Inter-operator variability of a finite element model of femurs with and without simulated metastatic defects

Femur metastases are associated with severe skeletal complications, including bone fracture [1]. Clinical scores, such as Mirel's, poorly estimate the risk of fracture. A recent study showed that subject-specific finite element (FE) models, based on QCT imaging, outweigh the performance of clinical experts when applied to patients [2]. However, several parameters of the FE models are operator-dependent and may affect the calculated failure load. The uncertainty on these parameters and their effects on the failure load have not been quantified. Therefore, the aim of the current study is to assess the inter-operator variability in a finite element model of femurs with and without created defects representing osteolytic metastases.