Metal and composite bone plates for B1 periprosthetic femoral fracture in healthy and osteoporotic condition: A comparative biomechanical study.

Abstract

The major concern after total hip arthroplasty (THA) is the incidence of periprosthetic fracture in the weaker bone, which can lead to subsequent revision surgery. Achieving the suitable fixation without affecting the stability of the well-fixed prosthesis remains controversial. Most of the studies examined the behavior of the Periprosthetic Fracture (PF) fixation (Vancouver "B1" type) through computational and experimentation on healthy bone condition with metal plates. The aim of the present study is to analyze the influences of the metal and composite bone plate PF fixation on the axial and shear movement at the fracture site. The PF fixation constructs were modeled with medical graded stainless-steel plate (construct A), titanium plate (construct B) and carbon/epoxy composite bone plate (construct C) with 12 holes and a 4 mm fracture gap. Analysis was carried out for all the stages (stage 1-Normal bone, stage 2-THA, stage 3-Immediate Post-Operative (IPO), stage 4-Post-Operative (PO) and, stage 5-Healed Bone (HB)) under various loadings for intact and osteoporosis conditions. The results showed higher stress in cortical bone for stage 3, whereas in all the other stages lower stresses were experienced in the cortical and cancelous bone under peak load in construct C for osteoporosis model compared with other constructs. The present study suggested the construct C may be suitable for osteoporosis bone conditions.