Load Capacity of Screw Anchor Installed in Concrete Substrate Reinforced with Steel Fibers Depending on Fiber Content.

Pull-out strength tests conducted on screw anchors in uncracked concrete substrates of the C25/30 class are presented in this article. The destructive force for anchor-concrete fasting was tested, and in the next step, the average pull-out strengths of screw anchors in concrete substrates with and without the addition of steel fiber were determined. Currently, the pull-out strengths of anchors in fiber-reinforced concrete substrates are defined as for unreinforced concrete substrates. Therefore, pull-out tests were performed for screw anchors in fiber-reinforced concrete substrates. Fiber contents of 10, 20, 30, and 50 kg/m3 were used. An increase in the load capacity of screw anchors in a fiber-reinforced concrete substrate was demonstrated in a pull-out test compared to base samples without fibers. The coefficient related to the actual fastening behavior of a screw anchor in the fiber-reinforced concrete substrate was determined. It was assumed that a coefficient of 13.10 should be adopted. This was the lowest value obtained for the load capacity in this study for screw anchors in a fiber-reinforced concrete substrate.

Pull-out resistance of connected K-wires for osteosynthesis: development of a numerical model.

A predictive finite element model was developed to investigate the best configuration of a fixation pins system consisting of two K-wires inserted in a synthetic model (Sawbones®) at different angles and secured to a connecting rod. Two key parameters were considered to determine the best configuration delivering the higher pull-out strength and lower pull-out length: the diameter and insertion angle. Results show that as the diameter and insertion angle increased, the pull-out force increased, while the pull-out length decreased. Results are successfully compared with available experimental data in literature. This model can be used as an alternative to experimental study.

A Novel Semi-Cannulated Screw Enhanced Bone Cement Augmentation and Pullout Strength in Posterior Cervical Lateral Mass Screw Fixations: An In Vitro Biomechanical and Morphological Study.

OBJECTIVE: To develop a novel semi-cannulated lateral mass screw (SC-LMS) for cervical posterior fixations and compare the fixation stability and safety of SC-LMS with regular solid lateral mass screw (S-LMS) in bone cement augmentation and pullout strength using fresh cadaveric cervical vertebrae. METHODS: The conventional multiaxial screw for cervical lateral mass fixation was modified to a cannulated screw with two lateral holes, used for bone cement injection in situ. Eight fresh human cervical vertebrae (C3, C4, and C5) were collected and used. µCT scan was performed to evaluate the bone quality of the lateral masses, including bone mineral density (BMD), trabecular thickness (Tb.Th), and trabecular separation (Tb.Sp). SCLMS or S-LMS were randomly inserted into the paired cervical vertebrae and pulled out as a screw loosening model. These screws were reinserted in with bone cement augmentation, scanned by µCT to obtain the bone cement distribution along the screws, and pulled out to test the screw purchase strength. RESULTS: Fmax values exhibited strong positive correlations with the local BMD (𝑟 = 0.8640, p < 0.0001) and Tb.Th (𝑟 = 0.6795, p = 0.0038), whereas a negative correlation with Tb.Sp (𝑟 = -0.5567, p = 0.0251). A significant difference was observed between the Fmax before and after PMMA injection on the SC-LMS side (p = 0.019). The SC-LMS exhibited lower risk of cement leakage than S-LMS after PMMA injection, and a positive correlation was observed between 𝐹max and the distribution volumes on the SC-LMS side. CONCLUSION: The novel SC-LMS provides more robust fixation stability and is safer than the S-LMS for PMMA augmentation, which may be related to the cement-screw-cement-bone complex formation.

The Influence of Sagittal Pin Angulation on the Stiffness and Pull-Out Strength of a Monolateral Fixator Construct.

Monolateral pin-to-bar-clamp fixators are commonly used to stabilize acute extremity injuries. Certain rules regarding frame geometry have been established that affect construct stability. The influence of sagittal pin angulation on construct stiffness and strength has not been investigated. The purpose of this biomechanical study was to demonstrate the effect of a pin angulation in the monolateral fixator using a composite cylinder model. Three groups of composite cylinder models with a fracture gap were loaded with different mounting variants of monolateral pin-to-bar-clamp fixators. In the first group, the pins were set parallel to each other and perpendicular to the specimen. In the second group, both pins were set convergent each in an angle of 15° to the specimen. In the third group, the pins were set each 15° divergent. The strength of the constructions was tested using a mechanical testing machine. This was followed by a cyclic loading test to produce pin loosening. A pull-out test was then performed to evaluate the strength of each construct at the pin-bone interface. Initial stiffness analyses showed that the converging configuration was the stiffest, while the diverging configuration was the least stiff. The parallel mounting showed an intermediate stiffness. There was a significantly higher resistance to pull-out force in the diverging pin configuration compared to the converging pin configuration. There was no significant difference in the pull-out strength of the parallel pins compared to the angled pin pairs. Convergent mounting of pin pairs increases the stiffness of a monolateral fixator, whereas a divergent mounting weakens it. Regarding the strength of the pin-bone interface, the divergent pin configuration appears to provide greater resistance to pull-out force than the convergent one. The results of this pilot study should be important for the doctrine of fixator mounting as well as for fixator component design.

Relationship between thread depth and fixation strength in cancellous bone screw.

BACKGROUND: Clarifying the effect of each parameter of screw design on its fixation strength is critical in the development of any type of screw. The purpose of this study was to clarify the relationship between the thread depth and fixation strength of metal screws for cancellous bone. METHODS: Nine types of custom-made screws with the only changed variable being the thread depth were manufactured. Other elements were fixed at a major diameter of 4.5 mm, a thread region length of 15 mm, a pitch of 1.6 mm, and a thread width of 0.20 mm. The pull-out strength and insertion torque of each screw were measured for each of two foam-block densities (10 or 20 pcf). The correlation between the thread depth of the screw and the mechanical findings were investigated with single regression analysis. RESULTS: Regardless of the foam-block density, the pull-out strength significantly increased as the thread depth increased from 0.1 mm to 0.4 mm; after that, the increase was more gradual (p < 0.01, respectively). The relationship between the thread depth and insertion torque was similar. In addition, the insertion torque tended to be more strongly affected by screw depth than the pull-out strength (2.6 times at 20 pcf and 1.4 times at 10 pcf). CONCLUSIONS: The pull-out strength of 4.5-mm-diameter metal screws in a cancellous bone model was found to be biphasic, although linearly correlated with the change in screw depth in both phases. The boundary of the correlation was 0.4 mm regardless of the density of the bone model, with the effect of screw depth on pull-out strength beyond that being small in comparison.

An Experimental Study on the Biomechanical Effectiveness of Bone Cement-Augmented Pedicle Screw Fixation with Various Types of Fenestrations.

OBJECTIVE: To analyze the effects of the number and shape of fenestrations on the mechanical strength of pedicle screws and the effects of bone cement augmentation (BCA) on the pull-out strength (POS) of screws used in conventional BCA. METHODS: For the control group, a conventional screw was defined as C1, a screw with cannulated end-holes was defined as C2, a C2 screw with six pinholes was defined as C3, and the control group type was set. Among the experimental screws, T1 was designed using symmetrically placed thru-hole type fenestrations with an elliptical shape, while T2 was designed with half-moon (HM)-shaped asymmetrical fenestrations. T3 and T4 were designed with single HM-shaped fenestrations covering three pitches and five pitches, respectively. T5 and T6 were designed with 0.6-mm and 1-mm wider fenestrations than T3. BCA was performed by injecting 3 mL of commercial bone cement in the screw, and mechanical strength and POS tests were performed according to ASTM F1717 and ASTM F543 standards. Synthetic bone (model #1522-505) made of polyurethane foam was used as a model of osteoporotic bone, and radiographic examinations were performed using computed tomography and fluoroscopy. RESULTS: In the fatigue test, at 75% ultimate load, fractures occurred 7781 and 9189 times; at 50%, they occurred 36122 and 82067 times; and at 25%, no fractures occurred. The mean ultimate load for each screw type was 219.1±52.39 N for T1, 234.74±15.9 N for T2, 220.70±59.23 N for T3, 216.45±32.4 N for T4, 181.55±54.78 N for T5, and 216.47±29.25 N for T6. In comparison with C1, T1, T2, T3, T4, and T6 showed significantly different ultimate load values (p<0.05). However, when the values for C2 and the fenestrated screws were evaluated with an unpaired t test, the ultimate load value of C2 significantly differed only from that of T2 (p=0.025). The ultimate load value of C3 differed significantly from those of T1 and T2 (C3 vs. T1 : p=0.048; C3 vs. T2 : p<0.001). Linear correlation analysis revealed a significant correlation between the fenestration area and the volume of bone cement (Pearson's correlation coefficient r=0.288, p=0.036). The bone cement volume and ultimate load significantly correlated with each other in linear correlation analysis (r=0.403, p=0.003). CONCLUSION: Fenestration yielded a superior ultimate load in comparison with standard BCA using a conventional screw. In T2 screws with asymmetrical two-way fenestrations showed the maximal increase in ultimate load. The fenestrated screws can be expected to show a stable position for the formation of the cement mass.

Evaluating Pull-Out Strength of Barbed Suture In Vitro by Using Porcine Tissue and Polydimethylsiloxane (PDMS).

Using barbed thread lifting for facial rejuvenation has become popular these days due to its minimally invasive procedures with reduced complications. However, only limited studies regarding its mechanical properties for face suspension were published. The aim of this study was to evaluate suture-holding ability regarding its facelift property, and different specimens were tested in order to establish an in vitro model. Fresh porcine tissue and the synthetic material polydimethylsiloxane (PDMS) were selected to simulate human skin for evaluating barbed suture pull-out strength by the universal material testing machine. The results showed that the pull-out strength of barbs between different porcine tissues varied without consistency. By contrast, PDMS (30:1) showed more consistent pull-out strength in each testing, and the average maximum load force was close to porcine tissue. Furthermore, after submerging barbed sutures in PBS for 0 days (T0), 7 days (T7) and 14 days (T14), a trend of decreased average maximum load force, displacement and force of 1.5 mm/2 mm/3 mm displacement could be detected by in vitro testing with PDMS (30:1). These results provide support for using PDMS (30:1) to evaluate suture pull-out strength and holding/lifting capacities in vitro to obtain consistent and objective information for evaluating substantial equivalence of devices. The established in vitro method could be used for the future development of barbed thread lifting technology.

Outstanding in vivo mechanical integrity of additively manufactured spinal cages with a novel "honeycomb tree structure" design via guiding bone matrix orientation.

BACKGROUND CONTEXT: Therapeutic devices for spinal disorders, such as spinal fusion cages, must be able to facilitate the maintenance and rapid recovery of spinal function. Therefore, it would be advantageous that future spinal fusion cages facilitate rapid recovery of spinal function without secondary surgery to harvest autologous bone. PURPOSE: This study investigated a novel spinal cage configuration that achieves in vivo mechanical integrity as a devise/bone complex by inducing bone that mimicked the sound trabecular bone, hierarchically and anisotropically structured trabeculae strengthened with a preferentially oriented extracellular matrix. STUDY DESIGN/SETTINGS: In vivo animal study. METHODS: A cage possessing an anisotropic through-pore with a grooved substrate, that we termed "honeycomb tree structure," was designed for guiding bone matrix orientation; it was manufactured using a laser beam powder bed fusion method through an additive manufacturing processes. The newly designed cages were implanted into sheep vertebral bodies for 8 and 16 weeks. An autologous bone was not installed in the newly designed cage. A pull-out test was performed to evaluate the mechanical integrity of the cage/bone interface. Additionally, the preferential orientation of bone matrix consisting of collagen and apatite was determined. RESULTS: The cage/host bone interface strength assessed by the maximum pull-out load for the novel cage without an autologous bone graft (3360±411 N) was significantly higher than that for the conventional cage using autologous bone (903±188 N) after only 8 weeks post-implantation. CONCLUSIONS: These results highlight the potential of this novel cage to achieve functional fusion between the cage and host bone. Our study provides insight into the design of highly functional spinal devices based on the anisotropic nature of bone. CLINICAL SIGNIFICANCE: The sheep spine is similar to the human spine in its stress condition and trabecular bone architecture and is widely recognized as a useful model for the human spine. The present design may be useful as a new spinal device for humans.

Replacement of Destructive Pull-out Test with Modal Analysis in Primary Fixation Stability Assessment of Spinal Pedicle Screw.

Background: Pedicle screw fixation devices are the predominant stabilization systems adopted for a wide variety of spinal defects. Accordingly, both pedicle screw design and bone quality are known as the main parameters affecting the fixation strength as measured by the pull-out force and insertion torque. The pull-out test method, which is recommended by the standards of the American Society for Testing and Materials (ASTM), is destructive. A non-destructive test method was proposed to evaluate the mechanical stability of the pedicle screw using modal analysis. Natural frequency (ωn) extracted from the modal analysis was then correlated with peak pull-out force (PPF) and peak insertion torque (PIT). Methods: Cylindrical pedicle screws with a conical core were inserted into two different polyurethane (PU) foams with densities of 0.16 and 0.32 g/cm3. The PIT and PPF were measured according to the well-established ASTM-F543 standard at three different insertion depths of 10, 20, and 30 mm. Modal analysis was carried out through recording time response of an accelerometer attached to the head of the screw impacted by a shock hammer. The effect of the insertion depth and foam density on the insertion torque, natural frequency, and pull-out force were quantified. Results: The maximum values of ωn, PIT, and PPT were obtained at 2,186 Hz, 123.75 N.cm, and 981.50 N, respectively, when the screw was inserted into the high-density foam at the depth of 30 mm. The minimum values were estimated at 332 Hz, 16 N.cm, and 127 N, respectively, within the low-density PU at the depth of 10 mm. The higher value of ωn was originated from higher bone screw stability and thus more fixation strength. According to the regression analysis outcomes, the natural frequency (ωn) was linearly dependent on the PIT (ωn=14 PIT) and also on the PPF (ωn=1.7 PPF). Coefficients of variation as the results of the modal analysis were significantly less than those in conventional methods (i.e. pull-out and insertion torque). Conclusion: The modal analysis was found to be a reliable, repeatable, and non-destructive method, which could be considered a prospective alternative to the destructive pull-out test that is limited to the in-vitro application only. The modal analysis could be applied to assess the stability of implantable screws, such as orthopedic and spinal screws.

Shape Memory Alloy-Polymer Composites: Static and Fatigue Pullout Strength under Thermo-Mechanical Loading.

This work was carried out within the context of an R&D project on morphable polymer matrix composites (PMC), actuated by shape memory alloys (SMA), to be used for active aerodynamic systems in automotives. Critical issues for SMA-polymer integration are analyzed that are mostly related to the limited strength of metal-polymer interfaces. To this aim, materials with suitable thermo-mechanical properties were first selected to avoid premature activation of SMA elements during polymer setting as well as to avoid polymer damage during thermal activation of SMAs. Nonstandard samples were manufactured for both static and fatigue pullout tests under thermo-mechanical loading, which are made of SMA wires embedded in cylindrical resin blocks. Fully coupled thermo-mechanical simulations, including a special constitutive model for SMAs, were also carried out to analyze the stress and temperature distribution in the SMA-polymer samples as obtained from the application of both mechanical loads and thermal activation of the SMA wires. The results highlighted the severe effects of SMA thermal activation on adhesion strength due to the large recovery forces and to the temperature increase at the metal-polymer interface. Samples exhibit a nominal pullout stress of around 940 MPa under static mechanical load, and a marked reduction to 280 MPa was captured under simultaneous application of thermal and mechanical loads. Furthermore, fatigue run-out of 5000 cycles was achieved, under the combination of thermal activation and mechanical loads, at a nominal stress of around 200 MPa. These results represent the main design limitations of SMA/PMC systems in terms of maximum allowable stresses during both static and cyclic actuation.

Comparison of insertion time, pull-out strength, and screw-media interface area of customized pedicle screw with different core and thread design against commercial pedicle screw: a pilot study on Indonesian Population.

OBJECTIVE: This research aimed to developing customized pedicle screw based on Indonesian vertebral anatomy and compare the insertion time, pull-out strength, and screw-media interface area of different screw design. We have developed 3 different types of pedicle screws (v-thread cylinder-core, square-thread cylinder-core and square-thread conical-core). The thread diameter was calculated from pedicle width of Indonesian population (6 mm). We used commercially available pedicle screw as control group (6.2 mm). RESULT: The insertion time were significantly difference between v-thread cylinder-core pedicle screw (22.94 s) with commercially available pedicle screw (15.86 s) (p < 0.05). The pull-out strength was significantly difference between commercially available pedicle screw (408.60 N) with square-thread conical pedicle screw (836.60 N) (p < 0.05). The square-thread conical-core group have the highest interface area (1486.21 mm2). The data comparison showed that the square-thread conical-core customized pedicle screw group has comparable insertion time and has better pull-out strength than commercially available pedicle screw.

Relation between diameter of a lateral screw and pull-out strength in distal clavicle fracture in plates with different geometry: A cadaveric biomechanical study.

Plate fixation has recently gained popularity among the various surgical methods used to treat Neer type II distal clavicle fractures. The use of a low-profile distal clavicle locking plate is logically considered a better option when there is no significant difference in the fixation strength between insertions of 3.5- and 2.7-mm diameter screws. Therefore, the purpose of this biomechanical study was to investigate any differences in fixation strength among varying sizes of screws that are used to treat distal clavicle fractures. The study was performed with 20 paired shoulder girdles from 10 fresh frozen cadavers. To create a type IIA fracture of Neer classification, osteotomy was performed perpendicularly to the longitudinal axis of the clavicle at the medial end point of the conoid ligament. Two custom-made fixtures designed to be attached to both upper and lower sides of the Instron were fabricated for the evaluation. The mean maximum pull-out strength for fixation using 3.5-mm diameter screws was 241.9 ± 67.8 N, whereas the mean pull-out strength in fixation with 2.7-mm diameter screws was 228.1 ± 63.0 N. There was no statistically significant difference between the two groups. Distal fragment fixation with distal clavicle locking plates using two 2.7-mm diameter screws showed comparable biomechanical pull-out strength at the time-zero setting to fixations with a hook plate using two 3.5-mm diameter screws. Therefore, the fixation of the distal fragment with a low-profile plate and 2.7-mm screws may be preferred as an alternative option if the distal fragment of the fractured clavicle is not extremely small.

Strength of interference screw fixation of meniscus prosthesis matches native meniscus attachments.

PURPOSE: Meniscal surgery is one of the most common orthopaedic surgical interventions. Total meniscus replacements have been proposed as a solution for patients with irreparable meniscal injuries. Reliable fixation is crucial for the success and functionality of such implants. The aim of this study was to characterise an interference screw fixation system developed for a novel fibre-matrix-reinforced synthetic total meniscus replacement in an ovine cadaveric model. METHODS: Textile straps were tested in tension to failure (n = 15) and in cyclic tension (70-220 N) for 1000 cycles (n = 5). The textile strap-interference screw fixation system was tested in 4.5 mm-diameter single anterior and double posterior tunnels in North of England Mule ovine tibias aged > 2 years using titanium alloy (Ti6Al4Va) and polyether-ether-ketone (PEEK) screws (n ≥ 5). Straps were preconditioned, dynamically loaded for 1000 cycles in tension (70-220 N), the fixation slippage under cyclic loading was measured, and then pulled to failure. RESULTS: Strap stiffness was at least 12 times that recorded for human meniscal roots. Strap creep strain at the maximum load (220 N) was 0.005 following 1000 cycles. For all tunnels, pull-out failure resulted from textile strap slippage or bone fracture rather than strap rupture, which demonstrated that the textile strap was comparatively stronger than the interference screw fixation system. Pull-out load (anterior 544 ± 119 N; posterior 889 ± 157 N) was comparable to human meniscal root strength. Fixation slippage was within the acceptable range for anterior cruciate ligament graft reconstruction (anterior 1.9 ± 0.7 mm; posterior 1.9 ± 0.5 mm). CONCLUSION: These findings show that the textile attachment-interference screw fixation system provides reliable fixation for a novel ovine meniscus implant, supporting progression to in vivo testing. This research provides a baseline for future development of novel human meniscus replacements, in relation to attachment design and fixation methods. The data suggest that surgical techniques familiar from ligament reconstruction may be used for the fixation of clinical meniscal prostheses.

Effect of placement angle, diameter, length and bone density on the pull-out strength of orthodontic mini-implants: An in vitro study.

OBJECTIVE: To evaluate the effect of the placement angle, diameter, length and bone density on the mechanical stability of orthodontic mini-implants by measuring their pull-out strengths. DESIGN: A total of 120 mini-implants of four different dimensions made from titanium were used. They measured 1.3 × 6.0mm, 1.3 × 8.0 mm, 1.5 × 6.0 mm and 1.5 × 8.0 mm. Synthetic polyurethane bone blocks (Saw Bones, USA) in two different densities were used. SETTING: Each size of mini-implant was inserted equidistantly into synthetic bone blocks of two different densities, in three different insertion angles of 30°, 60° and 90°. This resulted in 24 test groups with five mini-implants allocated to each group. METHODS: The pull-out strength was measured using an Instron Universal Testing Machine exerting a vertical force parallel to the long axis of the mini-implant until removal or failure occurred. Peak load at failure of the mini-implant was recorded in kN. RESULTS: Showed that mini-implants placed at an insertion angle of 30° offered least resistance to pull-out. Mini-implants 6.0 mm in length showed less pull-out strength compared to the longer 8.0-mm mini-implants. Mini-implants 1.3 mm in diameter provided similar pull-out values as 1.5-mm mini-implants. Bone densities of 0.20 g/cc and 0.32 g/cc did not affect the pull-out strength of mini-implants. CONCLUSION: From the study, it was concluded that a logical choice of mini-implant dimension and prudent use of placement technique can help achieve the treatment goals with a reduced hazard of mini-implant failure.

Screw inserting in different phase of cement affect the pull-out strength of cement augmented screws.

BACKGROUND: For large bone defects, after curettage of aggressive bone tumors; such as giant-cell tumors, cementation with supplement internal fixation was used to prevent subsequent collapse of the cement-bone constructs. The purpose of this study is to compare the pull-out strength of cement augmented screws between inserting screws in the working phase or hard phase of bone cement. HYPOTHESIS: Timing at which completed screw insertion takes place affecting the pull-out strength of cement augmented screws. METHODS: Pull-out strength was compared between screws; inserted within the working phases of cement, and after the cement was hardened in high viscos cement blocks. Each group consists of 10 cortex screws, 10 cancellous screws and 10 locking screws. The pull-out strength test was followed using the instructions of ASTM F543-13e1 Standard Specification and Test Methods, for Metallic Medical Bone Screws. RESULTS: Screws that were inserted in the working phases of cement had significantly higher pull-out strength, than those inserted in hard cement (p=0.021). The pull-out strength was statistically significant in difference among the types of screws (p<0.001), with locking screws having the highest pull-out strength. Furthermore, the pull-out strength of locking screws revealed no significant difference when either; inserted during the working or hardened phases of bone cement. CONCLUSION: Insertion of screws during the working periods of PMMA cement had higher pull out strength compared to the hard phase of cement. Hence, we recommend performing internal fixation before cementation after curettage of aggressive bone tumors. However, if the surgeon prefers to pack the cement first, for the benefit of avoiding residual bone defects, we suggest using a locking plate system to achieve comparable pull-out strength. LEVEL OF EVIDENCE: In-vitro study.

Mechanical testing of cephalomedullary nail lag screws after the addition of hydroxyapatite substitutes.

OBJECTIVE: To compare the effects of 3 implant designs, with and without hydroxyapatite reinforcement, on push/pull-out strength and rotational torque. METHODS: Three implant designs (Gamma 3, INTERTAN, and PFNA-II) were selected for comparison. A hydroxyapatite cylinder (NEOBRACE) was used to reinforce the interface between the femoral head and the lag screw. Maximum push-out strength, maximum pull-out strength, and peak rotational torque were measured in cellular blocks mimicking osteoporotic cancellous bone, with and without NEOBRACE. RESULTS: In the push-out test, INTERTAN produced a significantly higher push-out strength in osteoporotic bone density cellular blocks than the other lag screws and blades (P < .05). With the addition of NEOBRACE, push-out strength was significantly higher for INTERTAN and PFNA-II (P < .05) than for the non-NEOBRACE group. In the pull-out test, INTERTAN produced a significantly higher pull-out strength in the osteoporotic bone density cellular blocks than did the other lag screws and blades (P < .05). With the addition of NEOBRACE, the pull-out strengths of INTERTAN and Gamma 3 versus those of the non-NEOBRACE group significantly increased (P < .05). In the rotational torque test, INTERTAN produced significantly greater rotational torque in the osteoporotic cellular blocks than the other lag screws and blades (P < .05). The addition of NEOBRACE resulted in a significant increase in rotational torque only for INTERTAN (P < .05). CONCLUSION: The use of NEOBRACE supported an increase in push/pull-out strength and rotational torque, especially in systems with a relatively increased bone or implant interface area.Level of Evidence: Level V.

Effect Steel Fibre Content on the Load-Carrying Capacity of Fibre-Reinforced Concrete Expansion Anchor.

The article presents the pull-out strength tests carried out on M10 expansion anchors in non-cracked and cracked concrete with a crack width cw = 0.30 mm. The breaking loads and the average pull-out strength of anchors in fibre-reinforced concrete substrates were determined. Fibre content ratios of 15, 30 and 50 kg/m3 were used. In addition, two different classes of concrete (C20/25 and C50/60) were tested. The addition of steel fibres caused a decrease in the pull-out strength by 5% for non-cracked concrete of C20/25 class and fibre content up to 30 kg/m3 and a further 7% for the remaining specified dosage. While for concrete of the C50/60 class, it a decrease in the pull-out strength of up to 20% was observed. For cracked concrete class C20/25 with crack initiation cw = 0.30 mm, the reduction was from 9% to 16% in relation to non-cracked concrete and a maximum of 18% for the fibre content of 50 kg/m3. The difference between the tensile load capacity of C50/60 class cracked and non-cracked concrete was lower than 5% and fell within the measurement error.

Revising a loosened cancellous screw with a larger screw does not restore original pull-out strength - A biomechanical study.

BACKGROUND: Cancellous screw fixation is often used in fracture fixation. When this screw is over-tightened, damage to the bone and other non-linear processes such as fracture and construct failure would be involved. The objectives of this study were (1) to determine the reduction in pull-out strength when a cancellous screw spins and (2) to determine how much pull-out strength can be restored by revising with a larger diameter screw. METHODS: A biomechanical study using synthetic polyurethane foam (320 kg/m3) was performed to assess (1) the pull-out strength of a 6.5 mm cancellous screw, (2) the pull-out strength of a loosened 6.5 mm cancellous screw and (3) the pull-out strength of a loosened 6.5 mm cancellous screw revised with a 7.3 mm cancellous screw. FINDINGS: The baseline pull-out strength of the 6.5 mm cancellous screw was 2213.91 ± 200.51 N. There was a 79.1% (463.79 ± 99.95 N) reduction in pull-out strength once spinning occurs (p = 0.027). When a spinning 6.5 mm cancellous screw was revised to a 7.3 mm cancellous screw, the pull-out strength increased to 1313.65 ± 93.23 N, 59.3% of the baseline pull-out strength (2213.91 ± 200.51 N) (p = 0.027). INTEPRETATION: A loosened 6.5 mm cancellous screw results in a 79.1% reduction in pull-out strength. Revising a loosened cancellous screw by inserting a larger 7.3 mm diameter screw partially improves the pull-out strength to 59.3% of the baseline. Surgeons should consider the use of "two-finger tight" torque when inserting a screw to avoid stripping.

Dental implants' stability dependence on rotational speed and feed-rate of drilling: In-vivo and ex-vivo investigations.

This study aimed to explore the effects of drilling rotational speed and feed-rate on the stability of dental implants through in-vivo and ex-vivo experiments. To this end, a total of 16 identical dental implants were inserted in the mandible of four dogs. The osteotomies were made with two drilling rotational speeds, i.e., 800 and 1500 rpm, and two different feed-rates, i.e., 1 and 2 mm/s. Implant stability quotients (ISQs) were recorded immediately after inserting implants and then each week for four subsequent weeks. Then, all animals were euthanized, and a bone sample containing the implants was extracted from each hemi-mandible for the pull-out test. A two-way ANOVA was performed for ISQs, and pull-out strengths (PoS), and the significance level was set to <0.05. The effect of rotational speed and feed-rate, used in this study, on the primary stability quotients was not significant (P > 0.05). Increasing the rotational speed from 800 to 1500 rpm significantly increased both ISQ and PoS values at the end of the 4th week after the implantation (P = 0.022 and P = 0.001, respectively). Moreover, by decreasing the feed-rate from 2 to 1 mm/s, a significant increase in PoSs of the dental implants was observed four weeks after the implantation (P = 0.019). Results of this study showed that either by increasing drilling rotational speed, here from 800 to 1500 rpm, or by reducing feed-rate, here from 2 to 1 mm/s, the secondary stability would be reinforced. Further investigations are needed to see if and how the conclusions made in this study can be generalized.

Evaluation of the Relation Between Preload Values and Pull-Out Force of the Cortical Screw Used in Bone Fracture.

This study aims to examine the relation between pull-out strength and preload values of the cortical screw used in bone fracture fixation. The research question is that "Does the pull-out strength of the cortical screw used in the bone fracture fixation change with the preload values of the screw change?". To perform this purpose, the finite element method was selected due to its ease to evaluate and calculate the stresses on the whole model. Models of a cortical screw, partial plate, and bone were created using the SolidWorks program. The material properties of the bone were selected orthotropic material type. The bone fixed on the distal and proximal ends. The pull-out forces were applied at the bottom of the plate. The screw that has been loaded ranges from 100 N-700 N as preload. The pull-out forces were determined 200-400-600 N as in the literature. The results show that the pull-out strength of the screw was changed when the preloaded values higher than 400 N. However, it was seen that the pull-out strength does not substantially change when the preload values were lower than 400 N. When the preload values were applied ≥500 N, the maximum von Mises stresses on the screw exceeded the critical strength of the screw material. In conclusion, the critical preload value was determined as 500 N for the optimum pull-out strength.