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Does cancellous screw insertion torque depend on bone mineral density and/or microarchitecture?
- Source :
-
Journal of biomechanics [J Biomech] 2014 Jan 22; Vol. 47 (2), pp. 347-53. Date of Electronic Publication: 2013 Nov 27. - Publication Year :
- 2014
-
Abstract
- During insertion of a cancellous bone screw, the torque level reaches a plateau, at the engagement of all the screw threads prior to the screw head contact. This plateau torque (T(Plateau)) was found to be a good predictor of the insertion failure torque (stripping) and also exhibited strong positive correlations with areal bone mineral density (aBMD) in ovine bone. However, correlations between T(Plateau) and aBMD, as well as correlations between T(Plateau) and bone microarchitecture, have never been explored in human bone. The aim of this study was to determine whether T(Plateau), a predictor of insertion failure torque, depends on aBMD and/or bone microarchitecture in human femoral heads. Fifty-two excised human femoral heads were obtained. The aBMD and microarchitecture of each specimen were evaluated using dual X-ray Absorptiometry and micro-computed tomography. A cancellous screw was inserted into specimens using an automated micro-mechanical test device, and T(Plateau) was calculated from the insertion profile. T(Plateau) exhibited the strongest correlation with the structure model index (SMI, R=-0.82, p<0.001), followed by bone volume fraction (BV/TV, R=0.80, p<0.01) and aBMD (R=0.76, p<0.01). Stepwise forward regression analysis showed an increase for the prediction of T(Plateau) when aBMD was combined with microarchitectural parameters, i.e., aBMD combined with SMI (R(2) increased from 0.58 to 0.72) and aBMD combined with BV/TV and BS/TV (R(2) increased from 0.58 to 0.74). In conclusion, T(Plateau), a strong predictor for insertion failure torque, is significantly dependent on bone microarchitecture (particularly SMI and BV/TV) and aBMD.<br /> (© 2013 Elsevier Ltd. All rights reserved.)
- Subjects :
- Absorptiometry, Photon
Aged
Aged, 80 and over
Animals
Bone and Bones diagnostic imaging
Bone and Bones pathology
Female
Femur Head diagnostic imaging
Femur Head pathology
Hip Fractures pathology
Hip Fractures physiopathology
Hip Fractures surgery
Humans
Male
Regression Analysis
Sheep
Torque
X-Ray Microtomography instrumentation
X-Ray Microtomography methods
Bone Density
Bone Screws
Bone and Bones physiopathology
Femur Head physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1873-2380
- Volume :
- 47
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of biomechanics
- Publication Type :
- Academic Journal
- Accession number :
- 24360200
- Full Text :
- https://doi.org/10.1016/j.jbiomech.2013.11.030