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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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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. |
format | Online Article Text |
id | pubmed-4326438 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
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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