# BIOMECHANICS OF METASTATIC DEFECTS IN BONE

> **NIH NIH R01** · BETH ISRAEL DEACONESS MEDICAL CENTER · 1990 · $197,733

## Abstract

Improved palliative management of established metastatic osseous
lesions has resulted in marked increases both in survival times and
in the incidence of metastatic lesions and subsequent pathologic
fractures.  The assessment and treatment of established osseous
metastases is thus an increasingly important aspect of the clinical
management of cancer patients.  However, there are currently
available only the most qualitative of clinical guidelines for
assessing the increased fracture risk associated with metastatic
lesions and thus for determining the appropriate time for
prophylactic stabilization of impending fractures.  We have in the
previous funding period explored the biomechanics of diaphyseal
osseous metastatic lesions and demonstrated far more severe
strength losses (up to 85%) than had been previously thought to
occur with bone defects corresponding to established clinical
guidelines for prophylactic stabilization of impending fractures.
We have also developed the first preliminary guidelines for
increased fracture risk associated with lytic lesions of the
proximal femur and shown that planar radiographs cannot provide
sufficiently detailed information on lesion geometry to make
informed assessments of fracture risk.  We now propose to extend
our studies to intertrochanteric lesions of the femur and to the
vertebrae.  We will continue to use a combination of mathematical
modeling based on the finite element method and in-vitro testing
to establish key features of lesion geometry and loading which
incur marked increases in fracture risk.  We will also pursue
preliminary observations that the mechanical properties of cortical
and trabecular bone are severely degraded in areas immediately
adjacent to osseous metastases and that this factor can have marked
influences on bone strength.  And finally, to begin to build
stronger links to the clinical community, we will undertake a
limited prospective study of patients with metastatic lesions to
the femoral shaft, proximal femur, and vertebral body.
Collaborating orthopaedists and radiation therapists will order QCT
scans according to our protocols and provide us with CT tapes to
determine actual lesion geometries for comparison with our
idealized models.  We will also attempt to develop quantitative
techniques to estimate local bone mechanical properties around
typical lesions.  Based on these findings, we hope to provide an
integrated set of clinical guidelines which may be used to estimate
fracture risk associated with metastatic defects of diaphyseal
bone, the proximal femur, and the vertebral body.  We will then
design a controlled prospective clinical trail of these guidelines
to be tested as part of a subsequent renewal application.

## Key facts

- **NIH application ID:** 3179867
- **Project number:** 5R01CA040211-05
- **Recipient organization:** BETH ISRAEL DEACONESS MEDICAL CENTER
- **SAM.gov UEI:** C1CPANL3EWK4
- **Principal Investigator:** WILSON C HAYES
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 1990
- **Award amount:** $197,733
- **Award type:** 5
- **Project period:** 1985-07-01 → 1992-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/3179867

## Citation

> US National Institutes of Health, RePORTER application 3179867, BIOMECHANICS OF METASTATIC DEFECTS IN BONE (5R01CA040211-05). Retrieved via MORVS 2026-10-25 from https://api.morvs.ai/grant/nih/3179867. Licensed CC0.

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