$Post-operative fracture risk assessment following tumor curettage in the distal femur: a hybrid in vitro and in silico biomechanical approach$
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Post-operative fracture risk assessment following tumor curettage in the distal femur: a hybrid in vitro and in silico biomechanical approach

Abstract The distal femur is the predominant site for benign bone tumours and a common site for fracture following tumour removal or cementation. However, the lack of conclusive assessment criterion for post-operative fracture risk and appropriate devices for cement augmentation are serious concerns...

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Autores principales:	Azadeh Ghouchani, Gholamreza Rouhi, Mohammad Hosein Ebrahimzadeh
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/09fe7eb0d7e142aaa896cd1fdeb13ef9
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spelling	oai:doaj.org-article:09fe7eb0d7e142aaa896cd1fdeb13ef92021-12-02T16:08:47ZPost-operative fracture risk assessment following tumor curettage in the distal femur: a hybrid in vitro and in silico biomechanical approach10.1038/s41598-020-78188-32045-2322https://doaj.org/article/09fe7eb0d7e142aaa896cd1fdeb13ef92020-12-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-78188-3https://doaj.org/toc/2045-2322Abstract The distal femur is the predominant site for benign bone tumours and a common site for fracture following tumour removal or cementation. However, the lack of conclusive assessment criterion for post-operative fracture risk and appropriate devices for cement augmentation are serious concerns. Hence, a validated biomechanical tool was developed to assess bone strength, depending on the size and location of artificially created tumorous defects in the distal femora. The mechanics of the bone–cement interface was investigated to determine the main causes of reconstruction failure. Based on quantitative-CT images, non-linear and heterogeneous finite element (FE) models of human cadaveric distal femora with simulated tumourous defects were created and validated using in vitro mechanical tests from 14 cadaveric samples. Statistical analyses demonstrated a strong linear relationship (R2 = 0.95, slope = 1.12) with no significant difference between bone strengths predicted by in silico analyses and in vitro tests (P = 0.174). FE analyses showed little reduction in bone strength until the defect was 35% or more of epiphyseal volume, and reduction in bone strength was less pronounced for laterally located defects than medial side defects. Moreover, the proximal end of the cortical window and the most interior wall of the bone–cement interface were the most vulnerable sites for reconstruction failure.Azadeh GhouchaniGholamreza RouhiMohammad Hosein EbrahimzadehNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-13 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Azadeh Ghouchani Gholamreza Rouhi Mohammad Hosein Ebrahimzadeh Post-operative fracture risk assessment following tumor curettage in the distal femur: a hybrid in vitro and in silico biomechanical approach
description	Abstract The distal femur is the predominant site for benign bone tumours and a common site for fracture following tumour removal or cementation. However, the lack of conclusive assessment criterion for post-operative fracture risk and appropriate devices for cement augmentation are serious concerns. Hence, a validated biomechanical tool was developed to assess bone strength, depending on the size and location of artificially created tumorous defects in the distal femora. The mechanics of the bone–cement interface was investigated to determine the main causes of reconstruction failure. Based on quantitative-CT images, non-linear and heterogeneous finite element (FE) models of human cadaveric distal femora with simulated tumourous defects were created and validated using in vitro mechanical tests from 14 cadaveric samples. Statistical analyses demonstrated a strong linear relationship (R2 = 0.95, slope = 1.12) with no significant difference between bone strengths predicted by in silico analyses and in vitro tests (P = 0.174). FE analyses showed little reduction in bone strength until the defect was 35% or more of epiphyseal volume, and reduction in bone strength was less pronounced for laterally located defects than medial side defects. Moreover, the proximal end of the cortical window and the most interior wall of the bone–cement interface were the most vulnerable sites for reconstruction failure.
format	article
author	Azadeh Ghouchani Gholamreza Rouhi Mohammad Hosein Ebrahimzadeh
author_facet	Azadeh Ghouchani Gholamreza Rouhi Mohammad Hosein Ebrahimzadeh
author_sort	Azadeh Ghouchani
title	Post-operative fracture risk assessment following tumor curettage in the distal femur: a hybrid in vitro and in silico biomechanical approach
title_short	Post-operative fracture risk assessment following tumor curettage in the distal femur: a hybrid in vitro and in silico biomechanical approach
title_full	Post-operative fracture risk assessment following tumor curettage in the distal femur: a hybrid in vitro and in silico biomechanical approach
title_fullStr	Post-operative fracture risk assessment following tumor curettage in the distal femur: a hybrid in vitro and in silico biomechanical approach
title_full_unstemmed	Post-operative fracture risk assessment following tumor curettage in the distal femur: a hybrid in vitro and in silico biomechanical approach
title_sort	post-operative fracture risk assessment following tumor curettage in the distal femur: a hybrid in vitro and in silico biomechanical approach
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/09fe7eb0d7e142aaa896cd1fdeb13ef9
work_keys_str_mv	AT azadehghouchani postoperativefractureriskassessmentfollowingtumorcurettageinthedistalfemurahybridinvitroandinsilicobiomechanicalapproach AT gholamrezarouhi postoperativefractureriskassessmentfollowingtumorcurettageinthedistalfemurahybridinvitroandinsilicobiomechanicalapproach AT mohammadhoseinebrahimzadeh postoperativefractureriskassessmentfollowingtumorcurettageinthedistalfemurahybridinvitroandinsilicobiomechanicalapproach
_version_	1718384451916922880

Post-operative fracture risk assessment following tumor curettage in the distal femur: a hybrid in vitro and in silico biomechanical approach

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