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Cyclic Damage Accumulation in the Femoral Constructs Made With Cephalomedullary Nails

Hamandi, Farah and Whitney, Alyssa and Stouffer, Mark H. and Prayson, Michael J. and Rittweger, Jörn and Goswami, Tarun (2021) Cyclic Damage Accumulation in the Femoral Constructs Made With Cephalomedullary Nails. Frontiers in Bioengineering and Biotechnology, 8, p. 593609. Frontiers Media S.A.. doi: 10.3389/fbioe.2020.593609. ISSN 2296-4185.

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Official URL: https://www.frontiersin.org/articles/10.3389/fbioe.2020.593609/full

Abstract

Background: The purpose of this study was to evaluate the risk of peri-prosthetic fracture of constructs made with cephalomedullary (CM) long and short nails. The nails were made with titanium alloy (Ti-6Al-4V) and stainless steel (SS 316L). Methods: Biomechanical evaluation of CM nail constructs was carried out with regard to post-primary healing to determine the risk of peri-implant/peri-prosthetic fractures. Therefore, this research comprised of, non-fractured, twenty-eight pairs of cadaveric femora that were randomized and implanted with four types of fixation CM nails resulting in four groups. These constructs were cyclically tested in bi-axial mode for up to 30,000 cycles. All the samples were then loaded to failure to measure failure loads. Three frameworks were carried out through this investigation, Michaelis–Menten, phenomenological, and probabilistic Monte Carlo simulation to model and predict damage accumulation. Findings: Damage accumulation resulting from bi-axial cyclic loading in terms of construct stiffness was represented by Michaelis–Menten equation, and the statistical analysis demonstrated that one model can explain the damage accumulation during cyclic load for all four groups of constructs (P > 0.05). A two-stage stiffness drop was observed. The short stainless steel had a significantly higher average damage (0.94) than the short titanium nails (0.90, P < 0.05). Long titanium nail group did not differ substantially from the short stainless steel nails (P > 0.05). Results showed gender had a significant effect on load to failure in both torsional and bending tests (P < 0.05 and P < 0.001, respectively). Interpretation: Kaplan–Meier survival analysis supports the use of short titanium CM nail. We recommend that clinical decisions should take age and gender into consideration in the selection of implants

Item URL in elib:https://elib.dlr.de/141663/
Document Type:Article
Title:Cyclic Damage Accumulation in the Femoral Constructs Made With Cephalomedullary Nails
Authors:
AuthorsInstitution or Email of AuthorsAuthor's ORCID iD
Hamandi, FarahDepartment of Biomedical, Industrial, and Human Factors Engineering, Wright State University, Dayton, OH, United States,UNSPECIFIED
Whitney, AlyssaDepartment of Biomedical, Industrial, and Human Factors Engineering, Wright State University, Dayton, OH, United States,UNSPECIFIED
Stouffer, Mark H.Department of Orthopaedic Surgery, Sports Medicine and Rehabilitation, Wright State University, Dayton, OH, United States,UNSPECIFIED
Prayson, Michael J.Department of Orthopaedic Surgery, Sports Medicine and Rehabilitation, Wright State University, Dayton, OH, United States,UNSPECIFIED
Rittweger, JörnJoern.Rittweger (at) dlr.dehttps://orcid.org/0000-0002-2223-8963
Goswami, TarunDepartment of Biomedical, Industrial, and Human Factors Engineering, Wright State University, Dayton, OH, United States,UNSPECIFIED
Date:5 February 2021
Journal or Publication Title:Frontiers in Bioengineering and Biotechnology
Refereed publication:Yes
Open Access:Yes
Gold Open Access:Yes
In SCOPUS:Yes
In ISI Web of Science:Yes
Volume:8
DOI :10.3389/fbioe.2020.593609
Page Range:p. 593609
Publisher:Frontiers Media S.A.
Series Name:Biomechanics
ISSN:2296-4185
Status:Published
Keywords:Keywords: femur, cephalomedullary nail, damage accumulation, biomechanics, gender
HGF - Research field:Aeronautics, Space and Transport
HGF - Program:Space
HGF - Program Themes:Research under Space Conditions
DLR - Research area:Raumfahrt
DLR - Program:R FR - Research under Space Conditions
DLR - Research theme (Project):R - Bone metabolism and structural adaptation
Location: Köln-Porz
Institutes and Institutions:Institute of Aerospace Medicine > Muscle and Bone Metabolism
Deposited By: Arndt, Carina
Deposited On:20 Apr 2021 10:27
Last Modified:20 Apr 2021 10:27

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