Knee Joint Loading and Fracture Risk Analyses of Patients with Benign Bone Tumours: A Finite Element Analysis
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Authors
Cameron, Emily
Date
2024-08-21
Type
thesis
Language
eng
Keyword
finite element analysis , computed tomography based finite element analysis , knee joint , benign bone tumour , fracture risk , knee joint loading , patient-specific , FEA , CTFEA
Alternative Title
Abstract
Primary benign bone tumours are uncommon and most often affect children and young adults. Chondroblastoma, giant cell tumours, and aneurysmal bone cysts, are benign, aggressive tumours that commonly arise in the epiphysis of long bones, such as the proximal tibia or distal femur. Curettage and bone grafting are common treatment methods for benign bone tumours. Recent literature illustrates that clinical practices for determining pathologic fracture risk during joint loading are inaccurate, and often lead to unnecessary surgical procedures or revision surgeries. This thesis aimed to assess the predictive capability of patient specific computed tomography based finite element analysis (CTFEA) compared to traditional orthopaedic clinical fracture risk assessment methods, explore its potential impact on pre-operative surgical decision making and treatment planning, and evaluate its ability to predict safe levels of joint loading for patients with a diagnosis of benign bone tumors. The pre-operative computed tomography (CT) scans from four female patients in the Kingston Health Sciences Centre (ethics protocol: HSERB, TRAQ# 6039359) were included in the current research study. A well-established and experimentally validated workflow for developing patient specific finite element models of bone from CT scans was used to create diseased and intact tibiofemoral joint models for each patient within the dataset. A tibiofemoral joint loading sensitivity analysis was conducted to evaluate motion capture and ground reaction force data collected as part of this thesis and published instrumented total knee replacement data with respect to patients included within this study. Patient specific fracture risk and factor of safety (FOS) analyses were conducted for the diseased and intact bone (distal femur or proximal tibia) of each patient within this study during normal walking gait. Cases without high risk of fracture during walking had fracture and FOS analyses performed for jogging. Cases with high risk of fracture during walking had fracture and FOS analyses performed for partial weight bearing using a mobility device. This thesis provides insights into the development of patient-specific CTFEA, methods for evaluating tibiofemoral joint loading, patient-specific fracture risk assessment, and determining safe levels of locomotive activity in patients with primary benign bone tumors near the knee joint.
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Copying and Preserving Your Thesis
This publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.
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ProQuest PhD and Master's Theses International Dissemination Agreement
Intellectual Property Guidelines at Queen's University
Copying and Preserving Your Thesis
This publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.
Attribution 4.0 International