Clinical Orthopaedics and Related Research®

, Volume 467, Issue 7, pp 1839–1847 | Cite as

Differentially Loaded Radiostereometric Analysis to Monitor Fracture Stiffness: A Feasibility Study

  • Mellick J. ChehadeEmail author
  • Lucian B. Solomon
  • Stuart A. Callary
  • Sam H. Benveniste
  • Anthony P. Pohl
  • Donald W. Howie
Original Article


Inability to accurately and objectively assess the mechanical properties of healing fractures in vivo hampers clinical fracture management and research. We describe a method to monitor fracture stiffness during healing in a clinical research setting by detecting changes in fracture displacement using radiostereometric analysis and simultaneously measuring applied axial loads. A method was developed for load application, positioning of the patient, and radiographic setup to establish the technique of differentially loaded radiostereometric analysis (DLRSA). A DLRSA examination consists of radiostereometric analysis radiographs taken without load (preload), under different increments of load, and without load (postload). Six patients with distal femur fractures had DLRSA examinations at 6, 12, 18, and 26 weeks postoperatively. The DLRSA method was feasible in a clinical setting. The method provides objective and quantifiable data for internally fixed fractures and may be used in clinical research as a tool to monitor the in vivo stiffness of healing femoral fractures managed with nonrigid internal fixation.


High Tibial Osteotomy Fracture Fragment Conventional Radiograph Distal Femur Fracture Internal Fixation Device 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank Jamie Taylor for valuable direction, support, and input from radiology and Margaret McGee for help with study design and reviewing the manuscript. We also thank Julie West and the staff of the Radiology Department for providing resources and for their help taking the radiographs.


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Copyright information

© The Association of Bone and Joint Surgeons 2009

Authors and Affiliations

  • Mellick J. Chehade
    • 1
    • 2
    Email author
  • Lucian B. Solomon
    • 1
    • 2
  • Stuart A. Callary
    • 1
    • 2
  • Sam H. Benveniste
    • 1
    • 2
  • Anthony P. Pohl
    • 1
    • 2
  • Donald W. Howie
    • 1
    • 2
  1. 1.Discipline of Orthopaedics and TraumaThe University of AdelaideAdelaideAustralia
  2. 2.Department of Orthopaedics and TraumaRoyal Adelaide HospitalAdelaideAustralia

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