The use of polymethylmethacrylate in the management of hydatid disease of bone

Abstract

H ydatid disease of bone is rare. It probably represents between 0.5% and 4% of all human hydatid disease and, in about 60% of patients, affects the spine or pelvis. Between 1986 and 1998, we treated 15 cases of bone hydatidosis. Curettage, swabbing with povidone iodine and filling the defect with polymethylmethacrylate (PMMA) were carried out in ten patients. Three of these had a recurrence after five years, but seven had no signs of relapse during a mean follow-up of 52 months. We believe that the combination of antihelminthic therapy, wide resection and the use of PMMA gives the best outcome in the treatment of bone hydatidosis.

Primary Hydatidosis Of The Tibia: A Tricky Diagnosis

“…The patient may present with leg pain along with a palpable tumor, a pathologic fracture, or an infection. X-rays will show a single or multiple osteolytic cystic images [5] , it can be multilocular with reactive sclerosis forming a honeycombing pattern [6] . Periosteal thickening may appear on xray if there is a pathological fracture [7] .…”

“…But Booz revealed good results with curettage and bone grafting with pre and post operative chemotherapy and indicated radical resection for "uncontrollable cases" [18] while still considering total resection as the best solutions in the fibula and ribs. After curettage, scolecidal agents may be used, such as formalin and hypertonic saline, but it has been suggested that they do not kill all microscopic daughter cysts [6] . Yildiz has suggested the use of PMMA to fill the cavity instead of bone grafts, because cysts can recur in these bone grafts [6] .…”

“…After curettage, scolecidal agents may be used, such as formalin and hypertonic saline, but it has been suggested that they do not kill all microscopic daughter cysts [6] . Yildiz has suggested the use of PMMA to fill the cavity instead of bone grafts, because cysts can recur in these bone grafts [6] . It was suggested that the thermal energy and free radicals released during polymerization have a scolicidal effect.…”

Treatment of Hydatid Disease of the Tibia by Using Poly-Methyl Methacrylate (PMMA) Bone Cements, Clinical Results of a Case Series

“…It is proposed to have necrotic and lethal effects on remained daughter cysts (21)(22)(23). Monomers and other free radicals which release during the polymerization from PMMA might be toxic for living cells (21)(22)(23).…”

Primary hydatid cyst of the root of the thigh: a case report and review of the literature

“…Among them Echinococcus granulosus is the one most frequently responsible for human hydatidosis [1,2]. Hydatid disease of bone is a rare event, as it usually occurs in 0.5%-4% of human echinococcosis cases, even if there is some geographic variability in its incidence [1][2][3][4][5][6][7]; also soft tissue involvement is quite rare, either when it is primary or, more often, when it is secondary to the expansion of an adjacent bony lesion.…”