Risk factors for periprosthetic femoral fracture risk around a cemented polished taper-slip stem using an osteoporotic composite bone model

Sameer Jain; Ruth Drake; Ian Entwistle; James P Baren; Zachary Thompson; Andrew R Beadling; Michael G Bryant; Farag Shuweihdi; Hemant Pandit

doi:10.1177/09544119231225172

Risk factors for periprosthetic femoral fracture risk around a cemented polished taper-slip stem using an osteoporotic composite bone model

Sameer Jain^*, Ruth Drake, Ian Entwistle, James P Baren, Zachary Thompson, Andrew R Beadling, Michael G Bryant, Farag Shuweihdi, Hemant Pandit

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

This biomechanical study aimed to determine if variations in stem material, stem geometry, stem offset and cement viscosity affect mechanical resistance to postoperative periprosthetic fracture (PFF) after hip arthroplasty with a commonly used cemented polished taper-slip (PTS) stem (CPT, Zimmer Biomet) in a novel osteoporotic composite femoral bone model. Thirty-six osteoporotic composite femoral models were tested using a standardised in-vitro loading technique to simulate a typical PFF. Outcome measures were torque to failure (N), fracture energy (N/m²) and rotation to failure (°). Comparisons were made by stem material (cobalt chrome vs stainless steel), stem geometry (CPT stem vs Exeter stem), stem offset (standard offset vs extra extended offset) and cement viscosity (high viscosity vs low viscosity). Statistical comparisons were carried out with significance set at p < 0.05. All tested samples produced clinically representative fracture patterns with varying degrees of bone and cement comminution. There was no statistically significant difference in torque to failure, fracture energy or rotation to failure between any of the compared variables (all p > 0.05). This is the first biomechanical study on mechanical resistance to PFF using osteoporotic composite bone models. For the CPT stem, it confirms that stem material, stem offset, stem geometry and cement viscosity do not affect mechanical resistance to PFF in an osteoporotic bone model.

Original language	English
Pages (from-to)	324-331
Number of pages	8
Journal	Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine
Volume	238
Issue number	3
Early online date	18 Jan 2024
DOIs	https://doi.org/10.1177/09544119231225172
Publication status	Published - Mar 2024

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Materials used in the study have been funded by Zimmer Biomet. Some of this work has been funded by Leeds Hospitals Charity for the lead author (SJ).

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The following authors declare the following conflicting interests none of which are directly related to the scientific content within this manuscript. Hemant Pandit is a consultant for Zimmer Biomet, Medacta, Smith & Nephew, Invibio, Paradigm Biopharma, Allay Therapeutics, JRI Orthopaedics and Microport. Sameer Jain has received research funding from Leeds Hospitals Charities.

Publisher Copyright:
© IMechE 2024.

Keywords

cemented stem
composite bone
osteoporosis
Periprosthetic fracture
saw bone
taper-slip

ASJC Scopus subject areas

Mechanical Engineering

Access to Document

10.1177/09544119231225172

Cite this

Jain, S., Drake, R., Entwistle, I., Baren, J. P., Thompson, Z., Beadling, A. R., Bryant, M. G., Shuweihdi, F., & Pandit, H. (2024). Risk factors for periprosthetic femoral fracture risk around a cemented polished taper-slip stem using an osteoporotic composite bone model. Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, 238(3), 324-331. https://doi.org/10.1177/09544119231225172

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title = "Risk factors for periprosthetic femoral fracture risk around a cemented polished taper-slip stem using an osteoporotic composite bone model",

abstract = "This biomechanical study aimed to determine if variations in stem material, stem geometry, stem offset and cement viscosity affect mechanical resistance to postoperative periprosthetic fracture (PFF) after hip arthroplasty with a commonly used cemented polished taper-slip (PTS) stem (CPT, Zimmer Biomet) in a novel osteoporotic composite femoral bone model. Thirty-six osteoporotic composite femoral models were tested using a standardised in-vitro loading technique to simulate a typical PFF. Outcome measures were torque to failure (N), fracture energy (N/m2) and rotation to failure (°). Comparisons were made by stem material (cobalt chrome vs stainless steel), stem geometry (CPT stem vs Exeter stem), stem offset (standard offset vs extra extended offset) and cement viscosity (high viscosity vs low viscosity). Statistical comparisons were carried out with significance set at p < 0.05. All tested samples produced clinically representative fracture patterns with varying degrees of bone and cement comminution. There was no statistically significant difference in torque to failure, fracture energy or rotation to failure between any of the compared variables (all p > 0.05). This is the first biomechanical study on mechanical resistance to PFF using osteoporotic composite bone models. For the CPT stem, it confirms that stem material, stem offset, stem geometry and cement viscosity do not affect mechanical resistance to PFF in an osteoporotic bone model.",

keywords = "cemented stem, composite bone, osteoporosis, Periprosthetic fracture, saw bone, taper-slip",

author = "Sameer Jain and Ruth Drake and Ian Entwistle and Baren, {James P} and Zachary Thompson and Beadling, {Andrew R} and Bryant, {Michael G} and Farag Shuweihdi and Hemant Pandit",

note = "Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Materials used in the study have been funded by Zimmer Biomet. Some of this work has been funded by Leeds Hospitals Charity for the lead author (SJ). The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The following authors declare the following conflicting interests none of which are directly related to the scientific content within this manuscript. Hemant Pandit is a consultant for Zimmer Biomet, Medacta, Smith & Nephew, Invibio, Paradigm Biopharma, Allay Therapeutics, JRI Orthopaedics and Microport. Sameer Jain has received research funding from Leeds Hospitals Charities. Publisher Copyright: {\textcopyright} IMechE 2024.",

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Jain, S, Drake, R, Entwistle, I, Baren, JP, Thompson, Z, Beadling, AR , Bryant, MG, Shuweihdi, F & Pandit, H 2024, 'Risk factors for periprosthetic femoral fracture risk around a cemented polished taper-slip stem using an osteoporotic composite bone model', Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, vol. 238, no. 3, pp. 324-331. https://doi.org/10.1177/09544119231225172

Risk factors for periprosthetic femoral fracture risk around a cemented polished taper-slip stem using an osteoporotic composite bone model. / Jain, Sameer; Drake, Ruth; Entwistle, Ian et al.
In: Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, Vol. 238, No. 3, 03.2024, p. 324-331.

Research output: Contribution to journal › Article › peer-review

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AU - Jain, Sameer

AU - Drake, Ruth

AU - Entwistle, Ian

AU - Baren, James P

AU - Thompson, Zachary

AU - Beadling, Andrew R

AU - Bryant, Michael G

AU - Shuweihdi, Farag

AU - Pandit, Hemant

N1 - Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Materials used in the study have been funded by Zimmer Biomet. Some of this work has been funded by Leeds Hospitals Charity for the lead author (SJ). The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The following authors declare the following conflicting interests none of which are directly related to the scientific content within this manuscript. Hemant Pandit is a consultant for Zimmer Biomet, Medacta, Smith & Nephew, Invibio, Paradigm Biopharma, Allay Therapeutics, JRI Orthopaedics and Microport. Sameer Jain has received research funding from Leeds Hospitals Charities. Publisher Copyright: © IMechE 2024.

PY - 2024/3

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N2 - This biomechanical study aimed to determine if variations in stem material, stem geometry, stem offset and cement viscosity affect mechanical resistance to postoperative periprosthetic fracture (PFF) after hip arthroplasty with a commonly used cemented polished taper-slip (PTS) stem (CPT, Zimmer Biomet) in a novel osteoporotic composite femoral bone model. Thirty-six osteoporotic composite femoral models were tested using a standardised in-vitro loading technique to simulate a typical PFF. Outcome measures were torque to failure (N), fracture energy (N/m2) and rotation to failure (°). Comparisons were made by stem material (cobalt chrome vs stainless steel), stem geometry (CPT stem vs Exeter stem), stem offset (standard offset vs extra extended offset) and cement viscosity (high viscosity vs low viscosity). Statistical comparisons were carried out with significance set at p < 0.05. All tested samples produced clinically representative fracture patterns with varying degrees of bone and cement comminution. There was no statistically significant difference in torque to failure, fracture energy or rotation to failure between any of the compared variables (all p > 0.05). This is the first biomechanical study on mechanical resistance to PFF using osteoporotic composite bone models. For the CPT stem, it confirms that stem material, stem offset, stem geometry and cement viscosity do not affect mechanical resistance to PFF in an osteoporotic bone model.

AB - This biomechanical study aimed to determine if variations in stem material, stem geometry, stem offset and cement viscosity affect mechanical resistance to postoperative periprosthetic fracture (PFF) after hip arthroplasty with a commonly used cemented polished taper-slip (PTS) stem (CPT, Zimmer Biomet) in a novel osteoporotic composite femoral bone model. Thirty-six osteoporotic composite femoral models were tested using a standardised in-vitro loading technique to simulate a typical PFF. Outcome measures were torque to failure (N), fracture energy (N/m2) and rotation to failure (°). Comparisons were made by stem material (cobalt chrome vs stainless steel), stem geometry (CPT stem vs Exeter stem), stem offset (standard offset vs extra extended offset) and cement viscosity (high viscosity vs low viscosity). Statistical comparisons were carried out with significance set at p < 0.05. All tested samples produced clinically representative fracture patterns with varying degrees of bone and cement comminution. There was no statistically significant difference in torque to failure, fracture energy or rotation to failure between any of the compared variables (all p > 0.05). This is the first biomechanical study on mechanical resistance to PFF using osteoporotic composite bone models. For the CPT stem, it confirms that stem material, stem offset, stem geometry and cement viscosity do not affect mechanical resistance to PFF in an osteoporotic bone model.

KW - cemented stem

KW - composite bone

KW - osteoporosis

KW - Periprosthetic fracture

KW - saw bone

KW - taper-slip

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Jain S, Drake R, Entwistle I, Baren JP, Thompson Z, Beadling AR et al. Risk factors for periprosthetic femoral fracture risk around a cemented polished taper-slip stem using an osteoporotic composite bone model. Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine. 2024 Mar;238(3):324-331. Epub 2024 Jan 18. doi: 10.1177/09544119231225172

Risk factors for periprosthetic femoral fracture risk around a cemented polished taper-slip stem using an osteoporotic composite bone model

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

Access to Document

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