Surgical Management of Metastatic Pathologic Subtrochanteric Fractures

Inchaustegui, Maria L.; Ruiz, Kim; Gonzalez, Marcos R; Pretell-Mazzini, Juan

doi:10.2106/jbjs.rvw.22.00232

Cited by 9 publications

(4 citation statements)

References 36 publications

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“…We chose to use this assessment tool due to the observational nature of all studies included. Ten of the 22 items of the STROBE checklist were used, as reported in the previous literature 22-25 . Well-described items in the checklist received a score of 2 points, partly described items 1 point, and poorly described ones 0 points.…”

Section: Methodsmentioning

confidence: 99%

Postoperative Outcomes of Total Humerus Replacement for Oncologic Reconstruction of the Upper Limb

Gonzalez,

Werenski,

Lozano-Calderon

2024

JBJS Reviews

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Background: Total humerus replacement (THR) is a reconstruction procedure performed after resection of massive humeral tumors. However, there is limited literature on the rates of failure and functional outcomes of this implant. Our study aimed to determine the main failure modes, implant survival, and postoperative functional outcomes of THR. Methods: A comprehensive search of the PubMed and Embase databases was conducted. We registered our study on PROSPERO (448684) and used the Strengthening the Reporting of Observational Studies in Epidemiology checklist for quality assessment. The Henderson classification was used to assess endoprosthesis failure and the Musculoskeletal Tumor Society (MSTS) score for functional outcomes. Weighted means and standard deviations were calculated. Results: Ten studies comprising 171 patients undergoing THR were finally included. The overall failure rate was 32.2%. Tumor progression (12.6%) and prosthetic infections (9.4%) were the most common failure modes, followed by soft-tissue failures (5.9%), aseptic loosening (3.5%), and structural failure (1.8%). Two-year, 5-year, and 10-year implant survival rates for the entire cohort were 86%, 81%, and 69.3%. Ten-year implant survival for primary THRs was 78.3%, compared with 38.6% for revision THRs (p = 0.049). The mean MSTS score at the last follow-up was 77%. Patients whose implants did not fail had a higher MSTS score (79.3%) than those with failed implants (71.4%) (p = 0.02). Conclusion: One-third of THR will fail, mostly due to tumor progression and prosthetic infection. Overall functional scores were acceptable, with MSTS scores displaying great hand and elbow function but limited shoulder function. Level of Evidence: Level III. See Instructions for Authors for a complete description of levels of evidence.

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Section: Methodsmentioning

confidence: 99%

Postoperative Outcomes of Total Humerus Replacement for Oncologic Reconstruction of the Upper Limb

Gonzalez,

Werenski,

Lozano-Calderon

2024

JBJS Reviews

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“…We assessed the quality of the included studies using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist field. Ten of the 22 items of the STROBE checklist were used in accordance with previous studies in the orthopaedic literature [116][117][118][119][120] . Each item was graded on a scale of 0 to 2, with 2 points being used in well-described items, 1 point in partly described items, and 0 points in poorly described items.…”

Section: Assessment Of Study Qualitymentioning

confidence: 99%

Treatment and Outcomes of 4,973 Unicameral Bone Cysts

Ruiz-Arellanos,

Larios,

Inchaustegui

et al. 2024

JBJS Reviews

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» Unicameral bone cysts (UBCs) can increase the risk of pathologic fractures of both long and short bones. Although multiple treatments exist, data are conflicting regarding optimal management.» We sought to analyze treatment strategies for UBCs and their rates of successful treatment.» Success rates were analyzed according to treatment modality, with emphasis on filling techniques and/or decompression associated with curettage, and injection compounds.» Curettage with bone substitute and cyst decompression was identified as a highly successful technique for UBC treatment.» Decompressing the cyst wall after injection, regardless of the specific compound used, had a greater potential to enhance healing rates.» The management decision should be individually guided within the patient's context. Level of Evidence: Level III. See Instructions for Authors for a complete description of levels of evidence.

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“…Ten of the 22 items of the STROBE checklist were used as reported in previous orthopaedic literature. 3,11,12,16 Each item was graded on a scale of 0-2, with 2 points being used in well-described items, 1 point in partly described items, and 0 points in poorly described items. Studies with a cumulative score equal to or higher than 15 points were included.…”

Section: Assessment Of Study Qualitymentioning

confidence: 99%

Foot and Ankle Soft Tissue Sarcomas–Treatment and Oncologic Outcomes: A Systematic Review of the Literature

Fanfan,

Alvarez,

Gonzalez

et al. 2023

Foot Ankle Int.

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Background: Foot and ankle soft tissue sarcomas (STSs) are rare neoplasms associated with a high risk of local recurrence and metastasis. Although amputation is often performed, its impact on prognosis remains unknown. The aims of our systematic review were identifying risk factors for (1) disease-specific death, (2) local recurrence, (3) metastasis, and assessing (4) whether the type of surgery (amputation or limb-salvage) affected disease-specific survival. Methods: This systematic review was conducted following PRISMA guidelines. The PubMed, Embase, and Scopus databases were searched. Our study was registered in PROSPERO (ID: 415624). Quality appraisal was done using STROBE guidelines. Results: A total of 7 studies and 123 patients were included. Metastasis was the only risk factor for disease-specific death (OR = 107.85, P< .001). Previous unplanned excision (OR = 22.29, P = .009) and positive margins (OR = 64.48, P = .011) were associated with higher risk of local recurrence. Patients with high-grade tumors (OR = 13.22, P = .023) and tumors ≥6 cm (OR = 7.40, P = .022) were more likely to develop metastases. After adjusting for confounders (age, sex, and presence of metastasis), amputation was not associated with poorer disease-specific survival. Conclusion: Metastasis was the single most important risk factor for death with foot and ankle soft tissue sarcoma. Positive margins and history of previous unplanned excision are risk factors for local recurrence. The most important risk factors for metastasis are tumor grade and size ≥6 cm. Amputation was not associated with poorer disease-specific survival.

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Surgical Management of Metastatic Pathologic Subtrochanteric Fractures

Cited by 9 publications

References 36 publications

Postoperative Outcomes of Total Humerus Replacement for Oncologic Reconstruction of the Upper Limb

Postoperative Outcomes of Total Humerus Replacement for Oncologic Reconstruction of the Upper Limb

Treatment and Outcomes of 4,973 Unicameral Bone Cysts

Foot and Ankle Soft Tissue Sarcomas–Treatment and Oncologic Outcomes: A Systematic Review of the Literature

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