Department of Orthopaedic Surgery, University Medical Center Groningen, Groningen, The Netherlands.
Department of Orthopaedic Surgery, HongHui Medical Center Xi'an, Xi'an, China.
PLoS One. 2023 Oct 12;18(10):e0292177. doi: 10.1371/journal.pone.0292177. eCollection 2023.
Bone metastases are on the rise due to longer survival of cancer patients. Local tumor control is required for pain relief. Microwave ablation (MWA) is a technique for minimally invasive local tumor treatment. Tumor tissue is destroyed by application of local hyperthermia to induce necrosis. Given the most common setting of palliative care, it is generally considered beneficial for patients to start mobilizing directly following treatment. No data on mechanical strength in long bones after MWA have been published so far.
In- and ex-vivo experiments on sheep tibias were performed with MWA in various combinations of settings for time and power. During the in-vivo part sheep were sacrificed one or six weeks after ablation. Mechanical strength was examined with a three-point bending test for ablations in the diaphysis and with an indentation test for ablations in the metaphysis.
MWA does not decrease mechanical strength in the diaphysis. In the metaphysis strength decreased up to 50% six weeks after ablation, which was not seen directly after ablation.
MWA appears to decrease mechanical strength in long bone metaphysis up to 50% after six weeks, however strength remains sufficient for direct mobilization. The time before normal strength is regained after the remodeling phase is not known.
由于癌症患者的生存时间延长，骨转移的发病率正在上升。需要局部肿瘤控制以缓解疼痛。微波消融（MWA）是一种微创局部肿瘤治疗技术。通过应用局部高热来诱导坏死来破坏肿瘤组织。鉴于姑息治疗的最常见情况，通常认为患者在治疗后直接开始活动是有益的。迄今为止，尚未发表关于 MWA 后长骨机械强度的任何数据。
在绵羊胫骨上进行了体内和体外实验，采用了不同时间和功率组合的 MWA。在体内部分，在消融后 1 或 6 周处死绵羊。用三点弯曲试验检查骨干中的消融，用压痕试验检查干骺端中的消融的机械强度。
MWA 不会降低骨干的机械强度。在骺端，消融后 6 周时强度下降高达 50%，而直接消融后并未观察到这种情况。
MWA 似乎会使长骨骺端的机械强度在 6 周后降低高达 50%，但强度仍足以直接活动。在重塑阶段后恢复正常强度所需的时间尚不清楚。
