Biomechanical study of stress-strain states of the system «endoprosthesis humerus» in terms of tumor resection

Authors

  • Oleg Vyrva
  • Dmytro Mikhanovsky
  • Mykhaylo Karpinsky

DOI:

https://doi.org/10.15674/0030-59872015314-20

Keywords:

proximal humerus, tumor resection, arthro¬plasty, stress-strain state

Abstract

Objective: To compare the stress-strain state of the «prosthesis – humerus» system with loading on tension, bending and torsion in the case of resection in the upper, middle and lower thirds of the humeral diaphysis.

 Methods: It was developed a mathematical model that simulated cases of defects in the upper third, half and 2/3 of the proximal humerus formed after resection of the tumor and substituted with endoprosthesis. We investigated two types of implants: the first was fixed exclusively by intramedullary stem, the second had a combined mounting system and was fixed not only with the help of intramedullary stem but with the help of extracor­tical plates attached to the body of the endoprostesis and fixedly embraced the distal humerus. We tested models with three types of loadins — tension, bending and torsion.

Results: Having examined the first type of endoprosthesis we found that under tensile loading maximal stresses occur in the distal part of the bone at the level of the end of the intramedullary stem, and the most favorable situa­tion is the resection of the humerus at the level of the upper third. Research on flexing showed that the maximal loading concentrates in the central part of the model and does not depend on the level of resection of the humerus. The worst option was resection of the upper half of the humerus due to the critical area of maximum stress occurring in the basis of endoprosthesis at the junction of the body of the implant into the bone. The study of the second type of endoprosthesis revealed that for all kinds of loading additional extracortical plates give an opportunity to reduce the level of stresses in the bone tissue as well as the loading onto the critical zone. This combined system of fixing of the endoprosthesis will al­low to significantly reduce the amount of complications associated with the implant and the bone in the early and late postoperative period.

References

  1. Schwarzer A. C. The sacroiliac joint in chronic low back pain / A. C. Schwarzer, C. N. Aprill, N. Bogduk / Spine. — 1995. — Vol. 20 (1). — P. 31–37.
  2. Maigne J. Y. Results of sacroiliac joint double block and value of sacroiliac pain provocation tests in 54 patients with low back pain / J. Y. Maigne, A. Aivaliklis, F. Pfefer / Spine. — 1996. — Vol. 21 (16). — P. 1889–1892.
  3. The value of medical history and physical examination in diagnosing sacroiliac joint pain / P. Dreyfuss, M. Michaelson, K. Pauza [et al.] / Spine. — 1996. — Vol. 21 (22). — P. 2594–2602.
  4. Diagnosing painfull sacroiliac joints: A validity study of a McKenzie evaluation and sacroiliac provocation tests / M. Laslett, S. B. Young, C. N. Aprill, B. Mc Donald / Aust. J. Physiother. — 2003. — Vol. 49 (2). — P. 89–97.
  5. Mobility of the sacroilac joint in the elderly: A kinetic and radiology study / A. Vleeming, J. P. Van Wingerden, P. Dijkstra [et al.] // Clin. Biomech. — 1992. — Vol. 7 (3). — P. 170–176, doi: 10.1016/0268-0033(92)90032-Y.
  6. Anatomical variants with joint space measurments on CT / M. Demir, A. Mavi, E. Gumusburun [et al.] // Kobe J. Med. Sci. — 2007 — Vol. 53 (5). — P. 209–217.
  7. Dihlmann W. Diagnostic radiology of the sacroiliac joints / W. Dihlmann. — NY: Georg Thieme Verlag, 1980. — 157 p.
  8. Prognostic value of asymetrie laxity of the sacroiliac joints in pregnancy related pelvic pain / L. Damon, H. M. Buyruk, F. Guler-Uysal [et al.] // Spine. — 2002. — Vol. 27 (24). — P. 2820–2824.
  9. Staude V.A. Numerical simulation and analysis of the stress-strain state of sacro-iliac joint in different variants of lumbar lordisis / Staude V.A., Kondratyev A.V., Karpinsky M. Yul./ Orthopedics, Travmatology and prosthetics — 2012. — № 2 (587). — С. 50–56, doi: http://dx.doi.org/10.15674/0030-59872012250-56.
  10. Staude V.A. Numerical simulation and analysis of the stress-strain state of sacro-iliac joint with main ligaments / Staude V.A., Kondratyev A.V., Karpinsky M. Yul./ Orthopedics, Travmatology and prosthetics — 2015. — № 1 (598). — С. 34–41, doi: http://dx.doi.org/10.15674/0030-59872015134-41.
  11. Kapandzhy A. I. Spine. Joint fixation. Mechanic schemes of human body with comments. / A. I. Kapandzhy/ 6 — th edition.- M.”Aksmo”, 2009, — P. 334.
  12. Masi A. Anatomical, biomechanical and clinical perspectives on sacroiliac joints: an integrative synthesis of biodynamic mechanisms related to ankylosing spondylitis / A. Masi, M. Benjamin, A. Vleeming // Movement, stability and lumbopelvic pain: integration of research and therapy // Vleeming A, Mooney V, Stoeckhart R, eds.. — Edinburg: Churchill livingstone, 2007. — P. 205–227.
  13. Berezovsky V. A. Biophysical characteristics human tissues: reference book /Berezovsky V. A., Kolotilov N. N./ K.: Naukova dumka, 1990. — 224 p.
  14. Finite element methods in spine biomechanics research / L. G. Gilbertson, V. K. Goel, W. Z. Kong [et al.] // CRC Crit Rev Biomed Eng. — 1995. — № 23 (Pt. 5–6). — P. 411–473.
  15. Alyamovsky A. A. Solid Works/COSMOS Works. Engineering analysis by finit element method /A. A. Alyamovsky. — M: DMK Press, 2004. — 432 p.
  16. The biomechanics of back pain / M. Adams, M. Bogduk, K. Burton, P. Dolan– 2nd edition. — Edinburg: Churchill Livingstone, 2007. — 336 p.
  17. Popov G. I. Biomechanics of human movement activity / G. I. Popov, А. V. Samsonova. — М.: «Аkademiya», 2011. — 320 с.
  18. Don Tigny R. L. Critical analysis of the functional dynamics of the sacroiliac joints as they pertain to normal gait / R. L. Don Tigny // J. Orthop. Med. — 2005. — Vol. 27 (1). — P. 3–9.
  19. Gracovetsky S. Analysis and interpretation of gait in relation to lumbopelvic function / S. Gracovetsky: proceeding of the Fourth Interdisciplinary World Congress on Low Back a Pelvic Pain. — Montreal, Canada. ECO, Roterdam, 2001. — P. 45–63.

How to Cite

Vyrva, O., Mikhanovsky, D., & Karpinsky, M. (2015). Biomechanical study of stress-strain states of the system «endoprosthesis humerus» in terms of tumor resection. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (3), 14–20. https://doi.org/10.15674/0030-59872015314-20

Issue

Section

ORIGINAL ARTICLES