A novel minimally invasive and press-fit method for symphysiodesis - a biomechanical analysis

Abstract

Purpose Does the cylindrical shaped bone block allow a stable construct for the arthrodesis of the pubic symphysis compared to a rectangular shaped bone block. The cylindrical shaped bone block stabilized by a 3.5 symphyseal plate is inferior to the stabilization with an internal fxator. Methods This study analyzed the arthrodesis of the pubic symphysis on 24 synthetic pelvises, using a rectangular shaped bone block (control group) or a cylindrical shaped bone block, stabilized with a symphysis locking plate (n=8) as the standard clinical procedure. Additionally we analyzed the stability using an internal fxator. Results This study showed that utilizing a cylindrical shaped synthetic bone graft results in a signifcant higher contact area and compression force compared to the classical rectangular shaped graft. Furthermore, the stabilization with an internal fxator had the tendency for increases of compression force and contact area, yet without a statistical signifcance, when compared to the plate fxation. Conclusion The novel method of cylindrical symphysis resection and cylindrical bone block implantation allowed an increased biomechanical stability compared to using a classical rectangular bone graft, also resulting in higher contact area. Moreover, this technique would also allow a minimally invasive approach for this purpose, which in turn could preserve perisymphyseal ligaments, thereby improving healing in a clinical context.