Osteoarthritis, osteoarthrosis, and osteoarthropathy are diseases that doctors encounter daily in their practice. The use of all three terms is customary, often without a clear justification as to why a particular term is used for a particular case. In the past several decades, doctors mainly differentiated among these diseases based on clinical presentation and radiography. In the past several years, however, significant progress has been made in the field of biochemical, immunological, and cytohistological research, which has provided explanations for the pathogenesis of these conditions, enabled defining differences amongst them and facilitated the use of appropriate terms for each one of these diseases. The term arthritis (osteoarthritis) should be used exclusively for primarily inflammatory joint diseases-rheumatoid arthritis, juvenile arthritis, reactive arthritis (Reiter's syndrome). If the etiology is infectious, this must also be emphasized-septic (purulent) arthritis, tuberculous arthritis. Arthrosis (osteoarthrosis) relates to changes in the joints occurring due to pathological processes within the joint itself, but which, in their basis, are not inflammatory. Arthropathy is a term for joint disease stemming from another diseased organ or system of organs.
Introduction: Hip disarticulation and hemipelvectomy are surgical procedures with a high rate of local complications: swollen scrotum/labia, superficial necrosis, infection, and wound dehiscence. Aim: We present local complications in our series. Material and methods: 17 patients were included in the study, there were 16 cases of malignant tumors and one case of osteomyelitis. Twelve of the tumors were soft tissue tumors, and four were malignant bone tumors. The descriptive statistical methods and methods for hypothesis testing used were the following: mean value, standard deviation, and absolute numbers as structure indicators, the t-test, and Fisher's exact test. Results: Local complications were observed in ten patients. Scrotum/labia edema was observed in five, superficial necrosis in four, wound infection in six, and wound dehiscence in seven cases. A single complication was observed in three patients; two and three complications were observed in three cases, each; and four complications were observed in one patient. No significant statistical difference was found between male and female patients (p=1.000). Patients with complications were significantly older (p=0.008). The correlation was found only between wound infection and dehiscence (p=0.001). Staphylococcus aureus was found in three cases, Enterococcus faecalis in one, Pseudomonas aeruginosa in three, Proteus mirabilis in two, and Acinetobacter spp. in one. Two patients had a single agent infection, the remaining four had polymicrobial infection. The complication rate was 58.8%, with wound infection being the most common one. Age was found as a possible predictor. This might be in relation to the condition of the blood vessels, but also with the general condition of the patient. Conclusion: Complications in hip disarticulation/hemipelvectomy vary from insignificant to life-threatening, prolonging recovery and rehabilitation.
Introduction: Bone tumors are rare neoplasms whose therapy depends on the location. Pelvic bones represent a special anatomical entity diagnosis and therapy of pelvic tumors in addition to the pathohistological type largely depends on the anatomical specifics of that region. Aim: The aim of this study was to show the frequency, as well as clinical and pathological characteristics of primary and secondary tumors of the pelvic bones. Material and methods: The research as a descriptive study in the period from January 1, to December 31, 2019 at the Institute of Pathology of the Medical Faculty of the University of Belgrade and includes 33 patients. Demographic, clinical and radiological data were obtained from the Bone Tumor Registry. Statistical processing and analysis were done in the Statistical Package for Social Science SPSS Windows version 22 (IBM Chicago, Ilinois, USA). Results: Out of 33 patients, 55% had secondary pelvic tumors, primarily cancer metastases (37%). In 21% of cases, primary malignant bone tumor as diagnosed, and in 12%, primary benign bone tumor. Hematopoietic neoplasms were verified in 12%. Conclusion: Pelvic bone tumors are not common, but these neoplasms, in orthopedic oncology, represents their malignant biological behavior are of great importance. The most common primary malignant tumor in adults is chondrosarcoma, and in children Ewing sarcoma. Highest frequency for pelvic bone metastases has lung cancer. Plasmacytoma in adults, Langerhans cellular histiocytosis in children are hematological neoplasms seen at this site.
Introduction. The most common cause of pathological fractures are skeletal metastases. Ten percent of patients with diagnosed skeletal metastases will sustain a pathological fracture. Skeletal metastases can be treated by non-surgical methods, including analgesics, bisphosphonates, and radiotherapy, with the primary goal of relieving pain and slowing down tumor growth. Surgical treatment is indicated for impending or existing fractures. It includes stabilization with internal fixation using various nails, plates, and screws with or without osteoplasty, and endoprosthetic joint replacement, especially in lesions around major joints - hip, knee, and shoulder. Material and Methods. The study included patients operatively treated at the Institute of orthopedics "Banjica" and pathohistologically analyzed at the Institute of pathology in Belgrade during the period from February 2021 to January 2022. Inclusion criteria were an existing or impending pathological fracture of long bones, operative treatment with tissue sampling, and the consequent pathohistological diagnosis of metastatic carcinoma. Patients with biopsy-proven processes other than metastatic carcinomas were excluded from the study. The total number of patients included in the study was 69. Results. The mean age of patients at the pathological fracture occurrence was 67.7 (ranging from 42 to 88). Malignant diseases diagnosed were: breast cancer 36.1%, lung cancer 24.5%, kidney cancer 14.5%, prostate cancer 13.1%, colorectal cancer 2.9%, other cancer (8.9%). The radiological presentation was in the form of lysis in 75.4% and in blastic form in 24.6%. Operative treatment included arthroplasty in 53.6% of patients and stabilization with nail or plate in 46.4%. Conclusion. Pathological fractures represent the final outcome of tumor activity in a bone and cause significant suffering in patients expressed through severe pain and often immobility, which accelerates all the pathological processes and leads to death. Joint methods of contemporary chemotherapy, radiotherapy, and surgery enabled a significant life quality improvement and extension in these patients.
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