Periprosthetic metastasis: a rare cause for prosthetic loosening

Nagy, Mathias Thomas; Young, Andrew F.; Gorgees, Neshteman; Barrington, R

doi:10.1136/bcr-2013-008707

Cited by 4 publications

(7 citation statements)

References 7 publications

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“…These cases involved metastatic disease from the following primary malignancies: 5 cases of bronchogenic carcinoma; 3 cases of renal cell carcinoma; 2 cases of ovarian carcinoma; and 2 cases of breast cancer, gastric adenocarcinoma, malignant immunoblastic lymphoma, non-Hodgkin's lymphoma, thoracic mesothelioma, hepatocellular carcinoma, and prostate cancer (Table 1). [1,5–15]…”

Section: Discussionmentioning

confidence: 99%

Periprosthetic metastasis following total hip arthroplasty in a patient with lung carcinoma

Zhan

Gao

et al. 2019

Medicine

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Rationale:Periprosthetic osteolysis secondary to septic loosening and aseptic loosening is a well-described phenomenon associated with artificial hip arthroplasty. Periprosthetic bone loss as a result of metastatic infiltration is an uncommon cause of early, progressive loosening of joint replacement prosthesis and is rarely described in the literature.Patient concerns:The present study describes a 70-year-old male patient who was diagnosed with pulmonary squamous cell carcinoma 5 years after total hip arthroplasty (THA) and developed a metastasis from squamous cell carcinoma in the periprosthetic neosynovial tissue 1 year after formal chemotherapy. The main complaint was hip pain with limited activity for about 3 months.Diagnoses:Expansive bone destruction and periprosthetic osteolysis at the right femoral trochanter were identified through X-ray and 99mTc bone scan. The diagnosis of pulmonary squamous cell carcinoma metastasis was finally confirmed on the basis of postoperative pathological examination.Interventions:The patient underwent open surgery with proximal femoral prosthesis revision and tumor prosthesis resection to completely remove the tumor tissue and relieve pain.Outcomes:The patient was completely relieved of pain at discharge 2 weeks after surgery and experienced no complications. However, the patient died of respiratory failure due to disease progression 3 months after surgery.Lessons:We believe that clinicians should maintain a high index of suspicion and consider metastatic disease in differential diagnosis of cases of aseptic loosening, particularly if the patient has a history of malignant disease and the osteolytic lesion involves the outer cortex. In addition, patients with a known history of malignancy should be screened with a pre-operative bone scan to rule out any metastatic infiltration and regularly followed up at short intervals to detect any early bone loss.

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Section: Discussionmentioning

confidence: 99%

Periprosthetic metastasis following total hip arthroplasty in a patient with lung carcinoma

Zhan

Gao

et al. 2019

Medicine

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“…It is of particular interest that this patient presented with constant pain and continuous falls because of difficulty bearing weight for 11 months before there was radiographic evidence of a permeative lytic lesion. Only a handful of cases presented at pain onset with normal radiographic findings, followed by rapid progression of osteolysis 11,13,14,[16][17][18] . Interestingly, the only other case that presented a similar period between pain onset and radiographic evidence of destruction was an SCC of the lung with metastasis about a total hip arthroplasty 9 .…”

Section: Discussionmentioning

confidence: 99%

“…Although exceedingly rare, cases of arthroplasty failure because of metastatic spread of a distant primary malignancy exist in literature. The first report of a metastatic tumor adjacent to a total joint arthroplasty was in 1986, and several publications have since followed [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] . Yet, within these, only 3 reports follow a TKA 7,13,18 and involved patients with chronic pain and radiographic evidence of osteolysis at presentation.…”

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confidence: 99%

Periprosthetic Metastatic Lung Carcinoma About a Total Knee Arthroplasty

Baez

Nusbickel

Knapik

et al. 2022

JBJS Case Connector

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Case: A 64-year-old man presented with unrelenting left knee pain and an unremarkable radiograph 4 months after revision total knee arthroplasty (TKA). Pain persisted, despite conservative management, and repeat imaging demonstrated significant lysis of the left medial tibial condyle. A biopsy demonstrated metastatic squamous cell carcinoma of the lung. Management with excision and curettage of the tibial lesion was followed by palliative radiotherapy and chemotherapy until the patient died 7 months later. Conclusion:This case highlights metastasis as an etiology for persistent TKA pain in a patient with significant risk factors.Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/B955).

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“…Only a few studies have previously reported metastasis around orthopedic implants, and most of these reports were confined to implants of total arthroplasty or plates [2,3]. The reported cases of metastasis around orthopedic implants have originated from non-Hodgkin's lymphoma, malignant fibrous histiocytoma, immunoblastic lymphoma, carcinomas of the lung, gastric carcinoma, endometrial carcinoma, ovarian carcinoma, RCC, hepatocellular carcinoma, and prostate cancer [2][3][4]. Although various cancers have been reported, no definite common denominator exists among cases of metastasis.…”

Section: Discussionmentioning

confidence: 99%

Metastasis of renal cell carcinoma around suture anchor implants

Baek

Shin

Kim

et al. 2021

Clin Shoulder Elbow

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We present an unusual case of bone metastases from renal cell carcinoma around orthopedic implants in a 78-year-old female with osteolytic, expansile, highly vascularized, malignant infiltration around suture anchors in the proximal humerus. The patient had undergone arthroscopic rotator cuff repair using suture anchor implants 6 years previously. After diagnosis of bone metastasis, she was successfully treated with metastasectomy and internal fixation using a plate and screws, with cement augmentation. This report is the first to document metastases around a suture anchor in a bone and suggests the vulnerability of suture anchor implants to tumor metastasis.

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Periprosthetic metastasis: a rare cause for prosthetic loosening

Cited by 4 publications

References 7 publications

Periprosthetic metastasis following total hip arthroplasty in a patient with lung carcinoma

Periprosthetic metastasis following total hip arthroplasty in a patient with lung carcinoma

Periprosthetic Metastatic Lung Carcinoma About a Total Knee Arthroplasty

Metastasis of renal cell carcinoma around suture anchor implants

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