Acetabular complications are the most common cause for revision surgery following proximal femoral endoprosthetic replacement

2021 ◽  
Vol 103-B (10) ◽  
pp. 1633-1640 ◽  
Author(s):  
Johnathan Robert Lex ◽  
Scott Evans ◽  
Michael C. Parry ◽  
Lee Jeys ◽  
Jonathan D. Stevenson
Keyword(s):  
Bone Disease ◽  
Large Diameter ◽  
Metastatic Bone Disease ◽  
Implant Failure ◽  
Metastatic Tumour ◽  
Bipolar Hemiarthroplasty ◽  
Dual Mobility ◽  
Risk Of Death ◽  
Primary Bone

Aims Proximal femoral endoprosthetic replacements (PFEPRs) are the most common reconstruction option for osseous defects following primary and metastatic tumour resection. This study aimed to compare the rate of implant failure between PFEPRs with monopolar and bipolar hemiarthroplasties and acetabular arthroplasties, and determine the optimum articulation for revision PFEPRs. Methods This is a retrospective review of 233 patients who underwent PFEPR. The mean age was 54.7 years (SD 18.2), and 99 (42.5%) were male. There were 90 patients with primary bone tumours (38.6%), 122 with metastatic bone disease (52.4%), and 21 with haematological malignancy (9.0%). A total of 128 patients had monopolar (54.9%), 74 had bipolar hemiarthroplasty heads (31.8%), and 31 underwent acetabular arthroplasty (13.3%). Results At a mean 74.4 months follow-up, the overall revision rate was 15.0%. Primary malignancy (p < 0.001) and age < 50 years (p < 0.001) were risk factors for revision. The risks of death and implant failure were similar in patients with primary disease (p = 0.872), but the risk of death was significantly greater for patients who had metastatic bone disease (p < 0.001). Acetabular-related implant failures comprised 74.3% of revisions; however, no difference between hemiarthroplasty or arthroplasty groups (p = 0.209), or between monopolar or bipolar hemiarthroplasties (p = 0.307), was observed. There was greater radiological wear in patients with longer follow-up and primary bone malignancy. Re-revision rates following a revision PFEPR was 34.3%, with dual-mobility bearings having the lowest rate of instability and re-revision (15.4%). Conclusion Hemiarthroplasty and arthroplasty PFEPRs carry the same risk of revision in the medium term, and is primarily due to acetabular complications. There is no difference in revision rates or erosion between monopolar and bipolar hemiarthroplasties. The main causes of failure were acetabular wear in the hemiarthroplasty group and instability in the arthroplasty group. These risks should be balanced and patient prognosis considered when contemplating the bearing choice. Dual-mobility, constrained bearings, or large diameter heads (> 32 mm) are recommended in all revision PFEPRs. Cite this article: Bone Joint J 2021;103-B(10):1633–1640.

scholarly journals Epidemiology of Osteosarcoma : Single Center Study in Indonesia

2020 ◽  
Vol 13 (1) ◽  
pp. 105-108
Author(s):  
David Kalim ◽  
Andriandi
Keyword(s):  
Soft Tissue ◽  
Bone Disease ◽  
Bone Tumors ◽  
Prevalence Ratio ◽  
Soft Tissue Tumors ◽  
Metastatic Bone Disease ◽  
Primary Bone Tumors ◽  
Musculoskeletal Tumors ◽  
Musculoskeletal Tumour ◽  
Primary Bone

Objective- To assess osteosarcoma epidemiology in Haji Adam Malik General Hospital. Material and Methods- This study is a retrospective descriptive study with a crosssectional approach. Patient with musculoskeletal tumour (especially osteosarcoma) in Haji Adam Malik Hospital from January 2012 to Desember 2017 period, got their age, gender, musculoskeletal tumour type, biopsy result, tumour sites, treatment completion, metastasis and amputation status recorded from their medical record. Result-Primary bone tumors is the most cases and found in 50% of musculoskeletal tumors followed by soft tissue tumors and metastatic bone disease. Male (60%) have slightly higher prevalence than female in (40%). The incidence of primary bone tumors shows osteosarcoma, GCT, and osteochondroma are in the top three with 63%, 13%, and 6% respectively. Specifically for osteosarcoma, male and female have 1.9 : 1 prevalence ratio. The most common sites for osteosarcoma is distal the femur (45%) and proximal tibia (29%). About 63% of patients undergo complete treatment and with 55% recorded with metastasis in the first diagnosis and amputation was performed in 89% of patients. Conclusion- Primary bone tumors dominate the data with 50% for musculoskeletal tumors followed by 31% soft tissue tumors and 19% metastatic bone disease. The incidence of musculoskeletal tumors shows that men are slightly higher than women in 60% and 40%. The incidence of primary bone tumors shows osteosarcoma, giant cell tumor, and osteochondroma are in the top three with 63%, 13%, and 6% respectively.

scholarly journals Electrochemotherapy and Simultaneous Photodynamic Bone Stabilization of Upper Limbs in Metastatic Renal Cancer Disease: Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Ugo Albertini ◽  
Andrea Conti ◽  
Nicola Ratto ◽  
Pietro Pellegrino ◽  
Michele Boffano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Minimally Invasive ◽  
Bone Disease ◽  
Metastatic Bone Disease ◽  
Invasive Technique ◽  
Bone Lesions ◽  
Disease Case ◽  
Lytic Bone Lesions

Introduction. Metastatic bone disease represents a systemic pathology that heavily affects the quality of life of oncologic patients causing pain and functional disability. Methodology. We present the case of a patient with a history of renal cell cancer presenting pathologic fractures of both humeri and proximal right radius. Results. After a careful multidisciplinary approach, an adjuvant anticancer therapy and a photodynamic bone stabilization procedure were performed with a minimally invasive technique aiming to minimize pain and local disease progression, while restoring functional autonomy and improving the patient’s quality of life. Electrochemotherapy was delivered on the lytic bone lesions with extraskeletal involvement of the proximal left humerus and the proximal right radius, and then polymeric bone stabilization was performed on both humeri. At two months of follow-up, the patient presented satisfactory functional scores (MSTS score: 12/30 bilaterally; DASH scores: 46.7/100 for the right side and 48.3/100 for the left one), and pain was well controlled with opioid analgesics. Radiographs showed good results in terms of ossification of lytic bone lesions and durability of polymeric stabilization. At four months of follow-up, the patient reported a stable clinical scenario. Six months after surgery, due to extremely poor prognosis after the progression of primary disease, the patient was referred to palliative care and died shortly thereafter. Conclusion. Over the last decade, the management of metastatic bone disease has changed. Low-toxicity and minimally invasive procedures such as electrochemotherapy and polymeric bone stabilization might be performed concomitantly in selected patients, as an alternative to radiation therapy and to more demanding surgical procedures such as plating and adjuvant cementing.

Sr-89 therapy for metastatic bone disease: scintigraphic and radiographic follow-up.

Radiology ◽  
1987 ◽  
Vol 163 (3) ◽  
pp. 719-723 ◽  
Author(s):  
R Kloiber ◽  
C P Molnar ◽  
M Barnes
Keyword(s):  
Bone Disease ◽  
Metastatic Bone Disease

scholarly journals Secondary Bone Tumours in the Dog

1979 ◽  
Vol 16 (5) ◽  
pp. 520-529 ◽  
Author(s):  
S. A. Goedegebuure
Keyword(s):  
Bone Disease ◽  
Vertebral Column ◽  
Metastatic Bone Disease ◽  
Bone Tumours ◽  
Skeletal Metastases ◽  
Metastatic Tumour ◽  
Malignant Tumours ◽  
Epithelial Origin ◽  
Visceral Metastases ◽  
Frequent Site

During a 2 1/2-year period 209 dogs with 218 malignant tumours were examined for skeletal metastases. There were 77 malignant tumours without visceral or skeletal metastases. Twenty-four (17%) of the 141 tumours with visceral metastases also had skeletal metastases. Ninety-eight of these tumours were of epithelial origin, and of these 21 (21.4%) had skeletal metastases. In 14 dogs, more than one bone had a metastatic tumour. The humerus, femur and vertebral column were most frequently involved. The lung was the most frequent site of metastatic tumours; then, in order, the liver, kidney and skeleton. The incidence of primary and secondary bone tumours was similar. Metastatic bone disease in the dog is far more common than is generally realized.

Metastatic bone disease in patients with neuroendocrine tumors

2014 ◽  
Author(s):  
Krystallenia Alexandraki ◽  
Maria Chrysochoou ◽  
Maria Kaltsatou ◽  
Eleftherios Chatzellis ◽  
Marina Tsoli ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Bone Disease ◽  
Metastatic Bone Disease

The Carpentier-Edwards Classic and Physio Mitral Annuloplasty Rings: A Randomized Trial

2006 ◽  
Vol 8 (5) ◽  
pp. 389 ◽  
Author(s):  
Ghada M. M. Shahin ◽  
Geert J. M. G. van der Heijden ◽  
Michiel L. Bots ◽  
Maarten-Jan Cramer ◽  
Wybren Jaarsma ◽  
...  
Keyword(s):  
Left Ventricular Function ◽  
Ventricular Function ◽  
Absolute Risk ◽  
Statistical Significance ◽  
Nyha Class ◽  
Left Ventricular ◽  
Mitral Annuloplasty ◽  
Risk Of Death ◽  
Late Failure

<P>Objective: To evaluate clinical and echocardiographic outcomes for the semi-flexible Carpentier-Edwards Physio and the rigid Classic mitral annuloplasty ring. </P><P>Methods: Ninety-six patients were randomized for either a Classic (n = 53) or a Physio (n = 43) ring from October 1995 through July 1997. Mean follow-up was 5.1 years (range .1-6.6). We included standard patient characteristics at baseline and during follow-up. Analyses were adjusted for age and gender, and for factors that differed across groups at baseline. In 2002, echocardiography was performed in 74% of the survivors. </P><P>Results: We found a 16% difference in mortality: 14% in the Physio group (n = 6) and 30% in the Classic group (n = 16) (adjusted P = .41). Life table analysis shows that the absolute risk of death after 30 months is lower in the Physio group. Intra-operative repair failure occurred in 3 patients (6%) of the Classic group, and in 4 (9%) of the Physio group, resulting in mitral valve replacement. Late failure occurred in 1 patient (2%) in the Classic group, and in 4 (9%) in the Physio group. At follow-up, left ventricular function did not differ across groups (ejection fraction 45% and 48% (adjusted P = .65)). The combined NYHA class III-IV had improved for the Classic group in 42% and for the Physio group in 34%. </P><P>Conclusion: Although the 16% difference in mortality did not reach statistical significance, it is considered clinically important. No differences in morbidity, valve function, and left ventricular function were found. Further research to explain the difference in mortality is required.</P>

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