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Advisor(s)
Abstract(s)
As metástases ósseas resultam da disseminação de células cancerígenas do tumor primário para os ossos. A incidência de metástases ósseas tem aumentado devido à maior longevidade dos pacientes com tumores primários, resultante dos avanços nos tratamentos oncológicos. Em pacientes com múltiplas metástases ósseas, os tratamentos apresentam um carácter paliativo, com o objetivo de melhorar a sua qualidade de vida, através do alívio da dor. As metástases ósseas estão fortemente associadas a fraturas patológicas, nomeadamente no fémur. Nestes casos recorre-se cada vez mais a tratamentos minimamente invasivos, como a cimentoplastia percutânea e a fixação interna com hastes intramedulares. A presente tese baseou-se no estudo destas duas terapêuticas, através do desenvolvimento de modelos computacionais no programa ANSYS® (versão académica). A realização de análises térmicas e termomecânicas permitiu avaliar o efeito do calor resultante da polimerização de diferentes tipos de cimento ósseo, bem como avaliar os benefícios da combinação com a fixação interna por hastes intramedulares de materiais distintos. Os resultados destacaram as vantagens da combinação das duas técnicas, em detrimento da cimentoplastia de forma isolada. Além disso, o uso do CMW 3, com haste intramedular de qualquer um dos materiais demonstrou ser a combinação que permite uma melhoria funcional mais significativa.
Bone metastases occur when cancer cells from the primary tumor spread to the bones. The incidence of bone metastases is increasing due to the longer survival of patients with primary tumors, driven by advances in oncological treatments. In patients with multiple bone metastases, care is primarily palliative, aiming to improve their quality of life through pain relief. Bone metastases are strongly associated with pathological fractures, particularly in the femur. In these cases, minimally invasive treatments such as percutaneous cementoplasty and internal fixation with intramedullary nails are growing in popularity. This thesis focused on studying these two therapies by developing computational models using the ANSYS® software (academic version). Thermal and thermomechanical analyses were conducted to evaluate the heat effect resulting from the polymerization of different types of bone cement and to assess the benefits of combining it with internal fixation using intramedullary nails made from different materials. The results emphasized the advantages of combining these two techniques over standalone cementoplasty. Furthermore, the use of CMW 3 with an intramedullary nail of either material was shown to provide more significant functional improvement.
Bone metastases occur when cancer cells from the primary tumor spread to the bones. The incidence of bone metastases is increasing due to the longer survival of patients with primary tumors, driven by advances in oncological treatments. In patients with multiple bone metastases, care is primarily palliative, aiming to improve their quality of life through pain relief. Bone metastases are strongly associated with pathological fractures, particularly in the femur. In these cases, minimally invasive treatments such as percutaneous cementoplasty and internal fixation with intramedullary nails are growing in popularity. This thesis focused on studying these two therapies by developing computational models using the ANSYS® software (academic version). Thermal and thermomechanical analyses were conducted to evaluate the heat effect resulting from the polymerization of different types of bone cement and to assess the benefits of combining it with internal fixation using intramedullary nails made from different materials. The results emphasized the advantages of combining these two techniques over standalone cementoplasty. Furthermore, the use of CMW 3 with an intramedullary nail of either material was shown to provide more significant functional improvement.
Description
Keywords
Bone metastases Percutaneous cementoplasty Internal fixation Stress shielding Finite element method Thermomechanical analysis Metástases ósseas Cimentoplastia percutânea Fixação interna Método dos elementos finitos Análise termomecânica