Unrecognized Chondrosarcoma as a Cause of Total Hip Arthroplasty Failure.
Chondrosarcoma
Delayed
Hip replacement
Misdiagnosis
Total hip prosthesis
Unrecognized
Journal
Arthroplasty today
ISSN: 2352-3441
Titre abrégé: Arthroplast Today
Pays: United States
ID NLM: 101681808
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
17
06
2020
revised:
20
11
2020
accepted:
07
12
2020
entrez:
1
2
2021
pubmed:
2
2
2021
medline:
2
2
2021
Statut:
epublish
Résumé
Total hip arthroplasty (THA) is one of the most successful procedures in orthopedic surgery. The most frequent THA indications are osteoarthritis and avascular necrosis, whereas symptomatic aseptic loosening is the most common indication to revision surgery. Chondrosarcoma (CS) is the most frequent bone sarcoma in adults, and proximal femur is the most prevalent location. Wide resection is the treatment of choice.We report 3 cases of unrecognized high-grade CS in the setting of primary or revision THA and reviewed the literature on this rare clinical presentation. A systematic literature review on CS in the setting of THA, published between 1980 and 2020, was performed on PubMed, Embase, Medline, Ovid SP, and Web of Science, using the guidelines set in the Preferred Reporting Items for Systematic Reviews and Mata-analyses (PRISMA). Case series: Three patients were referred to our sarcoma center after failure of THA due to unrecognized high-grade CS. All 3 had rapid fatal outcome. Literature review: Fifty-nine articles were identified, of which 8 were included in the study. They confirmed that primary or revision THA failure due to unrecognized CS is extremely rare, with only few cases reported in the literature. Before proceeding to primary or revision arthroplasty, diagnosis must be ascertained. Atypical presentation of a common pathology, such as osteoarthritis, avascular necrosis, or aseptic loosening of an endoprosthesis, should raise suspicion for another cause to symptoms, and additional workup be performed. As our cases demonstrated, unrecognized or inadequately managed bone sarcoma may lead to poor or even fatal outcome.
Sections du résumé
BACKGROUND
BACKGROUND
Total hip arthroplasty (THA) is one of the most successful procedures in orthopedic surgery. The most frequent THA indications are osteoarthritis and avascular necrosis, whereas symptomatic aseptic loosening is the most common indication to revision surgery. Chondrosarcoma (CS) is the most frequent bone sarcoma in adults, and proximal femur is the most prevalent location. Wide resection is the treatment of choice.We report 3 cases of unrecognized high-grade CS in the setting of primary or revision THA and reviewed the literature on this rare clinical presentation.
METHODS
METHODS
A systematic literature review on CS in the setting of THA, published between 1980 and 2020, was performed on PubMed, Embase, Medline, Ovid SP, and Web of Science, using the guidelines set in the Preferred Reporting Items for Systematic Reviews and Mata-analyses (PRISMA).
RESULTS
RESULTS
Case series: Three patients were referred to our sarcoma center after failure of THA due to unrecognized high-grade CS. All 3 had rapid fatal outcome. Literature review: Fifty-nine articles were identified, of which 8 were included in the study. They confirmed that primary or revision THA failure due to unrecognized CS is extremely rare, with only few cases reported in the literature.
CONCLUSIONS
CONCLUSIONS
Before proceeding to primary or revision arthroplasty, diagnosis must be ascertained. Atypical presentation of a common pathology, such as osteoarthritis, avascular necrosis, or aseptic loosening of an endoprosthesis, should raise suspicion for another cause to symptoms, and additional workup be performed. As our cases demonstrated, unrecognized or inadequately managed bone sarcoma may lead to poor or even fatal outcome.
Identifiants
pubmed: 33521202
doi: 10.1016/j.artd.2020.12.005
pii: S2352-3441(20)30243-0
pmc: PMC7818612
doi:
Types de publication
Journal Article
Langues
eng
Pagination
84-90Informations de copyright
© 2020 The Authors.
Références
J Surg Oncol. 2017 Aug;116(2):252-257
pubmed: 28420036
Clin Orthop Relat Res. 1990 Mar;(252):299-306
pubmed: 2406070
Rev Med Suisse. 2010 Dec 22;6(276):2454-8
pubmed: 21250424
Can J Surg. 1998 Aug;41(4):273-82
pubmed: 9711160
Hip Int. 2020 Jan;30(1):64-70
pubmed: 31364408
Sarcoma. 2016;2016:2549616
pubmed: 27199613
J Bone Joint Surg Am. 2001 Nov;83(11):1630-42
pubmed: 11701784
Singapore Med J. 2014 Mar;55(3):e49-51
pubmed: 24664395
Rev Bras Ortop. 2016 Dec 30;52(6):748-754
pubmed: 29234663
J Arthroplasty. 2006 Apr;21(3):311-23
pubmed: 16627137
Clin Orthop Relat Res. 1990 Nov;(260):212-4
pubmed: 2225626
Bone Joint J. 2016 Nov;98-B(11):1542-1547
pubmed: 27803232
Arch Phys Med Rehabil. 2001 Oct;82(10):1472-5
pubmed: 11588755
J Bone Joint Surg Am. 2002;84-A Suppl 2:2-20
pubmed: 12479335
Lancet. 2007 Oct 27;370(9597):1508-19
pubmed: 17964352
JBJS Case Connect. 2020 Jan-Mar;10(1):e0324
pubmed: 32224655
Acta Oncol. 2019 Mar;58(3):273-282
pubmed: 30632866
J Bone Joint Surg Br. 1992 Sep;74(5):740-4
pubmed: 1326562
J Bone Joint Surg Am. 1990 Aug;72(7):1097-9
pubmed: 2384511
Curr Treat Options Oncol. 2009 Apr;10(1-2):94-106
pubmed: 19238552
Hip Int. 2015 Jan-Feb;25(1):98-100
pubmed: 25198302
Cancer. 2006 Jun 15;106(12):2682-91
pubmed: 16691621
J Bone Joint Surg Am. 2017 Feb 1;99(3):e9
pubmed: 28145959
Eur J Radiol. 2012 Dec;81(12):3793-801
pubmed: 21524868
Int Orthop. 2018 Dec;42(12):2941-2948
pubmed: 29681020
Radiology. 2010 Jun;255(3):857-65
pubmed: 20392983
Clin Orthop Relat Res. 2007 Jun;459:40-7
pubmed: 17414166
J Bone Joint Surg Br. 1997 Jul;79(4):583-9
pubmed: 9250743
Radiographics. 2004 Sep-Oct;24(5):1397-409
pubmed: 15371616
J Arthroplasty. 2009 Aug;24(5):728-34
pubmed: 18639434
PLoS One. 2017 Mar 16;12(3):e0173665
pubmed: 28301537
Oncologist. 2011;16(12):1771-9
pubmed: 22147000
Int Orthop. 2008 Oct;32(5):597-604
pubmed: 17443324
Clin Orthop Relat Res. 2017 Mar;475(3):686-695
pubmed: 27020434
Rom J Morphol Embryol. 2011;52(2):709-13
pubmed: 21655665
Ann Phys Rehabil Med. 2016 Jun;59(3):161-169
pubmed: 26797169
Skeletal Radiol. 1997 Jun;26(6):366-9
pubmed: 9229420
J Natl Cancer Inst. 2001 Sep 19;93(18):1405-10
pubmed: 11562392
Eur J Radiol. 2007 Jul;63(1):36-48
pubmed: 17555904