Pedicle frozen autograft–prosthesis composite reconstructions for malignant bone tumors of the proximal femur

Abstract Background Limb salvage surgery is becoming increasingly popular after tumor resection in the lower extremity. Biological reconstruction and use of megaprosthesis are main methods for malignant bone tumors of the proximal femur, which remain controversial due to short- and long-term complication in the proximal femur. Tumor-bearing bone treated by liquid nitrogen is one of biological reconstruction. This study aimed to evaluate the mid- and long-term functional outcomes and complications in patients treated with frozen autograft–prosthesis composite (FAPC) reconstructions in the proximal femur. Methods This retrospective study included 19 patients (10 women, 9 men) with malignant tumors of the proximal femur who underwent tumor-wide resection and FAPC reconstruction (mean age, 46 years; range, 9-77 years). The mean follow-up period of 69 months (range, 9-179 month). Functional outcomes, oncological outcomes and complications were evaluated by Musculoskeletal Tumor Society score, clinical and radiological examinations. Results The overall survival rate was 68.4%, and the mean Musculoskeletal Tumor Society functional score was 26.4 points (88%). FAPC survival rates were 100% and 50% at 5 and 10 years, respectively. Five of the 19 patients (26%) had complications: 2 required prosthesis removal and 2 developed a deep infection around acetabular. Wear of the acetabulum occurred in 2 cases, while disease recurrence was occurred in 1 case. There were no cases of greater trochanter avulsion, obvious absorption around frozen bone, prosthesis loosening or leg length discrepancy. Conclusions Due to without femoral osteotomy, this technique features satisfactory functional outcome and provide biomechanical stability that is comparable to those of other methods of biological reconstruction or megaprosthesis.

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Extra-Articular Wide Tumor Resection and Limb Reconstruction in Malignant Bone Tumors at the Proximal Femur

Orthopedics ◽

10.3928/0147-7447-20010501-11 ◽

2001 ◽

Vol 24 (5) ◽

pp. 445-447

Author(s):

Shinichiro Nakamura ◽

Katsuyuki Kusuzaki ◽

Hiroaki Murata ◽

Hideyuki Takeshita ◽

Masazumi Hirata ◽

...

Keyword(s):

Proximal Femur ◽

Bone Tumors ◽

Tumor Resection ◽

Malignant Bone Tumors ◽

Limb Reconstruction

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Proximal Femur Versus Acetabular Extra-articular Resection of the Hip Joint for Primary Malignant Bone Tumors : A Retrospective Comparative Review of 33 Cases

10.21203/rs.3.rs-917462/v1 ◽

2021 ◽

Author(s):

Victor Housset ◽

Philippe Anract ◽

Antoine Babinet ◽

Guillaume Auberger ◽

David Biau

Keyword(s):

Hip Joint ◽

Proximal Femur ◽

Bone Tumors ◽

Malignant Bone Tumors ◽

Primary Bone Tumors ◽

Comparative Review ◽

Primary Bone ◽

The Mean ◽

Cumulative Probabilities

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.

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Pedicle frozen autograft-prosthesis composite reconstructions for malignant bone tumors of the proximal femur

10.21203/rs.2.16782/v3 ◽

2020 ◽

Author(s):

gang xu ◽

Shinji Miwa ◽

Norio Yamamoto ◽

Katsuhiro Hayashi ◽

Akihiko Takeuchi ◽

...

Keyword(s):

Proximal Femur ◽

Functional Outcomes ◽

Bone Tumors ◽

Functional Score ◽

Malignant Bone Tumors ◽

Musculoskeletal Tumor ◽

Musculoskeletal Tumor Society ◽

Biological Reconstruction ◽

The Mean

Abstract Background Limb salvage surgery is becoming increasingly popular after tumor resection in the lower extremity. Biological reconstruction and use of megaprosthesis are main methods for malignant bone tumors of the proximal femur, which remain controversial due to short- and long-term complication in the proximal femur. Tumor-bearing bone treated by liquid nitrogen is one of biological reconstruction. This study aimed to evaluate the mid- and long-term functional outcomes and complications in patients treated with frozen autograft–prosthesis composite (FAPC) reconstructions in the proximal femur. Methods This retrospective study included 19 patients (10 women, 9 men) with malignant tumors of the proximal femur who underwent tumor-wide resection and FAPC reconstruction (mean age, 46 years; range, 9-77 years). The mean follow-up period of 69 months (range, 9-179 month). Functional outcomes, oncological outcomes and complications were evaluated by Musculoskeletal Tumor Society score, clinical and radiological examinations. Results The overall survival rate was 68.4%, and the mean Musculoskeletal Tumor Society functional score was 26.4 points (88%). FAPC survival rates were 100% and 50% at 5 and 10 years, respectively. Five of the 19 patients (26%) had complications: 2 required prosthesis removal and 2 developed a deep infection around acetabular. Wear of the acetabulum occurred in 2 cases, while disease recurrence was occurred in 1 case. There were no cases of greater trochanter avulsion, obvious absorption around frozen bone, prosthesis loosening or leg length discrepancy. Conclusions Due to without femoral osteotomy, this technique features satisfactory functional outcome and provide biomechanical stability that is comparable to those of other methods of biological reconstruction or megaprosthesis.

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The Evaluation of the Surgical and Functional Reseults of the Tumor Resection Prothesis in Proximal Femur Malignant Bone Tumors

Acta Oncologica Turcica ◽

10.5505/aot.2019.62134 ◽

2019 ◽

Vol 52 (2) ◽

pp. 250-255

Author(s):

Selçuk Yılmaz ◽

İsmail Burak Atalay ◽

Recep Öztürk ◽

Bedii Şafak Güngör

Keyword(s):

Proximal Femur ◽

Bone Tumors ◽

Tumor Resection ◽

Malignant Bone Tumors

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Limb Salvage Surgery with Tumor Prosthesis for the Malignant Bone Tumors Involving the Proximal Femur

The Journal of the Korean Bone and Joint Tumor Society ◽

10.5292/jkbjts.2014.20.1.7 ◽

2014 ◽

Vol 20 (1) ◽

pp. 7

Author(s):

Young Soo Chun ◽

Jong Hun Baek ◽

Seung Hyuk Lee ◽

Chung Hwan Lee ◽

Chung Soo Han

Keyword(s):

Limb Salvage ◽

Proximal Femur ◽

Bone Tumors ◽

Salvage Surgery ◽

Limb Salvage Surgery ◽

Malignant Bone Tumors ◽

Tumor Prosthesis

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Pedicle frozen autograft-prosthesis composite reconstructions for malignant bone tumors of the proximal femur

10.21203/rs.2.16782/v1 ◽

2019 ◽

Author(s):

gang xu ◽

Shinji Miwa ◽

Norio Yamamoto ◽

Katsuhiro Hayashi ◽

Akihiko Takeuchi ◽

...

Keyword(s):

Proximal Femur ◽

Functional Outcomes ◽

Bone Tumors ◽

Tumor Resection ◽

Malignant Bone Tumors ◽

Musculoskeletal Tumor ◽

Musculoskeletal Tumor Society ◽

Biological Reconstruction ◽

The Mean

Abstract Background Limb salvage surgery is becoming increasingly popular after tumor resection in the lower extremity. Biological reconstruction and use of megaprosthesis are main methods for malignant bone tumors of the proximal femur, which remain controversial due to short- and long-term complication in the proximal femur. Tumor-bearing bone treated by liquid nitrogen is one of biological reconstruction. This study aimed to evaluate the mid- and long-term functional outcomes and complications in patients treated with frozen autograft–prosthesis composite (FAPC) reconstructions in the proximal femur. Methods This retrospective study included 19 patients (10 women, 9 men) with malignant tumors of the proximal femur who underwent tumor-wide resection and FAPC reconstruction (mean age, 46 years; range, 9-77 years). The mean follow-up period of 66 months (range, 9-179 months). Functional outcomes, oncological outcome and complications were evaluated by Musculoskeletal Tumor Society score, clinical and radiological examinations. Results The overall survival rate was 68.4%, and the mean Musculoskeletal Tumor Society functional score was 26.4 points (88%). FAPC survival rates were 100% and 50% at 5 and 10 years, respectively. Five of the 19 patients (26%) had complications: 2 required prosthesis removal and 2 developed a deep infection around acetabular. Wear of the acetabulum occurred in 2 cases, while disease recurrence was occurred in 1 case. There were no cases of greater trochanter avulsion, obvious absorption around frozen bone, prosthesis loosening or leg length discrepancy. Conclusions Due to without femoral osteotomy, ease of soft-tissue attachment and preservation of bone matrix, FAPC reconstruction provide early limb stability and satisfactory functional outcome after malignant bone tumor resection in the proximal femur.

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Scintigraphy with 99m Tc-Phosphonate and 67Gallium in Patients Suspected of Primary Bone Tumors

Nuklearmedizin ◽

10.1055/s-0037-1620567 ◽

1982 ◽

Vol 21 (04) ◽

pp. 136-139 ◽

Cited By ~ 2

Author(s):

C.-J. Edeling

Keyword(s):

Soft Tissue ◽

Bone Scintigraphy ◽

Primary Tumor ◽

Bone Tumors ◽

Whole Body ◽

Skeletal Metastases ◽

Malignant Bone Tumors ◽

67Ga Scintigraphy ◽

Primary Bone Tumors ◽

Primary Bone

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.

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