Subject-specific planning of femoroplasty: A combined evolutionary optimization and particle diffusion model approach
Subject-specific planning of femoroplasty: A combined evolutionary optimization and particle diffusion model approach
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DOI：
10.1016/j.jbiomech.2014.05.002
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发表时间：
2014-07-18
影响因子：
2.4
通讯作者：
Armand, Mehran
中科院分区：
文献类型：
--
作者：
Basafa, Ehsan;Armand, Mehran
预防骨质疏松性髋部骨折的潜在有效治疗方法是通过注射（PMMA）骨水泥-股骨成形术等药物来增强股骨的机械性能。然而，该操作仅处于研究阶段，可以从计算机规划和优化中受益匪浅。我们报告了生物力学评估程序的计算规划和优化结果。采用进化优化方法对7例骨质疏松症骨试件进行有限元模型优化放置。优化后的标本间差异表明，靠近颈部上、下皮层和大转子上外侧的区域将受益于隆胸。然后，我们使用基于颗粒的骨水泥扩散模拟模型来匹配优化的模式，考虑到实际手术的局限性，包括限制注射体积以防止热坏死。模拟结果表明，仅使用9ml骨水泥，屈服载荷可显著提高30%以上。这一增长与先前的文献报道相当，其中使用超过40毫升的水泥来代替骨的总填充。这些发现，以及不同标本间优化方案的差异，强调了为有效规划股骨隆胸手术需要针对特定对象的模型。(C) 2014 Elsevier Ltd.版权所有。
A potential effective treatment for prevention of osteoporotic hip fractures is augmentation of the mechanical properties of the femur by injecting it with agents such as (PMMA) bone cement - femoroplasty. The operation, however, is only in research stage and can benefit substantially from computer planning and optimization. We report the results of computational planning and optimization of the procedure for biomechanical evaluation. An evolutionary optimization method was used to optimally place the cement in finite element (FE) models of seven osteoporotic bone specimens. The optimization, with some inter-specimen variations, suggested that areas close to the cortex in the superior and inferior of the neck and supero-lateral aspect of the greater trochanter will benefit from augmentation. We then used a particle-based model for bone cement diffusion simulation to match the optimized pattern, taking into account the limitations of the actual surgery, including limited volume of injection to prevent thermal necrosis. Simulations showed that the yield load can be significantly increased by more than 30%, using only 9 ml of bone cement. This increase is comparable to previous literature reports where gross filling of the bone was employed instead, using more than 40 ml of cement. These findings, along with the differences in the optimized plans between specimens, emphasize the need for subject-specific models for effective planning of femoral augmentation. (C) 2014 Elsevier Ltd. All rights reserved.