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Di Martino A, Pederiva D, Bordini B, Di Carlo G, Panciera A, Geraci G, Stefanini N, Faldini C. Proximal femoral replacement for non-neoplastic conditions: a systematic review on current outcomes. J Orthop Traumatol 2022; 23:18. [PMID: 35348913 PMCID: PMC8964877 DOI: 10.1186/s10195-022-00632-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 02/19/2022] [Indexed: 11/10/2022] Open
Abstract
Proximal femoral replacement (PFR) is a well-established treatment for neoplasia of the proximal femur. The use of this surgical technique for non-neoplastic conditions has increased over the years. We carried out a systematic review of the literature to study the indications, complications, and functional results when PFR is used for non-neoplastic conditions. Twenty-seven studies were included in the review with a total of 828 PFRs with a mean follow-up of 50 months (range 1-225 months). The main indications were infection (28%), periprosthetic fracture (27%), aseptic loosening (22%), and fracture (16%). The rate of reoperation was 20.3% overall. The overall revision rate was 15.4%. The main complications were dislocation (10.2%) and infection (7.3%). After 2010, the rates of reoperation (25.5% versus 18.2%), loosening (9.4% versus 3.2%), and dislocation (15.7% versus 7.9%) were lower than before 2010. The 30-day mortality ranged from 0% to 9%. The hip function scores improved post-surgery. In conclusion, the use of PFR in non-neoplastic conditions remains a marginal tool, associated with low direct mortality and high complication rates, but we expect its use to increase in the near future.
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Affiliation(s)
- Alberto Di Martino
- Department of Biomedical and Neurimotor Sciences - University of Bologna, Piazza di Porta S. Donato, 2, 40127, Bologna, Italy. .,Ist Orthopaedic Department, IRCCS - Istituto Ortopedico Rizzoli, via Giulio Cesare Pupilli, 1, 40136, Bologna, Italy.
| | - Davide Pederiva
- Department of Biomedical and Neurimotor Sciences - University of Bologna, Piazza di Porta S. Donato, 2, 40127, Bologna, Italy.,Ist Orthopaedic Department, IRCCS - Istituto Ortopedico Rizzoli, via Giulio Cesare Pupilli, 1, 40136, Bologna, Italy
| | - Barbara Bordini
- Medical Technology Lab, IRCCS - Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli, 1, 40136, Bologna, Italy
| | - Gabriele Di Carlo
- Department of Biomedical and Neurimotor Sciences - University of Bologna, Piazza di Porta S. Donato, 2, 40127, Bologna, Italy.,Ist Orthopaedic Department, IRCCS - Istituto Ortopedico Rizzoli, via Giulio Cesare Pupilli, 1, 40136, Bologna, Italy
| | - Alessandro Panciera
- Department of Biomedical and Neurimotor Sciences - University of Bologna, Piazza di Porta S. Donato, 2, 40127, Bologna, Italy.,Ist Orthopaedic Department, IRCCS - Istituto Ortopedico Rizzoli, via Giulio Cesare Pupilli, 1, 40136, Bologna, Italy
| | - Giuseppe Geraci
- Department of Biomedical and Neurimotor Sciences - University of Bologna, Piazza di Porta S. Donato, 2, 40127, Bologna, Italy.,Ist Orthopaedic Department, IRCCS - Istituto Ortopedico Rizzoli, via Giulio Cesare Pupilli, 1, 40136, Bologna, Italy
| | - Niccolò Stefanini
- Department of Biomedical and Neurimotor Sciences - University of Bologna, Piazza di Porta S. Donato, 2, 40127, Bologna, Italy.,Ist Orthopaedic Department, IRCCS - Istituto Ortopedico Rizzoli, via Giulio Cesare Pupilli, 1, 40136, Bologna, Italy
| | - Cesare Faldini
- Department of Biomedical and Neurimotor Sciences - University of Bologna, Piazza di Porta S. Donato, 2, 40127, Bologna, Italy.,Ist Orthopaedic Department, IRCCS - Istituto Ortopedico Rizzoli, via Giulio Cesare Pupilli, 1, 40136, Bologna, Italy
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Madenci AL, Weil BR, Liu Q, Murphy AJ, Gibson TM, Yasui Y, Leisenring WM, Howell RM, Tinkle CL, Nekhlyudov L, Diller LR, Armstrong GT, Oeffinger KC, Weldon CB. Long-Term Risk of Venous Thromboembolism in Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study. J Clin Oncol 2018; 36:JCO2018784595. [PMID: 30216123 DOI: 10.1200/jco.2018.78.4595] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose To estimate the incidence of late-occurring venous thromboembolism (VTE) among survivors of childhood cancer and to identify risk factors for VTE to facilitate diagnosis and prevention. Methods The Childhood Cancer Survivor Study is a multi-institutional cohort of 24,355 5-year childhood cancer survivors (diagnosed between 1970 and 1999; median age at last follow-up, 28.7 years [range, 5.6 to 58.9 years]; median follow-up since diagnosis, 21.3 years [range, 5.0 to 39.2 years]) and 5,051 sibling participants. The primary end point was self-reported late (≥ 5 years after cancer diagnosis) VTE. Rate ratios (RRs) were estimated with multivariable piecewise exponential models. Results Late VTE incidence among survivors and siblings was 1.1 and 0.5 events per 1,000 person-years, respectively (RR, 2.2; 95% CI, 1.7 to 2.8), with 2.5 excess events per 100 survivors over 35 years. Among survivors, risk factors for VTE were female sex (RR, 1.3; 95% CI, 1.1 to 1.6), cisplatin (reference none; 1 to 199 mg/m2: RR, 3.0 [95% CI, 1.4 to 6.5]; 200 to 399 mg/m2: RR, 1.9 [95% CI, 1.0 to 3.6]; ≥ 400 mg/m2: RR, 2.0 [95% CI, 1.2 to 3.3]), l-asparaginase (RR, 1.3; 95% CI, 1.0 to 1.7), obesity or underweight (reference body mass index [BMI] 18.5 to 24.9 kg/m2; BMI ≥ 30.0 kg/m2: RR, 1.6 [95% CI, 1.2 to 2.0]; BMI < 18.5 kg/m2: RR, 2.4 [95% CI, 1.7 to 3.4]), and late cancer recurrence or subsequent malignant neoplasm (RR, 4.6; 95% CI, 3.6 to 5.8). Among lower-extremity osteosarcoma survivors, limb salvage (reference amputation; RR, 3.1; 95% CI, 1.2 to 7.5) and cisplatin 200 to 399 or ≥ 400 mg/m2 (reference none; RR, 4.0 [95% CI, 1.1 to 14.6] and 2.9 [95% CI, 1.1 to 8.0], respectively) were independently associated with late VTE. VTE was associated with increased risk for nonexternal cause late mortality (RR, 1.9; 95% CI, 1.6 to 2.3). Conclusion Childhood cancer survivors are at increased risk for VTE across their lifespan and a diagnosis of VTE increases mortality risk. Interventions that target potentially modifiable comorbidities, such as obesity, warrant consideration, with prophylaxis for high-risk survivors, including those treated with cisplatin and limb-sparing approaches.
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Affiliation(s)
- Arin L Madenci
- Arin L. Madenci, Brent R. Weil, and Christopher B. Weldon, Boston Children's Hospital; Arin L. Madenci and Larissa Nekhlyudov, Brigham and Women's Hospital; Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller, and Christopher B. Weldon, Dana-Farber Cancer Institute; Arin L. Madenci, Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller and Christopher B. Weldon, Harvard Medical School, Boston, MA; Qi Liu, University of Alberta, Edmonton, Alberta, Canada; Andrew J. Murphy, Todd M. Gibson, Yutaka Yasui, Christopher L. Tinkle, and Gregory T. Armstrong, St Jude Children's Research Hospital, Memphis, TN; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Rebecca M. Howell, The University of Texas MD Anderson Cancer Center, Houston, TX; and Kevin C. Oeffinger, Duke University School of Medicine, Durham, NC
| | - Brent R Weil
- Arin L. Madenci, Brent R. Weil, and Christopher B. Weldon, Boston Children's Hospital; Arin L. Madenci and Larissa Nekhlyudov, Brigham and Women's Hospital; Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller, and Christopher B. Weldon, Dana-Farber Cancer Institute; Arin L. Madenci, Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller and Christopher B. Weldon, Harvard Medical School, Boston, MA; Qi Liu, University of Alberta, Edmonton, Alberta, Canada; Andrew J. Murphy, Todd M. Gibson, Yutaka Yasui, Christopher L. Tinkle, and Gregory T. Armstrong, St Jude Children's Research Hospital, Memphis, TN; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Rebecca M. Howell, The University of Texas MD Anderson Cancer Center, Houston, TX; and Kevin C. Oeffinger, Duke University School of Medicine, Durham, NC
| | - Qi Liu
- Arin L. Madenci, Brent R. Weil, and Christopher B. Weldon, Boston Children's Hospital; Arin L. Madenci and Larissa Nekhlyudov, Brigham and Women's Hospital; Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller, and Christopher B. Weldon, Dana-Farber Cancer Institute; Arin L. Madenci, Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller and Christopher B. Weldon, Harvard Medical School, Boston, MA; Qi Liu, University of Alberta, Edmonton, Alberta, Canada; Andrew J. Murphy, Todd M. Gibson, Yutaka Yasui, Christopher L. Tinkle, and Gregory T. Armstrong, St Jude Children's Research Hospital, Memphis, TN; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Rebecca M. Howell, The University of Texas MD Anderson Cancer Center, Houston, TX; and Kevin C. Oeffinger, Duke University School of Medicine, Durham, NC
| | - Andrew J Murphy
- Arin L. Madenci, Brent R. Weil, and Christopher B. Weldon, Boston Children's Hospital; Arin L. Madenci and Larissa Nekhlyudov, Brigham and Women's Hospital; Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller, and Christopher B. Weldon, Dana-Farber Cancer Institute; Arin L. Madenci, Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller and Christopher B. Weldon, Harvard Medical School, Boston, MA; Qi Liu, University of Alberta, Edmonton, Alberta, Canada; Andrew J. Murphy, Todd M. Gibson, Yutaka Yasui, Christopher L. Tinkle, and Gregory T. Armstrong, St Jude Children's Research Hospital, Memphis, TN; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Rebecca M. Howell, The University of Texas MD Anderson Cancer Center, Houston, TX; and Kevin C. Oeffinger, Duke University School of Medicine, Durham, NC
| | - Todd M Gibson
- Arin L. Madenci, Brent R. Weil, and Christopher B. Weldon, Boston Children's Hospital; Arin L. Madenci and Larissa Nekhlyudov, Brigham and Women's Hospital; Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller, and Christopher B. Weldon, Dana-Farber Cancer Institute; Arin L. Madenci, Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller and Christopher B. Weldon, Harvard Medical School, Boston, MA; Qi Liu, University of Alberta, Edmonton, Alberta, Canada; Andrew J. Murphy, Todd M. Gibson, Yutaka Yasui, Christopher L. Tinkle, and Gregory T. Armstrong, St Jude Children's Research Hospital, Memphis, TN; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Rebecca M. Howell, The University of Texas MD Anderson Cancer Center, Houston, TX; and Kevin C. Oeffinger, Duke University School of Medicine, Durham, NC
| | - Yutaka Yasui
- Arin L. Madenci, Brent R. Weil, and Christopher B. Weldon, Boston Children's Hospital; Arin L. Madenci and Larissa Nekhlyudov, Brigham and Women's Hospital; Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller, and Christopher B. Weldon, Dana-Farber Cancer Institute; Arin L. Madenci, Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller and Christopher B. Weldon, Harvard Medical School, Boston, MA; Qi Liu, University of Alberta, Edmonton, Alberta, Canada; Andrew J. Murphy, Todd M. Gibson, Yutaka Yasui, Christopher L. Tinkle, and Gregory T. Armstrong, St Jude Children's Research Hospital, Memphis, TN; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Rebecca M. Howell, The University of Texas MD Anderson Cancer Center, Houston, TX; and Kevin C. Oeffinger, Duke University School of Medicine, Durham, NC
| | - Wendy M Leisenring
- Arin L. Madenci, Brent R. Weil, and Christopher B. Weldon, Boston Children's Hospital; Arin L. Madenci and Larissa Nekhlyudov, Brigham and Women's Hospital; Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller, and Christopher B. Weldon, Dana-Farber Cancer Institute; Arin L. Madenci, Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller and Christopher B. Weldon, Harvard Medical School, Boston, MA; Qi Liu, University of Alberta, Edmonton, Alberta, Canada; Andrew J. Murphy, Todd M. Gibson, Yutaka Yasui, Christopher L. Tinkle, and Gregory T. Armstrong, St Jude Children's Research Hospital, Memphis, TN; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Rebecca M. Howell, The University of Texas MD Anderson Cancer Center, Houston, TX; and Kevin C. Oeffinger, Duke University School of Medicine, Durham, NC
| | - Rebecca M Howell
- Arin L. Madenci, Brent R. Weil, and Christopher B. Weldon, Boston Children's Hospital; Arin L. Madenci and Larissa Nekhlyudov, Brigham and Women's Hospital; Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller, and Christopher B. Weldon, Dana-Farber Cancer Institute; Arin L. Madenci, Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller and Christopher B. Weldon, Harvard Medical School, Boston, MA; Qi Liu, University of Alberta, Edmonton, Alberta, Canada; Andrew J. Murphy, Todd M. Gibson, Yutaka Yasui, Christopher L. Tinkle, and Gregory T. Armstrong, St Jude Children's Research Hospital, Memphis, TN; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Rebecca M. Howell, The University of Texas MD Anderson Cancer Center, Houston, TX; and Kevin C. Oeffinger, Duke University School of Medicine, Durham, NC
| | - Christopher L Tinkle
- Arin L. Madenci, Brent R. Weil, and Christopher B. Weldon, Boston Children's Hospital; Arin L. Madenci and Larissa Nekhlyudov, Brigham and Women's Hospital; Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller, and Christopher B. Weldon, Dana-Farber Cancer Institute; Arin L. Madenci, Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller and Christopher B. Weldon, Harvard Medical School, Boston, MA; Qi Liu, University of Alberta, Edmonton, Alberta, Canada; Andrew J. Murphy, Todd M. Gibson, Yutaka Yasui, Christopher L. Tinkle, and Gregory T. Armstrong, St Jude Children's Research Hospital, Memphis, TN; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Rebecca M. Howell, The University of Texas MD Anderson Cancer Center, Houston, TX; and Kevin C. Oeffinger, Duke University School of Medicine, Durham, NC
| | - Larissa Nekhlyudov
- Arin L. Madenci, Brent R. Weil, and Christopher B. Weldon, Boston Children's Hospital; Arin L. Madenci and Larissa Nekhlyudov, Brigham and Women's Hospital; Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller, and Christopher B. Weldon, Dana-Farber Cancer Institute; Arin L. Madenci, Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller and Christopher B. Weldon, Harvard Medical School, Boston, MA; Qi Liu, University of Alberta, Edmonton, Alberta, Canada; Andrew J. Murphy, Todd M. Gibson, Yutaka Yasui, Christopher L. Tinkle, and Gregory T. Armstrong, St Jude Children's Research Hospital, Memphis, TN; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Rebecca M. Howell, The University of Texas MD Anderson Cancer Center, Houston, TX; and Kevin C. Oeffinger, Duke University School of Medicine, Durham, NC
| | - Lisa R Diller
- Arin L. Madenci, Brent R. Weil, and Christopher B. Weldon, Boston Children's Hospital; Arin L. Madenci and Larissa Nekhlyudov, Brigham and Women's Hospital; Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller, and Christopher B. Weldon, Dana-Farber Cancer Institute; Arin L. Madenci, Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller and Christopher B. Weldon, Harvard Medical School, Boston, MA; Qi Liu, University of Alberta, Edmonton, Alberta, Canada; Andrew J. Murphy, Todd M. Gibson, Yutaka Yasui, Christopher L. Tinkle, and Gregory T. Armstrong, St Jude Children's Research Hospital, Memphis, TN; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Rebecca M. Howell, The University of Texas MD Anderson Cancer Center, Houston, TX; and Kevin C. Oeffinger, Duke University School of Medicine, Durham, NC
| | - Gregory T Armstrong
- Arin L. Madenci, Brent R. Weil, and Christopher B. Weldon, Boston Children's Hospital; Arin L. Madenci and Larissa Nekhlyudov, Brigham and Women's Hospital; Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller, and Christopher B. Weldon, Dana-Farber Cancer Institute; Arin L. Madenci, Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller and Christopher B. Weldon, Harvard Medical School, Boston, MA; Qi Liu, University of Alberta, Edmonton, Alberta, Canada; Andrew J. Murphy, Todd M. Gibson, Yutaka Yasui, Christopher L. Tinkle, and Gregory T. Armstrong, St Jude Children's Research Hospital, Memphis, TN; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Rebecca M. Howell, The University of Texas MD Anderson Cancer Center, Houston, TX; and Kevin C. Oeffinger, Duke University School of Medicine, Durham, NC
| | - Kevin C Oeffinger
- Arin L. Madenci, Brent R. Weil, and Christopher B. Weldon, Boston Children's Hospital; Arin L. Madenci and Larissa Nekhlyudov, Brigham and Women's Hospital; Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller, and Christopher B. Weldon, Dana-Farber Cancer Institute; Arin L. Madenci, Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller and Christopher B. Weldon, Harvard Medical School, Boston, MA; Qi Liu, University of Alberta, Edmonton, Alberta, Canada; Andrew J. Murphy, Todd M. Gibson, Yutaka Yasui, Christopher L. Tinkle, and Gregory T. Armstrong, St Jude Children's Research Hospital, Memphis, TN; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Rebecca M. Howell, The University of Texas MD Anderson Cancer Center, Houston, TX; and Kevin C. Oeffinger, Duke University School of Medicine, Durham, NC
| | - Christopher B Weldon
- Arin L. Madenci, Brent R. Weil, and Christopher B. Weldon, Boston Children's Hospital; Arin L. Madenci and Larissa Nekhlyudov, Brigham and Women's Hospital; Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller, and Christopher B. Weldon, Dana-Farber Cancer Institute; Arin L. Madenci, Brent R. Weil, Larissa Nekhlyudov, Lisa R. Diller and Christopher B. Weldon, Harvard Medical School, Boston, MA; Qi Liu, University of Alberta, Edmonton, Alberta, Canada; Andrew J. Murphy, Todd M. Gibson, Yutaka Yasui, Christopher L. Tinkle, and Gregory T. Armstrong, St Jude Children's Research Hospital, Memphis, TN; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Rebecca M. Howell, The University of Texas MD Anderson Cancer Center, Houston, TX; and Kevin C. Oeffinger, Duke University School of Medicine, Durham, NC
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