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A novel method for intraoperative osseomechanical strength measurements: a biomechanical ex vivo evaluation on proximal femora

  • Trauma Surgery
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Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The increasing number of geriatric traumatology cases has intensified the need to reliably and objectively evaluate local bone quality, the latter poses a decisive factor for the choice of an optimal approach to treat osteoporotic fractures. Osteodensitometry imaging techniques are not routinely available in acute operative settings, nor do they provide objective information on local bone properties specifically needed for the prognosis of implant stability.

Materials and methods

This study sought to verify ex vivo the feasibility and sensitivity of a novel method for the determination of local bone strength in the acute operative setting (intraoperative osseomechanical strength measurement; IOSM) that is based on the principle of material displacement resistance against the force of a rotary indenter. Samples consisted of human femoral heads obtained after total hip replacement. Comparisons were made with results obtained via conventional dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (qCT).

Results

Regression analyses of the results showed a highly significant correlation between the IOSM and the control methods (r = 0.61 and r = 0.56; p < 0.01), indicating that this new approach qualifies as a reliable tool for the intraoperative evaluation of the intrinsic local bone strength.

Conclusions

The intraoperative integration of this method may support surgeon on taking proper decisions in terms of optimal surgical approaches and prevention of complications inherent to osteoporotic bone.

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Author notes

  1. Alexander Maslaris and Olaf Brinkmann contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedics, Jena University Hospital, Friedrich-Schiller-University of Jena, Campus Eisenberg, Klosterlausnitzer Straße 81, 07607, Eisenberg, Germany

    Alexander Maslaris, Olaf Brinkmann, Georg Matziolis & Matthias Bungartz

  2. Department of Orthopedics, Laboratory of Biomechanics, Jena University Hospital, Friedrich-Schiller-University of Jena, Campus Eisenberg, Klosterlausnitzer Straße 81, 07607, Eisenberg, Germany

    Frank Layher

Authors
  1. Alexander Maslaris
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  2. Olaf Brinkmann
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Correspondence to Alexander Maslaris.

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Maslaris, A., Brinkmann, O., Layher, F. et al. A novel method for intraoperative osseomechanical strength measurements: a biomechanical ex vivo evaluation on proximal femora. Arch Orthop Trauma Surg 140, 727–734 (2020). https://doi.org/10.1007/s00402-019-03284-7

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