Finite Element Model-Computed Mechanical Behavior of Femurs with Metastatic Disease Varies Between Physiologic and Idealized Loading Simulations

Background and objectives: Femurs affected by metastatic bone disease (MBD) frequently undergo surgery to prevent impending pathologic fractures due to clinician-perceived increases in fracture risk. Finite element (FE) models can provide more objective assessments of fracture risk. However, FE mode...

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Bibliographic Details
Published in:Biomedical engineering and computational biology 2023-01, Vol.14, p.11795972231166240-11795972231166240
Main Authors: Johnson, Joshua E, Brouillette, Marc J, Miller, Benjamin J, Goetz, Jessica E
Format: Article
Language:English
Subjects:
Bone diseases
Bone surgery
Computation
Configurations
Contact force
Femur
Finite element method
Fractures
Joints (anatomy)
Mathematical models
Mechanical loading
Mechanical properties
Metastases
Metastasis
Muscles
Original
Simulation
Statistical analysis
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Summary:Background and objectives: Femurs affected by metastatic bone disease (MBD) frequently undergo surgery to prevent impending pathologic fractures due to clinician-perceived increases in fracture risk. Finite element (FE) models can provide more objective assessments of fracture risk. However, FE models of femurs with MBD have implemented strain- and strength-based estimates of fracture risk under a wide variety of loading configurations, and “physiologic” loading models typically simulate a single abductor force. Due to these variations, it is currently difficult to interpret mechanical fracture risk results across studies of femoral MBD. Our aims were to evaluate (1) differences in mechanical behavior between idealized loading configurations and those incorporating physiologic muscle forces, and (2) differences in the rankings of mechanical behavior between different loading configurations, in FE simulations to predict fracture risk in femurs with MBD. Methods: We evaluated 9 different patient-specific FE loading simulations for a cohort of 54 MBD femurs: strain outcome simulations—physiologic (normal walking [NW], stair ascent [SA], stumbling), and joint contact only (NW contact force, excluding muscle forces); strength outcome simulations—physiologic (NW, SA), joint contact only, offset torsion, and sideways fall. Tensile principal strain and femur strength were compared between simulations using statistical analyses. Results: Tensile principal strain was 26% higher (R2 = 0.719, P 
ISSN:1179-5972
1179-5972
DOI:10.1177/11795972231166240