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Cited by 63Bone fractures and treatmentsSpinal Fractures and Fixation TechniquesBone health and osteoporosis research

The DOI matches its Crossref record; 41 of the 41 references it cites were found in a registry or an index.

Continuous implant load monitoring to assess bone healing status-evidence from animal testing

Open access
Windolf, Markus, Varjas, Viktor, Gehweiler, Dominic, Schwyn, Ronald, Arens, Daniel, Constant, Caroline, Zeiter, Stephan, Richards, Robert Geoff, Ernst, Manuela·2022·Medicina
DOI 10.3390/medicina58070858PMC PMC9321316
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Abstract

Background and Objectives: Fracture healing is currently assessed through qualitative evaluation of radiographic images, which is highly subjective in nature. Radiographs can only provide snapshots in time, which are limited due to logistics and radiation exposure. We recently proposed assessing the bone healing status through continuous monitoring of the implant load, utilizing an implanted sensor system, the Fracture Monitor. The device telemetrically transmits statistically derived implant parameters via the patient’s mobile phone to assist physicians in diagnostics and treatment decision-making. This preclinical study aims to systematically investigate the device safety and performance in an animal setting. Materials and Methods: Mid-shaft tibial osteotomies of different sizes (0.6–30 mm) were created in eleven Swiss mountain sheep. The bones were stabilized with either a conventional Titanium or stainless-steel locking plate equipped with a Fracture Monitor. Data were continuously collected over the device’s lifetime. Conventional radiographs and clinical CT scans were taken longitudinally over the study period. The radiographs were systematically scored and CTs were evaluated for normalized bone volume in the defect. The animals were euthanized after 9 months. The sensor output was correlated with the radiologic parameters. Tissue samples from the device location were histologically examined. Results: The sensors functioned autonomously for 6.5–8.4 months until energy depletion. No macroscopic or microscopic adverse effects from device implantation were observed. The relative implant loads at 4 and 8 weeks post-operation correlated significantly with the radiographic scores and with the normalized bone volume metric. Conclusions: Continuous implant load monitoring appears as a relevant approach to support and objectify fracture healing assessments and carries a strong potential to enable patient-tailored rehabilitation in the future.

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Metadata

Authors
Windolf, M., Varjas, V., Gehweiler, D., Schwyn, R., Arens, D., Constant, C., Zeiter, S., Richards, R. G., & Ernst, M.
Affiliations
AO Foundation (CH)
Corresponding author
Windolf, Markus
ORCID
Venue
Medicina
Publisher
MDPI AG
Published
2022-06-27
Volume
58
Issue
7
Pages
858
ISSN
  • 1010-660X (ISSN-L)
  • 1648-9144
DOI
10.3390/medicina58070858
PMC
PMC9321316
OpenAlex
W4283660885
Cited by
63
References
41
Citations by year
2026: 11 · 2025: 23 · 2024: 23 · 2023: 3 · 2022: 3
FWCI
9.39
Type
journal article
Language
en
Open access
Licence
Locations
  • Medicina (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
AO Development Incubator
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone fractures and treatments
  • Health Sciences › Medicine › Surgery › Spinal Fractures and Fixation Techniques
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
Keywords
fracture healing, implantable sensors, tibial osteotomy, bone volume, radiographic scoring, device safety, telemetric data transmission, locking plate, sheep model
MeSH terms
Animals, Bone Plates, Fracture Fixation, Internal, Osteotomy, Sheep, Titanium, Fracture Healing

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