ArticleClinical orthopaedics and related research2015
Can high-friction intraannular material increase screw pullout strength in osteoporotic bone?
Article in Clinical orthopaedics and related research, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 10 citations in OpenAlex.
- Measurement of the sustentaculum tali range and biomechanical screw analysis based on the space shape of the calcaneal trabeculae.BMC musculoskeletal disorders · 2025Article
- Biomechanics of PHILOS plates in Vancouver B1 periprosthetic femoral fracture.Frontiers in bioengineering and biotechnology · 2023Article
- Biomechanics and finite element analysis comparing posterior T-plates with LCP for fixation of posterolateral tibial plate fractures.Frontiers in bioengineering and biotechnology · 2023Article
- Fixation stability comparison of bone screws based on thread design: buttress thread, triangle thread, and square thread.BMC musculoskeletal disorders · 2022Article
- Lateral migration resistance of screw is essential in evaluating bone screw stability of plate fixation.Scientific reports · 2021Article
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOsteoporotic bone brings unique challenges to orthopaedic surgery, including a higher likelihood of problematic screw stripping in cancellous bone. Currently, there are limited options to satisfactorily repair stripped screws. Additionally, nonstripped screws hold with less purchase in osteoporotic bone. QUESTIONS/PURPOSES: This study attempts to answer the following questions: (1) Does high-friction intraannular (HFIA) augmentation increase pullout strength in osteoporotic and in severely osteoporotic bone; and (2) can HFIA repair stripped bone thread in osteoporotic and severely osteoporotic bone?
methodsWe measured screw pullout strength using a synthetic bone model in three groups: (1) predrilled nonstripped control holes as controls; (2) predrilled nonstripped augmented with HFIA; and (3) predrilled stripped holes repaired with HFIA. We tested this in osteoporotic and severely osteoporotic synthetic bone for a total of six test groups. We measured screw pullout force using an electromechanical tensile-testing machine comparing pullout force between the test groups and controls.
resultsHFIA augmentation did not increase pullout force compared with the control group in the osteoporotic bone model (489 ± 175 versus 607 ± 76, respectively; effect size = 0.94 [95% confidence interval {CI}, -1.75 to 0.08], p = 0.06). However, in severely osteoporotic cancellous bone that was augmented, the HFIA material generated more pullout force than the control (51 ± 18 versus 35 ± 16, respectively; effect size = 0.94 [95% CI, -0.02 to 1.82], p = 0.05). In stripped holes, HFIA partially restored pullout strength but remained weaker than controls in both osteoporotic and severely osteoporotic bone models (osteoporotic: 320 ± 59 versus 607 ± 76, respectively; effect size = -4.28 [95% CI, -5.57 to -2.51], p < 0.001; severely osteoporotic: 21 ± 8 versus 35 ± 16, respectively; effect size = -1.13 [95% CI, -2.0 to 0.12], p = 0.027).
conclusionsHFIA effectively augmented severely osteoporotic bone for screw purchase, but this effect was not seen for osteoporotic bone. In a model simulating both osteoporotic and severely osteoporotic bone, we found that HFIA can be used to repair stripped screw holes, but the resulting construct remains weaker than nonstripped controls. CLINICAL RELEVANCE: The HFIA material looks promising as a potential solution to stripped screws in osteoporotic bone. However, this material has yet to be tested in human bone. Furthermore, the fine mesh material could be damaged by autoclaving and could break off in vivo causing unknown tissue reactions. We recommend additional testing in a living animal model to better understand how living bone will react to the HFIA material.
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