Haemophilic Pelvic Pseudotumour: A New Surgical Option

Pasta, Gianluigi; Ruggieri, Roberta; Annunziata, Salvatore; Gallese, Alessandro; Gagliardi, Vincenzo; Cuzzocrea, Fabrizio; Ghiara, Matteo; Russo, Mariaconcetta; Preti, Paola; Santi, R.; Mosconi, Mario; Benazzo, Francesco

doi:10.3390/healthcare9101269

Cited by 2 publications

(3 citation statements)

References 45 publications

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“…However, the effect is temporary and it better serves as an adjunctive procedure, shrinking the lesion to make it more amenable to surgical resection [63].…”

Section: Discussionmentioning

confidence: 99%

The Path from Diagnosis to Surgical Treatment of Hemophilic Elbow Arthropaty Can Be a Risky One: A Case Report

Pasta,

Annunziata,

Ruggieri

et al. 2024

Preprint

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We describe an interesting case report about a patient with hemophilia A with severe chronic elbow arthropathy who underwent multiple surgical because of his condition. We collected all the clinical and imaging findings, and we compared the decision-making flow chart and the surgery performed with the most recent indications, treatments and complications reported in the literature. The aim of this case report is to show how usually the hemophilic patient even if young usually comes to our attention from the beginning with complex and advance musculoskeletal disease. Elbow hemophilic arthropathy is a complex disease and the management in these patients could be more difficult than others because of the higher risk of complications rate after all surgical procedures, for this reason it’s very important to treat these patients in hub centers with expertise in well-coordinated multidisciplinary teams. The path from diagnosis to surgical treatment of hemophilic elbow arthropathy can be a risky one, as it happened in this case.

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“…However, the effect is temporary and it better serves as an adjunctive procedure, shrinking the lesion to make it more amenable to surgical resection [63].…”

Section: Discussionmentioning

confidence: 99%

The Path from Diagnosis to Surgical Treatment of Hemophilic Elbow Arthropaty Can Be a Risky One: A Case Report

Pasta,

Annunziata,

Ruggieri

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Reconstruction with a pedicle screw and rod system or plates combined with Kirschner wires or bone cement can be used for an HPT in the ilium with pelvic discontinuity 30 . When the HPTwas located in the retroperitoneal region, it should be excised with preservation of the capsule to reduce the risk of injury to the surrounding viscera 7,16,31 . When compression of a ureter is suspected, a double-J catheter should be placed preoperatively to avoid ureteral injury [31][32][33] .…”

Section: Discussionmentioning

confidence: 99%

“…When the HPTwas located in the retroperitoneal region, it should be excised with preservation of the capsule to reduce the risk of injury to the surrounding viscera 7,16,31 . When compression of a ureter is suspected, a double-J catheter should be placed preoperatively to avoid ureteral injury [31][32][33] .…”

Section: Discussionmentioning

confidence: 99%

A Novel Surgical Classification for Extremity and Pelvic Hemophilic Pseudotumors

Xiao

Chang

et al. 2023

Journal of Bone and Joint Surgery

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Background:A hemophilic pseudotumor (HPT) is a rare and challenging complication of hemophilia for which there is no classification system that provides uniformity of descriptions or that can be used to guide management. We have developed such a classification based on anatomical site, HPT severity, and corresponding surgical treatment.Methods:The PUMCH (Peking Union Medical College Hospital) classification was developed on the basis of clinical manifestations and imaging features. Extremity and pelvic HPTs were divided into 4 types and 6 subtypes according to anatomical site and whether or not there was destruction of adjacent bone. Associations between the PUMCH classification and surgical treatment, preoperative comorbidities, operative time, intraoperative bleeding, and postoperative complication rates were analyzed.Results:Forty-five patients with 53 HPTs that were treated at PUMCH between December 2005 and October 2021 were included. The mean age at the time of surgery was 35.4 ± 11.9 years, and the median follow-up duration was 60.3 months. Twenty-eight HPTs were classified as type I (13 IA, 7 IB, 8 IC); 3, as type II; 6, as type III; and 16, as type IV. All 20 type-IA and IB HPTs were treated with excision, and the 3 type-II HPTs were treated with curettage and bone grafting. Fourteen type-IV pelvic HPTs underwent excision, 2 of which needed concomitant pelvic reconstruction. Six type-IC HPTs and 1 type-III HPT underwent excision and osseous reconstruction. Amputation was required for 1 type-IC and 3 type-III HPTs. Type-IC HPTs had the longest mean operative time (194.3 ± 28.2 minutes) and the greatest intraoperative bleeding (2,000 mL [interquartile range, 1,100 to 3,000 mL]). Postoperative infection was more common in patients with type-III (50.0%) and type-IC (28.6%) HPTs, but not significantly so.Conclusions:The PUMCH classification is based on the anatomic pathology and surgical strategy for HPTs. The classification of HPTs corresponds to surgical outcomes, and may be helpful for decision-making regarding their surgical treatment.Level of Evidence:Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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Haemophilic Pelvic Pseudotumour: A New Surgical Option

Cited by 2 publications

References 45 publications

The Path from Diagnosis to Surgical Treatment of Hemophilic Elbow Arthropaty Can Be a Risky One: A Case Report

The Path from Diagnosis to Surgical Treatment of Hemophilic Elbow Arthropaty Can Be a Risky One: A Case Report

A Novel Surgical Classification for Extremity and Pelvic Hemophilic Pseudotumors

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