Exploring the optimal reconstruction strategy for Enneking III defects in pelvis bone tumors: a finite element analysis

Abstract Background Controversy exists regarding the reconstruction of bone defects in Enneking III. This study aimed to use the finite element analysis (FEA) method to clarify (1) the utility of reconstructing the pelvis Enneking III region and (2) the optimal approach for this reconstruction. Meth...

Full description

Saved in:
Bibliographic Details
Main Authors: Jiazhuang Zhu, Jianping Hu, Kunpeng Zhu, Xiaolong Ma, Zhen Huang, Chunlin Zhang
Format: Article
Language:English
Published: BMC 2025-01-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:https://doi.org/10.1186/s13018-025-05500-0
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832585593344753664
author Jiazhuang Zhu
Jianping Hu
Kunpeng Zhu
Xiaolong Ma
Zhen Huang
Chunlin Zhang
author_facet Jiazhuang Zhu
Jianping Hu
Kunpeng Zhu
Xiaolong Ma
Zhen Huang
Chunlin Zhang
author_sort Jiazhuang Zhu
collection DOAJ
description Abstract Background Controversy exists regarding the reconstruction of bone defects in Enneking III. This study aimed to use the finite element analysis (FEA) method to clarify (1) the utility of reconstructing the pelvis Enneking III region and (2) the optimal approach for this reconstruction. Methods FEA models were generated for three types of Enneking III defects in the pelvis, replacing all the defect areas in region III with a sizable solid box for topology optimization (TO). Based on the defect location and TO results, three reconstruction schemes were designed for each type of defect. We subsequently conducted simulations of static FEA under natural walking loads using ANSYS software (version 2022R1, Canonsburg, Pennsylvania, USA). Results Compared with Scheme A, reconstruction of the Enneking III region (Schemes B and C) led to a more uniform stress distribution and lower peak stress in the pelvis. Moreover, prostheses and screws exhibit decreased peak stress and deformation, with complex reconstruction schemes (C) outperforming simpler ones (B). Conclusions The FEA results suggest that reconstructing Enneking Zone III defects improves stress distribution and reduces peak stress in the pelvis compared to non-reconstruction, potentially enhancing stability and reducing fracture risks. Complex reconstruction schemes involving more contralateral pelvis regions demonstrate superior biomechanical performance. However, clinical decisions should be individualized, integrating biomechanical insights with comprehensive patient-specific factors.
format Article
id doaj-art-c2afd4ac8ec245e5a2fb3d4c005d9da0
institution Kabale University
issn 1749-799X
language English
publishDate 2025-01-01
publisher BMC
record_format Article
series Journal of Orthopaedic Surgery and Research
spelling doaj-art-c2afd4ac8ec245e5a2fb3d4c005d9da02025-01-26T12:43:34ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-01-0120111010.1186/s13018-025-05500-0Exploring the optimal reconstruction strategy for Enneking III defects in pelvis bone tumors: a finite element analysisJiazhuang Zhu0Jianping Hu1Kunpeng Zhu2Xiaolong Ma3Zhen Huang4Chunlin Zhang5Department of Orthopedic Surgery, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Orthopedic Surgery, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Orthopedic Surgery, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Orthopedic Surgery, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Orthopedic Surgery, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Orthopedic Surgery, Shanghai Tenth People’s Hospital, Tongji University School of MedicineAbstract Background Controversy exists regarding the reconstruction of bone defects in Enneking III. This study aimed to use the finite element analysis (FEA) method to clarify (1) the utility of reconstructing the pelvis Enneking III region and (2) the optimal approach for this reconstruction. Methods FEA models were generated for three types of Enneking III defects in the pelvis, replacing all the defect areas in region III with a sizable solid box for topology optimization (TO). Based on the defect location and TO results, three reconstruction schemes were designed for each type of defect. We subsequently conducted simulations of static FEA under natural walking loads using ANSYS software (version 2022R1, Canonsburg, Pennsylvania, USA). Results Compared with Scheme A, reconstruction of the Enneking III region (Schemes B and C) led to a more uniform stress distribution and lower peak stress in the pelvis. Moreover, prostheses and screws exhibit decreased peak stress and deformation, with complex reconstruction schemes (C) outperforming simpler ones (B). Conclusions The FEA results suggest that reconstructing Enneking Zone III defects improves stress distribution and reduces peak stress in the pelvis compared to non-reconstruction, potentially enhancing stability and reducing fracture risks. Complex reconstruction schemes involving more contralateral pelvis regions demonstrate superior biomechanical performance. However, clinical decisions should be individualized, integrating biomechanical insights with comprehensive patient-specific factors.https://doi.org/10.1186/s13018-025-05500-0Pelvis bone tumorsEnneking III defectsOptimal reconstruction strategyFinite element analysisTopology optimization
spellingShingle Jiazhuang Zhu
Jianping Hu
Kunpeng Zhu
Xiaolong Ma
Zhen Huang
Chunlin Zhang
Exploring the optimal reconstruction strategy for Enneking III defects in pelvis bone tumors: a finite element analysis
Journal of Orthopaedic Surgery and Research
Pelvis bone tumors
Enneking III defects
Optimal reconstruction strategy
Finite element analysis
Topology optimization
title Exploring the optimal reconstruction strategy for Enneking III defects in pelvis bone tumors: a finite element analysis
title_full Exploring the optimal reconstruction strategy for Enneking III defects in pelvis bone tumors: a finite element analysis
title_fullStr Exploring the optimal reconstruction strategy for Enneking III defects in pelvis bone tumors: a finite element analysis
title_full_unstemmed Exploring the optimal reconstruction strategy for Enneking III defects in pelvis bone tumors: a finite element analysis
title_short Exploring the optimal reconstruction strategy for Enneking III defects in pelvis bone tumors: a finite element analysis
title_sort exploring the optimal reconstruction strategy for enneking iii defects in pelvis bone tumors a finite element analysis
topic Pelvis bone tumors
Enneking III defects
Optimal reconstruction strategy
Finite element analysis
Topology optimization
url https://doi.org/10.1186/s13018-025-05500-0
work_keys_str_mv AT jiazhuangzhu exploringtheoptimalreconstructionstrategyforennekingiiidefectsinpelvisbonetumorsafiniteelementanalysis
AT jianpinghu exploringtheoptimalreconstructionstrategyforennekingiiidefectsinpelvisbonetumorsafiniteelementanalysis
AT kunpengzhu exploringtheoptimalreconstructionstrategyforennekingiiidefectsinpelvisbonetumorsafiniteelementanalysis
AT xiaolongma exploringtheoptimalreconstructionstrategyforennekingiiidefectsinpelvisbonetumorsafiniteelementanalysis
AT zhenhuang exploringtheoptimalreconstructionstrategyforennekingiiidefectsinpelvisbonetumorsafiniteelementanalysis
AT chunlinzhang exploringtheoptimalreconstructionstrategyforennekingiiidefectsinpelvisbonetumorsafiniteelementanalysis