Tumor Endoprosthesis Revision Rates Increase With Peri-Operative Chemotherapy But Are Reduced With the Use of Cemented Implant Fixation
Abstract Chemotherapy may reduce osseointegration of tumor endoprosthesis, while delaying chemotherapy may reduce survival. We studied the effects of chemotherapy and cemented fixation on tumor endoprosthesis survivorship with a retrospective analysis of 50 consecutive patients receiving lower limb...
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| Veröffentlicht in: | The Journal of arthroplasty 2014-07, Vol.29 (7), p.1418-1422 |
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| container_title | The Journal of arthroplasty |
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| creator | Pugh, Luke R., MD, FRCSC Clarkson, Paul W., MD, MSc, FRCSC Phillips, Amy E., MASc Biau, David J., MD Masri, Bassam A., MD, FRCSC |
| description | Abstract Chemotherapy may reduce osseointegration of tumor endoprosthesis, while delaying chemotherapy may reduce survival. We studied the effects of chemotherapy and cemented fixation on tumor endoprosthesis survivorship with a retrospective analysis of 50 consecutive patients receiving lower limb salvage surgery. We compared rates of radiographic loosening/revision and effect of cement fixation between chemotherapy/no chemotherapy cohorts. Chemotherapy increased the total revision rate (HR = 3.8 [1–14], P = 0.033), but did not affect aseptic loosening. Cement fixation reduced revision for loosening (HR = 0.09 (0.008–0.98), P = 0.012) and showed less radiographic loosening (HR = 0.09 (0.02–0.51), P = 0.00066). Cement fixation had lower rates of revision for loosening and radiographic loosening regardless of whether chemotherapy was given. We conclude that for these implants, cement fixation provides superior results to uncemented fixation. |
| doi_str_mv | 10.1016/j.arth.2014.01.010 |
| format | Article |
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We studied the effects of chemotherapy and cemented fixation on tumor endoprosthesis survivorship with a retrospective analysis of 50 consecutive patients receiving lower limb salvage surgery. We compared rates of radiographic loosening/revision and effect of cement fixation between chemotherapy/no chemotherapy cohorts. Chemotherapy increased the total revision rate (HR = 3.8 [1–14], P = 0.033), but did not affect aseptic loosening. Cement fixation reduced revision for loosening (HR = 0.09 (0.008–0.98), P = 0.012) and showed less radiographic loosening (HR = 0.09 (0.02–0.51), P = 0.00066). Cement fixation had lower rates of revision for loosening and radiographic loosening regardless of whether chemotherapy was given. We conclude that for these implants, cement fixation provides superior results to uncemented fixation.</description><identifier>ISSN: 0883-5403</identifier><identifier>EISSN: 1532-8406</identifier><identifier>DOI: 10.1016/j.arth.2014.01.010</identifier><identifier>PMID: 24612735</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Antineoplastic Agents - therapeutic use ; Bone Cements - therapeutic use ; cementation ; chemotherapy ; Chondrosarcoma - drug therapy ; Chondrosarcoma - surgery ; endoprosthesis ; Female ; Hip Prosthesis ; Humans ; implant survivorship ; Male ; malignancy ; Middle Aged ; Neoplasms - drug therapy ; Neoplasms - surgery ; Orthopedics ; Osteosarcoma - drug therapy ; Osteosarcoma - surgery ; Prosthesis Design ; Prosthesis Failure ; Reoperation ; Retrospective Studies ; Salvage Therapy ; surgical fixation</subject><ispartof>The Journal of arthroplasty, 2014-07, Vol.29 (7), p.1418-1422</ispartof><rights>Elsevier Inc.</rights><rights>2014 Elsevier Inc.</rights><rights>Copyright © 2014 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c481t-13e2a22d13299d6195f4b4d07b53d3629519f1f4760270f5eca154e58ba5d9d03</citedby><cites>FETCH-LOGICAL-c481t-13e2a22d13299d6195f4b4d07b53d3629519f1f4760270f5eca154e58ba5d9d03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.arth.2014.01.010$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27928,27929,45999</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24612735$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pugh, Luke R., MD, FRCSC</creatorcontrib><creatorcontrib>Clarkson, Paul W., MD, MSc, FRCSC</creatorcontrib><creatorcontrib>Phillips, Amy E., MASc</creatorcontrib><creatorcontrib>Biau, David J., MD</creatorcontrib><creatorcontrib>Masri, Bassam A., MD, FRCSC</creatorcontrib><title>Tumor Endoprosthesis Revision Rates Increase With Peri-Operative Chemotherapy But Are Reduced With the Use of Cemented Implant Fixation</title><title>The Journal of arthroplasty</title><addtitle>J Arthroplasty</addtitle><description>Abstract Chemotherapy may reduce osseointegration of tumor endoprosthesis, while delaying chemotherapy may reduce survival. We studied the effects of chemotherapy and cemented fixation on tumor endoprosthesis survivorship with a retrospective analysis of 50 consecutive patients receiving lower limb salvage surgery. We compared rates of radiographic loosening/revision and effect of cement fixation between chemotherapy/no chemotherapy cohorts. Chemotherapy increased the total revision rate (HR = 3.8 [1–14], P = 0.033), but did not affect aseptic loosening. Cement fixation reduced revision for loosening (HR = 0.09 (0.008–0.98), P = 0.012) and showed less radiographic loosening (HR = 0.09 (0.02–0.51), P = 0.00066). Cement fixation had lower rates of revision for loosening and radiographic loosening regardless of whether chemotherapy was given. We conclude that for these implants, cement fixation provides superior results to uncemented fixation.</description><subject>Adult</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Bone Cements - therapeutic use</subject><subject>cementation</subject><subject>chemotherapy</subject><subject>Chondrosarcoma - drug therapy</subject><subject>Chondrosarcoma - surgery</subject><subject>endoprosthesis</subject><subject>Female</subject><subject>Hip Prosthesis</subject><subject>Humans</subject><subject>implant survivorship</subject><subject>Male</subject><subject>malignancy</subject><subject>Middle Aged</subject><subject>Neoplasms - drug therapy</subject><subject>Neoplasms - surgery</subject><subject>Orthopedics</subject><subject>Osteosarcoma - drug therapy</subject><subject>Osteosarcoma - surgery</subject><subject>Prosthesis Design</subject><subject>Prosthesis Failure</subject><subject>Reoperation</subject><subject>Retrospective Studies</subject><subject>Salvage Therapy</subject><subject>surgical fixation</subject><issn>0883-5403</issn><issn>1532-8406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kk2LFDEQhhtR3HH1D3iQHL30mMpHf4AI67AfAwsr6y4eQyapZjJOd9okPTi_wL9tmlk9eBAKcqj3fUi9VUXxFugSKFQfdksd0nbJKIglhVz0WbEAyVnZCFo9Lxa0aXgpBeVnxasYd5QCSCleFmdMVMBqLhfFr4ep94FcDtaPwce0xegiuceDi84P5F4njGQ9mIA6Ivnm0pZ8weDKuxGDTu6AZLXF3mdf0OORfJ4SuQiYAXYyaE-G3CSP2e07ssIeh5Qb637c6yGRK_czY_zwunjR6X3EN0_vefF4dfmwuilv767Xq4vb0ogGUgkcmWbMAmdtaytoZSc2wtJ6I7nlFWsltB10oq4oq2kn0WiQAmWz0dK2lvLz4v2Jm6f9MWFMqnfR4D5_Bv0UVY6vrQEYQJayk9TkYGLATo3B9TocFVA1L0Dt1LwANS9AUcg189898adNj_av5U_iWfDxJMA85cFhUNE4HHJYLqBJynr3f_6nf-xm7wZn9P47HjHu_BSGnJ8CFZmi6ut8AvMFgKCUcgb8N8N1rDA</recordid><startdate>20140701</startdate><enddate>20140701</enddate><creator>Pugh, Luke R., MD, FRCSC</creator><creator>Clarkson, Paul W., MD, MSc, FRCSC</creator><creator>Phillips, Amy E., MASc</creator><creator>Biau, David J., MD</creator><creator>Masri, Bassam A., MD, FRCSC</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140701</creationdate><title>Tumor Endoprosthesis Revision Rates Increase With Peri-Operative Chemotherapy But Are Reduced With the Use of Cemented Implant Fixation</title><author>Pugh, Luke R., MD, FRCSC ; Clarkson, Paul W., MD, MSc, FRCSC ; Phillips, Amy E., MASc ; Biau, David J., MD ; Masri, Bassam A., MD, FRCSC</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c481t-13e2a22d13299d6195f4b4d07b53d3629519f1f4760270f5eca154e58ba5d9d03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Bone Cements - therapeutic use</topic><topic>cementation</topic><topic>chemotherapy</topic><topic>Chondrosarcoma - drug therapy</topic><topic>Chondrosarcoma - surgery</topic><topic>endoprosthesis</topic><topic>Female</topic><topic>Hip Prosthesis</topic><topic>Humans</topic><topic>implant survivorship</topic><topic>Male</topic><topic>malignancy</topic><topic>Middle Aged</topic><topic>Neoplasms - drug therapy</topic><topic>Neoplasms - surgery</topic><topic>Orthopedics</topic><topic>Osteosarcoma - drug therapy</topic><topic>Osteosarcoma - surgery</topic><topic>Prosthesis Design</topic><topic>Prosthesis Failure</topic><topic>Reoperation</topic><topic>Retrospective Studies</topic><topic>Salvage Therapy</topic><topic>surgical fixation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pugh, Luke R., MD, FRCSC</creatorcontrib><creatorcontrib>Clarkson, Paul W., MD, MSc, FRCSC</creatorcontrib><creatorcontrib>Phillips, Amy E., MASc</creatorcontrib><creatorcontrib>Biau, David J., MD</creatorcontrib><creatorcontrib>Masri, Bassam A., MD, FRCSC</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of arthroplasty</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pugh, Luke R., MD, FRCSC</au><au>Clarkson, Paul W., MD, MSc, FRCSC</au><au>Phillips, Amy E., MASc</au><au>Biau, David J., MD</au><au>Masri, Bassam A., MD, FRCSC</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tumor Endoprosthesis Revision Rates Increase With Peri-Operative Chemotherapy But Are Reduced With the Use of Cemented Implant Fixation</atitle><jtitle>The Journal of arthroplasty</jtitle><addtitle>J Arthroplasty</addtitle><date>2014-07-01</date><risdate>2014</risdate><volume>29</volume><issue>7</issue><spage>1418</spage><epage>1422</epage><pages>1418-1422</pages><issn>0883-5403</issn><eissn>1532-8406</eissn><abstract>Abstract Chemotherapy may reduce osseointegration of tumor endoprosthesis, while delaying chemotherapy may reduce survival. We studied the effects of chemotherapy and cemented fixation on tumor endoprosthesis survivorship with a retrospective analysis of 50 consecutive patients receiving lower limb salvage surgery. We compared rates of radiographic loosening/revision and effect of cement fixation between chemotherapy/no chemotherapy cohorts. Chemotherapy increased the total revision rate (HR = 3.8 [1–14], P = 0.033), but did not affect aseptic loosening. Cement fixation reduced revision for loosening (HR = 0.09 (0.008–0.98), P = 0.012) and showed less radiographic loosening (HR = 0.09 (0.02–0.51), P = 0.00066). Cement fixation had lower rates of revision for loosening and radiographic loosening regardless of whether chemotherapy was given. We conclude that for these implants, cement fixation provides superior results to uncemented fixation.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24612735</pmid><doi>10.1016/j.arth.2014.01.010</doi><tpages>5</tpages></addata></record> |
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| subjects | Adult Antineoplastic Agents - therapeutic use Bone Cements - therapeutic use cementation chemotherapy Chondrosarcoma - drug therapy Chondrosarcoma - surgery endoprosthesis Female Hip Prosthesis Humans implant survivorship Male malignancy Middle Aged Neoplasms - drug therapy Neoplasms - surgery Orthopedics Osteosarcoma - drug therapy Osteosarcoma - surgery Prosthesis Design Prosthesis Failure Reoperation Retrospective Studies Salvage Therapy surgical fixation |
| title | Tumor Endoprosthesis Revision Rates Increase With Peri-Operative Chemotherapy But Are Reduced With the Use of Cemented Implant Fixation |
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