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Rodríguez-Zamorano P, Galán-Olleros M, Manrique E, Puerto Velázquez MG, García-Maroto R, Galeote Rodríguez E, Marco F, Cebrián-Parra JL. Synovial Sarcoma of the Foot as an Atypical Cause of Persistent Metatarsalgia: A Report of 3 Cases. JBJS Case Connect 2022; 12:01709767-202209000-00024. [PMID: 35977038 DOI: 10.2106/jbjs.cc.22.00282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
CASE Three cases of atypical metatarsalgia are presented, all diagnosed with foot synovial sarcomas (SSs) at different stages of evolution, after a year of medical consultations. One case was treated with marginal excision without requiring bone excision; the second patient required amputation of the first ray; and the third patient, with advanced disease, required amputation through Chopart's joint. CONCLUSION Metatarsalgia is a recurrent reason for consultation in orthopaedics. Even so, patients with persistent symptoms should be studied further in depth. Computed tomography or magnetic resonance imaging can detect tumor pathology, such as SS, of insidious development.
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Affiliation(s)
| | - María Galán-Olleros
- Department of Traumatology and Orthopaedic Surgery, Hospital Clínico San Carlos, Madrid, Spain
| | - Elena Manrique
- Department of Traumatology and Orthopaedic Surgery, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Roberto García-Maroto
- Department of Traumatology and Orthopaedic Surgery, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Fernando Marco
- Department of Traumatology and Orthopaedic Surgery, Hospital Clínico San Carlos, Madrid, Spain
- Surgery Department, Complutense University, Madrid, Spain
| | - Juan Luis Cebrián-Parra
- Department of Traumatology and Orthopaedic Surgery, Hospital Clínico San Carlos, Madrid, Spain
- Surgery Department, Complutense University, Madrid, Spain
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2
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Gómez-Muñoz E, Navarro-Ruiz de Adana I, Cebrián-Parra JL, García-Maroto R, Marco F. [Functional evaluation and quality of life in megaprostheses implanted by musculoskeletal tumors in the lower limb]. Acta Ortop Mex 2022; 36:146-151. [PMID: 36862928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
INTRODUCTION radical resection is the surgical treatment of choice in musculoskeletal malignancies, which often settle in the pelvis and lower limbs. Megaprothesis reconstruction has been imposed in recent years as the gold standard in limb preservation surgery. MATERIAL AND METHODS descriptive retrospective study series of cases, including 30 patients operated between 2011 and 2019 of musculoskeletal pelvic and lower limb tumors at our institution that underwent limb-sparing reconstruction with the megaprosthesis. Functional results according to the MSTS (Musculoskeletal Tumor Society) index and complication rate were analyzed. RESULTS the average follow-up was 40.8 months (12-101.7). Nine patients (30%) underwent pelvic resections and reconstructions, 11 patients (36.7%) underwent hip reconstruction with megaprothesis due to femoral involvement, in three patients (10%) complete femur resection was performed, and seven patients (23.3%) underwent prosthetic reconstruction of the knee. The mean MSTS score was 72.5% (range: 40-95%), and the complication rate was 56.7% (17 patients), being de tumoral recurrence (29%) the main complication. CONCLUSION tumor megaprothesis give satisfying functional results, allowing the patients to realize a relatively normal life after a lower limb-sparing surgery.
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Affiliation(s)
- E Gómez-Muñoz
- Unidad de Traumatología Oncológica, Servicio de Traumatología y Cirugía Ortopédica, Hospital Clínico Universitario de San Carlos. Madrid, España
| | | | - J L Cebrián-Parra
- Unidad de Traumatología Oncológica, Servicio de Traumatología y Cirugía Ortopédica, Hospital Clínico Universitario de San Carlos. Madrid, España
| | - R García-Maroto
- Unidad de Traumatología Oncológica, Servicio de Traumatología y Cirugía Ortopédica, Hospital Clínico Universitario de San Carlos. Madrid, España
| | - F Marco
- Unidad de Traumatología Oncológica, Servicio de Traumatología y Cirugía Ortopédica, Hospital Clínico Universitario de San Carlos. Madrid, España
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3
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Galán-Olleros M, Marco J, Oteo D, Cristóbal-Bilbao R, Manrique E, García-Maroto R, Marco F, Cebrián-Parra JL. Orthopedic Surgical Treatment and Perioperative Complications in Multiple Myeloma Bone Disease: Analysis of a Series (2009-2018). Ann Surg Oncol 2020; 28:1158-1166. [PMID: 32661847 DOI: 10.1245/s10434-020-08819-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/22/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND More than 90% of patients with multiple myeloma (MM) develop lytic bone lesions that can be surgically treated for symptomatic relief and functional improvement. METHODS This was a retrospective observational analytic study conducted between 2009 and 2018, including 58 patients with MM bone disease who underwent 77 orthopedic surgical procedures and were co-managed by internal medicine. Analysis of data related to MM bone disease, different modalities of surgical treatment, perioperative complications, and survival was performed. RESULTS Median age was 72 years (66.5-77 years) and 56.9% of patients were males; 54.43% of injuries were located in the spine, 27.85% in the pelvis or lower limbs, 15.19% in the upper limbs, and 75.32% of patients had pathologic fractures. In 29.31% of the cases, the bone lesion was the debut of MM. Surgical procedures performed were mainly kyphoplasty (48.05%) and intramedullary nailing (29.87%). The overall complication rate following surgery was 74.03%. Only 20.78% of cases had a surgical complication. Among medical complications, we registered 28.57% transfusion requirements, 25.97% acute renal failures, 24.68% developed an infection, and 10.39% developed hypercalcemia. Patients were followed-up for a mean of 6.13 years and 37.93% suffered a new fracture. The median overall survival time for patients after surgery was 32.9 months (11.6-49). The estimated overall survival at 1, 3, and 5 years after surgery was 81.17%, 57%, and 34.11%, respectively. CONCLUSIONS The orthopedic surgical treatment of MM bone disease aims to improve symptomatology and patient quality of life; however, these patients have a high risk of perioperative complications and considerable early mortality, making multidisciplinary management with medical specialties essential.
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Affiliation(s)
- María Galán-Olleros
- Oncological Traumatology Unit, Department of Traumatology and Orthopedic Surgery, Hospital Clínico San Carlos, Madrid, Spain.
| | - Javier Marco
- Department of Internal Medicine, Hospital Clínico San Carlos, Madrid, Spain
| | - David Oteo
- Department of Internal Medicine, Hospital Clínico San Carlos, Madrid, Spain
| | - Rafael Cristóbal-Bilbao
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
| | - Elena Manrique
- Oncological Traumatology Unit, Department of Traumatology and Orthopedic Surgery, Hospital Clínico San Carlos, Madrid, Spain
| | - Roberto García-Maroto
- Oncological Traumatology Unit, Department of Traumatology and Orthopedic Surgery, Hospital Clínico San Carlos, Madrid, Spain
| | - Fernando Marco
- Oncological Traumatology Unit, Department of Traumatology and Orthopedic Surgery, Hospital Clínico San Carlos, Madrid, Spain.,Surgery Department, Complutense University, Madrid, Spain
| | - Juan Luis Cebrián-Parra
- Oncological Traumatology Unit, Department of Traumatology and Orthopedic Surgery, Hospital Clínico San Carlos, Madrid, Spain
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García-Pérez L, Ramos-García V, Serrano-Aguilar P, Pais-Brito JL, Aciego de Mendoza M, Martín-Fernández J, García-Maroto R, Arenaza JC, Bilbao A. EQ-5D-5L utilities per health states in Spanish population with knee or hip osteoarthritis. Health Qual Life Outcomes 2019; 17:164. [PMID: 31666071 PMCID: PMC6822337 DOI: 10.1186/s12955-019-1230-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 10/03/2019] [Indexed: 12/18/2022] Open
Abstract
Background The objective of this study was to obtain utilities by means of EQ-5D-5L for different health states in patients with knee osteoarthritis (KOA) or hip osteoarthritis (HOA) in Spain, and to compare these values with those used in foreign studies with the aim of discussing their transferability for their use in economic evaluations conducted in Spain. Methods Primary study: Observational prospective study of KOA or HOA patients in Spain. Sociodemographic and clinical characteristics were collected to characterize the sample. Utilities were elicited using the EQ-5D-5L questionnaire. ANOVA and bivariable analyses were conducted to identify differences between health states. Literature review: Using the bibliographic databases NSH EED and CEA Registry, we conducted searches of model-based cost utilities analyses of technologies in KOA or HOA patients. Health states and utilities were extracted and compared with values obtained from the Spanish sample. Results Three hundred ninety-seven subjects with KOA and 361 subjects with HOA were included, with average utilities of 0.544 and 0.520, respectively. In both samples, differences were found in utilities according to level of pain, stiffness and physical function (WOMAC) and severity of symptoms (Oxford scales), so that the worst the symptoms, the lower the utilities. The utilities after surgery were higher than before surgery. Due to limitations from our study related to sample size and observational design, it was not possible to estimate utilities for approximately half the health states included in the published models because they were directly related to specific technologies. For almost 100% of health states of the selected studies we obtained very different utilities from those reported in the literature. Conclusions To our knowledge this is the first article with detailed utilities estimated using the EQ-5D-5L in Spain for KOA and HOA patients. In both populations, utilities are lower for worse health states in terms of level of pain, stiffness and physical function according to WOMAC, and according to the Oxford scales. Most utilities obtained from the Spanish sample are lower than those reported in the international literature. Further studies estimating utilities from local populations are required to avoid the use of foreign sources in economic evaluations.
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Affiliation(s)
- Lidia García-Pérez
- Fundación Canaria de Investigación Sanitaria (FUNCANIS), Camino Candelaria No 44, 1a planta. 38109 El Rosario, Santa Cruz de Tenerife, Spain. .,Servicio de Evaluación del Servicio Canario de la Salud (SESCS), Camino Candelaria No 44, 1a planta. 38109 El Rosario, Santa Cruz de Tenerife, Spain. .,Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Spain. .,Instituto Universitario de Desarrollo Regional (IUDR), University of La Laguna, San Cristóbal de La Laguna, Spain. .,Centro de Investigaciones Biomédicas de Canarias (CIBICAN), San Cristóbal de La Laguna, Spain.
| | - Vanesa Ramos-García
- Fundación Canaria de Investigación Sanitaria (FUNCANIS), Camino Candelaria No 44, 1a planta. 38109 El Rosario, Santa Cruz de Tenerife, Spain.,Servicio de Evaluación del Servicio Canario de la Salud (SESCS), Camino Candelaria No 44, 1a planta. 38109 El Rosario, Santa Cruz de Tenerife, Spain
| | - Pedro Serrano-Aguilar
- Servicio de Evaluación del Servicio Canario de la Salud (SESCS), Camino Candelaria No 44, 1a planta. 38109 El Rosario, Santa Cruz de Tenerife, Spain.,Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Spain.,Centro de Investigaciones Biomédicas de Canarias (CIBICAN), San Cristóbal de La Laguna, Spain
| | - José Luis Pais-Brito
- Department of Orthopaedics and Traumatology, University Hospital of Canary Islands, Ctra. Ofra S/N La Cuesta, 38320 La Laguna, Tenerife, Spain.,Department of Orthopaedics and Traumatology, University of La Laguna, San Cristóbal de La Laguna, Spain
| | - María Aciego de Mendoza
- Department of Orthopaedics and Traumatology, University Hospital of Canary Islands, Ctra. Ofra S/N La Cuesta, 38320 La Laguna, Tenerife, Spain
| | - Jesús Martín-Fernández
- Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Spain.,Multiprofessional Teaching Unit of Primary and Community Care "Oeste", Health Service, c/ Alonso Cano 8, Móstoles, 28933, Madrid, Madrid, Spain.,Health Sciences Faculty, Rey Juan Carlos University, Madrid, Spain
| | - Roberto García-Maroto
- Traumatology and Orthopedic Surgery Service, Hospital Universitario Clínico San Carlos, C/ Profesor Martín Lagos S/N, 28040, Madrid, Spain
| | - Juan Carlos Arenaza
- Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Spain.,Traumatology and Orthopedic Surgery Service, Basurto University Hospital (Osakidetza), Avda. Montevideo, 18, 48013, Bilbao, Bizkaia, Spain
| | - Amaia Bilbao
- Health Services Research on Chronic Patients Network (REDISSEC), Bilbao, Spain.,Research Unit, Basurto University Hospital (Osakidetza), Avda. Montevideo, 18, 48013, Bilbao, Bizkaia, Spain
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Checa-Betegón P, Martínez-Aedo AU, García-Maroto R, Cebrián-Parra JL, Marco-Martínez F. [Aneurysmal bone cyst located on the acetabular roof in an 11-year-old male]. Acta Ortop Mex 2018; 32:361-365. [PMID: 31184009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The aneurysmal bone cyst is a benign rare tumor, which usually develops during childhood and its more often found in limbs. The most accepted treatment consists in curetagge and filling with graft. However, certain locations may be inaccesible for surgery and represent therapeutical challenges. We present the case of an 11 year-old male patient with limping and right hip pain without any traumatic nor infectious record. In the image studies with CT and MRI a lytic and expansive lession was found in the upper part of the right acetabulum and right iliac wing, all of which suggested an aneurysmal bone cyst with an associated acetabular fracture. A biopsy was performed which confirmed the diagnosis. He was treated with a CT-guided embolization and, due to its size, curetagge and allograft filling afterwards. He was asymptomatic after1 year of follow-up.
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Affiliation(s)
- P Checa-Betegón
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico Universitario San Carlos, Madrid, España
| | - A U Martínez-Aedo
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico Universitario San Carlos, Madrid, España
| | - R García-Maroto
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico Universitario San Carlos, Madrid, España
| | - J L Cebrián-Parra
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico Universitario San Carlos, Madrid, España
| | - F Marco-Martínez
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico Universitario San Carlos, Madrid, España
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Martín-Fernández J, García-Maroto R, Sánchez-Jiménez FJ, Bau-González A, Valencia-García H, Gutiérrez-Teira B, Arenaza JC, García-Pérez L, Linertová R, Bilbao A. Validation of the Spanish version of the Oxford knee score and assessment of its utility to characterize quality of life of patients suffering from knee osteoarthritis: a multicentric study. Health Qual Life Outcomes 2017; 15:186. [PMID: 28962613 PMCID: PMC5622506 DOI: 10.1186/s12955-017-0761-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 09/19/2017] [Indexed: 12/27/2022] Open
Abstract
Background Knee osteoarthritis (OA) represents a heavy burden for patients and the society as a whole. The Oxford Knee Score (OKS) is a well known tool to assess the quality of life in patients with Knee OA. The purpose of this study was to analyze the psychometric properties of the Spanish version of the OKS, including its reliability, validity, and responsiveness. Methods Prospective observational study that included 397 patients diagnosed with knee OA according to the criterion of the American Rheumatism Association, which were recruited in 3 different Spanish regions. Their self-perceived health-related quality of life (HRQL) was assessed through 3 questionnaires: a generic one (the EQ-5D-5 L) and two specific ones adapted to Spanish (the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Oxford Knee Score (OKS). The follow-up period was 6 months, and the acceptability of the OKS was evaluated, together with its psychometric properties, presence of ceiling and floor effects, validity, reliability, and sensitivity to change. Results The OKS was fully answered in 99.5% of cases, with no evidence of ceiling or floor effects. Its factor structure can be explained in a single dimension. Its discriminating capacity was very good compared to the groups generated by the WOMAC and the EQ-5D-5 L. The correlation of the OKS with the dimensions of the latter questionnaires was around 0.7. The test-retest reliability was excellent (ICC 0.993; CI 95%: 0.990–0.995) and so was its internal consistency (Cronbach’s α = 0.920). The effect size was 0.7 for moderate improvements in the HQRL, which is similar to that of the dimensions of the WOMAC and greater than for the EQ-5D-5 L. The minimum clinically significant difference that was detected by the questionnaire was 6.1 points, and the minimum detectable change was 4.4 points. Conclusions The Spanish-adapted version of the OKS is a useful, valid tool for assessing the perceived HRQL in patients suffering from knee OA, with psychometric properties similar to the WOMAC, and that allows for discriminating the patient’s condition at a particular moment as well as for appraising changes over time. Electronic supplementary material The online version of this article (10.1186/s12955-017-0761-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jesús Martín-Fernández
- C° Villamanta (C.S. Navalcarnero). Gerencia Asistencial de Atención Primaria. Servicio Madrileño de Salud, Avda Libertad 21 s/n, Villamanta, 28610, Madrid, Spain. .,Facultad de Ciencias de la Salud. Universidad Rey Juan Carlos, Avda Atenas s/n, 28922 Alcorcón, Madrid, Spain. .,Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Bilbao, Spain.
| | - Roberto García-Maroto
- Servicio de Traumatología. Hospital Universitario Clínico San Carlos. Servicio Madrileño de Salud, C/ Profesor Martín Lagos, S/N, 28040, Madrid, Spain
| | - Fco Javier Sánchez-Jiménez
- C.S. Gregorio Marañón. Gerencia Asistencial de Atención Primaria. Servicio Madrileño de Salud, Calle Polvoranca, 65. 28923 Alcorcón, Madrid, Spain
| | - Alonso Bau-González
- Servicio de Traumatología. Hospital Universitario Rey Juan Carlos, C/ Gladiolo s/n, 28933, Móstoles, Madrid, Spain
| | - Homero Valencia-García
- Servicio de Traumatología. Hospital Universitario Fundación Alcorcón, C/ Budapest, 1 28922 - Alcorcón, Madrid, Spain
| | - Blanca Gutiérrez-Teira
- C. S. El Soto. Gerencia Asistencial de Atención Primaria. Servicio Madrileño de Salud, Avenida Olímpica, 38, 28935, Móstoles, (Bizkaia), Spain
| | - Juan Carlos Arenaza
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Bilbao, Spain.,Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Basurto (Osakidetza), Avda. Montevideo, 18, 48013, Bilbao, (Bizkaia), Spain
| | - Lidia García-Pérez
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Bilbao, Spain.,Fundación Canaria de Investigación Sanitaria (FUNCANIS), Camino Candelaria N° 44, 1ª planta, 38109, El Rosario (Santa Cruz de Tenerife), Spain
| | - Renata Linertová
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Bilbao, Spain.,Fundación Canaria de Investigación Sanitaria (FUNCANIS), Camino Candelaria N° 44, 1ª planta, 38109, El Rosario (Santa Cruz de Tenerife), Spain
| | - Amaia Bilbao
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Bilbao, Spain.,Unidad de Investigación, Hospital Universitario Basurto (Osakidetza), Avda. Montevideo, 18, 48013, Bilbao, (Bizkaia), Spain
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7
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Martín-Fernández J, Gray-Laymón P, Molina-Siguero A, Martínez-Martín J, García-Maroto R, García-Sánchez I, García-Pérez L, Ramos-García V, Castro-Casas O, Bilbao A. Cross-cultural adaptation and validation of the Spanish version of the Oxford Hip Score in patients with hip osteoarthritis. BMC Musculoskelet Disord 2017; 18:205. [PMID: 28532445 PMCID: PMC5440982 DOI: 10.1186/s12891-017-1568-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 05/10/2017] [Indexed: 01/07/2023] Open
Abstract
Background Osteoarthritis (OA) of the hip is a disease that entails a major burden for patients and the society as a whole. One way of measuring this burden for the patient is through impact on Health-related Quality of Life (HRQL). The Oxford Hip Score (OHS) is a well-known tool to measure HRQL in patients with OA of the hip. This study aims to assess the psychometric properties of the Spanish-adapted version of the OHS, including its reliability, validity, and sensitivity to change. Methods Prospective observational study that included 361 patients diagnosed with hip OA (according to the criterion of the American College of Rheumatology) from 3 different Spanish regions. Their HRQL was assessed using a generic questionnaire, the EQ-5D-5 L, and two specific ones (the Western Ontario and McMaster Universities Osteoarthritis Index, WOMAC, and the OHS) adapted to Spanish. There was a follow-up period of 6 months, and the acceptability, psychometric properties, presence of ceiling and floor effects, validity, reliability, and sensitivity to changes of the OHS were measured. Results The OHS was fully answered in 99.4% of cases with no indication of ceiling or floor effects. Its factor structure can be explained in a single dimension. Its discriminative capacity was very good compared to the groups generated by the WOMAC and the EQ-5D-5 L. The correlation between the OHS and dimensions of the WOMAC or EQ-5D-5 L utilities was ≥0.7. Excellent test-retest reliability (ICC = 0.992; CI95%: 0.994–0.998) and internal consistency (Cronbach’s α = 0.928) were observed. The minimal clinically important difference (MCID) was 7.0 points, and the minimum detectable change (MDC) was 5.5 points. The effect size for moderate improvement in perceived HRQL was 0.73, similar to that of WOMAC dimensions and higher than the EQ-5D-5 L. Conclusions The Spanish-adapted version of the OHS is a useful, acceptable tool for the assessment of perceived HRQL in patients with hip OA, and has psychometric properties similar to those of the WOMAC that allow for discriminating both a patient’s condition at a given moment and changes that can occur over time. Electronic supplementary material The online version of this article (doi:10.1186/s12891-017-1568-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jesús Martín-Fernández
- C° Villamanta (C.S. Navalcarnero). Gerencia Asistencial de Atención Primaria. Servicio Madrileño de Salud, Madrid, Spain. .,Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain. .,Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Madrid, Spain.
| | - Pedro Gray-Laymón
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Rey Juan Carlos, Madrid, Spain
| | - Antonio Molina-Siguero
- C.S. Presentación Sabio, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
| | - Javier Martínez-Martín
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Fundación Alcorcón, Madrid, Madrid, Spain
| | - Roberto García-Maroto
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Clínico San Carlos, Servicio Madrileño de Salud, Madrid, Spain
| | - Isidoro García-Sánchez
- Servicio de Traumatología y Cirugía Ortopédica, Hospital Galdakao-Usansolo (Osakidetza), Galdakao (Bizkaia), Spain
| | - Lidia García-Pérez
- Fundación Canaria de Investigación Sanitaria (FUNCANIS), Santa Cruz de Tenerife, Spain.,Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Santa Cruz de Tenerife, Spain
| | - Vanesa Ramos-García
- Fundación Canaria de Investigación Sanitaria (FUNCANIS), Santa Cruz de Tenerife, Spain
| | - Olga Castro-Casas
- C° Villamanta (C.S. Navalcarnero). Gerencia Asistencial de Atención Primaria. Servicio Madrileño de Salud, Madrid, Spain
| | - Amaia Bilbao
- Unidad de Investigación, Hospital Universitario Basurto (Osakidetza) - Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao (Bizkaia), Spain
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8
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González-Pérez AM, Arvinius C, García-Coiradas J, García-Maroto R, Cebrian-Parra JL. [Surgical treatment of malignant primary tumors of the pelvis on Ennekings zone II]. Acta Ortop Mex 2016; 30:132-137. [PMID: 27984686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Surgical treatment of malignant bone tumors of the pelvis with periacetabular involvement is constantly evolving. Even though acetabular reconstructions improve quality of life without impairing cancer control, they are not complication free. Our purpose is to describe the functional outcomes and surgical complications of different reconstructive techniques for Enneking zone II tumors. MATERIAL AND METHODS Fifteen patients underwent surgery for malignant pelvic bone tumors between 2002 and 2012. Seven patients were retrospectively evaluated according to the Enneking and Dunham classification and were found to have periacetabular involvement, as follows: 3 were type II; 1 types I + II; 2 types II + III, and one types I + II + III. Five patients had a standard chondrosarcoma and 2 osteosarcoma. Patients included 4 males and 3 females; mean age was 43 years. The minimum follow-up period was 12 months (mean 6.14 years). All of them underwent cancer resection with periacetabular reconstruction: massive osteochondral allograft in 3 patients, structural allograft and hip arthroplasty in 2 patients, and prosthesis with iliac anchoring in 2. They were clinically, radiologically and functionally evaluated with the MSTS scale (1993). RESULTS The mean MSTS score 6 months after surgery was 20.71 (69%). Five patients (71.4%) had surgical complications: 2 dislocations of the native femoral head on the allograft; one aseptic prosthetic dislodgement, and 2 deep infections. All patients had free intraoperative borders. CONCLUSIONS Acetabular reconstructions after oncologic resection for malignant bone tumors seem to provide good functional outcomes. However, only selected cases should undergo surgeries associated with a high complication rate.
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Affiliation(s)
- A M González-Pérez
- Hospital Clínico San Carlos, Calle del Prof. Martín Lagos, s/n, 28040 Madrid, España
| | - C Arvinius
- Hospital Clínico San Carlos, Calle del Prof. Martín Lagos, s/n, 28040 Madrid, España
| | - J García-Coiradas
- Hospital Clínico San Carlos, Calle del Prof. Martín Lagos, s/n, 28040 Madrid, España
| | - R García-Maroto
- Hospital Clínico San Carlos, Calle del Prof. Martín Lagos, s/n, 28040 Madrid, España
| | - J L Cebrian-Parra
- Hospital Clínico San Carlos, Calle del Prof. Martín Lagos, s/n, 28040 Madrid, España
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9
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Abstract
Vasculopathic syndromes have been associated with hematological and solid organ malignancies. The pathogenesis of these syndromes remains largely unknown and there are no biologic markers identified. Whether it is or is not a paraneoplastic syndrome is under discussion, the close temporal relationship of cancer and vasculitis suggests that these vasculitides are a paraneoplastic condition. We report a case of a 45-year-old female patient with pelvic chondrosarcoma who underwent surgical treatment and started to present visual loss, systemic inflammatory response syndrome (SRIS), cardiac insufficiency, hepatosplenomegaly, cholestasis as well as pulmonary bleeding suggesting a sarcoma-associated vasculitis. All antibodies were negative as in secondary vasculitis. After corticoideal therapy the vasculitis resolved and at 3-year follow-up the patient had not showed any further medical complications or recurrences of the vasculitis. The parallel evolution of the vasculitis and the solid tumor combined with the resolution of the vasculitis after corticotherapy enhances the likelihood of a paraneoplastic vasculitis associated with a chondrosarcoma according to literature review.
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Affiliation(s)
- Camilla Arvinius
- Department of Orthopaedic Surgery and Traumatology, Hospital Clínico San Carlos 28 040 Madrid Spain
| | - Ana González-Pérez
- Department of Orthopaedic Surgery and Traumatology, Hospital Clínico San Carlos 28 040 Madrid Spain
| | - Javier García-Coiradas
- Department of Orthopaedic Surgery and Traumatology, Hospital Clínico San Carlos 28 040 Madrid Spain
| | - Roberto García-Maroto
- Department of Orthopaedic Surgery and Traumatology, Hospital Clínico San Carlos 28 040 Madrid Spain
| | - Juan Luis Cebrián-Parra
- Department of Orthopaedic Surgery and Traumatology, Hospital Clínico San Carlos 28 040 Madrid Spain
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García-Maroto R, García-Coiradas J, Milano G, Cebrián J, Marco F, López-Durán L. Safety and efficacy of kyphoplasty in the treatment of tumoral disease of the spine. Rev Esp Cir Ortop Traumatol (Engl Ed) 2015. [DOI: 10.1016/j.recote.2015.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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11
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García-Maroto R, García-Coiradas J, Milano G, Cebrián JL, Marco F, López-Durán L. [Safety and efficacy of kyphoplasty in the treatment of tumoral disease of the spine]. Rev Esp Cir Ortop Traumatol (Engl Ed) 2015; 59:406-12. [PMID: 26100740 DOI: 10.1016/j.recot.2015.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 04/12/2015] [Accepted: 05/02/2015] [Indexed: 12/24/2022] Open
Abstract
UNLABELLED Vertebral fractures in oncology patients cause significant pain and disability, with decreased quality of life. The aim of the study is to assess the efficacy and safety of kyphoplasty in this type of vertebral fracture in the acute phase. MATERIALS AND METHODS A retrospective study was conducted on 75 consecutive oncology patients with 122 acute vertebral fractures, who underwent bilateral balloon kyphoplasty, with a mean follow up of 11 months. RESULTS Almost all (91%) of the patients improved their pain level. The mean improvement in the Visual Analogue Scale (VAS) was 4.28 points (preoperative value 7.49 [SD 1.19], postoperative 3.21 [SD 0.95]). Before surgery, 53% of patients needed major opioids (40 cases), and one month after surgery only 12% (9 patients) required them. Quality of life determined by the Karnofsky index improved from 60.2 (SD 10) to 80.7 (SD 12.1). Cement leaks were found in 5.7% (7 cases), all without neurological repercussions. New fractures appeared in 11 patients. This subgroup showed a slight worsening of the initially acquired clinical improvement. No neurological or pulmonary complications related to surgical technique were found. CONCLUSIONS Kyphoplasty is an effective and safe for treating vertebral fractures in patients with cancer. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- R García-Maroto
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, España.
| | - J García-Coiradas
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, España
| | - G Milano
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, España
| | - J L Cebrián
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, España
| | - F Marco
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, España
| | - L López-Durán
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, España
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