Intralesional curettage versus prosthetic replacement for bone tumors - a finite element analysis case of limb salvage simulation in biomechanics

Background and objectives: To compare mechanical properties of femoral tumor treatments so that better operative strategy for limb tumors surgery is optimized. Methods: Fourteen femoral CT images were randomly selected to rebuild 3D models by MIMICS. They were then executed by reverse engineering softwares for simulative modes. Mode #1: Intralesional curettage with cement filled plus fixator; Mode #2: Distal femur resection with tumorous prosthesis replaced. Finally, the mechanical aspects such as stress and displacement were compared by finite element analysis. Results: Analyzed by AnSys, the observation indexes were measured as follows: for displacement of femurs, d = 1.4762 (< a = 3.9042 < c = 3.9845 < b = 4.1159) in mm is the most staple of all models; for displacement of implants (fixators or prostheses), it's similar to the behavior of femurs and with no significant difference; for stresses of femurs, no significant difference was found among all models; the stresses of implants (fixations and prostheses) were observed as d = 39.6334 (< a = 58.6206 < c = 61.8150 < b = 62.6626) in MPa correspondently, which is the least; for stresses of the general system, the average of peak values for integrated devices of all models are: d = 40.8072 (< a = 58.6206 < c = 61.7831 < b = 62.6626) in MPa, which is also the least. As a final result, both maximum values for displacement and stress of mode 2 are lower than those of mode 1. Conclusions: Our finite element analysis of limb salvage simulation in biomechanics proved that, to treat distal femoral bone tumors, prosthetic replacement is more efficient than intralesional curettage. (c) 2020 Elsevier B.V. All rights reserved.