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[Pathological fractures of the knee]
Jacek Kopacz1, Edward Warda, Tomasz Mazurkiewicz
1Katedra i Klinika Ortopedii i Traumatologii, Akademia Medyczna w Lublinie.
Chirurgia Narzadow Ruchu I Ortopedia Polska
|August 1, 2002
Summary
This study reviews 20 pathological knee fractures caused by tumors and benign lesions. Treatment varied, with malignant tumors showing poorer outcomes due to recurrence and metastasis, while benign lesions generally healed well.
Area of Science:
- Orthopedic Surgery
- Oncology
- Pathological Fractures
Context:
- Reviews treatment of 20 epiphyseal and low-metaphysis pathological knee fractures.
- Covers a 37-year period (1962-1999) at a single academic institution.
- Includes fractures from both malignant tumors and benign bone lesions.
Purpose:
- To present the methods and outcomes of treating pathological knee fractures.
- To analyze the efficacy of different treatment modalities based on lesion type.
- To report on patient survival and functional recovery.
Summary:
- Malignant tumors (lymphoma, plasmacytoma, adenocarcinoma metastases, hemangiopericytoma) and benign lesions (giant cell tumors, bone cysts, pigmented villonodular synovitis) caused 18 femur and 2 tibia fractures.
- Fractures from lymphomas and plasmacytoma healed with conservative treatment (plaster cast, traction) within 16 weeks.
- Surgical interventions included tumor resection, reconstruction, and in one case, hip exarticulation.
- Malignant cases had significant morbidity (recurrence, metastasis, death) and functional limitations.
- Benign lesions were treated with curettage, bone grafting, or methylmethacrylate, achieving fracture healing with an 8-year follow-up, though one case developed complications.
Impact:
- Highlights the challenges in managing pathological fractures, particularly those associated with malignant neoplasms.
- Demonstrates successful conservative and surgical management for benign pathological fractures.
- Underscores the importance of considering tumor type and behavior in treatment planning and prognosis for pathological knee fractures.