Successful surgical treatment of haemophilic pseudotumour, filling the defect with hydroxyapatite

Sagarra,; Lucas,; Torre, de la; Almagro,; González, Marcos; Garcia, Justin R.; Menéndez,

doi:10.1046/j.1365-2516.2000.00344.x

Cited by 24 publications

(11 citation statements)

References 11 publications

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“…Percutaneous curettage and filling with hydroxyapatite has been described by Sagarra et al . [14], who reported one case in which they filled the residual cavity with hydroxyapatite. This was manufactured from coral skeletal carbonate via a hydrothermal exchange procedure, which preserves the porous interconnecting structure.…”

Section: Percutaneous Managementmentioning

confidence: 99%

“…In adult patients, filling the defect with bone graft or fibrin glue via the percutaneous insertion of a trocar into the cyst has been recommended by Caviglia et al [13]. Percutaneous curettage and filling with hydroxyapatite has been described by Sagarra et al [14], who reported one case in which they filled the residual cavity with hydroxyapatite. This was manufactured from coral skeletal carbonate via a hydrothermal exchange procedure, which preserves the porous interconnecting structure.…”

Section: Curettage and Filling With Fibrin Seal And Cancellous Bone Gmentioning

confidence: 99%

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Haemophilic cysts (pseudotumours)

Rodríguez-Merchán

2002

Haemophilia

107

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It is very likely that with the advent of widespread maintenance therapy, pseudotumours will be less common in the future. It is important that they are diagnosed early, and prevention of muscular haematomas is the key to reducing their incidence. There are a number of therapeutic alternatives for this dangerous condition: surgical removal, percutaneous management, exeresis and filling of the dead cavity, irradiation, and embolization. The management of a patient with a haemophilic pseudotumour is complex, with a high rate of potential complications. Surgical excision is the treatment of choice but should only be carried out in major haemophilia centres by a multidisciplinary surgical team. The main postoperative complications are death, infection, fistulization, and pathological fractures (even requiring amputations of affected limbs). Pelvic pseudotumours can even become complicated by fistulization to the large bowel and by obstruction of the ureters. Untreated, proximal pseudotumours will ultimately destroy soft tissues, erode bone, and may produce neurovascular complications.

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Section: Percutaneous Managementmentioning

confidence: 99%

Section: Curettage and Filling With Fibrin Seal And Cancellous Bone Gmentioning

confidence: 99%

Haemophilic cysts (pseudotumours)

Rodríguez-Merchán

2002

Haemophilia

107

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“…Different therapy options have been described in the treatment of the haemophilic pseudotumour including surgical resection, arterial embolisation, radiotherapy, percutaneous curettage, and filling with fibrin and/or bone graft or hydroxyapatite [2,3,[10][11][12][13][14][15][16][17]. However, treatment of the haemophilic pseudotumour poses a challenge, and extensive clinical experience is essential to appropriately address this serious complication in patients with haemophilia.…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of the haemophilic pseudotumour: A single centre experience

Panotopoulos

Trieb

et al. 2012

International Orthopaedics (SICOT)

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Purpose Haemophilic pseudotumour was defined by Fernandez de Valderrama and Matthews as a progressive cystic swelling involving muscle, produced by recurrent haemorrhage into muscles adjacent to the bone. The pseudotumour mainly occurs in the long bones and the pelvis. The treatment of the haemophilic pseudotumour poses a challenge, and extensive clinical experience is essential to appropriately address this serious complication in patients with haemophilia. Consequently, the aim of this study is to present our own clinical experience and treatment results of the haemophilic pseudotumour. Methods We retrospectively reviewed the records of 87 patients with bleeding disorders treated between 1967 and 2011 for musculoskeletal complications of congenital bleeding disorders. We identified six patients with a haemophilic pseudotumour who were treated at our department. Results The mean age at surgery was 45.9 (range, 40-61) years. The iliac bone was affected in three patients (one right, two left), the right tibia (distal diaphysis) in one, the right thigh in two and the right ulna (proximal part) in one patient. One patient had two pseudotumours. The perioperative course was easily controllable with adequate factor VIII substitution. At the latest follow-up after 8.4 (range, 4-24) years, normal healing with no recurrence was observed. Conclusions The haemophilic pseudotumour is a rare but severe complication of hereditary bleeding disorders. In the international literature the resection and postoperative course are described as challenging and difficult, requiring detailed preoperative planning. It is advisable to perform such operations in specialised centres with close cooperation between surgeons and haematologists.

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“…This is not always possible as there may be destroyed bone. The peripheral pseudotumors are easily treated by the opening of a bone window, the drainage and curettage of the contents and then the packing of the pseudotumor space with bone and/or bone substitutes [11] mixed with glue [12]. Bony structures, e.g.…”

Section: Realistic Aimsmentioning

confidence: 99%