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Tytuł:
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Patient-specific computed tomography-based finite element analysis: a new tool to assess fracture risk in benign bone lesions of the femur.
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Autorzy:
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Schermann H; Orthopedic Surgery Division, Tel Aviv Sourasky Medical Center affiliated with Tel Aviv University, Tel Aviv, Israel.
Gortzak Y; National Unit of Orthopedic Oncology, Tel Aviv Sourasky Medical Center affiliated with Tel Aviv University, Tel Aviv, Israel.
Kollender Y; National Unit of Orthopedic Oncology, Tel Aviv Sourasky Medical Center affiliated with Tel Aviv University, Tel Aviv, Israel.
Dadia S; National Unit of Orthopedic Oncology, Tel Aviv Sourasky Medical Center affiliated with Tel Aviv University, Tel Aviv, Israel.
Trabelsi N; Department of Mechanical Engineering, Shamoon College of Engineering, Beer-Sheva, Israel; PerSimiO LTD, Beer-Sheva, Israel.
Yosibash Z; PerSimiO LTD, Beer-Sheva, Israel; School of Mechanical Engineering, The Iby and Aladar Fleischer Faculty of Engineering, Tel Aviv University, Ramat-Aviv, Israel. Electronic address: .
Sternheim A; National Unit of Orthopedic Oncology, Tel Aviv Sourasky Medical Center affiliated with Tel Aviv University, Tel Aviv, Israel.
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Źródło:
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Clinical biomechanics (Bristol, Avon) [Clin Biomech (Bristol, Avon)] 2020 Dec; Vol. 80, pp. 105155. Date of Electronic Publication: 2020 Aug 24.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: 1995- : Oxford : Elsevier Science
Original Publication: Bristol, UK : J. Wright, c1986-
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MeSH Terms:
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Finite Element Analysis*
Femur/*diagnostic imaging
Femur/*injuries
Fractures, Bone/*diagnostic imaging
Adult ; Aged ; Cohort Studies ; Female ; Femur/pathology ; Femur/surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Assessment ; Tomography, X-Ray Computed/methods ; Weight-Bearing
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Contributed Indexing:
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Keywords: Benign bone tumors; Bone strength; Femur; Finite element analysis; Fracture risk; Pathologic fracture
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Entry Date(s):
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Date Created: 20200911 Date Completed: 20210429 Latest Revision: 20210429
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Update Code:
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20240105
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DOI:
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10.1016/j.clinbiomech.2020.105155
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PMID:
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32916567
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Background: Most benign active and latent lesions of proximal femur do not predispose a patient to a pathologic fracture. Nonetheless, there is a tendency to perform internal fixation due to the lack of accurate clinical tools that may reliably confirm low risk of pathologic fracture. As many as 30% of these surgeries may be unnecessary. A patient-specific CT-based finite element analysis may quantify bone strength and risk of fracture under normal weight-bearing conditions.
Methods: The clinical relevance of such finite element analysis was investigated in a retrospective study on a cohort of 17 patients. Finite element analysis results (high risk = indication for surgery, low or moderate risk = follow-up) were compared to actual clinical decisions (surgery vs follow-up). All patients predicted by the finite element analysis as high risk underwent internal fixation and had good outcomes (n = 6).
Findings: Four of the 11 low- and moderate-risk finite element analysis patients (36%) were operated immediately, and seven (64%) were either operated after a delay of at least 6 months or were never operated. None sustained a pathologic fracture. Patients who were predicted as low fracture risk by finite element analysis remained fracture-free for a minimal period of 6 months. Prediction of high risk of pathologic fracture by finite element analysis was in complete agreement with the conventional clinical evaluation.
Interpretation: We consider finite element analysis a promising decision support system for the management of patients with benign tumors of femur, and that it may reliably endorse the decision to withhold surgery for patients at low fracture-risk.
(Copyright © 2020 Elsevier Ltd. All rights reserved.)
