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A novel combined hemipelvic endoprosthesis for peri-acetabular tumours involving sacroiliac joint: a finite element study

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Abstract

Purpose

Our aim was to introduce a novel combined hemipelvic endoprosthesis for pelvic reconstruction after Enneking type I/II/IV resection and to evaluate the biomechanical properties of the endoprosthesis using finite element analysis.

Methods

A three-dimensional finite element model of the postoperative pelvis was developed based on computed tomography (CT) images of the patient with the best post-operative limb function. A force of 400 N was applied along the longitudinal axis of the normal and post-operative pelvis for two positions: standing on two feet and sitting. Stress-distribution analysis was performed in both positions, and results were compared. Prosthesis improvements were simulated by intervertebral fusion and extra screw fixation.

Results

In the normal pelvis, stress distributions were mostly concentrated on the superior area of the acetabulum, arcuate line, sacroiliac joint and sacral midline in both static conditions, and peak stresses of 1.52 MPa and 4.53 MPa were observed at the superior area of the greater sciatic notch and ischial tuberosity, respectively. For the reconstructed hemipelvis, stress distributions were concentrated on the connecting rods of the acetabular component and the proximal segment of the pedicle rods, and peak stresses of 252 MPa and 213 MPa were observed on the proximal pedicle rods of the fourth lumbar vertebra for standing and sitting, respectively. Interbody fusion of the fourth and fifth lumbar vertebrae and extra screw fixation to the sacrum decreased the peak stresses by 33.0 % and 18.3 % while standing and by 10.8 % and 6.6 % while sitting.

Conclusion

Reconstruction with combined hemipelvic endoprosthesis after types I/II/IV resection of the pelvis fulfilled physiological and biomechanical demands of the hemipelvis and yielded good biomechanical characteristics.

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Acknowledgments

All authors have read and approved the final submitted manuscript.

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Authors and Affiliations

  1. Department of Musculoskeletal Oncology, The First Affiliated Hospital of Sun Yat-Sen University, 58#,Zhongshan Road II, Guangzhou, Guangdong, China, 510080

    Bo Wang, Xianbiao Xie, Jian Tu & Jingnan Shen

  2. Guangdong Provincial Medical Biomechanical Key Laboratory, Department of Anatomy, Southern Medical University, Tonghe, Guangzhou, Guangdong, China, 510515

    Peidong Sun, Weidong Wu & Jun Ouyang

Authors
  1. Bo Wang
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  2. Peidong Sun
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  3. Xianbiao Xie
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  4. Weidong Wu
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  5. Jian Tu
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  6. Jun Ouyang
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  7. Jingnan Shen
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Correspondence to Jun Ouyang or Jingnan Shen.

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Wang, B., Sun, P., Xie, X. et al. A novel combined hemipelvic endoprosthesis for peri-acetabular tumours involving sacroiliac joint: a finite element study. International Orthopaedics (SICOT) 39, 2253–2259 (2015). https://doi.org/10.1007/s00264-015-2891-7

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  • DOI: https://doi.org/10.1007/s00264-015-2891-7

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