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European Journal of Orthopaedic Surgery & Traumatology

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01.05.2020 | Original Article

Carbon/PEEK nails: a case–control study of 22 cases

verfasst von: Federico Sacchetti, Lorenzo Andreani, Michele Palazzuolo, Stephane Cherix, Enrico Bonicoli, Elisabetta Neri, Rodolfo Capanna

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 4/2020

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Abstract

Background

Interest around carbon/PEEK plates and nails has been raising. The elastic modulus close to the bone, the high load-carrying capacity and radiolucency make CFR/PEEK materials a potential breakthrough. In the literature, there are abundant data about CFR/PEEK plates in the treatment of proximal humerus, distal radius and distal fibula fractures. In patients affected by bone metastasis, CFR/PEEK nails were proved effective and safe with 12 months of follow-up. Very little is known about performances of CFR/PEEK nails in patients affected by other pathologies.

Purposes

The aim of the study was to evaluate safety and efficacy of CFR/PEEK nails in the treatment of various pathological conditions. It was also investigated whatever radiolucency of this nails could lead to a more objective evaluation of bone callus or disease site.

Patients and methods

In the study group were included 20 patients (22 bone segments) who underwent CFR/PEEK nail implantation (eight humerus, one tibia, nine femur and four knee arthrodesis). They were affected by pathological fractures, and in four cases, they required an arthrodesis of the knee. They were retrospectively evaluated considering nail failures and bone callus or disease progression (RUSH scores). Mean follow-up time was 11 months (min 6.8–max 20.3). In the control group were included patients treated with titanium nails in the same institution for the same pathologies. An interclass correlation coefficient (ICC) analysis was performed in both groups considering RUSH scores by two expert surgeon from two institution to assess whether radiolucency could lead to a more objective evaluation of disease or bone callus site.

Results

The ICC of mean values between RUSH scores was 0.882 (IC 95%: 0.702–0.953) in the CFR/PEEK group, while it was 0.778 (IC 95%: 0.41–0.91) in the titanium group. Observers’ evaluation showed a significantly higher obscuration by titanium nails than by CFR/PEEK nails. No osteosynthesis failures were reported in both groups.

Conclusions

Our results confirm the safety of CFR/PEEK nails in the short–medium term. The radiolucency of these materials led our observers to perform more objective evaluations of bone callus formation or disease progression compared to the titanium group given the higher ICC.

Level of evidence: III Case–control therapeutic study.

Akay M, Asian N (1995) An estimation of fatigue life for a carbon fibre/poly ether ether ketone hip joint prosthesis. Proc Inst Mech Eng 209(2):93–103. https://doi.org/10.1177/0956797614551162 CrossRef

Allal AS, Richter M, Russo M, Rouzaud M, Dulguerov P, Kurtz JM (1998) Dose variation at bone/titanium interfaces using titanium hollow screw osseointegrating reconstruction plates. Int J Radiat Oncol Biol Phys 40(1):215–219. https://doi.org/10.1016/S0360-3016(97)00587-7 CrossRefPubMed

Augat P, Morgan EF, Lujan TJ, Macgillivray TJ, Cheung WH (2014) Imaging techniques for the assessment of fracture repair. Injury 45(SUPPL. 2):S16–S22. https://doi.org/10.1016/j.injury.2014.04.004 CrossRefPubMed

Bagheri ZS, El Sawi I, Bougherara H, Zdero R (2014) Biomechanical fatigue analysis of an advanced new carbon fiber/flax/epoxy plate for bone fracture repair using conventional fatigue tests and thermography. J Mech Behav Biomed Mater 35:27–38. https://doi.org/10.1016/j.jmbbm.2014.03.008 CrossRefPubMed

Baidya KP, Ramakrishna S, Rahman M, Ritchie A (2001) Quantitative radiographic analysis of fiber reinforced polymer composites. J Biomater Appl 15(3):279–289. https://doi.org/10.1106/BKLQ-E2YG-D2LA-RG3R CrossRefPubMed

Bhandari M, Chiavaras M, Ayeni O, Chakraverrty R, Parasu N, Choudur H et al (2013) Assessment of radiographic fracture healing in patients with operatively treated femoral neck fractures. J Orthop Trauma 27(9):e213–e219. https://doi.org/10.1097/BOT.0b013e318282e692 CrossRefPubMed

Brockett CL, Carbone S, Fisher J, Jennings LM (2017) PEEK and CFR-PEEK as alternative bearing materials to UHMWPE in a fixed bearing total knee replacement: an experimental wear study. Wear 374–375:86–91. https://doi.org/10.1016/j.wear.2016.12.010 CrossRefPubMedPubMedCentral

Brown SA, Hastings RS, Mason JJ, Moet A (1990) Characterization of short-fibre reinforced thermoplastics for fracture fixation devices. Biomaterials 11(8):541–547. https://doi.org/10.1016/0142-9612(90)90075-2 CrossRefPubMed

Caforio M, Perugia D, Colombo M, Calori GM, Maniscalco P (2014) Preliminary experience with Piccolo Composite™, a radiolucent distal fibula plate, in ankle fractures. Injury 45(S6):S36–S38. https://doi.org/10.1016/j.injury.2014.10.020 CrossRefPubMed

10.

Chiavaras MM, Bains S, Choudur H, Parasu N, Jacobson J, Ayeni O et al (2013) The Radiographic Union Score for Hip (RUSH): the use of a checklist to evaluate hip fracture healing improves agreement between radiologists and orthopedic surgeons. Skelet Radiol 42(8):1079–1088. https://doi.org/10.1007/s00256-013-1605-8 CrossRef

11.

Diffo Kaze A, Maas S, Waldmann D, Zilian A, Dueck K, Pape D (2015) Biomechanical properties of five different currently used implants for open-wedge high tibial osteotomy. J Exp Orthop 2(1):14. https://doi.org/10.1186/s40634-015-0030-4 CrossRefPubMedPubMedCentral

12.

Errani C, Bazzocchi A, Spinnato P, Facchini G, Campanacci L, Rossi G et al (2019) What’ s new in management of bone metastases? Eur J Orthop Surg Traumatol 29(7):1367–1375. https://doi.org/10.1007/s00590-019-02446-y CrossRefPubMed

13.

Errani C, Mavrogenis AF, Cevolani L, Spinelli S, Piccioli A, Maccauro G et al (2017) Treatment for long bone metastases based on a systematic literature review. Eur J Orthop Surg Traumatol 27(2):205–211CrossRef

14.

Feerick EM, Kennedy J, Mullett H, FitzPatrick D, McGarry P (2013) Investigation of metallic and carbon fibre PEEK fracture fixation devices for three-part proximal humeral fractures. Med Eng Phys 35(6):712–722. https://doi.org/10.1016/j.medengphy.2012.07.016 CrossRefPubMed

15.

Filippiadis D, Mavrogenis AF, Mazioti A (2017) Metastatic bone disease from breast cancer: a review of minimally invasive techniques for diagnosis and treatment. Eur J Orthop Surg Traumatol 27(6):729–736CrossRef

16.

Fujihara K, Huang ZM, Ramakrishna S, Satknanantham K, Hamada H (2003) Performance study of braided carbon/PEEK composite compression bone plates. Biomaterials 24(15):2661–2667. https://doi.org/10.1016/S0142-9612(03)00065-6 CrossRefPubMed

17.

Haque S, Siddiqui G (2011) Re: The invisible nail: a technique report of treatment of a pathological humerus fracture with a radiolucent intramedullary nail. Injury 42(11):1390–1391. https://doi.org/10.1016/j.injury.2011.05.026 CrossRefPubMed

18.

Hillock R, Howard S (2014) Utility of carbon fiber implants in orthopedic surgery: literature review. Reconstruct Rev 4(1):23–32. https://doi.org/10.15438/rr.v4i1.55 CrossRef

19.

Howling GI, Sakoda H, Antonarulrajah A, Marrs H, Stewart TD, Appleyard S et al (2003) Biological response to wear debris generated in carbon based composites as potential bearing surfaces for artificial hip joints. J Biomed Mater Res Part B Appl Biomater 67(2):758–764. https://doi.org/10.1002/jbm.b.10068 CrossRefPubMed

20.

Jockiseh KA, Brown SA, Bauer TW, Merritt K (1992) Biological response to chopped-carbon-fiber reinforced peek. J Biomed Mater Res 26:133–146CrossRef

21.

Katthagen JC, Ellwein A, Lutz O, Voigt C, Lill H (2017) Outcomes of proximal humeral fracture fixation with locked CFR-PEEK plating. Eur J Orthop Surg Traumatol 27(3):351–358. https://doi.org/10.1007/s00590-016-1891-7 CrossRefPubMed

22.

Koch KM, Hargreaves BA, Pauly KB, Chen W, Gold GE, King KF (2010) Magnetic resonance imaging near metal implants. J Magn Reson Imaging JMRI 32(4):773–787. https://doi.org/10.1002/jmri.22313 CrossRefPubMed

23.

Koff MF, Shah P, Koch KM, Potter HG (2013) Quantifying image distortion of orthopedic materials in magnetic resonance imaging. J Magn Reson Imaging 38(3):610–618. https://doi.org/10.1002/jmri.23991 CrossRefPubMed

24.

Kurtz SM, Devine JN (2007) PEEK biomaterials in trauma, orthopedic, and spinal implants. Biomaterials 28(32):4845–4869. https://doi.org/10.1016/j.biomaterials.2007.07.013 CrossRefPubMedPubMedCentral

25.

Li CS, Vannabouathong C, Sprague S, Bhandari M (2014) The use of carbon-fiber-reinforced (CFR) peek material in orthopedic implants: a systematic review. Clin Med Insights: Arthritis Musculoskel Disorders 8:33–45. https://doi.org/10.4137/CMAMD.S20354 CrossRef

26.

Lill H, Hepp P, Korner J, Kassi JP, Verheyden AP, Josten C, Duda GN (2003) Proximal humeral fractures: how stiff should an implant be? A comparative mechanical study with new implants in human specimens. Arch Orthop Trauma Surg 123(2–3):74–81. https://doi.org/10.1007/s00402-002-0465-9 CrossRefPubMed

27.

Mavrogenis AF, Vottis C (2014) PEEK rod systems for the spine. Eur J Orthop Surg Traumatol 24:111–116CrossRef

28.

Morshed S (2014) Current options for determining fracture union. Adv Med 2014:1–12. https://doi.org/10.1016/j.brainresrev.2006.12.007 CrossRef

29.

Piccioli A, Piana R, Lisanti M, Di Martino A, Rossi B, Camnasio F et al (2017) Carbon-fiber reinforced intramedullary nailing in musculoskeletal tumor surgery: a national multicentric experience of the Italian Orthopaedic Society (SIOT) Bone Metastasis Study Group. Injury 48:S55–S59. https://doi.org/10.1016/S0020-1383(17)30659-9 CrossRefPubMed

30.

Postlethwaite KR, Philips JG, Booth S, Shaw J, Slater A (1989) The effects of small plate osteosynthesis on postoperative radiotherapy. Br J Oral Maxillofac Surg 27(5):375–378. https://doi.org/10.1016/0266-4356(89)90076-4 CrossRefPubMed

31.

Schliemann B, Hartensuer R, Koch T, Theisen C, Raschke MJ, Kösters C, Weimann A (2015) Treatment of proximal humerus fractures with a CFR-PEEK plate: 2-year results of a prospective study and comparison to fixation with a conventional locking plate. J Shoulder Elbow Surg 24(8):1282–1288. https://doi.org/10.1016/j.jse.2014.12.028 CrossRefPubMed

32.

Scholes SC, Unsworth A (2009) Wear studies on the likely performance of CFR-PEEK/CoCrMo for use as artificial joint bearing materials. J Mater Sci Mater Med 20(1):163–170. https://doi.org/10.1007/s10856-008-3558-3 CrossRefPubMed

33.

Skinner HB (1988) Composite technology for total hip arthroplasty. Clin Orthop Relat Res 235:224–236. https://doi.org/10.1097/00003086-198810000-00022 CrossRef

34.

Stefano B, Tedesco G, Ming L, Ghermandi R, Amichetti M, Fossati P, Krengli M, Mavilla L, Gasbarrini A (2018) Carbon-fiber-reinforced PEEK fixation system in the treatment of spine tumors: a preliminary report. Eur Spine J 27(4):874–881CrossRef

35.

Steinberg EL, Rath E, Shlaifer A, Chechik O, Maman E, Salai M (2012) Carbon fiber reinforced PEEK Optima-A composite material biomechanical properties and wear/debris characteristics of CF-PEEK composites for orthopedic trauma implants. J Mech Behav Biomed Mater 17:221–228. https://doi.org/10.1016/j.jmbbm.2012.09.013 CrossRefPubMed

36.

Tarallo L, Mugnai R, Adani R, Zambianchi F, Catani F (2014) A new volar plate made of carbon-fiber-reinforced polyetheretherketon for distal radius fracture: analysis of 40 cases. J Orthop Traumatol 15(4):277–283. https://doi.org/10.1007/s10195-014-0311-1 CrossRefPubMedPubMedCentral

37.

Tedesco G, Gasbarrini A, Bandiera S, Ghermandi R, Boriani S (2017) Composite PEEK/Carbon fiber implants can increase the effectiveness of radiotherapy in the management of spine tumors. J Spine Surg 3(3):323–329. https://doi.org/10.21037/jss.2017.06.20 CrossRefPubMedPubMedCentral

38.

Utzschneider S, Becker F, Grupp TM, Sievers B, Paulus A, Gottschalk O, Jansson V (2010) Inflammatory response against different carbon fiber-reinforced PEEK wear particles compared with UHMWPE in vivo. Acta Biomater 6(11):4296–4304. https://doi.org/10.1016/j.actbio.2010.06.002 CrossRefPubMed

39.

Wilson WK, Morris RP, Ward AJ, Carayannopoulos NL, Panchbhavi VK (2015) Torsional failure of carbon fiber composite plates versus stainless steel plates for comminuted distal fibula fractures. Foot Ankle Int 37(5):548–553. https://doi.org/10.1177/1071100715625291 CrossRef

40.

Xin-Ye N, Xiao-Bin T, Chang-Ran G, Da C (2012) The prospect of carbon fiber implants in radiotherapy. J Appl Clin Med Phys 13(4):152–159. https://doi.org/10.1120/jacmp.v13i4.3821 CrossRefPubMedCentral

41.

Zimel MN, Hwang S, Riedel ER, Healey JH (2015) Carbon fiber intramedullary nails reduce artifact in postoperative advanced imaging. Skelet Radiol 44(9):1317–1325. https://doi.org/10.1007/s00256-015-2158-9 CrossRef

Titel: Carbon/PEEK nails: a case–control study of 22 cases
verfasst von: Federico Sacchetti
Lorenzo Andreani
Michele Palazzuolo
Stephane Cherix
Enrico Bonicoli
Elisabetta Neri
Rodolfo Capanna
Publikationsdatum: 01.05.2020
Verlag: Springer Paris
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 4/2020
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-019-02602-4

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Carbon/PEEK nails: a case–control study of 22 cases

Abstract

Background

Purposes

Patients and methods

Results

Conclusions

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Neu im Fachgebiet Orthopädie und Unfallchirurgie

Ärztliche Empathie hilft gegen Rückenschmerzen

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Update Orthopädie und Unfallchirurgie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Background

Purposes

Patients and methods

Results

Conclusions

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