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Экстремальный возврат нескольких миелом после "Total Knee Artropolocy: Implications for Orthopaedic Richers-A Case Report and Literic Review".

Множественная миелома (ММ) — гематологическая порча клеток В, характеризующаяся распространением клональных плазменных клеток в костном мозге. Внешняя болезнь является более агрессивной формой MM, в которой моноклонные клетки распространяются за пределами костного мозга, образуя плазменные цитомы. Это дело подчеркивает: 56-year-old Мужчина, появляющийся с дополнительным повторением MM в мягких тканях, окружающих место разреза его полной коленной артропопластики. К счастью, после радиационной и химиотерапии его последняя оценка показала полное разрешение конкреций в радиационном поле. Как ортоп

The impact of incident vertebral and non-vertebral fractures on health related quality of life in postmenopausal women.

BACKGROUND: Little empirical research has examined the multiple consequences of osteoporosis on quality of life. METHODS: Health related quality of life (HRQL) was examined in relationship to incident fractures in 2009 postmenopausal women 50 years and older who were seen in consultation at our tertiary care, university teaching hospital-affiliated office and who were registered in the Canadian Database of Osteoporosis and Osteopenia (CANDOO) patients. Patients were divided into three study groups according to incident fracture status: vertebral fractures, non-vertebral fractures and no fract

Osteolytic lesions: Multiple myeloma or prostate cancer?

Multiple myeloma is a cancer which is characterized by proliferation of malignant B-cells and plasma cell infiltration of bone marrow. Lytic lesions are one of its hallmarks, on radiological assessment. We report 2 cases who presented within 1 year to our hospital with bony lytic lesions on CT scan. They were investigated for multiple myeloma; however, there were no further features to suggest this. Both patients were confirmed to have prostate cancer. This is unusual as prostate cancer produces sclerotic lesions (unusual hardening or thickening of the bone).

Joint-preserving palliative surgery using self-locking screws of intramedullary nail and percutaneous cementoplasty for proximal humeral metastasis in the advanced cancer patients.

BackgroundWe introduced a palliative joint-preserving surgery using proximal self-locking screws of intramedullary (IM) nail and percutaneous cementoplasty (PC) in patients with proximal humeral metastases, including the head and neck, and evaluated the outcome of the surgical method.MethodsTwenty-three patients (mean age = 63.0 ± 11.8 years, M:F = 14:9) had IM nailing with a self-locking screw system and PC for the treatment of humeral head and neck metastases. Usually, three proximal locking screws were inserted after IM nailing, and 20.9 ± 8.0 ml of polymethylmethacrylate (PMMA) bone cement

Use of O-arm with neuronavigation in percutaneous vertebroplasty reduces the surgeon's exposure to intraoperative radiation.

IntroductionPercutaneous vertebroplasty is commonly used to treat spinal fractures. The authors compare radiation exposure as potential risk for the surgical team during vertebroplasty guided by O-arm combined with neuronavigation versus vertebroplasty guided by C-arm fluoroscopy.Material and methodsThe clinical material consisted of a group of 29 patients (44 vertebrae) with fractures of the thoracolumbar spine treated with percutaneous vertebroplasty guided by O-arm with neuronavigation. In this new method, the operating room staff leaves the operating room for the duration of the 3D scan of

Osteoporotic vertebral fractures: an update.

INTRODUCTION: Osteoporotic vertebral fractures (OVFs) are the most common type of fragility fractures. They have a significant and usually detrimental impact on the patient's functional status and mortality rate, constituting a substantial burden for the patients, their families, and the healthcare system. This narrative review aims to summarize the current knowledge of osteoporotic vertebral fractures and secondary fracture prevention. METHODS: A comprehensive literature search was conducted across major medical databases, including PubMed, Scopus, and Web of Science. Relevant studies, guide

Adefovir dipivoxil-induced hypophosphatemic osteomalacia and osteoporosis: a case report and literature review.

The nephrotoxicity of adefovir dipivoxil (ADV) can induce Fanconi syndrome, which causes hypophosphatemic osteomalacia. We report a case of a 67-year-old postmenopausal woman who had been receiving long-term adefovir dipivoxil therapy for chronic hepatitis B. She presented with severe bone pain and multiple pseudofractures, and was diagnosed with drug-induced hypophosphatemic osteomalacia. Following discontinuation of adefovir and supplementation with vitamin D and phosphate, her biochemical parameters normalized and bone pain significantly improved, indicating that osteomalacia had been essen

Vertebroplasty and kyphoplasty: a comparative review of efficacy and adverse events.

Vertebroplasty and kyphoplasty have become common surgical techniques for the treatment of vertebral compression fractures. Vertebroplasty involves the percutaneous injection of bone cement into the cancellous bone of a vertebral body with the goals of pain alleviation and preventing further loss of vertebral body height. Kyphoplasty utilizes an inflatable balloon to create a cavity for the cement with the additional potential goals of restoring height and reducing kyphosis. Vertebroplasty and kyphoplasty are effective treatment options for the reduction of pain associated with vertebral body

The Crosstalk Between B Cells and the Skeletal System During Development, Aging, and in Pathological Conditions.

Purpose of reviewIn this review, we describe the interaction between B cells and bone during development, aging, and disease. RECENT FINDINGS: There is an increased interest in identifying the mechanisms of interaction between immune cells and the skeletal system. This knowledge is critical for understanding the pathology of autoimmune diseases and developing therapeutic interventions. Humoral immunity depends on B cells and their secreted immunoglobulin (antibodies). Earlier studies described B cell influence on the skeletal system, with a major focus on the role of plasma cells and secreted

Reducing diagnostic delay in hypophosphatasia: a case series of 14 patients presenting to general rheumatology.

OBJECTIVES: Hypophosphatasia (HPP) is a rare genetic metabolic bone disease that can cause chronic pain and fractures. Its hallmark is a persistently low serum ALP. HPP is now recognised by many osteoporosis specialists, but other specialists, such as rheumatologists and primary care physicians, may be less aware of this condition, causing diagnostic delay and possible harm to these patients. Our objective was to highlight features that can reduce this delay. METHODS: We retrospectively analysed 14 patients that presented with musculoskeletal pain to general rheumatology clinic at St. George'

The Phenotype of Bone Turnover in Patients with Fragility Hip Fracture: Experience in a Fracture Liaison Service Population.

Background: Hip fragility fractures are becoming one of the main health care problems in countries with an aging population. This study aimed to evaluate the clinical characteristics and the usefulness of bone turnover markers in patients with a hip fracture. Methods: In a cohort of 363 patients (84.1 ± 9.2 years) with hip fractures we measured 25-hydroxyvitamin D (25OHD), bone alkaline phosphatase, type I collagen β carboxy telopeptide (βCTX), and parathyroid hormone (PTH). We recorded patients’ Charlson Comorbidity Index (CCI) and previous history of fragility fractures. Results: Vitamin D a

Effective examination methods for identifying the primary origins of metastatic bone tumors of unknown primary origin during the initial visit: A retrospective chart review study.

ObjectiveTo provide appropriate treatment for patients, early diagnosis of the primary origin of skeletal metastases of unknown primary origin is important. This study aimed to assess the examination strategy effective for identifying the primary origin of skeletal metastases of unknown primary origin.MethodsSixty-one patients with skeletal metastases of unknown primary origin were reviewed. The primary origin was examined via physical examination, blood test including tumor markers, chest radiography, thoracoabdominal computed tomography scan, positron emission tomography-computed tomography

Prognostic factors and skeletal-related events in patients with bone metastasis from gastric cancer.

The number of studies on bone metastasis (BM) from gastric cancer (GC) is currently limited. Therefore, the aim of the present study was to investigate the characteristics, skeletal-related events (SREs) and prognosis of GC in patients with BMs. Data from 60 patients with BMs from GC were retrospectively retrieved and patient-, tumor- and BM-related characteristics were analyzed. Kaplan-Meier survival curves were analyzed using the univariate log-rank test. Multivariate analyses were conducted using the Cox proportional hazards model. The median patient age was 63.5 years (range, 26-83 years).

Proximal femoral multiple myeloma pathological fractures, impending and actual fractures - a patient survival study.

INTRODUCTION: The femur is a common site for Multiple Myeloma (MM) involvement. This study explores the impact of preventive surgery for anticipated femoral pathological fractures (IFF), based on Mirels classification, versus treatment of pathological femur fracture (PFF) on MM patient mortality and morbidity. METHODS: Retrospective cohort of 33 patients undergoing surgery due to femoral MM involvement (2004-2015), 18 patients with PFF, 15 patients with IFF, followed up until deceased or to July 2016. Demographic data, oncological, pathological, radiation, surgical reports, outpatient clinica

The Advantages of Radiofrequency Echographic MultiSpectrometry in the Evaluation of Bone Mineral Density in a Population with Osteoarthritis at the Lumbar Spine.

BACKGROUND: Osteoarthritis (OA) in the lumbar spine can potentially lead to an overestimation of bone mineral density (BMD), and this can be a challenge in accurately diagnosing conditions like osteoporosis, where precise measurement of BMD is crucial. Radiofrequency Echographic Multi Spectrometry (REMS) is being recognized as an innovative diagnostic tool for assessing bone status. The purpose of this study was to evaluate whether the use of REMS may enhance the identification of osteoporosis in patients with osteoarthritis. METHODS: A cohort of 500 patients (mean age: 63.9 ± 11.2 years) dia

Evaluation of Changes in Activities of Daily Living and Quality of Life of Patients with Bone Metastasis Who Underwent Conservative Therapy through Bone Metastasis Cancer Boards.

Background and Objectives: Changes in activities of daily living (ADL) and quality of life (QOL) of patients with bone metastasis who underwent surgical treatment through Bone Metastasis Cancer Boards (BMCBs), a recent multidisciplinary approach for managing bone metastases, have been reported; however, no reports exist on patients who undergo conservative treatment. In this study, we aimed to evaluate these patients' ADL and QOL and examine the factors influencing changes in these parameters. Materials and Methods: We retrospectively reviewed 200 patients with bone metastases who underwent co

Effect of exercise on bone-related outcomes in patients with cancer affected by bone metastases or bone loss: a systematic review and meta-analysis.

INTRODUCTION: This systematic review and meta-analysis aimed to evaluate the effects of exercise interventions on bone mineral density (BMD), bone mineral content (BMC), and bone turnover markers in patients with cancer and compromised bone health. MATERIALS AND METHODS: A comprehensive search of four electronic databases was conducted to identify randomized controlled trials evaluating the effect of exercise intervention compared to supplementation or bone-targeted agents only on BMD, BMC and bone turnover markers. Meta-analyses were performed using random-effects models to calculate effect

Исцеление литических повреждений и восстановление костного здоровья в множестве миеломы посредством ингибиции склеростинов.

Множественная миелома (ММ) связана с изнурительным заболеванием костей, которое создает серьезные терапевтические проблемы. Болезнь костей MM характеризуется повышенной ресорбцией костей и подавлением остеобластов, что препятствует ремонту поврежденных костей. Склеростин, антагонист Wnt сигнализатора, выше у пациентов MM, и его ингибиция с нейтрализующим антителом (Scl-ab) была продемонстрирована для восстановления остеобластной функции в мышиных моделях MM. Однако остается неясным, может ли Scl-ab способствовать ремонту скелета, обеспечивать эффективный контроль над опухолью в сочетании с ант

Treatment of bone tumours by radiofrequency thermal ablation.

Radiofrequency thermal ablation (RFTA) is considered the treatment of choice for osteoid osteomas, in which it has long been safely used. Other benign conditions (chondroblastoma, osteoblastoma, giant cell tumour, etc.) can also be treated by this technique, which is less invasive than traditional surgical procedures. RFTA ablation is also an option for the palliation of localized, painful osteolytic metastatic and myeloma lesions. The reduction in pain improves the quality of life of patients with cancer, who often have multiple morbidities and a limited life expectancy. In some cases, these

A review and update of vertebral fractures due to metastatic tumors of various sites to the spine: Percutaneous vertebroplasty.

BACKGROUND: Vertebral fractures (VFs) are the most usual convolution of metastatic tumors and the vertebral column is the third most ordinary site for painful bone metastases and remains a chief factor of morbidity in cancer patients. METHODS: In this paper, we investigated the previous literature on the status of clinical and prospects for the use of percutaneous vertebroplasty (PVP) with polymethylmethacrylate as a remedial alternative for the therapy of refractory pain resulting from malignant vertebral compression and pathologic fractures associated with metastatic tumors of various sites

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… Other complications associated with local trauma contain rib fractures and fracture of the posterior vertebral elements, which occur in <1% of cases and remaining cases are infection and allergic reaction to the cement, which can cause cardiovascular instability [ 50 ]. …