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Kumar H, Mittemari KN, Nimmagadda VC, Abraham AT, Nadagouda S, Choudry D. The Functional Outcome of Limb Salvage of Proximal Femur Tumors With Modular Endoprosthesis: A Prospective Study. Cureus 2023; 15:e50375. [PMID: 38213364 PMCID: PMC10782409 DOI: 10.7759/cureus.50375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 01/13/2024] Open
Abstract
Introduction The proximal femur is a common site for primary bone sarcomas, including Ewing's sarcoma, chondrosarcoma, osteosarcoma, and giant cell tumors (GCT). Extensive resections are challenging to reconstruct because the size of the tumor may necessitate an extensive resection of the femur to achieve adequate oncologic clearance. The resection of the proximal femur can result in hip joint instability due to the loss of the strong native hip capsule or hip abductor strength. With a wide range of reconstruction options, such as resection arthrodesis, allograft-prosthetic composite (APC), and endoprosthesis, we can achieve limb salvage with good functional outcomes. Objective The objective of this case series is to evaluate the clinical outcomes and complications associated with endoprosthesis replacement in patients with proximal femur tumors. Methods A prospective analysis was conducted with 32 patients who underwent modular endoprosthesis replacement for proximal femoral tumors at our institution. Patient data, tumor characteristics, surgical details, and postoperative outcomes were collected and analyzed. Results The study involved 32 patients who met the inclusion criteria. They were assessed using the Musculoskeletal Tumor Society Score (MSTS), which showed good functional outcomes in 72.84% of the patients. The study highlights the functional outcomes and potential complications associated with the use of modular prostheses. Conclusion Endoprosthesis replacement in proximal femur tumors is a viable treatment option, providing good functional outcomes and an acceptable method for limb salvage, which enhances the quality of life.
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Affiliation(s)
- Hiranya Kumar
- Trauma and Orthopedics, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND
| | - Karthik N Mittemari
- Orthopedics, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND
| | | | - Ajith T Abraham
- Orthopedic Surgery, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND
| | - Shivaraj Nadagouda
- Orthopedics, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND
| | - Deepank Choudry
- Orthopedics, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND
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Shi J, Zhao Z, Yan T, Guo W, Yang R, Tang X, Qu H, Dong S. Surgical treatment of benign osteolytic lesions in the femoral head and neck: a systematic review. BMC Musculoskelet Disord 2021; 22:549. [PMID: 34134687 PMCID: PMC8210383 DOI: 10.1186/s12891-021-04442-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/02/2021] [Indexed: 12/29/2022] Open
Abstract
Background and objectives Treatment of benign osteolytic lesions in the femoral head and neck can be extremely challenging, particularly in children with open physis or for aggressive tumors with pathological fracture. There remains the difficult management decision as to whether to perform complete excision of the involved area or only curettage. Moreover, there is no agreed consensus on the optimal approach to lesion access when performing curettage, which included the transcervical, open and direct approach. The current systematic review aims to provide guidance for selection of surgical methods in clinical practice by comparing the advantages and drawbacks of different procedures. Methods A comprehensive literature search of PubMed, Embase and Web of Science databases were executed for human studies restricted to the English language. The search was filtered to include studies published from January 1980 to January 2020. Results A total of 33 articles including 274 patients were enrolled in the final analysis. The most common diagnosis was chondroblastoma (CBT) (104, 38.0%), followed by giant cell tumor (GCT) (56, 20.4%). There were 57 (20.8%) patients with pathological fracture. Intralesional curettage was performed in 257 (93.8%) patients with the local recurrence of 12.5% at the mean follow-up of 51.5 months. The patients who were presented with open physis or curetted via transcervical approach developed higher local recurrence in patients with CBT (P < 0.001). The local recurrence rate of GCT is 33.3% after curettage, while 8 of 9 (88.9%) patients with fracture were treated successfully with joint preservation. Two of 45 (4.4%) patients developed avascular necrosis (AVN) of femoral head after surgical hip dislocation. The reported Musculoskeletal Tumor Society (MSTS) Score was comparable among patients with different approaches to curettage. Conclusion The majority of benign osteolytic lesions in the femoral head and neck can be treated with intralesional curettage with acceptable local tumor control and satisfactory function. The incidence of local recurrence might be decreased dramatically for lesion access under direct visualization. The native joint maintenance could be achieved even in patients with aggressive lesions presenting pathological fracture. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04442-y.
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Affiliation(s)
- Jingtian Shi
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, 100044, China
| | - Zhiqing Zhao
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, 100044, China
| | - Taiqiang Yan
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, 100044, China.
| | - Wei Guo
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, 100044, China
| | - Rongli Yang
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, 100044, China
| | - Xiaodong Tang
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, 100044, China
| | - Huayi Qu
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, 100044, China
| | - Sen Dong
- Musculoskeletal Tumor Center, Peking University People's Hospital, Beijing, 100044, China
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Zekry KM, Yamamoto N, Hayashi K, Takeuchi A, Alkhooly AZAA, Abd-Elfattah AS, Fouly EH, Ahmed AR, Tsuchiya H. Treatment of the benign lytic lesions of the proximal femur with synthetic bone graft. J Orthop Surg Res 2018; 13:270. [PMID: 30373674 PMCID: PMC6206894 DOI: 10.1186/s13018-018-0982-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 10/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Benign bone tumors and tumor-like conditions are commonly located in the proximal femur. The main indications for surgical treatment are lesions with impending or actual pathological fractures, or with aggressive or recurrent lesions. However, patients complaining of persistent pain, limping, or abnormal gait patterns are also considered for surgical treatment. In this study, we describe the outcomes of the surgical treatment of benign lytic lesions of the proximal femur by curettage followed by implantation of synthetic bone graft. METHODS This retrospective study included 27 patients (22 females and 5 males) with benign lytic lesions of the proximal femur. The average age was 25.5 years (6-65 years), and the mean follow-up period was 54.5 months (9-145 months). The histopathological diagnoses were fibrous dysplasia (8 patients), simple bone cyst (8 patients), chondroblastoma (7 patients), giant cell tumor (3 patients), and eosinophilic granuloma (1 patient). These lesions were managed with curettage followed by implantation of the bone defects with alpha tricalcium phosphate in 14 patients, beta tricalcium phosphate granules in 11 patients, hydroxyapatite granules in 1 patient, and combined beta tricalcium phosphate and hydroxyapatite granules in 1 patient. Internal fixation was performed in three patients. RESULTS The mean operative time was 143 min (80-245 min). Patients had regained normal unrestricted activity without pain at the operation site. Patients treated with beta tricalcium phosphate achieved radiographic consolidation of the bone defects within 1 year after the surgery, and those treated with alpha tricalcium phosphate or hydroxyapatite experienced no progression nor recurrence of the lesions. Local tumor recurrence was observed in one patient with giant cell tumor 5 years after the surgery. Post-operative pathological fracture was occurred in one patient with a simple bone cyst of the subtrochanteric region 1 month after surgery. No post-operative infection was observed. CONCLUSION We concluded that the treatment of benign lytic lesions of the proximal femur, either primary or recurrent, using synthetic bone graft is a safe and satisfactory method and the addition of internal fixation should be carefully planned.
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Affiliation(s)
- Karem M Zekry
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.,Department of Orthopaedic Surgery, Faculty of Medicine, Minia University, El-Minya, Egypt
| | - Norio Yamamoto
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
| | - Katsuhiro Hayashi
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Akihiko Takeuchi
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Ali Zein A A Alkhooly
- Department of Orthopaedic Surgery, Faculty of Medicine, Minia University, El-Minya, Egypt
| | | | - Ezzat H Fouly
- Department of Orthopaedic Surgery, Faculty of Medicine, Minia University, El-Minya, Egypt
| | - Adel Refaat Ahmed
- Department of Orthopaedic Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
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Liu H, Xiong Y, Fang X, Duan H. [Treatment of proximal femoral benign lesions by proximal femoral nail anti-rotation combined with curettage and bone graft through the Watson-Jones approach]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2018; 32:893-898. [PMID: 30129314 DOI: 10.7507/1002-1892.201801128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective To evaluate the feasibility and effectiveness of proximal femoral nail anti-rotation (PFNA) combined with curettage and bone graft through Watson-Jones approach in the treatment of proximal femur benign tumors and tumor like lesions. Methods The clinical data of 38 patients with benign tumors and tumor like lesions in the proximal femur who were treated through the Watson-Jones approach with PFNA combined with curettage and bone graft between January 2008 and January 2015 were retrospective analysed. There were 24 males and 14 females with an average age of 28 years (range, 15-57 years). Pathological types included 20 cases of fibrous dysplasia, 7 cases of bone cyst, 5 cases of aneurysmal bone cyst, 3 cases of giant cell tumor of bone, 2 cases of enchondroma, and 1 case of non-ossifying fibroma. Before operation, hip pain occurred in 19 patients, pathological fracture occurred in 12 patients, limb shortening and coxa varus deformity was found in 4 patients, and 3 patients received surgery for the local recurrence. The operation time, intraoperative blood loss, and full-weight bearing time after operation were recorded. Patients were followed up to observe union of bone graft and the position of internal fixator on X-ray films and CT images. Visual analogue scale (VAS) score was used to evaluate the level of pain. The Musculoskeletal Tumor Society (MSTS93) score was used to evaluate lower limb function. Harris hip score was used to evaluate hip joint function. Results The operation time was 130-280 minutes (mean, 182 minutes) and the intraoperative blood loss was 300-1 500 mL (mean, 764 mL). After operation, 3 cases of fat liquefaction of incision healed successfully by carefully dressing, and the rest incisions healed by first intention. All patients started partially weight-bearing exercise at 2-4 weeks after operation. The total weight-bearing time was 3-6 months (mean, 4.2 months). All the patients were followed up 24-108 months (median, 60 months). Imaging examination showed that the bone graft fused and the fusion time was 8-18 months (mean, 11.4 months). During the follow-up period, there was no complication such as pathological fracture, femoral head ischemic necrosis, hip joint dislocation, internal fixation loosening and fracture, and no tumor recurrence or distant metastasis occurred. At last follow-up, the VAS score, MSTS93 score, and Harris score were significantly improved when compared with preoperative ones ( P<0.05). Conclusion The treatment of proximal femoral benign lesions by PFNA combined with curettage and bone graft through the Watson-Jones approach is safe and effective, with advantages of better mechanical stability, less residual tumor, and less postoperative complications.
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Affiliation(s)
- Hongyuan Liu
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China
| | - Yan Xiong
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China
| | - Xiang Fang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China
| | - Hong Duan
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,
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Liu H, Fang X, Yu Z, Lang Y, Xiong Y, Duan H. Surgical strategy for benign lesions in proximal femur: internal fixation or endoprosthetic replacement. INTERNATIONAL ORTHOPAEDICS 2018; 42:2691-2698. [PMID: 29666889 DOI: 10.1007/s00264-018-3922-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 03/26/2018] [Indexed: 02/05/2023]
Abstract
PURPOSE The purpose of this study was to explore the indications for the two most frequently applied surgical procedures for benign lesions in the proximal femur. METHODS We retrospectively reviewed 142 patients with benign lesions in the proximal femur from January 2010 to January 2015. Internal fixation (IF) was adopted in 110 patients, while endoprosthetic replacement (EPR) was applied in 32 patients. Clinical data, including operation time, blood loss, hospitalization time, and hospitalization expenses, were compared between the groups. Limb mobilization was evaluated by the Musculoskeletal Tumor Society Score-93 (MSTS-93) and Harris Hip Score (HHS). Local recurrences and complications were statistically compared. RESULTS The average follow-up was 66 months (range 32-84 months). In the EPR group, operation time and hospitalization time were significantly shorter (p < 0.05 and p < 0.05, respectively), while blood loss and hospitalization expenses were significantly higher (p < 0.05 and p < 0.05, respectively). Functional outcomes of the MSTS-93 and HHS were higher at the three week follow-up in the EPR group (p < 0.001 and p < 0.001, respectively) but lower at 6 months (p = 0.031 and p = 0.042, respectively). No differences were observed in the two scores at three months (p = 0.261 and p = 0.134, respectively). Local recurrence and complication rates were similar in the two groups (p = 0.895 and p = 0.942, respectively). CONCLUSION The strategy for benign proximal femur lesions should depend on the site, size, initial diagnosis, and thinning degree of cortical bone. IF and EPR both result in satisfactory local control and functional and radiological results, while EPR is more suitable for aggressive and recurrent lesions and serves as an effective measure after IF failure.
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Affiliation(s)
- Hongyuan Liu
- Department of Orthopedics, West China Hospital, Sichuan University, 37 Guo Xue Lane, Chengdu, 610041, Sichuan, People's Republic of China
| | - Xiang Fang
- Department of Orthopedics, West China Hospital, Sichuan University, 37 Guo Xue Lane, Chengdu, 610041, Sichuan, People's Republic of China
| | - Zeping Yu
- Department of Orthopedics, West China Hospital, Sichuan University, 37 Guo Xue Lane, Chengdu, 610041, Sichuan, People's Republic of China
| | - Yun Lang
- Department of Orthopedics, People's Hospital of Deyang City, Deyang, 618000, Sichuan, People's Republic of China
| | - Yan Xiong
- Department of Orthopedics, West China Hospital, Sichuan University, 37 Guo Xue Lane, Chengdu, 610041, Sichuan, People's Republic of China
| | - Hong Duan
- Department of Orthopedics, West China Hospital, Sichuan University, 37 Guo Xue Lane, Chengdu, 610041, Sichuan, People's Republic of China.
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Lin J, Chen R, Yan W, Zhang Y, Chen D. [Treatment of benign bone lesions of proximal femur using dynamic hip screw and intralesional curettage via Watson-Jones approach]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2018; 32:31-35. [PMID: 29806361 DOI: 10.7507/1002-0179.201707092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Objective To explore the effectiveness of dynamic hip screw (DHS) and intralesional curettage via Watson-Jones approach in treatment of benign bone lesions of the proximal femur. Methods Between March 2012 and December 2016, 20 patients (21 lesions) with benign bone tumors or tumor like conditions of proximal femurs were treated with DHS and intralesional curettage via Watson-Jones approach. Their average age was 27.8 years (range, 11-51 years), including 13 males and 7 females. The pathological diagnosis were fibrous dysplasia in 11 cases, simple bone cyst in 2 cases, aneurysmal bone cyst in 2 cases, benign fibrous histocytoma in 2 cases, giant cell tumor in 2 cases, and chondroblastoma in 1 case, including 3 pathological fractures. According to the Enneking staging system, 18 patients were in stage S1, 3 patients with pathological fractures in stage S2. There was no varus deformity or valgus deformity. The operation time, intraoperative blood loss, and time of full weight-bearing were recorded. X-ray film and CT were used to observe the bone graft fusion and location of DHS. Complications were recorded. Visual analogue scale (VAS) and Musculoskeletal Tumor Society (MSTS) scoring were used to evaluate function of lower limbs. Results The average operation time was 177.1 minutes (range, 110-265 minutes). The average intraoperative blood loss was 828.6 mL (range, 200-2 300 mL). There was superficial incision infection in 1 case, deep incision infection in 1 case, and hip discomfort in 1 case, respectively. All patients were followed up 6-63 months (mean, 27.4 months). The time of full weight-bearing was 2 days in 2 patients with giant cell tumor and 2 to 13 weeks with an average of 7.2 weeks in the other patients. At last follow-up, VAS and MSTS were 0.19±0.51 and 29.62±0.97 respectively, showing significant differences when compared with the values before operation (3.52±2.62 and 23.71±8.77) ( t=5.565, P=0.000; t=-3.020, P=0.007 ). X-ray film showed the all bone grafts fusion with mean time of 8.2 months (range, 5-12 months). There was no pathological fracture of the femur, local tumor recurrence, chronic hip pain, dislocation, or femoral head necrosis during follow-up. Conclusion The treatment of benign bone lesion of the proximal femur using DHS and intralesional curettage via Watson-Jones approach is a safe and effective method.
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Affiliation(s)
- Jiasheng Lin
- Department of Musculoskeletal Tumor, the Second Hospital of Fuzhou Affiliated to Xiamen University, Fuzhou Fujian, 350007, P.R.China
| | - Rong Chen
- Department of Musculoskeletal Tumor, the Second Hospital of Fuzhou Affiliated to Xiamen University, Fuzhou Fujian, 350007,
| | - Wei Yan
- Department of Musculoskeletal Tumor, the Second Hospital of Fuzhou Affiliated to Xiamen University, Fuzhou Fujian, 350007, P.R.China
| | - Yiyuan Zhang
- Department of Musculoskeletal Tumor, the Second Hospital of Fuzhou Affiliated to Xiamen University, Fuzhou Fujian, 350007, P.R.China
| | - Dongdong Chen
- Department of Musculoskeletal Tumor, the Second Hospital of Fuzhou Affiliated to Xiamen University, Fuzhou Fujian, 350007, P.R.China
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Abstract
BACKGROUND Benign aggressive bone lesions of the femoral head and neck are mostly seen in young adults and warrant treatment for pain, impending fracture or established fracture, and disease clearance. It becomes challenging to treat them effectively while attempting salvage of the femoral head and yet achieving long term disease control with minimum complications. We describe our technique and experience in dealing with these lesions which can achieve the above-mentioned goals and can be easily replicated. MATERIALS AND METHODS We analyzed 15 cases of surgically treated, biopsy-proven benign, locally aggressive lesions affecting the femoral head and neck in skeletally mature individuals. All cases were treated with extended curettage through anterolateral modified Smith-Petersen approach along with tricortical iliac crest bone graft (combined with fibular graft in some cases) reconstruction with or without suitable internal fixation. RESULTS All, except one, patients were available for follow up. The age ranged from 18 to 43 years and the follow up ranged between 24 and 124 months (average 78 months). These included aneurysmal bone cysts (9), giant cell tumors (4), and fibrous dysplasia (2). The indication was pain (8), with impending (2) or established pathological neck femur fracture (5). In all cases, there was satisfactory healing of lesion and timely rehabilitation. Nonunion, avascular necrosis or local recurrences were not seen. The MSTS functional score was good or excellent in all (range 26-29, average 28). CONCLUSION Benign aggressive lesions affecting femoral head and neck in young and middle-aged adults pose a treatment challenge. A sturdy, lasting reconstruct with acceptable functional outcome and minimal recurrence rate can be achieved by salvaging the femoral head and neck using curettage and reconstruction, obviating the need for replacement at such an early age.
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Affiliation(s)
- Yogesh Panchwagh
- Department of Orthopaedic Oncology, Deenanath Mangeshkar Hospital and Research Centre, Pune, Maharashtra, India,Department of Orthopaedic Oncology, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India,Address for correspondence: Dr. Yogesh Panchwagh, 101, Vasant, Plot 29, Bharat Kunj Soc. No. 2, Erandwana, Pune - 411 038, Maharashtra, India. E-mail:
| | - Sujit K Joshi
- Department of Pathology, Deenanath Mangeshkar Hospital and Research Centre, Sancheti Institute for Orthopedics and Rehabilitation, Pune, Maharashtra, India
| | - Parag K Sancheti
- Department of Orthopaedic Oncology, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India
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Sharfman ZT, Atzmon R, Gortzak Y, Rotem G, Drexler M, Haviv B, Amar E, Rath E. Hip arthroscopy for intra-capsular benign tumors: a case series. J Hip Preserv Surg 2016; 3:312-317. [PMID: 29632691 PMCID: PMC5883178 DOI: 10.1093/jhps/hnw025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 06/24/2016] [Indexed: 11/19/2022] Open
Abstract
The purpose of this study is to demonstrate the assessment of intra-capsular femoral head and neck tumors, and to describe the arthroscopic surgical technique used to resect and fill the bone defects. Three cases of benign femoral head and neck lesions are presented. Two benign enchondromas and one benign osteochondroma were resected arthroscopically. Traction was used in one case. Modified Harris Hip Score improved in all three cases to scores of 95 or greater with an average improvement of 16 points with a minimum follow up of 15 months. Arthroscopic surgical resection of intra-capsular femoral hip lesions offers an effective alternative to open resection. This technique offered good outcomes in the limited cohort. We suggest that arthroscopic resection of intra-capsular femoral hip lesions be considered in relevant cases as an alternative to open resection.
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Affiliation(s)
- Zachary T Sharfman
- Tel Aviv University Sackler Faculty of Medicine.,Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 64239, Israel
| | - Ran Atzmon
- Tel Aviv University Sackler Faculty of Medicine.,Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 64239, Israel
| | - Yair Gortzak
- Tel Aviv University Sackler Faculty of Medicine.,The National Unit of Orthopedic Oncology, Tel Aviv Sourasky Medical Center, 6 Weizmann Str. Tel Aviv, Israel
| | - Gilad Rotem
- Tel Aviv University Sackler Faculty of Medicine.,Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 64239, Israel
| | - Michael Drexler
- Tel Aviv University Sackler Faculty of Medicine.,Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 64239, Israel
| | - Barak Haviv
- Tel Aviv University Sackler Faculty of Medicine.,Arthroscopy and Sports Injuries Unit, Rabin Medical Center, Petah Tikva 4941492, Israel
| | - Eyal Amar
- Tel Aviv University Sackler Faculty of Medicine.,Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 64239, Israel
| | - Ehud Rath
- Tel Aviv University Sackler Faculty of Medicine.,Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 64239, Israel
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Salunke AA, Shah J, Warikoo V, Kumar R, Galande A, Pokharkar H, Pandit J. Salvage of the proximal femur following pathological fractures involving benign bone tumors. J Surg Oncol 2016; 114:254. [DOI: 10.1002/jso.24291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Accepted: 03/31/2016] [Indexed: 11/09/2022]
Affiliation(s)
| | - Jaymin Shah
- Gujarat Cancer Research Institute (G.C.R.I.); Ahemdabad India
| | - Vikas Warikoo
- Gujarat Cancer Research Institute (G.C.R.I.); Ahemdabad India
| | - Ramesh Kumar
- Gujarat Cancer Research Institute (G.C.R.I.); Ahemdabad India
| | - Ashok Galande
- Gujarat Cancer Research Institute (G.C.R.I.); Ahemdabad India
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Nakamura T, Matsumine A, Asanuma K, Matsubara T, Sudo A. Treatment of the benign bone tumors including femoral neck lesion using compression hip screw and synthetic bone graft. SICOT J 2015; 1:15. [PMID: 27163071 PMCID: PMC4849251 DOI: 10.1051/sicotj/2015009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The proximal femur is one of the most common locations for benign bone tumors and tumor like conditions. We describe the clinical outcomes of the surgical treatment of benign lesions of the proximal femur including femoral neck using compression hip screw and synthetic bone graft. METHODS Thirteen patients with benign bone tumors or tumor like conditions of the proximal femur including femoral neck were surgically treated. Their average age at the time of presentation was 35 years and the average follow-up time was 76 months. RESULTS The average intraoperative blood loss was 1088 mL and intraoperative blood transfusion was required in eight patients. The average operative time was 167 minutes. All patients required one week and 12 weeks after surgery before full weight-bearing was allowed. All patients had regained full physical function without pain by the final follow-up. No patient sustained a pathological fracture of the femur following the procedure. All patients achieved partial or complete radiographic consolidation of the lesion within one year except one patient who developed a local tumor recurrence in 11 months. Post-operative superficial wound infection was observed in one patient, which resolved with intravenous antibiotics. Chronic hip pain was observed in one patient due to the irritation of tensor fascia lata muscle by the tube plate. CONCLUSION We suggest that the treatment of benign bone lesion of the proximal femur using compression hip screw and synthetic bone graft is a safe and effective method.
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Affiliation(s)
- Tomoki Nakamura
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine Tsu Japan
| | - Akihiko Matsumine
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine Tsu Japan
| | - Kunihiro Asanuma
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine Tsu Japan
| | - Takao Matsubara
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine Tsu Japan
| | - Akihiro Sudo
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine Tsu Japan
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