Simulating activities of daily living with finite element analysis improves fracture prediction for patients with metastatic femoral lesions

Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society
Jacklyn R GoodheartKenneth A Mann

Abstract

Predicting fracture risk for patients with metastatic femoral lesions remains an important clinical problem. Mirels' criterion remains the most formalized radiographic scoring system with good sensitivity (correctly identifying clinical fractures) but relatively poor specificity (correctly identify cases that do not fracture). A series of patients with metastatic femoral lesions had Computed Tomography (CT) scans, were followed prospectively for 4 months, and categorized into fracture (n = 5), non-fracture (n = 28), or stabilized (n = 11) groups. CT based-Finite Element (FE) modeling was used to predict fracture for these cases using axial compression (AC), level walking (LW), and aggressive stair ascent (ASA) loading conditions. The FE predicted fracture force was greater for the non-fracture compared to the fracture group for all loading cases. The ability of the FE models to predict fracture cases (sensitivity) was similar for the groups (Mirels, AC, LW: 80%, ASA: 100%). The ability of the models to correctly predict the non-fracture cases (specificity) was improved for AC (71%) and LW (86%) loading conditions, when compared to Mirels specificity (43%), but poorer for the ASA (21%) conditions. The results suggest that FE mod...Continue Reading

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Citations

Mar 2, 2017·JBJS Reviews·Michael B O'SullivanTessa Balach
Mar 7, 2018·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Florieke EggermontEsther Tanck
Feb 24, 2018·PM & R : the Journal of Injury, Function, and Rehabilitation·Gráinne SheillJuliette Hussey
Mar 13, 2020·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Timothy A Damron, Kenneth A Mann
May 1, 2020·The Bone & Joint Journal·A SternheimZ Yosibash
Jul 14, 2020·Computer Methods in Biomechanics and Biomedical Engineering·Cristina Falcinelli, Cari Whyne
Aug 13, 2020·Orthopaedics & Traumatology, Surgery & Research : OTSR·Vincent CrennUNKNOWN members of the So.F.C.O.T.
Nov 17, 2019·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·C W P G van der WalY M van der Linden

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