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Original ArticleOpen Access
Stability of Subchondral Bone Defect Reconstruction at Distal Femur : Comparison Between Polymethylmethacrylate Alone and Steinmann Pin Reinforcement of Polymethylmethacrylate
Asavamongkolkul A 
,
Pongkunakorn A ,
Harnroongroj M
,
Pongkunakorn A ,
Harnroongroj M APICHAT ASAVAMONGKOLKUL, MD*,
ANUWAT PONGKUNAKORN, MD**,
THODSART HARNROONGROJ, MD*
Polymethylmethacrylate (PMMA) is often used to fill the large subchondral defects follow-
ing intralesional curettage of a giant cell tumor of the bone. Many authors have reported the use of
Steinmann pins to reinforce the bone cement. However, whether this is of real benefit in improving the
stability of the defect is controversial. Thirteen matched pairs of cadaveric distal femurs were obtained
and tested in uni-axial compression to determine the strength of this reconstruction. The strength of
normal distal femurs was compared with the strength of defective femurs using 5 matched pairs of
cadaveric distal femurs. A significant difference between the two groups was demonstrated in the failure
load, stiffness, yield point and total energy absorbed to failure (p
<
0.05). The second part consisted
of eight matched pairs of specimens filled with PMMA alone
versus
PMMA with Steinmann pin
reinforcement. There was no significant difference in failure load, stiffness, yield point and total energy
absorbed to failure (p
>
0.05). The addition of Steinmann pins did not significantly improve the strength
of the subchondral defect reconstruction in uni-axial compression compared with PMMA reconstruc-
tion alone.
Key word : Distal Femur, Biomechanical Study, Polymethylmethacrylate, Steinmann Pin
ANUWAT PONGKUNAKORN, MD**,
THODSART HARNROONGROJ, MD*
Polymethylmethacrylate (PMMA) is often used to fill the large subchondral defects follow-
ing intralesional curettage of a giant cell tumor of the bone. Many authors have reported the use of
Steinmann pins to reinforce the bone cement. However, whether this is of real benefit in improving the
stability of the defect is controversial. Thirteen matched pairs of cadaveric distal femurs were obtained
and tested in uni-axial compression to determine the strength of this reconstruction. The strength of
normal distal femurs was compared with the strength of defective femurs using 5 matched pairs of
cadaveric distal femurs. A significant difference between the two groups was demonstrated in the failure
load, stiffness, yield point and total energy absorbed to failure (p
<
0.05). The second part consisted
of eight matched pairs of specimens filled with PMMA alone
versus
PMMA with Steinmann pin
reinforcement. There was no significant difference in failure load, stiffness, yield point and total energy
absorbed to failure (p
>
0.05). The addition of Steinmann pins did not significantly improve the strength
of the subchondral defect reconstruction in uni-axial compression compared with PMMA reconstruc-
tion alone.
Key word : Distal Femur, Biomechanical Study, Polymethylmethacrylate, Steinmann Pin
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