Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Operative Treatment for Metastatic Disease of the Pelvis and the Proximal.

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Chapter 87: Orthopedic Treatment of Metastatic Bone Disease

Bilateral atypical femoral fracture and end-stage arthritis of the hip, treated with total hip arthroplasty Scott M. Sandilands, DO, Jesus M. Villa,

Presentation transcript:

Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Operative Treatment for Metastatic Disease of the Pelvis and the Proximal End of the Femur*† by TIMOTHY A. DAMRON, and FRANKLIN H. SIM J Bone Joint Surg Am Volume 82(1): January 1, 2000 ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1-A: Preoperative anteroposterior radiograph of a right hip, showing a fracture of the femoral neck secondary to metastatic prostate cancer. TIMOTHY A. DAMRON, and FRANKLIN H. SIM J Bone Joint Surg Am 2000;82: ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 1-B: Anteroposterior radiograph made after bipolar hemiarthroplasty with use of a long- stem femoral component. TIMOTHY A. DAMRON, and FRANKLIN H. SIM J Bone Joint Surg Am 2000;82: ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 2-A: Preoperative anteroposterior radiograph of the proximal end of a left femur, showing a laterally based area of intertrochanteric destruction (arrows) secondary to metastatic breast cancer. TIMOTHY A. DAMRON, and FRANKLIN H. SIM J Bone Joint Surg Am 2000;82: ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 2-B: Anteroposterior radiograph made after prophylactic intertrochanteric fixation with a dynamic hip-screw augmented with methylmethacrylate and a supplementary screw. TIMOTHY A. DAMRON, and FRANKLIN H. SIM J Bone Joint Surg Am 2000;82: ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 3-A: Anteroposterior radiograph of the proximal end of a right femur, showing a pathological intertrochanteric fracture secondary to metastatic breast cancer. TIMOTHY A. DAMRON, and FRANKLIN H. SIM J Bone Joint Surg Am 2000;82: ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 3-B: Anteroposterior radiograph made after bipolar hemiarthroplasty with insertion of a long-stem calcar-replacement prosthesis with cement. TIMOTHY A. DAMRON, and FRANKLIN H. SIM J Bone Joint Surg Am 2000;82: ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 4-A: Anteroposterior radiograph of the proximal end of a left femur, showing a large lytic destructive area in the subtrochanteric region (arrows) that was representative of an impending pathological fracture secondary to metastatic hypernephroma. TIMOTHY A. DAMRON, and FRANKLIN H. SIM J Bone Joint Surg Am 2000;82: ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 4-B: Anteroposterior radiograph made after prophylactic fixation with a reconstruction intramedullary nail. TIMOTHY A. DAMRON, and FRANKLIN H. SIM J Bone Joint Surg Am 2000;82: ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 5-A Anteroposterior radiograph of a left femur, showing extensive destruction and a subtrochanteric pathological fracture. TIMOTHY A. DAMRON, and FRANKLIN H. SIM J Bone Joint Surg Am 2000;82: ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 5-B Anteroposterior radiograph made after resection of the diseased proximal femoral bone and reconstruction with an early type of nonmodular proximal femoral replacement hemiarthroplasty performed with cement. TIMOTHY A. DAMRON, and FRANKLIN H. SIM J Bone Joint Surg Am 2000;82: ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 6-A Anteroposterior radiograph of the left side of a pelvis, showing a class-II defect23 of the acetabular wall (arrow) secondary to metastatic breast cancer. TIMOTHY A. DAMRON, and FRANKLIN H. SIM J Bone Joint Surg Am 2000;82: ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 6-B Anteroposterior radiograph made after total hip arthroplasty with acetabular reconstruction with a Ganz antiprotrusio ring, screws, and cement. TIMOTHY A. DAMRON, and FRANKLIN H. SIM J Bone Joint Surg Am 2000;82: ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 7-A Anteroposterior radiograph of the pelvis, showing a solitary metastasis from hypernephroma involving the right ischium (arrows) and extending to the acetabulum. TIMOTHY A. DAMRON, and FRANKLIN H. SIM J Bone Joint Surg Am 2000;82: ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 7-B Anteroposterior radiograph made after excision of the involved bone segment and reconstruction with a saddle prosthesis. TIMOTHY A. DAMRON, and FRANKLIN H. SIM J Bone Joint Surg Am 2000;82: ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 8 Conceptual illustration showing the typical complex reconstruction of a class-III defect23 in the acetabulum with flexible Steinmann pins and an antiprotrusio device. TIMOTHY A. DAMRON, and FRANKLIN H. SIM J Bone Joint Surg Am 2000;82: ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 9-A Anteroposterior radiograph of the pelvis, showing a class-III defect23 of the left acetabular dome and the peripheral rim due to metastatic renal cancer. TIMOTHY A. DAMRON, and FRANKLIN H. SIM J Bone Joint Surg Am 2000;82: ©2000 by The Journal of Bone and Joint Surgery, Inc.

Fig. 9-B Anteroposterior radiograph of the left side of the pelvis, made after reconstruction with Steinmann pins and an antiprotrusio device as part of a total hip arthroplasty performed with cement. TIMOTHY A. DAMRON, and FRANKLIN H. SIM J Bone Joint Surg Am 2000;82: ©2000 by The Journal of Bone and Joint Surgery, Inc.