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Functional outcome and complications following reconstruction for Harrington class II and III periacetabular metastasis

BACKGROUND: Metastatic bone disease involving the acetabulum is a debilitating condition causing significant pain and disability for patients. Many methods of reconstruction have been described for treating Harrington class II and III lesions with different results and complications. Our objectives...

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Autores principales: Kiatisevi, Piya, Sukunthanak, Bhasanan, Pakpianpairoj, Charoenchai, Liupolvanish, Prasert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4326438/
https://www.ncbi.nlm.nih.gov/pubmed/25578802
http://dx.doi.org/10.1186/1477-7819-13-4
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author Kiatisevi, Piya
Sukunthanak, Bhasanan
Pakpianpairoj, Charoenchai
Liupolvanish, Prasert
author_facet Kiatisevi, Piya
Sukunthanak, Bhasanan
Pakpianpairoj, Charoenchai
Liupolvanish, Prasert
author_sort Kiatisevi, Piya
collection PubMed
description BACKGROUND: Metastatic bone disease involving the acetabulum is a debilitating condition causing significant pain and disability for patients. Many methods of reconstruction have been described for treating Harrington class II and III lesions with different results and complications. Our objectives were to report functional results, implant survival and complications following reconstruction for Harrington class II and III periacetabular metastases by using anti-protusio cages, screws and joint replacement. METHODS: We reviewed 22 patients undergoing acetabular reconstruction for metastatic disease. There were 5 Harrington class II and 17 class III lesions. Intralesional curettage, multiple screws and cemented total hip replacement were performed in all patients. Anti-protusio cages were used in 19 hips. No Steinmann pins were used. Sixteen patients died at a median survival time of 12 months (range, 4 to 28 months) after surgery. Six patients were alive at last follow-up at a median of 8 months (range, 3 to 15 months). RESULTS: Postoperatively, the average ECOG score was improved from 3.1 to 1.7 and Visual Analog Scale was improved from 8.4 to 2.2. One patient developed hip dislocation and one patient developed superficial infection. The mean Musculoskeletal Tumor Society (MSTS) functional score was 70 (range, 27 to 87). There was no prosthetic loosening or revision. Twenty patients were able to walk. Eight patients became community ambulators, twelve became household ambulators and two were bed-bound. CONCLUSIONS: Good functional outcome and better ambulation could be expected following class II and III periacetabular reconstruction using anti-protusio cages, screws and cemented hip replacement. Few complications were noted and manageable. Although most of these patients with metastatic disease had limited life expectancies, their quality of life would be improved with appropriate patient selection and surgical reconstruction.
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spelling pubmed-43264382015-02-14 Functional outcome and complications following reconstruction for Harrington class II and III periacetabular metastasis Kiatisevi, Piya Sukunthanak, Bhasanan Pakpianpairoj, Charoenchai Liupolvanish, Prasert World J Surg Oncol Research BACKGROUND: Metastatic bone disease involving the acetabulum is a debilitating condition causing significant pain and disability for patients. Many methods of reconstruction have been described for treating Harrington class II and III lesions with different results and complications. Our objectives were to report functional results, implant survival and complications following reconstruction for Harrington class II and III periacetabular metastases by using anti-protusio cages, screws and joint replacement. METHODS: We reviewed 22 patients undergoing acetabular reconstruction for metastatic disease. There were 5 Harrington class II and 17 class III lesions. Intralesional curettage, multiple screws and cemented total hip replacement were performed in all patients. Anti-protusio cages were used in 19 hips. No Steinmann pins were used. Sixteen patients died at a median survival time of 12 months (range, 4 to 28 months) after surgery. Six patients were alive at last follow-up at a median of 8 months (range, 3 to 15 months). RESULTS: Postoperatively, the average ECOG score was improved from 3.1 to 1.7 and Visual Analog Scale was improved from 8.4 to 2.2. One patient developed hip dislocation and one patient developed superficial infection. The mean Musculoskeletal Tumor Society (MSTS) functional score was 70 (range, 27 to 87). There was no prosthetic loosening or revision. Twenty patients were able to walk. Eight patients became community ambulators, twelve became household ambulators and two were bed-bound. CONCLUSIONS: Good functional outcome and better ambulation could be expected following class II and III periacetabular reconstruction using anti-protusio cages, screws and cemented hip replacement. Few complications were noted and manageable. Although most of these patients with metastatic disease had limited life expectancies, their quality of life would be improved with appropriate patient selection and surgical reconstruction. BioMed Central 2015-01-12 /pmc/articles/PMC4326438/ /pubmed/25578802 http://dx.doi.org/10.1186/1477-7819-13-4 Text en © Kiatisevi et al.; licensee BioMed Central. 2015 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Kiatisevi, Piya
Sukunthanak, Bhasanan
Pakpianpairoj, Charoenchai
Liupolvanish, Prasert
Functional outcome and complications following reconstruction for Harrington class II and III periacetabular metastasis
title Functional outcome and complications following reconstruction for Harrington class II and III periacetabular metastasis
title_full Functional outcome and complications following reconstruction for Harrington class II and III periacetabular metastasis
title_fullStr Functional outcome and complications following reconstruction for Harrington class II and III periacetabular metastasis
title_full_unstemmed Functional outcome and complications following reconstruction for Harrington class II and III periacetabular metastasis
title_short Functional outcome and complications following reconstruction for Harrington class II and III periacetabular metastasis
title_sort functional outcome and complications following reconstruction for harrington class ii and iii periacetabular metastasis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4326438/
https://www.ncbi.nlm.nih.gov/pubmed/25578802
http://dx.doi.org/10.1186/1477-7819-13-4
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