Biomechanical Study on the Novel Biomimetic Hemi-Pelvis Prosthesis

doi:10.1016/S1672-6529(13)60244-9

摘要/Abstract

关键词: biomimetic prosthesis, pelvic reconstruction, biomechanics, FEM

Abstract:

A pelvic endoprosthesis is the primary means of pelvic reconstruction after internal hemipelvectomy. In this study, a novel biomimetic hemipelvic prosthesis, including an artificial ilium, an artificial acetabulum, and an artificial pubis, was developed. A Finite Element Method (FEM) was carried out to investigate the biomechanical performance of a pelvis reconstructed with biomimetic hemipelvic prosthesis. Two models, including the reconstructed pelvis and the original pelvis (control model), were established according to the geometry from CT data of a human male patient with pelvic bone sarcomas. The FE models predict that the biomechanical function of the pelvic ring can be reestablished using this prosthesis. Results show that the body force loaded on the S1 vertebra is restored and transferred towards the sacro-iliac joint, and along the ilium onto the bearing surface of the artificial ilium, then to the artificial acetabulum and pubis. Von Mises stresses observed in this reconstructed pelvis model are still within a low and elastic range below the yielding strength of cortical bone and Ti6Al4V. The values of deformation and strain of the reconstructed pelvis are close to the data obtained in the original pelvis. With the partial replacement of the pubis, little influence is found towards the pubis symphysis. However, the interface between the prosthesis and pelvic bone may become the critical part of the reconstructed pelvis due to the discontinuity in the material properties, which results in stress shielding and deformation constraining. So a biomimetic flexible connection or inter layer to release the deformation of pelvis is suggested in future designing.

Key words: biomimetic prosthesis, pelvic reconstruction, biomechanics, FEM

Zikai Hua, Yongwei Fan, Qinghong Cao, Xianbo Wu. [J]. J4, 2013, 10(4): 505-513.

Zikai Hua, Yongwei Fan, Qinghong Cao, Xianbo Wu. Biomechanical Study on the Novel Biomimetic Hemi-Pelvis Prosthesis[J]. J4, 2013, 10(4): 505-513.

参考文献

[1] Dalal S A, Burgess A R, Siegel J H, Young J W, Brumback R J, Poka A, Dunham C M, Gens D, Bathon H. Pelvic fracture in multiple trauma: Classification by mechanism is key to pattern of organ injury, resusciative requirements, and out-come. Journal of Trauma, 1989, 29, 981–1000.

[2] Wirbel R J, Schulte M, Mutschler W E. Surgical treatment of pelvic sarcomas: Oncologic and functional outcome. Clini-cal Orthopaedics and Related Research, 2001, 390, 190–205.

[3] Mavrogenis A F, Soultanis K, Patapis P, Guerra G, Fabbri N, Ruggieri P, Papagelopoulos P J. Pelvic Resections. Ortho-pedics, 2012, 35, 232–243.

[4] Nieder E, Elson R A, Engelbrecht E, Kasselt M R, Keller A, Steinbrink K. The saddle prosthesis for salvage of the de-stroyed acetabulum. Journal of Bone and Joint Surgery
[Br], 1990, 72, 1014–1022.

[5] Ji T, Guo W, Tang X D, Yang Y. Reconstruction of type II+III pelvic resection with a modular hemipelvic endo-prosthesis: A finite element analysis study. Orthopaedic Surgery, 2010, 2, 272–277.

[6] Guo Z, Li J, Pei G X, Li X D, Wang Z. Pelvic reconstruction with a combined hemipelvic prostheses after resection of primary malignant tumor. Surgical Oncology, 2010, 19, 95–105.

[7] Dai K R, Yan M N, Zhu Z A, Sun Y H. Computer-aided custom-made hemipelvic prosthesis used in extensive pelvic lesions. Journal of Arthroplasty, 2007, 22, 981–986.

[8] Aljassir F, Beadel G P, Turcotte R E, Griffin A M, Bell R S, Wunder J S, Isler M H. Outcome after pelvic sarcoma re-section reconstructed with saddle prosthesis. Clinical Or-thopaedics and Related Research, 2005, 438, 36–41.

[9] Jansen J A, van de Sande M A, Dijkstra P D. Poor long-term clinical results of saddle prosthesis after resection of peri-acetabular tumors. Clinical Orthopaedics and Related Re-search, 2013, 471, 324–331.

[10] Sun W, Li J, Li Q, Li G D, Cai Z D. Clinical effectiveness of hemipelvic reconstruction using computer-aided cutom-made prostheses after resection of malignant pelvic tumors. Journal of Arthroplasty, 2011, 26, 1508–1513.

[11] Schoellner C, Schoellner D. Pedestal cup operation in acetabular defects after hip cup loosening: A progress report. Zeitschrift fur Orthopadie und Ihre Grenzgebiete, 2000, 138, 215–221.

[12] Wu M P. The use of prostheses in pelvic reconstructive surgery: Joy or toy? Taiwanese Journal of Obstetrics and Gynecology, 2008, 47, 151–156.

[13] Anderson A E, Peters C L, Tuttle B D, Weiss J A. Sub-ject-specific finite element model of the pelvis: Develop-ment, validation and sensitivity studies. Journal of Biome-chanical Engineering, 2005, 127, 364–373.

[14] Dalstra M, Huiskes R. Load transfer across the pelvic bone. Journal of Biomechanical Engineering, 1995, 28, 715–24.

[15] Phillips A T M, Pankaj P, Howie C R, Usmani A S, Simpson A H R W. Finite element modelling of the pelvis: Inclusion of muscular and ligamentous boundary conditions. Medical Engineering and Physics, 2007, 29, 739–748.

[16] Dalstra M, Huiskes R, van Erning L. Development and validation of a three-dimensional finite element model of the pelvic bone. Journal of Biomechanical Engineering, 1995, 117, 272–278.

[17] Donachie M J. Titanium. A technical guide, 2nd ed. ASM International, Ohio, USA, 2000.

[18] Reilly D T, Burstein A H. The mechanical properties of cortical bone, Journal of Bone and Joint Surgery
[Am], 1974, 56, 1001–1022.

[19] Jia Y W, Cheng L M, Yu G R, Du C F, Yang Z Y, Yu Y, Ding Z Q. A finite element analysis of the pelvic recon-struction using fibular transplantation fixed with four dif-ferent rod-screw systems after type I resection. Chinese Medical Journal, 2008, 121, 321–326.

[20] Su S H, Hua Z K, Zhang J H. Design and mechanics simu-lation of bionic lubrication system of artificial joints. Jour-nal of Bionic Engineering, 2006, 3, 155–160.

[21] Yong L, Ge S R, Jin Z M. Wettability modification for biosurface of titanium alloy by means of sequential car-burization. Journal of Bionic Engineering, 2009, 6, 219–223.