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J Arthroplasty ; 34(5): 987-990, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30824292

RESUMO

BACKGROUND: Intraoperative femur fractures are a common complication of revision hip arthroplasty. This study examined the use of a prophylactic cable in stopping a crack from propagating beyond the cable. METHODS: Seventy sheep femora were prepared. A 5-mm vertical incision was performed. Using a force-controlled materials testing machine, a Wagner shaft was advanced until a crack occurred. Cracks were visualized with green ink. In the first part, the control group without any cable (n = 10) was compared with polyethylene (n = 15) and single CoCr cable (n = 15) groups. The cables were positioned 15 mm distal to the osteotomy. In the second part, three different CoCr configurations were compared, single-wrapped (n = 15), double-wrapped (n = 125), and two separate cables at 10 and 15 mm distal to the osteotomy (n = 15). RESULTS: The polyethylene cable stopped only 3 of 15 cracks (20%), whereas the CoCr cable stopped 11 of 15 cracks (73%) (P = .009). The force needed to initiate the crack between the different groups was not significant. Twelve (80%) of 15 cracks were stopped at the level of the cable with two separate CoCr cables and 15 (100%) of 15 cracks with a double-wrapped cable (P = .11). CONCLUSION: This study demonstrated that an elastic cable is not suitable for preventive cabling. The force required to form a crack is not improved with the use of a prophylactic cable placed 10-15 mm below the osteotomy. While the results on the different configurations were not conclusive, the double-wrapped cable was able to stop all cracks from progressing distally.


Assuntos
Artroplastia de Quadril/efeitos adversos , Artroplastia de Quadril/instrumentação , Fraturas do Fêmur/prevenção & controle , Fêmur/cirurgia , Fraturas Periprotéticas/prevenção & controle , Animais , Materiais Biocompatíveis , Fenômenos Biomecânicos , Ligas de Cromo , Fraturas do Fêmur/etiologia , Fêmur/lesões , Humanos , Teste de Materiais , Osteotomia/efeitos adversos , Osteotomia/métodos , Fraturas Periprotéticas/etiologia , Polietileno , Ovinos
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