Rehabilitation of a Patient Receiving a Large-Resection Hip Prosthesis Because of a Phosphaturic Mesenchymal Tumor

Lopresti, Maurizio; Daolio, Primo Andrea; Rancati, Jacopo M.; Ligabue, Nicoletta; Andreolli, Arnaldo; Panella, Lorenzo

doi:10.4081/cp.2015.814

Cited by 9 publications

(12 citation statements)

References 12 publications

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“…In their case report, Lopresti et al demonstrate how difficult and time consuming the diagnostics of tumor–induced osteomalacia can be [ 53 ]. They report a patient presenting diffuse costal and vertebral pain without any trauma over a three–year period.…”

Section: Bone Healthmentioning

confidence: 99%

Crucial Role of Vitamin D in the Musculoskeletal System

et al. 2016

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Vitamin D is well known to exert multiple functions in bone biology, autoimmune diseases, cell growth, inflammation or neuromuscular and other immune functions. It is a fat-soluble vitamin present in many foods. It can be endogenously produced by ultraviolet rays from sunlight when the skin is exposed to initiate vitamin D synthesis. However, since vitamin D is biologically inert when obtained from sun exposure or diet, it must first be activated in human beings before functioning. The kidney and the liver play here a crucial role by hydroxylation of vitamin D to 25-hydroxyvitamin D in the liver and to 1,25-dihydroxyvitamin D in the kidney. In the past decades, it has been proven that vitamin D deficiency is involved in many diseases. Due to vitamin D’s central role in the musculoskeletal system and consequently the strong negative impact on bone health in cases of vitamin D deficiency, our aim was to underline its importance in bone physiology by summarizing recent findings on the correlation of vitamin D status and rickets, osteomalacia, osteopenia, primary and secondary osteoporosis as well as sarcopenia and musculoskeletal pain. While these diseases all positively correlate with a vitamin D deficiency, there is a great controversy regarding the appropriate vitamin D supplementation as both positive and negative effects on bone mineral density, musculoskeletal pain and incidence of falls are reported.

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Section: Bone Healthmentioning

confidence: 99%

Crucial Role of Vitamin D in the Musculoskeletal System

et al. 2016

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“…Limb salvage and preservation of joint function and the prospect for rapid mobilization are the major advantages of distal femoral reconstruction for patients that have previously undergone total knee arthroplasty. This may be especially true for older patients or those with reduced physical conditions who may be mobilized sooner when the limb is preserved [17, 37]. Joint functionality after DFR in individuals with multiple revisions is expected to be at an acceptable level [9, 10, 15, 23].…”

Section: Discussionmentioning

confidence: 99%

Distal femoral reconstruction following failed total knee arthroplasty is accompanied with risk for complication and reduced joint function

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Puchner

Staats

et al. 2019

BMC Musculoskelet Disord

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BackgroundSubstantial bone loss following failed total knee arthroplasty (TKA) represents a major challenge in revision arthroplasty, that can require distal femoral reconstruction (DFR). In this study, we aimed to assess the clinical outcome and the complication frequencies of individuals who underwent DFR with modular megaprostheses. Additionally, we aimed to compare functional outcome measures after DFR in these sophisticated cases to an age-matched control group of total knee prostheses to quantify the potential loss of function.MethodsA retrospective chart review of 30 consecutive patients after DFR from 1997 to 2017 with a mean age of 74.38 years (± 10.1) was performed. Complications were classified according to the Henderson classification. Knee Society Score (KSS) was calculated and range of motion (ROM) was assessed.ResultsThirteen (43.3%) patients had at least one complication requiring revision surgery. Revision-free survival was 74.8% at one year, 62.5% at three and 40.9% at 10 years post-op. Soft-tissue failure complications were found in three (10.0%) patients, aseptic loosening in four (13.3%) patients, structural failure in one (3.3%) patient and infection in eight (26.6%) patients. Of those with infection, five (16.6%) experienced ongoing prosthetic joint infection and three (10.0%) developed new infection after distal femur reconstruction. Patients with DFR achieved 69.3% of KSS pain score, 23.1% KSS function score and 76.2% of ROM compared to patients with primary TKA.ConclusionsDFR after failed TKA represents a treatment procedure with high risk for complication in this particular group. Despite the prospect of rapid postoperative mobilization, reduced functionality, range of motion and mobilization have to be considered when choosing this treatment option.

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“…Based on our review of the literature on PubMed, the average time from onset of symptoms to a confirmed diagnosis of TIO often exceeds 2.5 years. [1–3,8–11,17,18] Definitive treatment is further delayed by an average of 5 years due to inability to find the underlying tumor due to the characteristics of being small and slow growing and being located in particular or atypical sites. [8–11,17,18] Typical laboratory findings include hyperphosphaturia, elevated alkaline phosphatase, and low serum 1,25-dihydroxy vitamin D in literature, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…[1–3,8–11,17,18] Definitive treatment is further delayed by an average of 5 years due to inability to find the underlying tumor due to the characteristics of being small and slow growing and being located in particular or atypical sites. [8–11,17,18] Typical laboratory findings include hyperphosphaturia, elevated alkaline phosphatase, and low serum 1,25-dihydroxy vitamin D in literature, respectively. [1–3,12,13] Hypophosphatemia is secondary to inhibition of renal phosphorus reabsorption, and the vitamin D synthetic defect blocks the compensatory rise of calcitriol stimulated by the hypophosphatemia.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of tumor-induced osteomalacia causing by phosphaturic mesenchymal tumor of the foot

et al. 2019

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Tumor-induced osteomalacia causing by phosphaturic mesenchymal tumor of the foot is exceedingly rare, thus may bring great challenges to the timely and proper diagnosis and treatment of clinicians. The only definitive management is removal of the phosphaturic mesenchymal tumor completely. The objective of this article is to report 2 unusual cases with tumor-induced osteomalacia causing by phosphaturic mesenchymal tumor of the foot. We describe 2 patients with phosphaturic mesenchymal tumor involving the foot who were successfully treated with tumor resection. On presentation to our institution, the patients both had signs of severe osteomalacia, and the patients’ most outstanding complaints were diffuse bone pain, general weakness, and disabled walking. A 53-year-old female underwent surgical excision of pathogenic tumor on the sole of left foot. A 62-year-old female underwent complete excision of pathogenic tumor of right plantar. The patients showed appropriate destruction of the tumor, adequate pain relief, and the elevated blood phosphorus levels compared with the previous status. Surgical resection is the most effective treatment option for patients with tumor-induced osteomalacia who can undergo appropriate surgical treatment. This represents a safe and reasonable approach to sustainably relieve pain and other symptoms with tumor-induced osteomalacia in the foot.

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Rehabilitation of a Patient Receiving a Large-Resection Hip Prosthesis Because of a Phosphaturic Mesenchymal Tumor

Cited by 9 publications

References 12 publications

Crucial Role of Vitamin D in the Musculoskeletal System

Crucial Role of Vitamin D in the Musculoskeletal System

Distal femoral reconstruction following failed total knee arthroplasty is accompanied with risk for complication and reduced joint function

Successful treatment of tumor-induced osteomalacia causing by phosphaturic mesenchymal tumor of the foot

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