The treatment of benign lesions of the proximal femur with non-vascularised autologous fibular strut grafts

George, Bernard; Abudu, A.; Grimer, RJ; Carter, S. R.; Tillman, R. M.

doi:10.1302/0301-620x.90b5.20330

Cited by 60 publications

(64 citation statements)

References 10 publications

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“…Managing patients according to this protocol, we observed no pathologic fractures even though more than 80% of the nonaggressive benign lesions were treated conservatively. To date, most articles on benign tumors or tumor-like lesions of the proximal femur have reported surgical treatments either for fractured or fracture-prone femurs [2,4,7,8,19]. However, there have been no specific guidelines for surgical decision making of these benign lesions in the proximal femur.…”

Section: Discussionmentioning

confidence: 99%

“…In many cases, these silent lesions only require surveillance, not surgery [16]. Lesions in the proximal femur, however, raise a higher concern for fracture because of the stresses of weightbearing in this anatomic site; thus, surgical treatment often is preferred [4,7]. There are several guidelines for prophylactic fixation of metastatic diseases such as Mirels' [12] or Harrington's classifications [5].…”

Section: Introductionmentioning

confidence: 99%

“…Surgical options have been reported for treating benign tumors or tumor-like lesions in the proximal femur, ranging from simple decompression to complex procedures [4]. Because these lesions are not life threatening and may at times spontaneously regress, the decision whether to operate often is more difficult than the actual method of surgical treatment.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Can Certain Benign Lesions of the Proximal Femur Be Treated Without Surgery?

Shin¹,

Yeo²,

Seo³

2013

Clinical Orthopaedics &Amp; Related Research

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Background Benign lesions in the proximal femur can cause pathologic fractures. To avoid fracture, benign tumors and tumor-like lesions in this region often are treated surgically, yet there have been few reports regarding the decision-making processes or protocols for nonsurgical treatment of these lesions. Questions/purposes In this study, we asked (1) whether some benign lesions of the proximal femur can be managed safely using a conservative protocol, and (2) if observed according to such a protocol, what are the outcomes of such lesions at this anatomic site? Methods Fifty-four consecutive patients who had been followed for at least 12 months were enrolled in this study. The mean age of the patients at first visit was 38 years (range, 13-70 years), and the minimum followup was 12 months (mean, 25 months; range, 12-59 months). After ruling out malignancy, lesions were categorized as aggressive benign tumors or nonaggressive benign lesions using a standardized approach. We used conservative treatment for most patients with nonaggressive, benign lesions. Surgery was performed only for patients with nonaggressive lesions who met our fracture risk criteria: pain on initiating hip movement, progressively worsening pain, cortical thinning, and the absence of a sclerotic margin.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Can Certain Benign Lesions of the Proximal Femur Be Treated Without Surgery?

Shin¹,

Yeo²,

Seo³

2013

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

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“…(14) Allografts, on the other hand, offer the advantages of reduced rate of graft resorption, no donor site morbidity and wide availability; however, they may have a higher rate of infection, a reduced rate of incorporation and a small risk of disease transfer and immunogenicity. (14,15) Augmentation with an internal fixation device can provide additional mechanical support, so as to lessen the risk of a pathological stress fracture, especially during the initial 6-12 months before significant graft incorporation. (13,15) Based on previous studies, (6,12,13) the compression hip screw appears to be the most commonly applied internal fixation device.…”

Section: Mr Imaging Findingsmentioning

confidence: 99%

Successful treatment of solitary intraosseous haemangioma of the femoral neck

Xia¹,

Sittampalam²,

Howe³

et al. 2015

smedj

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Intraosseous haemangiomas (IOHs) are benign vascular bone tumours that account for 1% of all primary bone tumours. They are most frequently seen in the vertebrae and skull, and are rarely found in long bones. Herein, we present an uncommon case of a 25-year-old woman with a solitary IOH that occupied the left femoral neck. We describe the clinical, radiological and histological details of the case, as well as the three-year outcome of the surgical treatment, which successfully preserved the femoral head. We also conducted a review of the literature on this uncommon entity.

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“…Additionally, symptomatic patients complaining of recurrent pain or exhibiting a restricted range of motion in the affected joints are considered for surgical treatment (1,2,4). There are various surgical treatment strategies for benign bone tumors, consisting of curettage, curettage with autologous/allogeneic bone grafting, and curettage with artificial bone grafting (3)(4)(5)(6)(7)(8). Calcium phosphate cement (CPC) is an injectable biocompatible bone substitute that has been used for various applications in orthopedic surgery, due to its easy handling, high mechanical strength and good osteoconductive biological properties (4,(6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Treatment of bone defect with calcium phosphate cement subsequent to tumor curettage in pediatric patients

et al. 2015

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Abstract. The aim of the present study was to investigate the mid-to long-term clinical performance of calcium phosphate cement (CPC) in the treatment of benign bone tumors in pediatric patients with a follow-up of at least 2-years. The cases of 33 patients with benign bone tumors treated by curettage and subsequent implantation of CPC were retrospectively reviewed. The patients consisted of 13 males and 20 females, with a median age of 13 years and median follow-up time of 79 months. All patients were alive at the time of review. No toxicity was detected in routine blood tests. Radiography was used to confirm that CPC was well adapted to the surrounding host bone, although the resorbability of CPC was not obtained for all patients at the final follow-up. Local tumor recurrence occurred in 4 patients. None of the patients reported post-operative fractures. In total, 6 patients required a second surgical procedure, as follows: 4 patients in whom local tumor recurrence occurred; 1 patient with post-operative superficial wound infection, who underwent wound debridement; and 1 patient that required the removal of CPC due to deep infection at the proximal humerus. All patients had regained full physical function without any pain at the final follow-up. The present study recommends that the properties of CPC should be taken into consideration and applied to the reconstruction of bone defects subsequent to curettage of bone tumors.

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The treatment of benign lesions of the proximal femur with non-vascularised autologous fibular strut grafts

Cited by 60 publications

References 10 publications

Can Certain Benign Lesions of the Proximal Femur Be Treated Without Surgery?

Can Certain Benign Lesions of the Proximal Femur Be Treated Without Surgery?

Successful treatment of solitary intraosseous haemangioma of the femoral neck

Treatment of bone defect with calcium phosphate cement subsequent to tumor curettage in pediatric patients

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