Stability of Subchondral Bone Defect Reconstruction at
Distal Femur : Comparison Between Polymethylmetha
crylate Alone and Steinmann Pin Reinforcement of Poly
methylmethacrylatet
APICHAT ASAVAMONGKOLKUL, MD*,
ANUWAT PONGKUNAKORN, MD**,
THODSART HARNROONGROJ, MD*
Affiliation : * Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700,
** Department of Orthopaedic SUigery, Sobprab Hospital, Lampang 52170, Thailand.
t This study was granted by Siriraj Grant for Research Development and Medical Education.
AbstractPolymethylmethacrylate (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.
Keywords : Distal Femur, Biomechanical Study, Polymethylmethacrylate, Steinmann Pin
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