Biomechanical comparison of acetabular fracture fixation with stand-alone THA or in combination with plating

Wenzel L, Sandriesser S, Glowalla C, Gueorguiev B, Perl M, Stuby FM, Augat P, Hungerer S (2022)

Publication Type: Journal article

Publication year: 2022

Journal

European Journal of Trauma and Emergency Surgery Springer Verlag (Germany)

Abstract

Purpose A common surgical treatment in anterior column acetabular fractures with preexisting osteoarthritis is THA, which is commonly combined with plate osteosynthesis. Implantation of a solitary revision cup cranially fixed to the os ilium is less common. The purpose of this study was to compare the stabilization of anterior column acetabular fractures fixed with a cranial socket revision cup with flange and iliac peg or with a suprapectineal plate osteosynthesis combined with an additional revision cup. Methods In 20 human hemipelves, an anterior column fracture was stabilized by either a cranial socket revision cup with integrated flange (CF = Cup with Flange) or by a suprapectineal plate combined with a revision cup (CP = Cup and Plate). Each specimen was loaded under a stepwise increasing dynamic load protocol. Initial construct stiffness, interfragmentary movements along the fracture line, as well as femoral head movement in relation to the acetabulum were analyzed. Results Both groups showed comparable initial construct stiffness (CP: 3180 +/- 1162 N/mm and CF: 3754 +/- 668 N/mm; p = 0.158). At an applied load of 1400 N, interfragmentary movements at the acetabular (p = 0.139) and the supraacetabular region (p = 0.051) revealed comparable displacement for both groups and remained below 1 mm. Femoral head movement in relation to the acetabulum also remained below 1 mm for both test groups (p = 0.260). Conclusion From a biomechanical point of view, both surgical approaches showed comparable fracture reduction in terms of initial construct stiffness and interfragmentary movement. The potential benefit of the less-invasive cranial socket revision cup has to be further investigated in clinical studies.

Authors with CRIS profile

Mario Perl Lehrstuhl für Unfallchirurgie und Orthopädie

Involved external institutions

AO Research Institute

Switzerland (CH) Berufsgenossenschaftliche Unfallklinik (BGU) Murnau

Germany (DE)

How to cite

APA:

Wenzel, L., Sandriesser, S., Glowalla, C., Gueorguiev, B., Perl, M., Stuby, F.M.,... Hungerer, S. (2022). Biomechanical comparison of acetabular fracture fixation with stand-alone THA or in combination with plating. European Journal of Trauma and Emergency Surgery. https://doi.org/10.1007/s00068-021-01872-0

MLA:

Wenzel, Lisa, et al. "Biomechanical comparison of acetabular fracture fixation with stand-alone THA or in combination with plating." European Journal of Trauma and Emergency Surgery (2022).

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