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Drill holes decrease cancellous bone strength: A comparative study of 33 paired osteoporotic human and 9 paired
Marcin Ceynowa1, Krzysztof Zerdzicki2, Pawel Klosowski2
1Department of Orthopedic Surgery, Medical University of Gdańsk, Gdańsk, Poland.
Plos One
|October 29, 2020
Summary
Drilling cancellous bone for screws reduces strength proportionally to area lost. Human bone is stronger and stiffer than synthetic bone, but relative weakening is similar.
Area of Science:
- Orthopedic biomechanics
- Biomaterials science
Background:
- Cancellous bone mechanical properties are crucial for orthopedic procedures.
- Synthetic bone substitutes are used in biomechanical studies, but their direct applicability to human bone is debated.
Purpose of the Study:
- To compare the compressive strength of human cancellous bone with and without guide wire holes.
- To compare the mechanical properties of human cancellous bone to synthetic bone samples.
- To assess the impact of drilling on bone strength and stiffness.
Main Methods:
- Cuboid samples of human cancellous bone from femoral heads and synthetic femurs were prepared.
- One sample from each pair was drilled to simulate guide wire placement.
- Uniaxial compression tests were performed using a Zwick-Roell Z020 strength testing machine.
Main Results:
- Drilling reduced the cross-sectional area by a mean of 24%.
- Force at failure decreased by 18% in human bone and 25% in synthetic bone.
- Human bone exhibited approximately twice the strength and four times the stiffness of synthetic bone.
Conclusions:
- Bone weakening after drilling is proportional to the loss of cross-sectional area.
- While human bone is intrinsically stronger and stiffer, the relative decrease in mechanical properties due to damage is comparable between human and synthetic bone.
- Biomechanical study results from synthetic bone should be interpreted cautiously regarding absolute force values in humans, though relative changes may be indicative.
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