Effect of Hydroxyapatite Augmentation on Femoral Lag Screw Insertion in Intertrochanteric Femoral Fractures in the Elderly: A Biomechanical Study

羟基磷灰石增强对老年人股骨粗隆间骨折股骨拉力螺钉植入的影响:一项生物力学研究

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Abstract

BACKGROUND: This study aimed to investigate the effect of hydroxyapatite (HA) augmentation on the maximum lag screw insertion torque (T(Max)) using extracted human femoral heads. MATERIALS AND METHODS: Hemispherical femoral heads extracted from patients who underwent bipolar hip arthroplasty were used. These samples were divided into the HA treatment group (HA group) and the non-HA treatment group (N group). After drilling, HA was inserted into the femoral heads in the HA group. A lag screw was inserted into the femoral head using a dedicated jig in both groups. The bone mineral density of the uninjured contralateral femoral neck (f-BMD), T(Max), and the T(Max)/f-BMD ratio were evaluated. RESULTS: Twenty-seven samples were analyzed in this study: 14 samples in the HA group and 13 samples in the N group. No significant differences were observed in f-BMD and T(Max) between the two groups (HA: 0.49 ± 0.11 vs. N: 0.48 ± 0.092 g/cm(2), p = 0.90; HA: 5.6 ± 1.9 vs. N: 4.3 ± 1.9 N・m, p = 0.78). Considering bone mineral density, the HA group showed a significantly higher T(Max)/f-BMD ratio than the N group (11.7 ± 3.3 vs. 8.9 ± 3.2 N・m・cm(2)/g, p = 0.036). Correlation coefficients between f-BMD and T(Max)in both groups were moderately strong (r = 0.50 vs. 0.50). CONCLUSION: Our results suggest that HA augmentation improves lag screw fixation strength in the treatment of osteoporotic intertrochanteric femoral fractures.

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