical complications after five years post-implantation. Since adequate bone-implant contact and proper implant alignment are critical factors for successful osseointegration, it is essential to identify the factors influencing these outcomes. This study aimed to assess the effects of residual femur length and implant sizing on bone-implant contact and implant alignment.
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