Alterations in femoral neck strength following pelvic irradiation. A finite element analysis of simulated eccentric forces using bone density data derived from CT.


Journal

Bone
ISSN: 1873-2763
Titre abrégé: Bone
Pays: United States
ID NLM: 8504048

Informations de publication

Date de publication:
04 2021
Historique:
received: 11 11 2020
revised: 19 01 2021
accepted: 21 01 2021
pubmed: 30 1 2021
medline: 6 7 2021
entrez: 29 1 2021
Statut: ppublish

Résumé

Radiotherapy is known to produce long-term skeletal complications. We aim to evaluate the biomechanical effect on femoral neck bone from hypothetical eccentric loads on pre- and post-radiotherapy CT-images for patients treated for rectal cancer. Pre- and post-radiotherapy CT-images of rectal cancer from 10 patients were selected randomly. The cortical and trabecular bone was segmented by hand. The biomechanical simulations of 4 eccentric loads and one load aligned with the femoral neck axis were completed using finite element analysis (FEA) in both pre- and post-patient models. A comparative statistical study was completed of pre- and post-radiotherapy patient models of stress and displacement factors. Significant differences were found in eccentric loads in both factors. Natural load has a significant difference in stress, but no differences were found for displacements. The absolute difference in eccentric load applied to the anterior area location on the same patient implies from 5.3% to 40.5% of the stress yield values reported in previous studies. Loads applied to the anterior area of the femoral head must be considered in fracture simulations because the percentage of yield stress of pre- and post-irradiated bones shows a significant biomechanical change.

Sections du résumé

BACKGROUND AND PURPOSE
Radiotherapy is known to produce long-term skeletal complications. We aim to evaluate the biomechanical effect on femoral neck bone from hypothetical eccentric loads on pre- and post-radiotherapy CT-images for patients treated for rectal cancer.
MATERIAL AND METHODS
Pre- and post-radiotherapy CT-images of rectal cancer from 10 patients were selected randomly. The cortical and trabecular bone was segmented by hand. The biomechanical simulations of 4 eccentric loads and one load aligned with the femoral neck axis were completed using finite element analysis (FEA) in both pre- and post-patient models.
RESULTS
A comparative statistical study was completed of pre- and post-radiotherapy patient models of stress and displacement factors. Significant differences were found in eccentric loads in both factors. Natural load has a significant difference in stress, but no differences were found for displacements. The absolute difference in eccentric load applied to the anterior area location on the same patient implies from 5.3% to 40.5% of the stress yield values reported in previous studies.
CONCLUSIONS
Loads applied to the anterior area of the femoral head must be considered in fracture simulations because the percentage of yield stress of pre- and post-irradiated bones shows a significant biomechanical change.

Identifiants

pubmed: 33513450
pii: S8756-3282(21)00027-2
doi: 10.1016/j.bone.2021.115865
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

115865

Informations de copyright

Copyright © 2021 Elsevier Inc. All rights reserved.

Auteurs

Víctor M Almendros-Abellán (VM)

D-ENERMAT, Instituto de Energías Renovables, University of Castilla-La Mancha, Paseo Investigación 1, Building 3, 02071 Albacete, Spain; CADE Engineered Technologies, Albacete, Spain.

Miguel Castro-García (M)

D-ENERMAT, Instituto de Energías Renovables, University of Castilla-La Mancha, Paseo Investigación 1, Building 3, 02071 Albacete, Spain.

Jesús Canales-Vázquez (J)

D-ENERMAT, Instituto de Energías Renovables, University of Castilla-La Mancha, Paseo Investigación 1, Building 3, 02071 Albacete, Spain.

Patricia Berenguel-Herraiz (P)

CADE Engineered Technologies, Albacete, Spain.

Sebastià Sabater (S)

Dept. of Radiation Oncology, Complejo Hospitalario Universitario de Albacete, Spain. Electronic address: ssabater@sescam.jccm.es.

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Classifications MeSH