A clinical, radiographic, and cost comparison of cerclage techniques: wires vs cables

Area of Science:

• Orthopedic surgery
• Biomaterials engineering
• Radiographic analysis

Background:

• The cerclage technique is crucial for securing femoral fractures, allografts, and plates in orthopedic procedures.
• Optimal material selection, specifically wires versus cables, for cerclage remains unclear.
• Total hip arthroplasty (THA) provides a relevant clinical context for evaluating cerclage techniques.

Purpose of the Study:

• To compare the efficacy and cost-effectiveness of wires versus cables in the cerclage technique during total hip arthroplasty.
• To determine if there is a significant difference in radiographic outcomes and patient-reported function between wire and cable cerclage.
• To assess the mechanical failure rates of wires and cables used in this context.

Main Methods:

• Retrospective radiographic review of 6,460 total hip arthroplasties performed between 1986 and 2003.
• Analysis of 249 cases where wires or cables were utilized for cerclage.
• Comparison of complication rates (e.g., breakage), Harris hip scores, and pain scores between wire and cable groups.

Main Results:

• A low rate of mechanical failure was observed for both wires (1.72%) and cables (0.92%), with no statistically significant difference (P < .5373).
• No significant differences were found in Harris hip function or pain scores between patients who received wire cerclage versus cable cerclage.
• Luque wires, costing significantly less ($29.79) than cables ($275.40), demonstrated comparable performance.

Conclusions:

• Both wiring and cabling are viable options for cerclage in total hip arthroplasty, with similar functional and pain outcomes.
• Wiring presents a more cost-effective alternative to cabling without compromising clinical results.
• The study suggests that wiring may be the preferred cerclage technique due to its economic advantages and comparable performance.