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Percutaneous long bone cementoplasty of the limbs: experience with fifty-one non-surgical patients

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Abstract

Objective

To review our 10-year experience with percutaneous long bone cementoplasty (PLBC) in poor surgical patients.

Materials and methods

Fifty-one patients were included. Primary endpoints were pain and functional outcomes one month following PLBC. A secondary endpoint dealt with factors predicting cement leakage. Delayed adverse events and overall survival (OS) were also investigated.

Results

Sixty-six lesions were treated. Local pain relief at 1-month occurred in 59/66 lesions (89.4 %); pain improvement was significantly more common for lesions of the upper limb (p < 0.05). Limb functionality at one month improved in 46/64 lesions (71.8 %); lesions ≤ 3 cm showed better outcomes in terms of limb function (p <0.05). Cement leakage was minor and asymptomatic in 26 cases (26/66, 39.4 %); in one case (1/66, 1.5 %) symptomatic minor amount of intra-articular cement leakage occurred. Factors predicting cement leakage were diaphyseal location of the lesions, cortical bone disruption and extra-bone tumour extension (p < 0.05). The most common delayed adverse event was fracture (6/66, 9.1 %). OS at 1-, 2- and 3-years was 61.2 %, 30.9 % and 23.0 %, respectively.

Conclusions

For poor surgical candidates, at 1-month follow-up, PLBC proved to be safe and effective. If stress fracture occurs following PLBC, surgical external fixation is still an affordable therapeutic option.

Key Points

• Percutaneous long bone cementoplasty may be proposed to poor surgical patients

• Pain palliation is more significant for lesions of the upper limb

• Limb function improves significantly for lesions sized ≤ 3 cm

• Fracture is the most common delayed adverse event (9 % of cases)

• If cement stress fracture occurs, surgical external fixation is still feasible

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Abbreviations

PMMA:

Polymethylmethacrylate

PLBC:

Percutaneous long bone cementoplasty

CBCT:

C-arm Cone Bean CT

mTFE:

Mean time to the first delayed adverse event

NS:

Non-significant

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Acknowledgments

All the authors would like to thank sincerely Emiliano Schena, PhD for his kind statistical advice and Jones Iriondo for her kind assistance with paper drafting.

The scientific guarantor of this publication is Dr. Jean Palussiere, MD, Chief of the Department of Radiology, Institut Bergonié, Bordeaux, France. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board.

Methodology: Retrospective, Observational, Performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Institut Bergonié, 229 Cours de l’Argonne, 33000, Bordeaux, France

    Roberto Luigi Cazzato, Xavier Buy, Omer Eker, Thierry Fabre & Jean Palussiere

  2. Department of Radiology and Diagnostic Imaging, Università “Campus Bio-Medico di Roma”, Via Alvaro del Portillo 200, 00128, Rome, Italy

    Roberto Luigi Cazzato

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  1. Roberto Luigi Cazzato
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  2. Xavier Buy
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Correspondence to Roberto Luigi Cazzato.

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Cazzato, R.L., Buy, X., Eker, O. et al. Percutaneous long bone cementoplasty of the limbs: experience with fifty-one non-surgical patients. Eur Radiol 24, 3059–3068 (2014). https://doi.org/10.1007/s00330-014-3357-9

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  • DOI: https://doi.org/10.1007/s00330-014-3357-9

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