{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:42:28Z","timestamp":1760150548382,"version":"build-2065373602"},"reference-count":32,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T00:00:00Z","timestamp":1700524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ludwig-Maximilians-University of Munich","award":["1043"],"award-info":[{"award-number":["1043"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Osteoporotic proximal femur fractures are on the rise due to demographic change. The most dominant surgical treatment option for per\/subtrochanteric fractures is cephalomedullary nailing. As it has been shown to increase primary stability, cement augmentation has become increasingly popular in the treatment of osteoporotic per\/subtrochanteric femur fractures. The ultimate goal is to achieve stable osteosynthesis, allowing for rapid full weight-bearing to reduce possible postoperative complications. In recent years, bioresorbable bone cements have been developed and are now mainly used to fill bone voids. The aim of this study was to evaluate the biomechanical stability as well as the micro-structural behaviour of bioresorbable bone cements compared to conventional polymethylmethacrylate (PMMA)-cements in a subtrochanteric femur fracture model. Biomechanical as well as micro-computed tomography morphology analysis revealed no significant differences in both bone cements, as they showed equal mechanical stability and tight interdigitation into the spongious bone of the femoral head. Given the positive risk\/benefit ratio for bioresorbable bone cements, their utilisation should be evaluated in future clinical studies, making them a promising alternative to PMMA-bone cements.<\/jats:p>","DOI":"10.3390\/jcm12237202","type":"journal-article","created":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T12:12:13Z","timestamp":1700568733000},"page":"7202","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Micro-Structural and Biomechanical Evaluation of Bioresorbable and Conventional Bone Cements for Augmentation of the Proximal Femoral Nail"],"prefix":"10.3390","volume":"12","author":[{"given":"Christoph","family":"Linhart","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3602-6785","authenticated-orcid":false,"given":"Manuel","family":"Kistler","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8774-7892","authenticated-orcid":false,"given":"Maximilian","family":"Saller","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Axel","family":"Greiner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Lampert","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Kassube","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5389-5341","authenticated-orcid":false,"given":"Christopher A.","family":"Becker","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"B\u00f6cker","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9439-7632","authenticated-orcid":false,"given":"Christian","family":"Ehrnthaller","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.cger.2014.01.001","article-title":"Epidemiology of fragility fractures","volume":"30","author":"Friedman","year":"2014","journal-title":"Clin. Geriatr. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1007\/s00402-011-1313-6","article-title":"Long-term functional outcome in geriatric hip fracture patients","volume":"131","author":"Kammerlander","year":"2011","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1007\/s00113-015-0051-6","article-title":"Augmentation techniques on the proximal femur","volume":"118","author":"Neuerburg","year":"2015","journal-title":"Unfallchirurg"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Vigano, M., Pennestri, F., Listorti, E., and Banfi, G. (2023). Proximal hip fractures in 71,920 elderly patients: Incidence, epidemiology, mortality and costs from a retrospective observational study. BMC Public Health, 23.","DOI":"10.1186\/s12889-023-16776-4"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.ijsu.2017.05.042","article-title":"Intramedullary nails versus sliding hip screws for AO\/OTA 31-A2 trochanteric fractures in adults: A meta-analysis","volume":"43","author":"Zhu","year":"2017","journal-title":"Int. J. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.otsr.2012.12.019","article-title":"Antirotation proximal femoral nail versus dynamic hip screw for intertrochanteric fractures: A meta-analysis of randomized controlled studies","volume":"99","author":"Shen","year":"2013","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1007\/s00776-013-0468-0","article-title":"Percutaneous compression plate versus proximal femoral nail anti-rotation in treating elderly patients with intertrochanteric fractures: A prospective randomized study","volume":"18","author":"Guo","year":"2013","journal-title":"J. Orthop. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1016\/j.apmr.2015.01.023","article-title":"Predictors of long-term mortality in older people with hip fracture","volume":"96","author":"Kristensen","year":"2015","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1016\/j.injury.2013.03.003","article-title":"Cement augmentation of the proximal femoral nail antirotation for the treatment of osteoporotic pertrochanteric fractures--a biomechanical cadaver study","volume":"44","author":"Fensky","year":"2013","journal-title":"Injury"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.clinbiomech.2016.12.013","article-title":"The role of lesser trochanter fragment in unstable pertrochanteric A2 proximal femur fractures\u2014Is refixation of the lesser trochanter worth the effort?","volume":"42","author":"Ehrnthaller","year":"2017","journal-title":"Clin. Biomech."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1007\/s00402-013-1902-7","article-title":"Long-term results of the augmented PFNA: A prospective multicenter trial","volume":"134","author":"Kammerlander","year":"2014","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.1016\/j.injury.2011.07.010","article-title":"Standardised cement augmentation of the PFNA using a perforated blade: A new technique and preliminary clinical results. A prospective multicentre trial","volume":"42","author":"Kammerlander","year":"2011","journal-title":"Injury"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1016\/j.injury.2018.04.022","article-title":"Cement augmentation of the Proximal Femoral Nail Antirotation (PFNA)\u2014A multicentre randomized controlled trial","volume":"49","author":"Kammerlander","year":"2018","journal-title":"Injury"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1002\/jbm.b.31353","article-title":"Temperature evaluation during PMMA screw augmentation in osteoporotic bone--an in vitro study about the risk of thermal necrosis in human femoral heads","volume":"90","author":"Boner","year":"2009","journal-title":"J. Biomed. Mater. Res. B Appl. Biomater."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1007\/s11657-021-00995-6","article-title":"Quality indicators in the treatment of geriatric hip fractures: Literature review and expert consensus","volume":"16","author":"Sermon","year":"2021","journal-title":"Arch. Osteoporos."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1007\/s00586-010-1279-z","article-title":"Bioceramic vertebral augmentation with a calcium sulphate\/hydroxyapatite composite (Cerament SpineSupport): In vertebral compression fractures due to osteoporosis","volume":"19","author":"Rauschmann","year":"2010","journal-title":"Eur. Spine J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1002\/jbm.b.31524","article-title":"Osteotomy of distal radius fracture malunion using a fast remodeling bone substitute consisting of calcium sulphate and calcium phosphate","volume":"92","author":"Abramo","year":"2010","journal-title":"J. Biomed. Mater. Res. B Appl. Biomater."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1186\/1745-6215-15-75","article-title":"CERAMENT treatment of fracture defects (CERTiFy): Protocol for a prospective, multicenter, randomized study investigating the use of CERAMENT\u2122 BONE VOID FILLER in tibial plateau fractures","volume":"15","author":"Nusselt","year":"2014","journal-title":"Trials"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"179","DOI":"10.2106\/JBJS.19.00680","article-title":"Autologous Iliac Bone Graft Compared with Biphasic Hydroxyapatite and Calcium Sulfate Cement for the Treatment of Bone Defects in Tibial Plateau Fractures: A Prospective, Randomized, Open-Label, Multicenter Study","volume":"102","author":"Hofmann","year":"2020","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1302\/1863-2548.14.190155","article-title":"Percutaneous cyst aspiration with injection of two different bioresorbable bone cements in treatment of simple bone cyst","volume":"14","author":"Dong","year":"2020","journal-title":"J. Child. Orthop."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1007\/s00234-012-1016-x","article-title":"Osteoporotic vertebral compression fracture augmentation by injectable partly resorbable ceramic bone substitute (Cerament|SPINESUPPORT): A prospective nonrandomized study","volume":"54","author":"Masala","year":"2012","journal-title":"Neuroradiology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"S112","DOI":"10.1007\/s00586-012-2228-9","article-title":"Effectiveness of a bone substitute (CERAMENT\u2122) as an alternative to PMMA in percutaneous vertebroplasty: 1-year follow-up on clinical outcome","volume":"21","author":"Marcia","year":"2012","journal-title":"Eur. Spine J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1002\/jbmr.141","article-title":"Guidelines for assessment of bone microstructure in rodents using micro-computed tomography","volume":"25","author":"Bouxsein","year":"2010","journal-title":"J. Bone Min. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.1007\/s00068-021-01746-5","article-title":"Cement augmentation of internal fixation for trochanteric fracture: A systematic review and meta-analysis","volume":"48","author":"Yamamoto","year":"2022","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.1097\/BOT.0000000000001643","article-title":"Osteoporotic Bone: When and How to Use Augmentation?","volume":"33","author":"Schuetze","year":"2019","journal-title":"J. Orthop. Trauma"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1097\/BRS.0000000000004093","article-title":"Vertebral Augmentation of Cancer-Related Spinal Compression Fractures: A Systematic Review and Meta-Analysis","volume":"46","author":"Mattie","year":"2021","journal-title":"Spine"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2026","DOI":"10.2106\/JBJS.21.01516","article-title":"Cost-Effectiveness of Cement Augmentation Versus No Augmentation for the Fixation of Unstable Trochanteric Fractures","volume":"104","author":"Joeris","year":"2022","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1007\/s00402-020-03531-2","article-title":"Cement augmentation of the proximal femur nail antirotation: Is it safe?","volume":"141","author":"Schuetze","year":"2021","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1586\/17434440.2013.827529","article-title":"The composite of hydroxyapatite and calcium sulphate: A review of preclinical evaluation and clinical applications","volume":"10","author":"Nilsson","year":"2013","journal-title":"Expert. Rev. Med. Devices"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1007\/s15010-020-01418-3","article-title":"Treatment of fracture-related infection of the lower extremity with antibiotic-eluting ceramic bone substitutes: Case series of 35 patients and literature review","volume":"48","author":"Pesch","year":"2020","journal-title":"Infection"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Hoelscher-Doht, S., Heilig, M., von Hertzberg-Boelch, S.P., Jordan, M.C., Gbureck, U., Meffert, R.H., and Heilig, P. (2023). Experimental magnesium phosphate cement paste increases torque of trochanteric fixation nail advanced blades in human femoral heads. Clin. Biomech., 109.","DOI":"10.1016\/j.clinbiomech.2023.106088"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1111\/apm.12918","article-title":"Establishment and effects of allograft and synthetic bone graft substitute treatment of a critical size metaphyseal bone defect model in the sheep femur","volume":"127","author":"Hettwer","year":"2019","journal-title":"APMIS"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/23\/7202\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:25:46Z","timestamp":1760131546000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/23\/7202"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,21]]},"references-count":32,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["jcm12237202"],"URL":"https:\/\/doi.org\/10.3390\/jcm12237202","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2023,11,21]]}}}