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Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_I | Pages 54 - 54
1 Mar 2008
Talbot M Turcotte R Isler M Doyon J Desharnais L Chabot P
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A prospective evaluation of the functional status and quality of life of patients undergoing surgery for long bone and acetabular metastases was performed. Sixty-nine patients were enrolled in the study. IM nailing and prosthetic replacement were the most common methods of treatment. Results were assessed using the MSTS 1987, MSTS 1993, TESS and SF-36 pre-op and then at six and twelve weeks post-op. There was a significant improvement in all of these parameters. The need for pain medication also decreased significantly. These results show surgical treatment of bone metastases can be benificial to patients with a short life expectancy.

The purpose of this study was to objectively assess the benefits of surgical treatment of bone metastases in the first three months post-operatively.

This is the first prospective study to evaluate the impact of surgery on the quality of life and function of patients burdened by metastases to the appendicular skeleton.

Sixty-nine patients gave their informed consent to be followed prospectively. Patients were administered the SF-36, MSTS 1987, MSTS 1993 and TESS questionnaires pre-op, at six weeks and three months post-op.

Average age was sixty-one years. Average follow-up was six months with 71% of patients deceased at the latest follow-up. Thirty-five patients had a pathological fracture and thirty-four had an impending fracture. IM Nailing was performed in thirty-six patients, prosthetic replacement in twenty and various other methods of stabilization in the thirteen other cases. Complications occurred in 25% of patients. There was a statistically significant improvement in the MSTS 1987 (from 13,6 to 22,8), MSTS 1993 (21,7 to 51,7), TESS (37,7 to 67,7) and pain medication use in the first three months post-op. SF-36 physical component scores improved significantly at six and twelve weeks while mental component scores improved significantly only at twelve weeks post-op.

Our data shows that surgical treatment of metastatic disease to long bones improves functional status and quality of life in a relatively short time frame. This is significant in a group of patients suffering from advanced neoplasia.

This study suggest interesting benefits in the overall well-being of patients treated surgically for bone metastases.

Funding: Funding was received from CHIR and FREOM.


Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_I | Pages 55 - 55
1 Mar 2008
Nguyen H Isler M Turcotte R Normandin D Desharnais L Doyon J
Full Access

This study was designed to be the first to prospectively evaluate CT-guided radiofrequency ablation for osteoid osteoma in terms of pain control, medication consumption, quality of life and patient function.

Over two years, forty patients with symptoms and radiographic findings classic for osteoid osteoma were offered radioablation. Patients were asked to fill out facial, subjective and visual analog pain scales and to undergo the Musculoskeletal Tumour Society 1987 functional assessment.

Results show immediate and lasting resolution of symptoms, a sharp drop in drug use and a significant improvement in function thus supporting the role of radioablation as first line therapy.

The purpose of this study was to prospectively evaluate the usefulness of radioablation for osteoid osteoma in terms of pain control, analgesic drug consumption, quality of life and patient function.

Radioablation appears to be a safe and effective method of treatment for osteoid osteoma. It offers immediate and lasting resolution of symptoms. Results support its role as first line therapy.

This is the first study to prospectively measure the outcome of patients treated with CT-guided radiofrequency ablation for osteoid osteoma.

The mean follow-up time is 6.93 months (sd: 6.51). All but seven procedures were done under regional anaesthesia. No complications were reported. 50% of core biopsy specimens were diagnostic of osteoid osteoma. The visual analog pain scale showed a value of 2.13(sd: 2.5) pre-op and 0.33(sd: 1.07) at 1 year (p=0.00033). The MSTS score rose from 28.86(sd: 4.68) pre-operatively to 34.06(sd: 1.95) after one year (p=0.000000049). Medication consumption was markedly reduced. All eighteen patients with more than one- year follow-up are drug free.

Over two years, forty patients with symptoms and radiographic findings classic for osteoid osteoma who had already received various treatments were offered radioablation. Written consent was obtained and patients were asked to fill out facial, subjective and visual analog pain scales. The Musculoskeletal Tumour Society 1987 functional assessment was performed. This data was collected two weeks prior to treatment and then at two weeks, three months and one year after treatment. The procedure was performed under CT guidance and on a one-day hospital admission basis.