Functional and Oncological Outcome of Acetabular Reconstruction for the Treatment of Metastatic Disease*

Marco, Rex A.W.; Sheth, Dhiren S.; Boland, Patrick J.; Wunder, Jay S.; Siegel, Jeffrey A.; Healey, John H.

doi:10.2106/00004623-200005000-00005

Cited by 150 publications

(141 citation statements)

References 12 publications

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“…Similar to other studies [1,8,13,16,19,23,25,26], we observed frequent complications, and one patient died perioperatively. One patient had early recurrent instability and was considered for revision surgery with implantation of a constrained liner, but he died of disease progression before surgery was performed.…”

Section: Discussionsupporting

confidence: 91%

“…Patients experienced good relief of pain, improvement in ambulatory status, and improvements in HHS. Our observations are similar to those of others who used the Harrington technique and its modifications (Table 2) [1,8,13,16,19,25,26]. The largest reported series is from Marco et al [16].…”

Section: Discussionsupporting

confidence: 91%

“…Finally, we did not attempt to identify factors that might be associated with prolonged prognosis. Although factors associated with shorter overall survival have been identified (eg, visceral metastases [16]), there are difficulties and inaccuracies associated with attempts to predict survival in this patient population [17]. Advanced mathematical modeling techniques are being developed to help predict the survival of patients with metastatic bone disease [7].…”

Section: Discussionmentioning

confidence: 99%

“…Various modifications to the technique include the use of screws instead of pins (sometimes introduced in an antegrade fashion) [16], the use of antiprotrusio rings [25], and the use of bulk allograft combined with a cemented reconstruction [1]. These constructs have a high initial success rate but may fail with time primarily owing to disease progression and cup loosening or migration, with the two largest published series [8,16] each having a failure rate of approximately 9% (range, 0%-9%).…”

Section: Introductionmentioning

confidence: 99%

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Surgical Technique: Porous Tantalum Reconstruction for Destructive Nonprimary Periacetabular Tumors

Khan

Rose

Yanagisawa

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Large bone loss and frequently irradiated existing bone make reconstructing metastatic and other nonprimary periacetabular tumors challenging. Although existing methods are initially successful, they may fail with time. Given the low failure rates of porous tantalum acetabular implants in other conditions with large bone loss or irradiated bone, we developed a technique to use these implants in these neoplastic cases where others might fail. Description of Technique After local tumor curettage, a large uncemented tantalum shell (sometimes with tantalum augments) was fixed to remaining bone using numerous screws. When substantial medial bone loss was present, an antiprotrusio cage was placed over the top of the cup and secured to remaining ilium and ischium. Patients and Methods We retrospectively reviewed 20 patients who underwent THAs for neoplastic bone destruction with the described technique. Their mean age was 60 years (range, 22-80 years). We recorded pain and ambulatory status, pain medication use, and Harris hip scores. We assessed for progressive radiolucent lines and component migration on followup radiographs. Eleven of the 20 patients died at a mean of 17 months after surgery. The minimum followup for surviving patients was 26 months (mean, 56 months; range, 26-85 months).

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surgical Technique: Porous Tantalum Reconstruction for Destructive Nonprimary Periacetabular Tumors

Khan

Rose

Yanagisawa

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…We performed univariate analysis using paired t-tests to compare estimated blood loss, packed red blood cell transfusion volume, and operative time between the groups. Further, paired t-tests were used to compare these dependent variables in each of the following anatomic subgroups: humerus; intramedullary nailing or limited excision-open nailing combination; open femoral surgery including long-stem hemiarthroplasty, THA, Harrington reconstruction (reinforcement of acetabular deficiency with pins, cement, and antiprotrusio ring prostheses) [8]; proximal femoral resection; and pelvic or scapular surgery.…”

Section: Data and Statistical Analysesmentioning

confidence: 99%

Embolization of Hypervascular Bone Metastases Reduces Intraoperative Blood Loss: A Case-control Study

Pazionis

Papanastassiou

Maybody

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Small case series suggest that preoperative transcatheter arterial embolization minimizes bleeding and facilitates surgery for hypervascular metastatic bone tumors. However, control groups would make our confidence in clinical recommendations stronger, but small patient numbers make prospective trials difficult to conduct on this topic. Questions/purposes In this case-control study, we asked whether (1) patients who undergo embolization have less estimated blood loss and/or shorter operative time than patients who do not have embolization; (2) larger tumor size, greater initial tumor vascularity, and longer interval from embolization to surgery are associated with greater estimated blood loss and packed red blood cell transfusion volume; and (3) embolization does not affect renal function in patients with normal preoperative renal function. Methods We retrospectively reviewed records of patients with hypervascular bone metastases treated at our institution between 1998 and 2008. Twenty-seven patients with renal cell carcinoma and 12 with thyroid carcinoma who underwent embolization before 41 surgical procedures were matched to 41 patients who did not have embolization with respect to age, diagnosis, tumor size and potential vascularity, and procedure type; matching was performed without knowledge of outcomes. In univariate and multivariate analyses, age, tumor size, use of embolization, surgery type and risk, embolization-to-surgery interval, and degree of devascularization were evaluated for correlations with estimated blood loss, packed red blood cell transfusion volume, operative time, and postembolization renal function. Results Overall, patients who had embolization had less mean estimated blood loss (0.90 versus 1.77 L; p = 0.002), packed red blood cell transfusion volume (2.15 versus 3.56 U; p = 0.020), and operative time

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Chapter 87. Orthopedic Treatment of Metastatic Bone Disease

Weber¹,

Kominsky²

2008

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism

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Functional and Oncological Outcome of Acetabular Reconstruction for the Treatment of Metastatic Disease*

Cited by 150 publications

References 12 publications

Surgical Technique: Porous Tantalum Reconstruction for Destructive Nonprimary Periacetabular Tumors

Surgical Technique: Porous Tantalum Reconstruction for Destructive Nonprimary Periacetabular Tumors

Embolization of Hypervascular Bone Metastases Reduces Intraoperative Blood Loss: A Case-control Study

Chapter 87. Orthopedic Treatment of Metastatic Bone Disease

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