UNCEMENTED ARTHROPLASTY AFTER HIP METASTATIC DISEASE AND MULTIPLE MYELOMA

ABSTRACT Objective: To describe a case series using a combination of narrative, graphical exploratory analysis and Bayesian Network modeling. Methods: Case series with 34 patients undergoing uncemented and hybrid arthroplasty procedures secondary to hip pain or fracture secondary to metastatic disease or multiple myeloma. Results: The most common tumors included gastrointestinal, multiple myeloma and breast cancer. Most devices were total arthroplasty (n = 16, 84.2%) rather than partial and uncemented arthroplasty (n = 12, 63.2%) rather than hybrid. The average time between surgery and deambulation was 20 days, the average length of hospital stay was 13 days, and the average patient survival was 589 days. Only one infection was reported. Uncemented and hybrid arthroplasty devices did not differ regarding time to walk, as well as the length of hospital stay in this sample. Conclusion: Our model may be used as a prior for the addition of subsequent patient samples, personalizing, thus, its recommendations to other patient populations. Level of Evidence IV, Case series.

Gct: what happened after 10 years of curettage and cement? Retrospective study of 46 cases

Comparar o resultado funcional de pacientes tratados portumor de células gigantes (TCG) que evoluíram com e sem artrose, edeterminar se o desenvolvimento da artrose está relacionado à distânciaentre o tumor e o osso subcondral. Métodos: 46 pacientes tratadospor TCG entre 1975 e 1999 preencheram os critérios de inclusão. OTCG foi diagnosticado por biópsia percutânea e confirmado após aressecção em todos os casos. As classificações de Campanacci eKellgren, a distância do cimento para o osso subcondral e o escorede MSTS foram obtidos para todos os casos. Resultados: A distânciado cimento para o osso subcondral está associada ao maior risco dedesenvolver artrose, mas não houve diferença nos escores funcionaisde MSTS entre os pacientes com e sem artrose. Conclusão: A distânciaentre o cimento e o osso subcondral tem valor prognóstico comrelação ao aparecimento de artrose, mas isso não acarreta impactono resultado funcional. Nível de Evidência IV, Estudo Terapêutico...

To compare the functional outcome of patients with andwithout arthrosis, and to determine whether the development of arthrosisis related to the distance of the tumor from the subchondralbone. Methods: Forty six patients treated for Giant-cell tumor (GCT)between 1975 and 1999 met inclusion criteria. GCT was diagnosedby percutaneous biopsy and confirmed after resection, in allcases. Campanacci’s and Kellgren’s classification, the distance ofthe cement to the articular surface and MSTS score were obtainedthroughout the sample. Results: The distance of the cement to thesubchondral bone was associated with greater risk of developingarthrosis, but there was no difference in MSTS scores betweenpatients with or without arthrosis. Conclusion: We found that thedistance from the cement to the subchondral bone has a prognosticvalue regarding future arthrosis, but it does not impact on thefunctional outcome. Level of Evidence IV, Therapeutic Study...

Estudo comparativo prospectivo e randomizado entre o tratamento cirúrgico das fraturas diafisárias do úmero com placa em ponte e haste intramedular bloqueada (análise preliminar) / Comparative, prospective and randomized study of humeral shaft fractures requiring surgical treatment: bridging plate versus locked intramedullary nail (preliminary analysys)

A grande maioria das fraturas de diáfise de úmero são de tratamento conservador. As indicações absolutas(ie lesão vascular) e relativas(ie paralisia nervosa primária) para tratamento cirúrgico estão bem estabelecidas na literatura. Os dois principais métodos utilizados para tal, a placa de auto-compressão e a haste intramedular travada possuem estudos comparando-os.No entanto não existem trabalhos comparando a haste intramedular com a placa em ponte e é a este fim que o presente estudo destina-se.

The treatment of the great majority of humeral shaft fractures is conservative. Absolute indications (i.e., vascular injury) and relative indications (i.e., primary nervous palsy) for surgical treatment are well established by literature. The two most used methods for that purpose - the self - compression plate and the locked intramedullary nail - have already been comparatively studied. However, there are no studies comparing intramedullary nails to the bridging plate, therefore, this is the objective of the present study.