Abstract
Aims: Fixation failure due to osteoporosis is a major complication of osteosynthesis using compression hip screws (CHS). Biocompatible materials have been developed to improve CHS purchase and to limit fixation failure. Cortoss™ is a novel, injectable composite that interdigitates with bone, mimicking native cortical bone. This pilot study tested the immediate anchoring strength and safety of Cortoss in patients with peritrochanteric fracture. Methods: Ethical Committee approval and patient informed consent were obtained. Screws were advanced under fluoroscopy to their final position, and torque was measured electronically. Screws were backed out approximately 1 cm, 2.5 mL Cortoss was injected under fluoroscopy, and the screw was reinserted. An increase in rotational torque of at least 30% was achieved after allowing time for the bone filler to set. Results: The study population consisted of 20 patients (18 females, 2 males), 70 years or older (range 70 to 96 years) with osteoporosis. The mean preaugmentation torque was 1.23 Nm (range 0 to 4.8 Nm) and the mean postaugmentation torque was 1.81 Nm (range 0.7 to 4.8 Nm). All 20 screws were judged clinically tight after fixation. X-ray images showed that Cortoss contacted the screw threads and interdigitated with surrounding bone. No adverse events were reported. Conclusions: Cortoss provided safe and effective anchorage of CHS. By preventing screw cutout, Cortoss may provide long-term benefit to osteoporotic hip fracture patients by limiting fixation failure.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
