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MECHANICAL STRENGTH EVOLUTION OF A RECONSTRUCTED FEMUR DURING FOLLOW-UP

MECHANICAL STRENGTH EVOLUTION OF A RECONSTRUCTED FEMUR DURING FOLLOW-UP. Taddei F. * , Martelli S. * , Montanari L. * , Greco V. * , Leardini A. § , Viceconti M. * , Manfrini M. #. * Laboratorio di Tecnologia Medica § Laboratorio di Analisi del Movimento # Muscoloskeletal Oncology Department.

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MECHANICAL STRENGTH EVOLUTION OF A RECONSTRUCTED FEMUR DURING FOLLOW-UP

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  1. MECHANICAL STRENGTH EVOLUTION OF A RECONSTRUCTED FEMUR DURING FOLLOW-UP Taddei F.*, Martelli S.*, Montanari L.*, Greco V.*, Leardini A.§, Viceconti M.*, Manfrini M.# *Laboratorio di Tecnologia Medica §Laboratorio di Analisi del Movimento #Muscoloskeletal Oncology Department

  2. Clinical case • 10 years old child • Osteosarcoma at the distal left femoral dyaphisis • Operated in July 2001 • The tumor did not interest sourrounding blood vessels and nerves • The patient was eligible for limb salvage surgery • Reconstruction of the distal femur with a massive allograft in conjunction with a vascularised fibula autograft Date of operation: 06/2001

  3. Follow-up controls Pre-op 36 months 29 months 44 months 13 months 1 month 7 months

  4. AMIRA v. 4.0 (Amiravis Inc, USA) BONEMAT_V2 HyperMesh v. 7.0 (HyperWorks Inc., USA) FEM generation • Segmentation • Automatic mesh generation • 10-node tetrahedra • Convergence test • Material mapping Taddei F, et al.. Med Eng Phys. 2004 Jan;26(1):61-9.

  5. FEM in-vitro validation Comparison with experimentally measured strains on 5 cadaveric femurs Taddei F, et al..J. Biomech. 2005 , e-pub ahead of print Schileo E., et al, poster #67, EORS 2006

  6. Boundary conditions Model - motion registration

  7. Boundary condition • MS model: • 9 bone segments • 6 joints: • hip (ball and socket) • knee (hinge) • ankle (hinge) • 108 landmarks • 84 muscles * • Static optimisation algorithm ** *Kepple T.M. et al., J Biomech. 1998, 31, 77-80. **Friederich J.A. et al, J Biomech. 1990, 23(1), 91-5. **Crowninshield R.D. et al.,J Biomech, 1981,14, 793-801.

  8. Follow-up study

  9. Results Tumour lesion Von Mises stress (Mpa)

  10. Results Risk of fracture definition RF=e1/eyield * eyield = 1.02% ** *Taylor D, Nat Mater 2003; 2(3):133-4. *Bayraktar HH, et. al, J Biomech 2004; 37(1):27-35. **Currey JD, J Biomech. 2004 Apr;37(4):549-56.

  11. Results Risk of fracture

  12. Results Risk of fracture

  13. Results Deformed shape

  14. Results Von Mises stress (MPa)

  15. Results Risk of fracture

  16. Mineral density femoral neck Results

  17. Results Risk of fracture

  18. Results Von Mises stress (MPa)

  19. Thank you!

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