A new approach of metastatic bone fracture prediction using a patient-specific model including metastatic tissue, daily-life activities and local failure criteria

2026-07-22

Osteolytic bone metastases are responsible for long bone fracture leading to restricted mobility, surgery, or medullar compression that severely alter quality of life and have a huge socio-economic impact. Current fragility scores to estimate the fracture risk in patients with metastatic femur are based on qualitative evaluation from Quantitative Computed Tomography (QCT) scans and lack sensitivity and specificity. Efforts are now made towards the development of patient-specific finite element models to assess the strength of tumoral bone segments, but their accuracy is hampered by several limitations, including limited knowledge of metastatic bone mechanical properties, simulations performed only for single stance loading condition, and simulations providing a global failure criteria. The aim of METABONE is, therefore, to use a novel approach to better predict the fracture risk of metastatic femur. A patient-specific finite element model will be developed based on QCT scans, which will include the real material properties of ex vivo human metastatic bone determined experimentally in the first part of the project. The composition and mechanical behaviour of diseased bone tissue are hypothesised to be rather different from healthy tissue and influential of femoral strength. This model will be used clinically on patients with osteolytic lesions located in proximal femur to assess the fracture risk during daily life activities, using a local failure criteria and a range of different loading conditions. This novel methodology, combining experimental and numerical approaches, is expected to significantly improve the accuracy of fracture risk prediction. Successful completion of METABONE will have the potential to guide clinical decision making, by providing clinicians with a more accurate tool to optimize locomotor strategy and oncology program, in order to prevent bone fracture, improve survival and quality of life of the patients.

France

2026-02-15