Intralesional curettage versus prosthetic replacement for bone tumors — a finite element analysis case of limb salvage simulation in biomechanics

Peng, Matthew Jian-Qiao; Cao, XiongWei; Chen, Haiyan; Hu, Yong; Li, XinXu; Lao, Yongqiang; Bai, Bo

doi:10.1016/j.cmpb.2020.105775

Cited by 12 publications

(7 citation statements)

References 13 publications

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“…5a). Generally, the FE results of the normal femur were consistent with those of previous studies [20,23].…”

Section: The Stress Distribution On the Normal Femursupporting

confidence: 90%

Cementless curved endoprosthesis stem for distal femoral reconstruction in a Chinese population: a combined anatomical & biomechanical study

Wang

et al. 2022

BMC Musculoskelet Disord

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Background The endoprosthetic knee reconstruction using a current universal femoral stem might not be suitable for local population due to the anatomical difference between Chinese and Western populations. We measured the anatomical parameters of Chinese femurs as reference for stem design, and proposed a cementless, curved, short endoprosthesis stem for the reconstruction of distal femur. This study analyzed the biomechanical performance of the newly designed stem aimed at the identification of better operative strategy. Methods The CT–scanning data of femurs derived from 96 healthy Chinese volunteers were imported into the Mimics software, and a segmental measurement strategy was applied to evaluate the radius of curvature (ROC) of the femoral medullary cavity. Then, 4 kinds of endoprosthetic replacement models were created based on the measurement results. Model A: the distal tumor resected femora + straight stem A; Model B: the distal tumor resected femora + curved stem B; Model C: the distal tumor resected femora + curved stem C; Model D: the distal tumor resected femora + curved stem D. Finally, the mechanical difference among these models were compared by finite element analysis. Results The mean femoral ROC of Segment1, 2, 3, 4, 5 measured in the present study was 724.5 mm, 747.5 mm, 1016.5 mm, 1286.5 mm, and 1128 mm, respectively. Based on the femoral ROC of Segment2, the stem ROC of the curved stem B, C, and D was designed as 475 mm, 700 mm, and 1300 mm, respectively. Generally, all endoprosthetic replacement models showed a normal–like stress distribution on the femurs. However, compared to the straight stem, the biomimetic curved stem showed better biomechanical performance both in terms of reducing the extent of the stress shielding of the femur and in terms of minimizing the stress distribution of the implant. Conclusions The uncemented, curved, short stem with suitable ROC can perfectly match the Chinese femoral canal morphology which has better mechanical properties than the conventional femoral stem. Thus, this newly designed femoral stem might be an optimized method for treatment of malignant femoral tumours in the Chinese populations in the case that the numerical results are supported by future experimental studies.

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“…5a). Generally, the FE results of the normal femur were consistent with those of previous studies [20,23].…”

Section: The Stress Distribution On the Normal Femursupporting

confidence: 90%

Cementless curved endoprosthesis stem for distal femoral reconstruction in a Chinese population: a combined anatomical & biomechanical study

Wang

et al. 2022

BMC Musculoskelet Disord

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“…Another key indication for assessing stress transfer is the stress distribution. The uneven high-stress concentration of the block represents inadequate stress transfer capability and uneven mechanical stimulation ( Peng M. J. et al, 2021 ; Vogel et al, 2021 ). In this study, a larger high-stress concentration area was found on the UHMWPE block which has been proved to be a challenge for long-term use ( Arab et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, the preset size cannot be changed, making it impossible to match bone defects of varying sizes. As a result, osteotomies that exceeded the extent of the bone defect were always performed to satisfy the design requirement ( Peng M. J. et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Comparison Between Porous Ti6Al4V Block and Tumor Prosthesis UHMWPE Block for the Treatment of Distal Femur Bone Defects

Zhang

Liu

Han

et al. 2022

Front. Bioeng. Biotechnol.

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Purpose: The management of bone defects is a crucial content of total knee revision. This study compared the biomechanical performance of porous Ti6Al4V block and tumor prosthesis UHMWPE block in treating distal femoral bone defects.Methods: The finite element models of AORI type 3 distal femoral bone defect treated with porous Ti6Al4V block and UHMWPE block were established. Sensitivity analysis was performed to obtain the appropriate mesh size. The biomechanical performance of treatment methods in bone defects were evaluated according to the peak stress, the Von Mises stress distribution, and the average stresses of regions of interest under the condition of standing on one foot and flexion of the knee. Statistical analysis was conducted by independent samples t-test in SPSS (p < 0.05).Results: In the standing on one-foot state, the peak stress of the porous Ti6Al4V block was 12.42 MPa and that of the UHMWPE block was 19.97 MPa, which is close to its yield stress (21 MPa). Meanwhile, the stress distribution of the UHMWPE block was uneven. In the flexion state, the peak stress of the porous Ti6Al4V block was 16.28 MPa, while that of the UHMWPE block was 14.82 MPa. Compared with the porous Ti6Al4V block group, the average stress of the region of interest in UHMWPE block group was higher in the standing on one foot state and lower in the flexion state (p < 0.05).Conclusion: More uniform stress distribution was identified in the porous Ti6Al4V block application which could reserve more bone. On the contrary, uneven stress distribution and a larger high-stress concentration area were found in the UHMWPE block. Hence, the porous Ti6Al4V block is recommended for the treatment of AORI type 3 distal femoral bone defect.

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“…To clearly evaluate the stress transfer capability, the stress distribution of the various blocks was also studied. The lower stress and less high-stress area of the block indicate better stress transfer capability (Peng et al 2021;Vogel et al 2021). In all studied motions, the peak stress of the TO block was found lower than that of the original block (up to 34%) and the porous block (up to 11%), and the distribution of high-stress in the TO block was the least.…”

Section: Discussionmentioning

confidence: 99%

Porous Metal Block Based on Topology Optimization to Treat Distal Femoral Bone Defect in Total Knee Revision

et al. 2022

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Intralesional curettage versus prosthetic replacement for bone tumors — a finite element analysis case of limb salvage simulation in biomechanics

Cited by 12 publications

References 13 publications

Cementless curved endoprosthesis stem for distal femoral reconstruction in a Chinese population: a combined anatomical & biomechanical study

Cementless curved endoprosthesis stem for distal femoral reconstruction in a Chinese population: a combined anatomical & biomechanical study

Biomechanical Comparison Between Porous Ti6Al4V Block and Tumor Prosthesis UHMWPE Block for the Treatment of Distal Femur Bone Defects

Porous Metal Block Based on Topology Optimization to Treat Distal Femoral Bone Defect in Total Knee Revision

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