Assessment of fracture risk in proximal tibia with tumorous bone defects by a finite element method

There has not been a satisfying method to predict the fracture risk in tumorous bone lesions. To tackle this challenge, we used a finite element method to assess the fracture risk in the proximal tibia (pT) when the size and location of the tumorous defects are varied in bone. Towards this end, the circular cortical defects, mimicking the tumorous lesions by forming cortical window defects, with a diameter (Ф) of 20, 30, 40, or 50 mm, are structured on the anteromedial, lateral, posterior wall of pT, which is located 5, 15, and 25 mm below articular margin, respectively. We found that under walking conditions, the Von Mises Stress of each defective tibia model was larger than that of the intact tibia model and also showed a positive linear correlation with the sizes of the defects. A notable fracture risk was not observed until the defect was Ф30 mm or larger. When the defect emerged, the anteromedial wall resisted fracture risk more than the rest of wall. Our results show that the size and location of the bone tumors are important factors affecting the fracture risk of pT. Our findings will be beneficial to clinicians when deciding what treatment to use for pT lesions.