Extra-articular resection of the hip joint for pelvic sarcomas: Are there any oncological and functional risks compared with intra-articular resection?
Background: While extra-articular resection (EAR) of the knee and shoulder joint is associated with poorer clinical outcomes, the oncological and functional risks of EAR of the hip joint are unknown. We aimed to compare these risks between EAR of the hip joint and intra-articular resection (IAR). Me...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-12-01
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| Series: | Journal of Bone Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2212137421000567 |
| _version_ | 1818752911201533952 |
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| author | Tomohiro Fujiwara Yusuke Tsuda Jonathan Stevenson Michael Parry Lee Jeys |
| author_facet | Tomohiro Fujiwara Yusuke Tsuda Jonathan Stevenson Michael Parry Lee Jeys |
| author_sort | Tomohiro Fujiwara |
| collection | DOAJ |
| description | Background: While extra-articular resection (EAR) of the knee and shoulder joint is associated with poorer clinical outcomes, the oncological and functional risks of EAR of the hip joint are unknown. We aimed to compare these risks between EAR of the hip joint and intra-articular resection (IAR). Methods: We conducted a comparative study of 75 patients who underwent en-bloc tumour resection and limb-salvage reconstruction for bone sarcomas of the peri-acetabulum between 1996 and 2016. We divided patients into two groups for analyses; EAR (n = 21) and IAR (n = 54). Results: There was no statistical difference in oncological outcomes; the 5-year cumulative incidence of disease-specific death was 34% and 35% in the EAR and IAR groups, respectively (p = 0.943), and the 5-year cumulative incidence of LR was 26% and 34%, respectively (p = 0.482). The most common complications were dislocation (28%) and deep infection (28%); there was equally no difference between the groups. The mean Musculoskeletal Tumour Society score was 66% and 65% in the EAR and IAR groups, respectively (p = 0.795), and were significantly lower in patients with deep infection (52% vs. 69%; p = 0.013). In a sub-analysis on the outcomes in patients who underwent PI-uninvolved PII-resection for chondrosarcoma, no major differences in oncologic and functional outcomes were confirmed. Conclusion: Patients undergoing EAR and limb-salvage reconstructions of the hip joint have undistinguishable oncological, clinical and functional outcomes compared to those undergoing IAR and reconstructions. If preoperative imaging suggests articular tumour involvement, there appears to be no detrimental effect of undertaking EAR to optimise local control. |
| first_indexed | 2024-12-18T04:58:59Z |
| format | Article |
| id | doaj.art-9cd0601092ff4fe0ac810ae9e8ca1f95 |
| institution | Directory Open Access Journal |
| issn | 2212-1374 |
| language | English |
| last_indexed | 2024-12-18T04:58:59Z |
| publishDate | 2021-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Bone Oncology |
| spelling | doaj.art-9cd0601092ff4fe0ac810ae9e8ca1f952022-12-21T21:20:12ZengElsevierJournal of Bone Oncology2212-13742021-12-0131100401Extra-articular resection of the hip joint for pelvic sarcomas: Are there any oncological and functional risks compared with intra-articular resection?Tomohiro Fujiwara0Yusuke Tsuda1Jonathan Stevenson2Michael Parry3Lee Jeys4Oncology Service, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, United Kingdom; Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan; Corresponding author at: The Royal Orthopaedic Hospital, Bristol Road South, Birmingham B31 2AP, UK.Oncology Service, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, United KingdomOncology Service, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, United KingdomOncology Service, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, United KingdomOncology Service, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, United KingdomBackground: While extra-articular resection (EAR) of the knee and shoulder joint is associated with poorer clinical outcomes, the oncological and functional risks of EAR of the hip joint are unknown. We aimed to compare these risks between EAR of the hip joint and intra-articular resection (IAR). Methods: We conducted a comparative study of 75 patients who underwent en-bloc tumour resection and limb-salvage reconstruction for bone sarcomas of the peri-acetabulum between 1996 and 2016. We divided patients into two groups for analyses; EAR (n = 21) and IAR (n = 54). Results: There was no statistical difference in oncological outcomes; the 5-year cumulative incidence of disease-specific death was 34% and 35% in the EAR and IAR groups, respectively (p = 0.943), and the 5-year cumulative incidence of LR was 26% and 34%, respectively (p = 0.482). The most common complications were dislocation (28%) and deep infection (28%); there was equally no difference between the groups. The mean Musculoskeletal Tumour Society score was 66% and 65% in the EAR and IAR groups, respectively (p = 0.795), and were significantly lower in patients with deep infection (52% vs. 69%; p = 0.013). In a sub-analysis on the outcomes in patients who underwent PI-uninvolved PII-resection for chondrosarcoma, no major differences in oncologic and functional outcomes were confirmed. Conclusion: Patients undergoing EAR and limb-salvage reconstructions of the hip joint have undistinguishable oncological, clinical and functional outcomes compared to those undergoing IAR and reconstructions. If preoperative imaging suggests articular tumour involvement, there appears to be no detrimental effect of undertaking EAR to optimise local control.http://www.sciencedirect.com/science/article/pii/S2212137421000567SarcomaPelvisExtra-articular resectionIntra-articular resectionHip joint |
| spellingShingle | Tomohiro Fujiwara Yusuke Tsuda Jonathan Stevenson Michael Parry Lee Jeys Extra-articular resection of the hip joint for pelvic sarcomas: Are there any oncological and functional risks compared with intra-articular resection? Journal of Bone Oncology Sarcoma Pelvis Extra-articular resection Intra-articular resection Hip joint |
| title | Extra-articular resection of the hip joint for pelvic sarcomas: Are there any oncological and functional risks compared with intra-articular resection? |
| title_full | Extra-articular resection of the hip joint for pelvic sarcomas: Are there any oncological and functional risks compared with intra-articular resection? |
| title_fullStr | Extra-articular resection of the hip joint for pelvic sarcomas: Are there any oncological and functional risks compared with intra-articular resection? |
| title_full_unstemmed | Extra-articular resection of the hip joint for pelvic sarcomas: Are there any oncological and functional risks compared with intra-articular resection? |
| title_short | Extra-articular resection of the hip joint for pelvic sarcomas: Are there any oncological and functional risks compared with intra-articular resection? |
| title_sort | extra articular resection of the hip joint for pelvic sarcomas are there any oncological and functional risks compared with intra articular resection |
| topic | Sarcoma Pelvis Extra-articular resection Intra-articular resection Hip joint |
| url | http://www.sciencedirect.com/science/article/pii/S2212137421000567 |
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