Thermomechanical Virtual Simulation of Bone Metastases with Percutaneous Cementoplasty and Internal Fixation
Bone metastases occur when cancer cells from the primary tumor spread to the bones. The incidence of bone metastases is increasing due to the longer survival of patients with primary tumors, driven by advances in cancer treatments. In patients with multiple bone metastases, care is primarily palliat...
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2025-02-01
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| author | Catarina G. R. de Sá Pires Maria A. Marques Elza M. M. Fonseca Vânia C. C. Oliveira |
| author_facet | Catarina G. R. de Sá Pires Maria A. Marques Elza M. M. Fonseca Vânia C. C. Oliveira |
| author_sort | Catarina G. R. de Sá Pires |
| collection | DOAJ |
| description | Bone metastases occur when cancer cells from the primary tumor spread to the bones. The incidence of bone metastases is increasing due to the longer survival of patients with primary tumors, driven by advances in cancer treatments. In patients with multiple bone metastases, care is primarily palliative, aiming to improve their quality of life through pain relief. Bone metastases are strongly associated with pathological fractures, particularly in the femur. In these cases, minimally invasive treatments such as percutaneous cementoplasty and internal fixation with intramedullary nails are growing in popularity. Methods: This manuscript focuses on studying these two therapies by developing virtual models using ANSYS<sup>®</sup> software. Thermal and thermomechanical analyses were conducted to evaluate the heat effect resulting from the polymerization of different types of bone cement and to assess the benefits of combining it with internal fixation using intramedullary nails made of different materials. Results: The results highlight the advantages of combining these two techniques compared to cementoplasty alone. Furthermore, the use of Gentamicin Bone Cement (CMW 3<sup>®</sup>) with an intramedullary nail made of either material has been shown to provide a more significant functional improvement. Conclusions: The combination of cementoplasty with internal fixation is more effective than cementoplasty alone. The use of CMW 3<sup>®</sup> cement with an intramedullary nail made of either material provides greater control over the growth of the metastatic lesion. The chosen injection angle results in an excessive volume of cement, causing a high degree of thermal necrosis. |
| format | Article |
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| institution | OA Journals |
| issn | 2673-7078 |
| language | English |
| publishDate | 2025-02-01 |
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| spelling | doaj-art-cfe494a8b0854763998d17890e853ee22025-08-20T02:11:04ZengMDPI AGBiomechanics2673-70782025-02-01511210.3390/biomechanics5010012Thermomechanical Virtual Simulation of Bone Metastases with Percutaneous Cementoplasty and Internal FixationCatarina G. R. de Sá Pires0Maria A. Marques1Elza M. M. Fonseca2Vânia C. C. Oliveira3School of Engineering, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida, 431, 4200-072 Porto, PortugalSchool of Engineering, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida, 431, 4200-072 Porto, PortugalSchool of Engineering, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida, 431, 4200-072 Porto, PortugalCentro Hospitalar do Porto, Institute of Biomedical Sciences Abel Salazar, University of Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313 Porto, PortugalBone metastases occur when cancer cells from the primary tumor spread to the bones. The incidence of bone metastases is increasing due to the longer survival of patients with primary tumors, driven by advances in cancer treatments. In patients with multiple bone metastases, care is primarily palliative, aiming to improve their quality of life through pain relief. Bone metastases are strongly associated with pathological fractures, particularly in the femur. In these cases, minimally invasive treatments such as percutaneous cementoplasty and internal fixation with intramedullary nails are growing in popularity. Methods: This manuscript focuses on studying these two therapies by developing virtual models using ANSYS<sup>®</sup> software. Thermal and thermomechanical analyses were conducted to evaluate the heat effect resulting from the polymerization of different types of bone cement and to assess the benefits of combining it with internal fixation using intramedullary nails made of different materials. Results: The results highlight the advantages of combining these two techniques compared to cementoplasty alone. Furthermore, the use of Gentamicin Bone Cement (CMW 3<sup>®</sup>) with an intramedullary nail made of either material has been shown to provide a more significant functional improvement. Conclusions: The combination of cementoplasty with internal fixation is more effective than cementoplasty alone. The use of CMW 3<sup>®</sup> cement with an intramedullary nail made of either material provides greater control over the growth of the metastatic lesion. The chosen injection angle results in an excessive volume of cement, causing a high degree of thermal necrosis.https://www.mdpi.com/2673-7078/5/1/12bone metastasespercutaneous cementoplastyCMW 3<sup>®</sup> cementinternal fixationstress shieldingfinite element method |
| spellingShingle | Catarina G. R. de Sá Pires Maria A. Marques Elza M. M. Fonseca Vânia C. C. Oliveira Thermomechanical Virtual Simulation of Bone Metastases with Percutaneous Cementoplasty and Internal Fixation Biomechanics bone metastases percutaneous cementoplasty CMW 3<sup>®</sup> cement internal fixation stress shielding finite element method |
| title | Thermomechanical Virtual Simulation of Bone Metastases with Percutaneous Cementoplasty and Internal Fixation |
| title_full | Thermomechanical Virtual Simulation of Bone Metastases with Percutaneous Cementoplasty and Internal Fixation |
| title_fullStr | Thermomechanical Virtual Simulation of Bone Metastases with Percutaneous Cementoplasty and Internal Fixation |
| title_full_unstemmed | Thermomechanical Virtual Simulation of Bone Metastases with Percutaneous Cementoplasty and Internal Fixation |
| title_short | Thermomechanical Virtual Simulation of Bone Metastases with Percutaneous Cementoplasty and Internal Fixation |
| title_sort | thermomechanical virtual simulation of bone metastases with percutaneous cementoplasty and internal fixation |
| topic | bone metastases percutaneous cementoplasty CMW 3<sup>®</sup> cement internal fixation stress shielding finite element method |
| url | https://www.mdpi.com/2673-7078/5/1/12 |
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