Cemented vs uncemented megaprostheses in proximal femur metastases: a multicentric comparative study
Abstract Background Hip megaprostheses are a long known reconstructive method in the treatment of proximal femur metastases. The use of cemented or uncemented stems is still matter of debate. The aim of this study to compare cemented and uncemented megaprostheses on functional outcomes and complicat...
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-022-05726-7 |
| _version_ | 1797653587850952704 |
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| author | Maria Serena Oliva Francesco Muratori Raffaele Vitiello Antonio Ziranu Lorenzo Foschi Giuseppe Rovere Cesare Meschini Domenico Andrea Campanacci Giulio Maccauro |
| author_facet | Maria Serena Oliva Francesco Muratori Raffaele Vitiello Antonio Ziranu Lorenzo Foschi Giuseppe Rovere Cesare Meschini Domenico Andrea Campanacci Giulio Maccauro |
| author_sort | Maria Serena Oliva |
| collection | DOAJ |
| description | Abstract Background Hip megaprostheses are a long known reconstructive method in the treatment of proximal femur metastases. The use of cemented or uncemented stems is still matter of debate. The aim of this study to compare cemented and uncemented megaprostheses on functional outcomes and complications, in order to establish the role of cementation. Methods We retrospectively analysed 51 metastatic patients with proximal femur metastases treated with endoprosthetic reconstruction by megaprostheses, 25 with cementless stems and 26 with cemented ones with different megaprosthetic implants. The primary endpoint was MSTS score, and the secondary endpoint was to state the incidence of surgical and clinical complications in the two groups. An un-paired T test was used to compare anthropometric, anamnestic data, and MSTS. Chi-square test was performed for evaluation of complication in the two group. Multiple linear regression was used to match the functional outcomes and complications’ incidence in the population study. Logistic regression was performed to analyse the odds ratio of different parameters and their role in the incidence of complications. Results The mean follow-up was 50.1 months (+ 12.5). In thirty case right side was involved. No statistical differences were noticed between Group A and B regard the age, gender, active fracture/impending fracture. Comparing the MSTS results within the two groups at last follow-up, the score cemented group was higher than cementless one (17.9 + 7.8 vs 24.2 + 5.3; statistical significance p = 0.001). Regarding surgical complications a logistic regression was performed to analyse the odds ratio of age, cementation and length of resection; cementation confirm and odds ratio of 11 times in the incidence of surgical complications. Conclusions Cementation seems to be more liable to complications onset, while improves functional score in metastatic patients compared to uncemented megaprostheses. More studies have to be conducted in order to create a protocol and establish criteria to use cemented or uncemented stems in a frail population like metastatic patients. |
| first_indexed | 2024-03-11T16:46:45Z |
| format | Article |
| id | doaj.art-eb8601312e6845f1a016db1026099be4 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-11T16:46:45Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-eb8601312e6845f1a016db1026099be42023-10-22T11:03:49ZengBMCBMC Musculoskeletal Disorders1471-24742022-09-0122S21810.1186/s12891-022-05726-7Cemented vs uncemented megaprostheses in proximal femur metastases: a multicentric comparative studyMaria Serena Oliva0Francesco Muratori1Raffaele Vitiello2Antonio Ziranu3Lorenzo Foschi4Giuseppe Rovere5Cesare Meschini6Domenico Andrea Campanacci7Giulio Maccauro8Fondazione Policlinico Universitario Agostino Gemelli – IRCCSOrtopedia Oncologica e Ricostruttiva Azienda Ospedaliera Universitaria CareggiFondazione Policlinico Universitario Agostino Gemelli – IRCCSFondazione Policlinico Universitario Agostino Gemelli – IRCCSOrtopedia Oncologica e Ricostruttiva Azienda Ospedaliera Universitaria CareggiFondazione Policlinico Universitario Agostino Gemelli – IRCCSFondazione Policlinico Universitario Agostino Gemelli – IRCCSOrtopedia Oncologica e Ricostruttiva Azienda Ospedaliera Universitaria CareggiFondazione Policlinico Universitario Agostino Gemelli – IRCCSAbstract Background Hip megaprostheses are a long known reconstructive method in the treatment of proximal femur metastases. The use of cemented or uncemented stems is still matter of debate. The aim of this study to compare cemented and uncemented megaprostheses on functional outcomes and complications, in order to establish the role of cementation. Methods We retrospectively analysed 51 metastatic patients with proximal femur metastases treated with endoprosthetic reconstruction by megaprostheses, 25 with cementless stems and 26 with cemented ones with different megaprosthetic implants. The primary endpoint was MSTS score, and the secondary endpoint was to state the incidence of surgical and clinical complications in the two groups. An un-paired T test was used to compare anthropometric, anamnestic data, and MSTS. Chi-square test was performed for evaluation of complication in the two group. Multiple linear regression was used to match the functional outcomes and complications’ incidence in the population study. Logistic regression was performed to analyse the odds ratio of different parameters and their role in the incidence of complications. Results The mean follow-up was 50.1 months (+ 12.5). In thirty case right side was involved. No statistical differences were noticed between Group A and B regard the age, gender, active fracture/impending fracture. Comparing the MSTS results within the two groups at last follow-up, the score cemented group was higher than cementless one (17.9 + 7.8 vs 24.2 + 5.3; statistical significance p = 0.001). Regarding surgical complications a logistic regression was performed to analyse the odds ratio of age, cementation and length of resection; cementation confirm and odds ratio of 11 times in the incidence of surgical complications. Conclusions Cementation seems to be more liable to complications onset, while improves functional score in metastatic patients compared to uncemented megaprostheses. More studies have to be conducted in order to create a protocol and establish criteria to use cemented or uncemented stems in a frail population like metastatic patients.https://doi.org/10.1186/s12891-022-05726-7MetastasesProximal femurMegaprostheses |
| spellingShingle | Maria Serena Oliva Francesco Muratori Raffaele Vitiello Antonio Ziranu Lorenzo Foschi Giuseppe Rovere Cesare Meschini Domenico Andrea Campanacci Giulio Maccauro Cemented vs uncemented megaprostheses in proximal femur metastases: a multicentric comparative study BMC Musculoskeletal Disorders Metastases Proximal femur Megaprostheses |
| title | Cemented vs uncemented megaprostheses in proximal femur metastases: a multicentric comparative study |
| title_full | Cemented vs uncemented megaprostheses in proximal femur metastases: a multicentric comparative study |
| title_fullStr | Cemented vs uncemented megaprostheses in proximal femur metastases: a multicentric comparative study |
| title_full_unstemmed | Cemented vs uncemented megaprostheses in proximal femur metastases: a multicentric comparative study |
| title_short | Cemented vs uncemented megaprostheses in proximal femur metastases: a multicentric comparative study |
| title_sort | cemented vs uncemented megaprostheses in proximal femur metastases a multicentric comparative study |
| topic | Metastases Proximal femur Megaprostheses |
| url | https://doi.org/10.1186/s12891-022-05726-7 |
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