Optimizing long bone metastases treatment: Thermal necrosis effect with two different cement types and titanium or CF/PEEK intramedullary nail

Multiple bone metastases management requires pain relief and mechanical stability to achieve functional improvement. Inducing tumour cell necrosis is important for local tumour control. A two dimensional thermal and transient numerical model based on finite element method was built to predict the temperature distribution produced by cement polymerization when mimicking a femoral lytic lesion. The bone cement filled the metastatic lesion and titanium, or CF/PEEK intramedullary nail was used. Additionally, two different cement types were compared. Cement A has low viscosity and cement B high viscosity. The titanium intramedullary nail has shown to be the best heat conductor. Significant thermal necrosis occurs with a thin or thick cement amount, and either with low or high viscosity cement types. When choosing to optimize this synergistic effect, a titanium intramedullary nail and cement A induce the largest necrotic area. The results play a role in the multidisciplinary management of long bone metastases.