OBJECTIVE: To review our 10-year experience with percutaneous long bone cementoplasty (PLBC) in poor surgical patients. MATERIALS AND METHODS: Fifty-one patients were included. Primary endpoints were pain and functional outcomes one month following PLBC. A secondary endpoint dealt with factors predicting cement leakage. Delayed adverse events and overall survival (OS) were also investigated. RESULTS: Sixty-six lesions were treated. Local pain relief at 1-month occurred in 59/66 lesions (89.4%); pain improvement was significantly more common for lesions of the upper limb (p < 0.05). Limb functionality at one month improved in 46/64 lesions (71.8%); lesions ≤ 3 cm showed better outcomes in terms of limb function (p <0.05). Cement leakage was minor and asymptomatic in 26 cases (26/66, 39.4 %); in one case (1/66, 1.5%) symptomatic minor amount of intra-articular cement leakage occurred. Factors predicting cement leakage were diaphyseal location of the lesions, cortical bone disruption and extra-bone tumour extension (p < 0.05). The most common delayed adverse event was fracture (6/66, 9.1%). OS at 1-, 2- and 3-years was 61.2%, 30.9% and 23.0%, respectively. CONCLUSIONS: For poor surgical candidates, at 1-month follow-up, PLBC proved to be safe and effective. If stress fracture occurs following PLBC, surgical external fixation is still an affordable therapeutic option. KEY POINTS: Percutaneous long bone cementoplasty may be proposed to poor surgical patients. Pain palliation is more significant for lesions of the upper limb. Limb function improves significantly for lesions sized ≤ 3 cm. Fracture is the most common delayed adverse event (9% of cases). If cement stress fracture occurs, surgical external fixation is still feasible.
OBJECTIVE: To review our 10-year experience with percutaneous long bone cementoplasty (PLBC) in poor surgical patients. MATERIALS AND METHODS: Fifty-one patients were included. Primary endpoints were pain and functional outcomes one month following PLBC. A secondary endpoint dealt with factors predicting cement leakage. Delayed adverse events and overall survival (OS) were also investigated. RESULTS: Sixty-six lesions were treated. Local pain relief at 1-month occurred in 59/66 lesions (89.4%); pain improvement was significantly more common for lesions of the upper limb (p < 0.05). Limb functionality at one month improved in 46/64 lesions (71.8%); lesions ≤ 3 cm showed better outcomes in terms of limb function (p <0.05). Cement leakage was minor and asymptomatic in 26 cases (26/66, 39.4 %); in one case (1/66, 1.5%) symptomatic minor amount of intra-articular cement leakage occurred. Factors predicting cement leakage were diaphyseal location of the lesions, cortical bone disruption and extra-bone tumour extension (p < 0.05). The most common delayed adverse event was fracture (6/66, 9.1%). OS at 1-, 2- and 3-years was 61.2%, 30.9% and 23.0%, respectively. CONCLUSIONS: For poor surgical candidates, at 1-month follow-up, PLBC proved to be safe and effective. If stress fracture occurs following PLBC, surgical external fixation is still an affordable therapeutic option. KEY POINTS: Percutaneous long bone cementoplasty may be proposed to poor surgical patients. Pain palliation is more significant for lesions of the upper limb. Limb function improves significantly for lesions sized ≤ 3 cm. Fracture is the most common delayed adverse event (9% of cases). If cement stress fracture occurs, surgical external fixation is still feasible.
Authors: Salvatore Masala; Tommaso Volpi; Francesco P M Fucci; Maria Cantonetti; Massimiliano Postorino; Giovanni Simonetti Journal: Support Care Cancer Date: 2010-05-27 Impact factor: 3.603
Authors: Franz Liska; Philipp Schmitz; Norbert Harrasser; Peter Prodinger; Hans Rechl; Rüdiger von Eisenhart-Rothe Journal: Unfallchirurg Date: 2018-01 Impact factor: 1.000