Survival and outcomes of modular endoprosthetic reconstruction of the proximal femur for primary and non-primary bone tumors: Single institutional results

Author(s):  
Charles A. Gusho ◽  
Bishir Clayton ◽  
Nabil Mehta ◽  
Matthew W. Colman ◽  
Steven Gitelis ◽  
...  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jin Mei ◽  
Lili Pang ◽  
Zhongchao Jiang

Abstract Background The calcar femorale was identified long ago. However, our current understanding of the calcar is insufficient, and its related concepts are sometimes confused. The calcar femoral is an important anatomical structure of the proximal femur, and its function can be overlooked. In trauma, tumors, or other diseases, the calcar femorale can be destroyed or changed pathologically. As a result, the mechanical structure of the proximal femur becomes destroyed, causing pathological fractures. How to address the destruction of the calcar femorale or the damage to the calcar femorale is discussed in this article. Main text Destruction of the calcar femorale is accompanied by many conditions, including trauma, tumors, and other diseases. The types of hip fractures caused by trauma include femoral neck fractures and intertrochanteric fractures. Dynamic hip screws, proximal femoral nail anti-rotation, and multiple parallel cannulate pins can be used in different conditions. When metastatic and primary bone tumors involve the calcar femorale, endoprostheses are widely used. Other diseases, such as fibrous dysplasia and aneurysmal bone cyst are treated differently. Conclusions The calcar femorale can redistribute stresses and the destruction of the calcar femorale can lead to an increase in posterior medial stress. Many factors need to be considered when deciding whether to reconstruct the calcar femorale. Effective treatment strategies for managing the destruction of calcar femorale will need first establishing the precise mechanism of the destruction of the calcar and then designing therapies towards these mechanisms. Further investigation to the calcar needs to be carried out.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Dipak B. Ramkumar ◽  
Sean P. Kelly ◽  
Niveditta Ramkumar ◽  
Lisa B. Ercolano ◽  
Santiago Lozano-Calderon ◽  
...  

2021 ◽  
Author(s):  
Victor Housset ◽  
Philippe Anract ◽  
Antoine Babinet ◽  
Guillaume Auberger ◽  
David Biau

Abstract Introduction Extra-articular resection (EAR) of the hip joint is prone to significant complications and morbidity. Thus, this study evaluates the cumulative incidences and main reasons of reoperation following EAR of primary bone tumors of the hip to determine whether the outcomes are different between EAR of the pelvis and that of the proximal femur. Patients and methods Thirty-three patients presented with a PMBT of the proximal femur or pelvis were included in this study. Among all PMBTs, 58% originated from the pelvis and 42% were from the proximal femur. Twenty patients had chondrosarcomas (61%), 10 had osteosarcomas (30%), and 3 had sarcomas of another histological subtype (9%). Results The mean follow-up was of 76 months (range: 24–220 months). The cumulative probabilities of revision for any reason was 52% (95% confidence interval [CI]: 30%–70%) five years after surgery. The five-year cumulative probabilities of revision were 13% (95% CI: 4%–27%), 24% (95% CI: 10%–42%) and 34% (95% CI: 14%–56%) for mechanical, infectious and tumoral reasons, respectively. The five-year cumulative probabilities of revision for any reason were 78% (95% CI: 37%–94%) and 14% (95% CI: 2%–38%) for the pelvis and proximal femur, respectively ( p = 0.004). Posterior column preservation was significantly associated with more mechanical complications even after adjusting for the resection site ( p = 0.043). Conclusion Half of patients undergoing EAR of the hip joint for PMBT of the proximal femur or acetabulum will require another operation. EAR of the pelvis is associated with significantly worse outcome than EAR of the proximal femur.


1982 ◽  
Vol 21 (04) ◽  
pp. 136-139 ◽  
Author(s):  
C.-J. Edeling

Whole-body scintigraphy with both 99mTc-phosphonate and 67Ga was performed on 92 patients suspected of primary bone tumors. In 46 patients with primary malignant bone tumors, scintigraphy with 99mTc-phosphonate disclosed the primary tumor in 44 cases and skeletal metastases in 11, and 67Ga scintigraphy detected the primary tumor in 43 cases, skeletal metastases in 6 cases and soft-tissue metastases in 8 cases. In 25 patients with secondary malignant bone tumors, bone scintigraphy visualized a single lesion in 10 cases and several lesions in 15 cases, and 67Ga scintigraphy detected the primary tumor in 17 cases, skeletal metastases in 17 cases and soft-tissue metastases in 9 cases. In 21 patients with benign bone disease positive uptake of 99mTc-phosphonate was recognized in 19 cases and uptake of 67Ga in 17 cases. It is concluded that bone scintigraphy should be used in patients suspected of primary bone tumors. If malignancy is suspected, 67Ga scintigraphy should be performed in addition.


2019 ◽  
Vol 65 (2) ◽  
pp. 165-171
Author(s):  
Aleksey Belyaev ◽  
Georgiy Prokhorov ◽  
Anna Arkhitskaya

A review of the literature shows that surgical procedures will remain the standard treatment for primary bone tumors. Analysis of studies on the assessment of long-term results shows that additional double cryogenic treatment of the curettage cavity can improve the treatment outcomes of patients with giant cell tumors, dysplastic diseases and some forms of malignant lesions. The traditional execution of the procedure is associated with the open installation of liquid nitrogen in the bone cavity, which requires special skills in handling aggressive refrigerant from the staff and does not exclude complications. In case of multiple metastatic bone lesions, surgical treatment is not indicated. The recent emergence in clinical practice of new equipment with a closed liquid nitrogen circulation circuit inside cryoprobes resumes interest in cryoabla-tion of bone tumor lesions using modern minimally invasive puncture cryotechnology and expanding indications for its use in patients with severe comorbidities.


Author(s):  
Alessandro Luzzati ◽  
Gennaro Maria Scotto ◽  
Luca Cannavò ◽  
Giuseppe Orlando ◽  
Alessandra Scotto di Uccio ◽  
...  

2015 ◽  
Vol 139 (9) ◽  
pp. 1149-1155 ◽  
Author(s):  
Xiaohui Niu ◽  
Hairong Xu ◽  
Carrie Y. Inwards ◽  
Yuan Li ◽  
Yi Ding ◽  
...  

Context Although primary bone tumors are extremely rare, the literature suggests that there are variations in the epidemiologic characteristics in different populations. The most frequently cited epidemiologic characteristics of primary bone tumors are derived from a large US series (Mayo Clinic), with no comparable study thus far performed in China. Objective To identify any potential epidemiologic differences between Chinese patients and a US series of patients. Design We performed a comparison study between 9200 patients treated at Beijing Ji Shui Tan Hospital (JST) and 10 165 patients treated at Mayo Clinic (MC), Rochester Minnesota. Detailed epidemiologic features were analyzed. Results We found that giant cell tumor and osteosarcoma have significantly higher incidences in the JST than the MC patients (P < .001). However, JST patients had a significantly lower incidence of Ewing sarcoma, chordoma, fibrosarcoma, myeloma, and malignant lymphoma (P < .001). For most benign and malignant bone tumors, the Chinese cohort had a more distinct male predominance than the US cohort. Malignant bone tumors had a monomodal age distribution in the JST patient group, with a bimodal age distribution in the MC cohort. Also, there were was a predilection for tumors of the femur and tibia among the JST patients (P < .001). Conclusions Our data confirm that epidemiologic variations of primary bone tumors exist in different populations. Factors that may contribute to these observed differences are proposed and discussed.


1989 ◽  
Vol 38 (2) ◽  
pp. 813-819
Author(s):  
Kensuke Yonemura ◽  
Tatsuaki Tsuchiya ◽  
Takaaki Sagara ◽  
Katsumasa Takagi ◽  
Kimiaki Nishida ◽  
...  

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