Development and first biomechanical validation of a score to predict bone implant interface stability based on clinical qCT scans

Abstract Sufficient implant anchoring in osteoporotic bone is one major challenge in trauma and orthopedic surgery. In these cases, preoperative planning of osteosynthesis is becoming increasingly important. This study presents the development and first biomechanical validation of a bone-implant-anc...

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Autores principales:	Dirk Wähnert, Andre Frank, Johanna Ueberberg, Lukas F. Heilmann, Odile Sauzet, Michael J. Raschke, Dominic Gehweiler
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ce47cb91052d45759d04f3a95b573649
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spelling	oai:doaj.org-article:ce47cb91052d45759d04f3a95b5736492021-12-02T14:26:54ZDevelopment and first biomechanical validation of a score to predict bone implant interface stability based on clinical qCT scans10.1038/s41598-021-82788-y2045-2322https://doaj.org/article/ce47cb91052d45759d04f3a95b5736492021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-82788-yhttps://doaj.org/toc/2045-2322Abstract Sufficient implant anchoring in osteoporotic bone is one major challenge in trauma and orthopedic surgery. In these cases, preoperative planning of osteosynthesis is becoming increasingly important. This study presents the development and first biomechanical validation of a bone-implant-anchorage score based on clinical routine quantitative computer tomography (qCT) scans. 10 pairs of fresh frozen femora (mean age 77.4 years) underwent clinical qCT scans after placing 3 referential screws (for matching with the second scan). Afterwards, three 4.5 mm cortical screws (DePuy Synthes, Zuchwil, Switzerland) were placed in each distal femur in the dia-metaphyseal transition followed by the second CT scan. The femur was segmented using thresholding and its outer shape was visualized as a surface model. A 3D model of the cortex screw in STL format was used to model the screw surface precisely. For each femur, the 3 cortex screw models were exactly positioned at the locations previously determined using the second CT scan. The BMD value was calculated at the center of each triangle as an interpolation from the measured values at the three vertices (triangle corners) in the CT. Scores are based on the sum of all the triangles’ areas multiplied by their BMD values. Four different scores were calculated. A screw pull-out test was performed until loss of resistance. A quadratic model adequately describes the relation between all the scores and pull-out values. The square of the best score explains just fewer than 70% of the total variance of the pull-out values and the standardized residual which were approximately normally distributed. In addition, there was a significant correlation between this score and the peak pull-out force (p < 0.001). The coefficient of determination was 0.82. The presented score has the potential to improve preoperative planning by adding the mechanical to the anatomical dimension when planning screw placement.Dirk WähnertAndre FrankJohanna UeberbergLukas F. HeilmannOdile SauzetMichael J. RaschkeDominic GehweilerNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Dirk Wähnert Andre Frank Johanna Ueberberg Lukas F. Heilmann Odile Sauzet Michael J. Raschke Dominic Gehweiler Development and first biomechanical validation of a score to predict bone implant interface stability based on clinical qCT scans
description	Abstract Sufficient implant anchoring in osteoporotic bone is one major challenge in trauma and orthopedic surgery. In these cases, preoperative planning of osteosynthesis is becoming increasingly important. This study presents the development and first biomechanical validation of a bone-implant-anchorage score based on clinical routine quantitative computer tomography (qCT) scans. 10 pairs of fresh frozen femora (mean age 77.4 years) underwent clinical qCT scans after placing 3 referential screws (for matching with the second scan). Afterwards, three 4.5 mm cortical screws (DePuy Synthes, Zuchwil, Switzerland) were placed in each distal femur in the dia-metaphyseal transition followed by the second CT scan. The femur was segmented using thresholding and its outer shape was visualized as a surface model. A 3D model of the cortex screw in STL format was used to model the screw surface precisely. For each femur, the 3 cortex screw models were exactly positioned at the locations previously determined using the second CT scan. The BMD value was calculated at the center of each triangle as an interpolation from the measured values at the three vertices (triangle corners) in the CT. Scores are based on the sum of all the triangles’ areas multiplied by their BMD values. Four different scores were calculated. A screw pull-out test was performed until loss of resistance. A quadratic model adequately describes the relation between all the scores and pull-out values. The square of the best score explains just fewer than 70% of the total variance of the pull-out values and the standardized residual which were approximately normally distributed. In addition, there was a significant correlation between this score and the peak pull-out force (p < 0.001). The coefficient of determination was 0.82. The presented score has the potential to improve preoperative planning by adding the mechanical to the anatomical dimension when planning screw placement.
format	article
author	Dirk Wähnert Andre Frank Johanna Ueberberg Lukas F. Heilmann Odile Sauzet Michael J. Raschke Dominic Gehweiler
author_facet	Dirk Wähnert Andre Frank Johanna Ueberberg Lukas F. Heilmann Odile Sauzet Michael J. Raschke Dominic Gehweiler
author_sort	Dirk Wähnert
title	Development and first biomechanical validation of a score to predict bone implant interface stability based on clinical qCT scans
title_short	Development and first biomechanical validation of a score to predict bone implant interface stability based on clinical qCT scans
title_full	Development and first biomechanical validation of a score to predict bone implant interface stability based on clinical qCT scans
title_fullStr	Development and first biomechanical validation of a score to predict bone implant interface stability based on clinical qCT scans
title_full_unstemmed	Development and first biomechanical validation of a score to predict bone implant interface stability based on clinical qCT scans
title_sort	development and first biomechanical validation of a score to predict bone implant interface stability based on clinical qct scans
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/ce47cb91052d45759d04f3a95b573649
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Development and first biomechanical validation of a score to predict bone implant interface stability based on clinical qCT scans

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