Cargando…
Treatment of the benign lytic lesions of the proximal femur with synthetic bone graft
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, lim...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206894/ https://www.ncbi.nlm.nih.gov/pubmed/30373674 http://dx.doi.org/10.1186/s13018-018-0982-z |
_version_ | 1783366441729261568 |
---|---|
author | Zekry, Karem M. Yamamoto, Norio Hayashi, Katsuhiro Takeuchi, Akihiko Alkhooly, Ali Zein A. A. Abd-Elfattah, Ahmed Saleh Fouly, Ezzat H. Ahmed, Adel Refaat Tsuchiya, Hiroyuki |
author_facet | Zekry, Karem M. Yamamoto, Norio Hayashi, Katsuhiro Takeuchi, Akihiko Alkhooly, Ali Zein A. A. Abd-Elfattah, Ahmed Saleh Fouly, Ezzat H. Ahmed, Adel Refaat Tsuchiya, Hiroyuki |
author_sort | Zekry, Karem M. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6206894 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-62068942018-10-31 Treatment of the benign lytic lesions of the proximal femur with synthetic bone graft Zekry, Karem M. Yamamoto, Norio Hayashi, Katsuhiro Takeuchi, Akihiko Alkhooly, Ali Zein A. A. Abd-Elfattah, Ahmed Saleh Fouly, Ezzat H. Ahmed, Adel Refaat Tsuchiya, Hiroyuki J Orthop Surg Res Research Article 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. BioMed Central 2018-10-29 /pmc/articles/PMC6206894/ /pubmed/30373674 http://dx.doi.org/10.1186/s13018-018-0982-z Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. 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 Article Zekry, Karem M. Yamamoto, Norio Hayashi, Katsuhiro Takeuchi, Akihiko Alkhooly, Ali Zein A. A. Abd-Elfattah, Ahmed Saleh Fouly, Ezzat H. Ahmed, Adel Refaat Tsuchiya, Hiroyuki Treatment of the benign lytic lesions of the proximal femur with synthetic bone graft |
title | Treatment of the benign lytic lesions of the proximal femur with synthetic bone graft |
title_full | Treatment of the benign lytic lesions of the proximal femur with synthetic bone graft |
title_fullStr | Treatment of the benign lytic lesions of the proximal femur with synthetic bone graft |
title_full_unstemmed | Treatment of the benign lytic lesions of the proximal femur with synthetic bone graft |
title_short | Treatment of the benign lytic lesions of the proximal femur with synthetic bone graft |
title_sort | treatment of the benign lytic lesions of the proximal femur with synthetic bone graft |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206894/ https://www.ncbi.nlm.nih.gov/pubmed/30373674 http://dx.doi.org/10.1186/s13018-018-0982-z |
work_keys_str_mv | AT zekrykaremm treatmentofthebenignlyticlesionsoftheproximalfemurwithsyntheticbonegraft AT yamamotonorio treatmentofthebenignlyticlesionsoftheproximalfemurwithsyntheticbonegraft AT hayashikatsuhiro treatmentofthebenignlyticlesionsoftheproximalfemurwithsyntheticbonegraft AT takeuchiakihiko treatmentofthebenignlyticlesionsoftheproximalfemurwithsyntheticbonegraft AT alkhoolyalizeinaa treatmentofthebenignlyticlesionsoftheproximalfemurwithsyntheticbonegraft AT abdelfattahahmedsaleh treatmentofthebenignlyticlesionsoftheproximalfemurwithsyntheticbonegraft AT foulyezzath treatmentofthebenignlyticlesionsoftheproximalfemurwithsyntheticbonegraft AT ahmedadelrefaat treatmentofthebenignlyticlesionsoftheproximalfemurwithsyntheticbonegraft AT tsuchiyahiroyuki treatmentofthebenignlyticlesionsoftheproximalfemurwithsyntheticbonegraft |