Abstract:
Objectives:The paradoxical migration of the femoral neck element (FNE) superomedially against gravity, with respect to the intramedullary component of the cephalomedullary device, is a poorly understood phenomenon increasingly seen in the management of pertrochanteric hip fractures with the intramedullary nail. The aim of this study was to investigate the role of bidirectional loading on the medial migration phenomenon, based on unique wear patterns seen on scanning electron microscopy of retrieved implants suggestive of FNE toggling. Methods:A total of 18 synthetic femurs (Sawbones, Vashon Island, Washington) with comminuted pertrochanteric fractures were divided into three groups (n = 6 per group). Fracture fixation was performed using the Proximal Femoral Nail Antirotation (PFNA) implant (Synthes, Oberdorf, Switzerland; n = 6). Group 1 was subjected to unidirectional compression loading (600 N), with an elastomer (70A durometer) replacing loose fracture fragments to simulate surrounding soft-tissue tensioning. Group 2 was subjected to bidirectional loading (600 N compression loading, 120 N tensile loading), also with the elastomer replacing loose fracture fragments. Group 3 was subjected to bidirectional loading (600 N compression loading, 120 N tensile loading) without the elastomer. All constructs were tested at 2 Hz for 5000 cycles or until cut-out occurred. The medial migration distance (MMD) was recorded at the end of the testing cycles. Results:The MMDs for Groups 1, 2, and 3 were 1.02 mm, 6.27 mm, and 5.44 mm respectively, with reliable reproduction of medial migration seen in all groups. Bidirectional loading groups showed significantly higher MMDs compared with the unidirectional loading group (p < 0.01). Conclusion:Our results demonstrate significant contributions of bidirectional cyclic loading to the medial migration phenomenon in cephalomedullary nail fixation of pertrochanteric hip fractures.Cite this article: G. W. Law, Y. R. Wong, A. K-S. Yew, A. C. T. Choh, J. S. B. Koh, T. S. Howe. Medial migration in cephalomedullary nail fixation of pertrochanteric hip fractures: A biomechanical analysis using a novel bidirectional cyclic loading model. Bone Joint Res 2019;8:313-322. DOI: 10.1302/2046-3758.87.BJR-2018-0271.R1.
journal_name
Bone Joint Resjournal_title
Bone & joint researchauthors
Law GW,Wong YR,Yew AK,Choh ACT,Koh JSB,Howe TSdoi
10.1302/2046-3758.87.BJR-2018-0271.R1subject
Has Abstractpub_date
2019-08-02 00:00:00pages
313-322issue
7issn
2046-3758pii
10.1302_2046-3758.87.BJR-2018-0271.R1journal_volume
8pub_type
杂志文章abstract:OBJECTIVES:To study the measurement properties of a joint specific patient reported outcome measure, a measure of capability and a general health-related quality of life (HRQOL) tool in a large cohort of patients with a hip fracture. METHODS:Responsiveness and associations between the Oxford Hip Score (a hip specific ...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.33.2000250
更新日期:2014-03-19 00:00:00
abstract::The treatment of osteochondral lesions and osteoarthritis remains an ongoing clinical challenge in orthopaedics. This review examines the current research in the fields of cartilage regeneration, osteochondral defect treatment, and biological joint resurfacing, and reports on the results of clinical and pre-clinical s...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.29.2000189
更新日期:2013-09-16 00:00:00
abstract:OBJECTIVES:A patient-centred approach, usually achieved through shared decision making, has the potential to help improve decision making around knee arthroplasty surgery. However, such an approach requires an understanding of the factors involved in patient decision making. This review's objective is to systematically...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.410.2000420
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVES:To investigate the differences of open reduction and internal fixation (ORIF) of complex AO Type C distal radius fractures between two different models of a single implant type. METHODS:A total of 136 patients who received either a 2.4 mm (n = 61) or 3.5 mm (n = 75) distal radius locking compression plate (...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.16.2000008
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVES:This study aimed to characterise and qualitatively grade the severity of the corrosion particles released into the hip joint following taper corrosion. METHODS:The 26 cases examined were CoC/ABG Modular (n = 13) and ASR/SROM (n = 13). Blood serum metal ion levels were collected before and after revision sur...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.59.2000507
更新日期:2016-09-01 00:00:00
abstract:Objectives:Recently, the field of tissue engineering has made numerous advances towards achieving artificial tendon substitutes with excellent mechanical and histological properties, and has had some promising experimental results. The purpose of this systematic review is to assess the efficacy of tissue engineering in...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.74.BJR-2017-0326
更新日期:2018-05-05 00:00:00
abstract:OBJECTIVES:Pedicle-lengthening osteotomy is a novel surgery for lumbar spinal stenosis (LSS), which achieves substantial enlargement of the spinal canal by expansion of the bilateral pedicle osteotomy sites. Few studies have evaluated the impact of this new surgery on spinal canal volume (SCV) and neural foramen dimens...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.56.2000469
更新日期:2016-06-01 00:00:00
abstract:AIMS:Treatment of chronic osteomyelitis (COM) for young patients remains a challenge. Large bone deficiencies secondary to COM can be treated using induced membrane technique (IMT). However, it is unclear which type of bone graft is optimal. The goal of the study was to determine the clinical effectiveness of bone marr...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.101.BJR-2020-0229.R1
更新日期:2021-01-01 00:00:00
abstract::Fractures of the proximal femur are one of the greatest challenges facing the medical community, constituting a heavy socioeconomic burden worldwide. Controversy exists regarding the optimal treatment for patients with unstable trochanteric proximal femoral fractures. The recognised treatment alternatives are extramed...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.210.2000183
更新日期:2013-10-02 00:00:00
abstract:OBJECTIVES:To investigate psychosocial and biomedical outcomes following total hip replacement (THR) and to identify predictors of recovery from THR. METHODS:Patients with osteoarthritis (OA) on the waiting list for primary THR in North West England were assessed pre-operatively and at six and 12 months post-operative...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.211.2000206
更新日期:2013-11-27 00:00:00
abstract:Objectives:We investigated the reliability of the cobalt-chromium (CoCr) synovial joint fluid ratio (JFR) in identifying the presence of a severe aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL) response and/or suboptimal taper performance (SOTP) following metal-on-metal (MoM) hip arthroplasty. We then...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.83.BJR-2018-0049.R1
更新日期:2019-04-02 00:00:00
abstract:Aims:To evaluate graft healing of decellularized porcine superflexor tendon (pSFT) xenograft in an ovine anterior cruciate ligament (ACL) reconstruction model using two femoral fixation devices. Also, to determine if pSFT allows functional recovery of gait as compared with the preoperative measurements. Methods:A tota...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.96.BJR-2020-0030.R2
更新日期:2020-07-23 00:00:00
abstract:OBJECTIVES:We aimed to determine the effect of surgical approach on the histology of the femoral head following resurfacing of the hip. METHODS:We performed a histological assessment of the bone under the femoral component taken from retrieval specimens of patients having revision surgery following resurfacing of the ...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.29.2000179
更新日期:2013-09-18 00:00:00
abstract:Objectives:The primary stability of the cementless Oxford Unicompartmental Knee Replacement (OUKR) relies on interference fit (or press fit). Insufficient interference may cause implant loosening, whilst excessive interference could cause bone damage and fracture.The aim of this study was to identify the optimal interf...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.73.BJR-2017-0193.R1
更新日期:2018-05-05 00:00:00
abstract:OBJECTIVES:As tumours of bone and soft tissue are rare, multicentre prospective collaboration is essential for meaningful research and evidence-based advances in patient care. The aim of this study was to identify barriers and facilitators encountered in large-scale collaborative research by orthopaedic oncological sur...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.65.BJR-2016-0192.R1
更新日期:2017-05-01 00:00:00
abstract:Objectives:The aim of this study was to investigate the biomechanical effect of the anterolateral ligament (ALL), anterior cruciate ligament (ACL), or both ALL and ACL on kinematics under dynamic loading conditions using dynamic simulation subject-specific knee models. Methods:Five subject-specific musculoskeletal mod...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.811.BJR-2019-0103.R1
更新日期:2019-12-03 00:00:00
abstract:OBJECTIVES:The number of surgical procedures performed each year to treat femoroacetabular impingement (FAI) continues to rise. Although there is evidence that surgery can improve symptoms in the short-term, there is no evidence that it slows the development of osteoarthritis (OA). We performed a feasibility study to d...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.22.2000137
更新日期:2013-02-01 00:00:00
abstract::Cartilage repair in terms of replacement, or regeneration of damaged or diseased articular cartilage with functional tissue, is the 'holy grail' of joint surgery. A wide spectrum of strategies for cartilage repair currently exists and several of these techniques have been reported to be associated with successful clin...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.34.2000238
更新日期:2014-04-02 00:00:00
abstract:OBJECTIVE:The objective of this study was to explore dimensionality of the Oxford Hip Score (OHS) and examine whether self-reported pain and functioning can be distinguished in the form of subscales. METHODS:This was a secondary data analysis of the UK NHS hospital episode statistics/patient-reported outcome measures ...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.311.2000313
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVES:To assess the structure and extracellular matrix molecule expression of osteogenic cell sheets created via culture in medium with both dexamethasone (Dex) and ascorbic acid phosphate (AscP) compared either Dex or AscP alone. METHODS:Osteogenic cell sheets were prepared by culturing rat bone marrow stromal c...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.511.BJR-2016-0013.R1
更新日期:2016-11-01 00:00:00
abstract::Osteoporosis (OP) is a chronic metabolic bone disease characterized by the decrease of bone tissue per unit volume under the combined action of genetic and environmental factors, which leads to the decrease of bone strength, makes the bone brittle, and raises the possibility of bone fracture. However, the exact mechan...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.98.BJR-2020-0089.R1
更新日期:2020-08-02 00:00:00
abstract:AIMS:This study aimed to investigate the effect of solute carrier family 20 member 2 (SLC20A2) gene mutation (identified from a hereditary multiple exostoses family) on chondrocyte proliferation and differentiation. METHODS:ATDC5 chondrocytes were cultured in insulin-transferrin-selenium medium to induce differentiati...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.911.BJR-2020-0112.R1
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVES:To assess the accuracy of patient-specific instruments (PSIs) versus standard manual technique and the precision of computer-assisted planning and PSI-guided osteotomies in pelvic tumour resection. METHODS:CT scans were obtained from five female cadaveric pelvises. Five osteotomies were designed using Mimic...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.610.BJR-2017-0094.R1
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVES:In order to ensure safety of the cell-based therapy for bone regeneration, we examined in vivo biodistribution of locally or systemically transplanted osteoblast-like cells generated from bone marrow (BM) derived mononuclear cells. METHODS:BM cells obtained from a total of 13 Sprague-Dawley (SD) green fluor...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.33.2000257
更新日期:2014-03-20 00:00:00
abstract:Objectives:The aim of this study was to analyze drain fluid, blood, and urine simultaneously to follow the long-term release of vancomycin from a biphasic ceramic carrier in major hip surgery. Our hypothesis was that there would be high local vancomycin concentrations during the first week with safe low systemic trough...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.82.BJR-2018-0174.R2
更新日期:2019-03-02 00:00:00
abstract:BACKGROUND:Resveratrol is a polyphenolic compound commonly found in the skins of red grapes. Sirtuin 1 (SIRT1) is a human gene that is activated by resveratrol and has been shown to promote longevity and boost mitochondrial metabolism. We examined the effect of resveratrol on normal and osteoarthritic (OA) human chondr...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.33.2000226
更新日期:2014-03-10 00:00:00
abstract:OBJECTIVES:Pseudotumours (abnormal peri-prosthetic soft-tissue reactions) following metal-on-metal hip resurfacing arthroplasty (MoMHRA) have been associated with elevated metal ion levels, suggesting that excessive wear may occur due to edge-loading of these MoM implants. This study aimed to quantify in vivo edge-load...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.14.2000019
更新日期:2012-04-01 00:00:00
abstract:Objectives:Different criteria for assessing the reduction quality of trochanteric fractures have been reported. The Baumgaertner reduction quality criteria (BRQC) are relatively common and the Chang reduction quality criteria (CRQC) are relatively new. The objectives of the current study were to compare the reliability...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.810.BJR-2019-0032.R1
更新日期:2019-11-02 00:00:00
abstract:OBJECTIVES:We aimed to examine the characteristics of deep venous flow in the leg in a cast and the effects of a wearable neuromuscular stimulator (geko; FirstKind Ltd) and also to explore the participants' tolerance of the stimulator. METHODS:This is an open-label physiological study on ten healthy volunteers. Duplex...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.29.2000176
更新日期:2013-09-02 00:00:00
abstract:OBJECTIVES:Microindentation has the potential to measure the stiffness of an individual patient's bone. Bone stiffness plays a crucial role in the press-fit stability of orthopaedic implants. Arming surgeons with accurate bone stiffness information may reduce surgical complications including periprosthetic fractures. T...
journal_title:Bone & joint research
pub_type: 杂志文章
doi:10.1302/2046-3758.69.BJR-2016-0317.R2
更新日期:2017-09-01 00:00:00