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

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.