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Modular hemipelvic endoprosthesis with a sacral hook: a finite element study

Authors
  • Wang, Bo1
  • Sun, Peidong2
  • Yao, Hao1
  • Tu, Jian1
  • Xie, Xianbiao1
  • Ouyang, Jun2
  • Shen, Jingnan1
  • 1 The First Affiliated Hospital of Sun Yat-Sen University, Department of Musculoskeletal Oncology, 58#, Zhongshan Road II, Guangzhou, Guangdong, 510080, China , Guangzhou (China)
  • 2 Southern Medical University, Medical Biomechanical Key Laboratory of Guangdong Province, Department of Anatomy, Tonghe, Guangzhou, Guangdong, 510515, China , Guangzhou (China)
Type
Published Article
Journal
Journal of Orthopaedic Surgery and Research
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Sep 11, 2019
Volume
14
Issue
1
Identifiers
DOI: 10.1186/s13018-019-1338-z
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundA novel hemipelvic endoprosthesis with a sacral hook was introduced previously, and its clinical outcome with midterm follow-up showed decreased prosthesis-related complications, especially decreased rate of aseptic loosening. The aim of present study was to evaluate the role of a sacral hook in prosthesis stability and the biomechanical properties of this hemipelvic endoprosthesis.MethodsA three-dimensional model of the postoperative pelvis was developed using computed tomography (CT) images. A force of 500 N was applied, and the distribution of stress and displacement was evaluated. Comparisons were performed to explore the role of the sacral hook in prosthesis stability. Prosthesis improvement was simulated to reduce unexpected breakage of the pubic connection plate.ResultsIn the reconstructed hemipelvis, stress distributions were concentrated on the superior area of the acetabulum, sacral connection component, and sacral hook. A maximum stress of 250 MPa was observed at the root of the sacral connection component. The sacral hook reduced the maximum stress and displacement by 14.1% and 32.5%, respectively, when the prosthesis was well fixed and by 10.0% and 42.1%, respectively, when aseptic loosening occurred. Increasing the thickness of the pubic connection plate from 2 to 3.5 mm reduced the maximum stress by 32.0% and 15.8%, respectively.ConclusionA hemipelvic endoprosthesis with a sacral hook fulfills the biomechanical demands of the hemipelvis and is safe under static conditions. The sacral hook is important for prosthesis stability. Increasing the thickness of the pubic connection plate can reduce the maximum stress and risk of fatigue breakage.

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