Biomechanical analysis of iliac crest loading following cortico-cancellous bone harvesting

  • Background Iliac crest bone harvesting is a frequently performed surgical procedure widely used to treat bone defects. The objective of this study is to assess the biomechanical quantities related to risk for pelvic fracture after harvesting an autologous bone graft at the anterior iliac crest. Methods Finite element models with a simulated harvest site (sized 15 × 20 mm, 15 × 35 mm, 30 × 20 mm and 30 × 35 mm) in the iliac wing are created. The relevant loading case is when the ipsilateral leg is lifted off the ground. Musculoskeletal analysis is utilized to compute the muscle and joint forces involved in this motion. These forces are used as boundary conditions for the finite element analyses. Bone tissue stress is analyzed. Results Critical stress peaks are located between the anterior superior iliac spine (ASIS) and the anterior edge of the harvest site. Irrespective of the graft size, the iliac wing does not show any significant stress peaks with the harvest site being 20 to 25 mm posterior to the ASIS. The harvest area itself inhibits the distribution of the forces applied on the ASIS to extend to the posterior iliac wing. This leads to a lack of stress posterior to the harvest site. A balanced stress distribution with no stress peaks appears when the bone graft is taken below the iliac crest. Conclusion A harvest site located at least 20 to 25 mm posterior to the ASIS should be preferred to minimize the risk of iliac fatigue fracture.

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Metadaten
Author:Paul Schmitz, Christoph Cornelius Neumann, Carsten Neumann, Michael Nerlich, Sebastian DendorferORCiD
DOI:https://doi.org/10.1186/s13018-018-0822-1
Parent Title (English):Journal of Orthopaedic Surgery and Research
Document Type:Article
Language:English
Year of first Publication:2018
Release Date:2020/03/03
Tag:ASIS; Autologous bone graft; Biomechanical investigation; Bone harvesting; FEA; Fatigue fracture; Iliac crest; Pelvis
GND Keyword:Beckenkammknochen; Knochenentnahme; Spongiosa; Biomechanische Analyse
Volume:13
Issue:108
Institutes:Fakultät Maschinenbau
Regensburg Center of Biomedical Engineering - RCBE
Labor Biomechanik - LBM
OpenAccess Publikationsweg:Erstveröffentlichungen
Licence (German):License LogoCreative Commons - CC BY - Namensnennung 4.0 International