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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Autores principales:	Tomohiro Fujiwara, Yusuke Tsuda, Jonathan Stevenson, Michael Parry, Lee Jeys
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Sarcoma Pelvis Extra-articular resection Intra-articular resection Hip joint Diseases of the musculoskeletal system RC925-935 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/9cd0601092ff4fe0ac810ae9e8ca1f95
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spelling	oai:doaj.org-article:9cd0601092ff4fe0ac810ae9e8ca1f952021-11-12T04:32:32ZExtra-articular resection of the hip joint for pelvic sarcomas: Are there any oncological and functional risks compared with intra-articular resection?2212-137410.1016/j.jbo.2021.100401https://doaj.org/article/9cd0601092ff4fe0ac810ae9e8ca1f952021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2212137421000567https://doaj.org/toc/2212-1374Background: 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.Tomohiro FujiwaraYusuke TsudaJonathan StevensonMichael ParryLee JeysElsevierarticleSarcomaPelvisExtra-articular resectionIntra-articular resectionHip jointDiseases of the musculoskeletal systemRC925-935Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENJournal of Bone Oncology, Vol 31, Iss , Pp 100401- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Sarcoma Pelvis Extra-articular resection Intra-articular resection Hip joint Diseases of the musculoskeletal system RC925-935 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Sarcoma Pelvis Extra-articular resection Intra-articular resection Hip joint Diseases of the musculoskeletal system RC925-935 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 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?
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.
format	article
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
title	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_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_sort	extra-articular resection of the hip joint for pelvic sarcomas: are there any oncological and functional risks compared with intra-articular resection?
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/9cd0601092ff4fe0ac810ae9e8ca1f95
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Extra-articular resection of the hip joint for pelvic sarcomas: Are there any oncological and functional risks compared with intra-articular resection?

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