Measurement of morphological parameters of giant cell tumor of bone in the knee

Guo, Lin; Jia, Peng; Hu, Yongcheng; Sun, Miao; Wang, Zhi; Zhang, Xuening

doi:10.3892/ol.2019.10064

Cited by 1 publication

(1 citation statement)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The metaphyseal sleeve was introduced with a low rate of loosening, providing a direct cementless fixation option at the metaphysis [ 12 ] and thus, complying with the principles of conservation to preserve as much bone stock as possible [ 13 ]. Lin et al [ 14 ] reported that in patients with giant cell tumor of bone (GCTB) in the distal femur, 80% of the maximal longitudinal diameter measurements of tumors in the distal femur were 4.4–8.9 cm and 80% of the shortest distance from the articular surface values were within 0.01–0.75 cm. So, excessive bone would be removed for the reconstruction with the current tumor prosthesis.…”

Section: Introductionmentioning

confidence: 99%

Influence of a metaphyseal sleeve on the stress-strain state of a bone-tumor implant system in the distal femur: an experimental and finite element analysis

Tian²,

Yang

et al. 2020

J Orthop Surg Res

View full text Add to dashboard Cite

Background Aseptic loosening of distal femoral tumor implants significantly correlates with the resection length. We designed a new “sleeve” that is specially engaged in the metaphysis at least 5 cm proximal to the knee joint line to preserve as much bone stock as possible. This study investigates the influence of a metaphyseal sleeve on the stress-strain state of a bone tumor implant system in the distal femur. Methods Cortex strains in intact and implanted femurs were predicted with finite element (FE) models. Moreover strains were experimentally measured in a cadaveric femur with and without a sleeve and stem under an axial compressive load of 1000 N. The FE models, which were validated by linear regression, were used to investigate the maximal von Mises stress and the implanted-to-intact (ITI) ratios of strain in the femur with single-legged stance loading under immediate postoperative and osseointegration conditions. Results Good agreement was noted between the experimental measurements and numerical predictions of the femoral strains (coefficient of determination (R2) ≥ 0.95; root-mean-square error (RMSE%) ≈ 10%). The ITI ratios for the metaphysis were between 13 and 28% and between 10 and 21% under the immediate postoperative and osseointegration conditions, respectively, while the ITI ratios for the posterior and lateral cortices around the tip of the stem were 110% and 119% under the immediate-postoperative condition, respectively, and 114% and 101% under the osseointegration condition, respectively. The maximal von Mises stresses for the implanted femur were 113.8 MPa and 43.41 MPa under the immediate postoperative and osseointegration conditions, which were 284% and 47% higher than those in the intact femur (29.6 MPa), respectively. Conclusions This study reveals that a metaphyseal sleeve may cause stress shielding relative to the intact femur, especially in the distal metaphysis. Stress concentrations might mainly occur in the posterior cortex around the tip of the stem. However, stress concentrations may not be accompanied by periprosthetic fracture under the single-legged stance condition.

show abstract

Section: Introductionmentioning

confidence: 99%