Carbon-fiber reinforced intramedullary nailing in musculoskeletal tumor surgery: a national multicentric experience of the Italian Orthopaedic Society (SIOT) Bone Metastasis Study Group

Andrea Piccioli, Raimondo Piana, Michele Lisanti, Alberto Di Martino, Barbara Rossi, Francesco Camnasio, Marco Gatti, Pietro Maniscalco, Franco Gherlinzoni, Maria Silvia Spinelli, Davide Maria Donati, Roberto Biagini, Rodolfo Capanna, Vincenzo Denaro

Research output: Contribution to journalArticle

Abstract

INTRODUCTION:
Carbon fiber reinforced (CFR) implants have been proposed for the treatment of fractures or impending fractures of the long bones in the oncology patient. Aim of this study is to present the largest cohort of oncology patients operated by CFR nailing by the Italian Orthopaedic Society (SIOT) Bone Metastasis Study Group.
METHODS:
53 adult oncology patients were operated on with a CFR-PEEK nail. All the data from adjuvants therapies were collected. Bone callus formation, response to radiotherapy, relapse or progression of the osteolysis were recorded. Hardware survival and failure, breakage and need for implant revision were also analysed.
RESULTS:
Anatomical implantation of nails include humerus (n = 35), femur (n =11) and tibia (n = 7). The most frequent tumors affecting the bone were myeloma (n = 13), breast (n = 11), lung (n = 8), and renal cell cancer (n = 7). Acrylic cement reinforcement was used in 2 patients. One patient was subjected to electrochemotherapy after nail insertion. Intraoperative and early postoperative complications occurred in 13.2% and 7.54% of patients respectively. Eight patients had local progression and one developed a stress fracture proximally to the distal static screw. Radiographic union occurred in 14 patients; one screw loosening was recorded.
DISCUSSION:
There is currently a lack of solid evidence on the clinical use of CFR nails in oncologic patients. This is the first and largest study of CFR nailing, with the longest available follow up.
CONCLUSIONS:
Implant related complications and surgery-related morbidity should be taken into account in the decision-making process for the surgical management of these patients. These data can improve the surgeon-patient communication and guide further studies on patients' survival and complications with respect to surgery.
Original languageEnglish
Pages (from-to)S55-S59
Number of pages5
JournalInjury
Volume48
Issue numbersuppl 3
DOIs
Publication statusPublished - Oct 2017

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Intramedullary Fracture Fixation
Orthopedics
Neoplasm Metastasis
Bone and Bones
Neoplasms
Nails
carbon fiber
Electrochemotherapy
Stress Fractures
Osteolysis
Survival
Humerus
Bone Fractures
Bony Callus
Tibia
Renal Cell Carcinoma
Osteogenesis
Femur
Decision Making
Breast

Keywords

  • Carbon fiber
  • Metastasis
  • Nail
  • Primary bone tumor
  • Radiotherapy
  • Soft tissue sarcoma

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Carbon-fiber reinforced intramedullary nailing in musculoskeletal tumor surgery: a national multicentric experience of the Italian Orthopaedic Society (SIOT) Bone Metastasis Study Group. / Piccioli, Andrea ; Piana, Raimondo; Lisanti, Michele; Martino, Alberto Di; Rossi, Barbara; Camnasio, Francesco; Gatti, Marco; Maniscalco, Pietro; Gherlinzoni, Franco; Spinelli, Maria Silvia; Donati, Davide Maria; Biagini, Roberto; Capanna, Rodolfo; Denaro, Vincenzo.

In: Injury, Vol. 48, No. suppl 3, 10.2017, p. S55-S59.

Research output: Contribution to journalArticle

Piccioli, A, Piana, R, Lisanti, M, Martino, AD, Rossi, B, Camnasio, F, Gatti, M, Maniscalco, P, Gherlinzoni, F, Spinelli, MS, Donati, DM, Biagini, R, Capanna, R & Denaro, V 2017, 'Carbon-fiber reinforced intramedullary nailing in musculoskeletal tumor surgery: a national multicentric experience of the Italian Orthopaedic Society (SIOT) Bone Metastasis Study Group', Injury, vol. 48, no. suppl 3, pp. S55-S59. https://doi.org/10.1016/S0020-1383(17)30659-9
Piccioli, Andrea ; Piana, Raimondo ; Lisanti, Michele ; Martino, Alberto Di ; Rossi, Barbara ; Camnasio, Francesco ; Gatti, Marco ; Maniscalco, Pietro ; Gherlinzoni, Franco ; Spinelli, Maria Silvia ; Donati, Davide Maria ; Biagini, Roberto ; Capanna, Rodolfo ; Denaro, Vincenzo. / Carbon-fiber reinforced intramedullary nailing in musculoskeletal tumor surgery: a national multicentric experience of the Italian Orthopaedic Society (SIOT) Bone Metastasis Study Group. In: Injury. 2017 ; Vol. 48, No. suppl 3. pp. S55-S59.
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abstract = "INTRODUCTION:Carbon fiber reinforced (CFR) implants have been proposed for the treatment of fractures or impending fractures of the long bones in the oncology patient. Aim of this study is to present the largest cohort of oncology patients operated by CFR nailing by the Italian Orthopaedic Society (SIOT) Bone Metastasis Study Group.METHODS:53 adult oncology patients were operated on with a CFR-PEEK nail. All the data from adjuvants therapies were collected. Bone callus formation, response to radiotherapy, relapse or progression of the osteolysis were recorded. Hardware survival and failure, breakage and need for implant revision were also analysed.RESULTS:Anatomical implantation of nails include humerus (n = 35), femur (n =11) and tibia (n = 7). The most frequent tumors affecting the bone were myeloma (n = 13), breast (n = 11), lung (n = 8), and renal cell cancer (n = 7). Acrylic cement reinforcement was used in 2 patients. One patient was subjected to electrochemotherapy after nail insertion. Intraoperative and early postoperative complications occurred in 13.2{\%} and 7.54{\%} of patients respectively. Eight patients had local progression and one developed a stress fracture proximally to the distal static screw. Radiographic union occurred in 14 patients; one screw loosening was recorded.DISCUSSION:There is currently a lack of solid evidence on the clinical use of CFR nails in oncologic patients. This is the first and largest study of CFR nailing, with the longest available follow up.CONCLUSIONS:Implant related complications and surgery-related morbidity should be taken into account in the decision-making process for the surgical management of these patients. These data can improve the surgeon-patient communication and guide further studies on patients' survival and complications with respect to surgery.",
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TY - JOUR

T1 - Carbon-fiber reinforced intramedullary nailing in musculoskeletal tumor surgery: a national multicentric experience of the Italian Orthopaedic Society (SIOT) Bone Metastasis Study Group

AU - Piccioli, Andrea

AU - Piana, Raimondo

AU - Lisanti, Michele

AU - Martino, Alberto Di

AU - Rossi, Barbara

AU - Camnasio, Francesco

AU - Gatti, Marco

AU - Maniscalco, Pietro

AU - Gherlinzoni, Franco

AU - Spinelli, Maria Silvia

AU - Donati, Davide Maria

AU - Biagini, Roberto

AU - Capanna, Rodolfo

AU - Denaro, Vincenzo

PY - 2017/10

Y1 - 2017/10

N2 - INTRODUCTION:Carbon fiber reinforced (CFR) implants have been proposed for the treatment of fractures or impending fractures of the long bones in the oncology patient. Aim of this study is to present the largest cohort of oncology patients operated by CFR nailing by the Italian Orthopaedic Society (SIOT) Bone Metastasis Study Group.METHODS:53 adult oncology patients were operated on with a CFR-PEEK nail. All the data from adjuvants therapies were collected. Bone callus formation, response to radiotherapy, relapse or progression of the osteolysis were recorded. Hardware survival and failure, breakage and need for implant revision were also analysed.RESULTS:Anatomical implantation of nails include humerus (n = 35), femur (n =11) and tibia (n = 7). The most frequent tumors affecting the bone were myeloma (n = 13), breast (n = 11), lung (n = 8), and renal cell cancer (n = 7). Acrylic cement reinforcement was used in 2 patients. One patient was subjected to electrochemotherapy after nail insertion. Intraoperative and early postoperative complications occurred in 13.2% and 7.54% of patients respectively. Eight patients had local progression and one developed a stress fracture proximally to the distal static screw. Radiographic union occurred in 14 patients; one screw loosening was recorded.DISCUSSION:There is currently a lack of solid evidence on the clinical use of CFR nails in oncologic patients. This is the first and largest study of CFR nailing, with the longest available follow up.CONCLUSIONS:Implant related complications and surgery-related morbidity should be taken into account in the decision-making process for the surgical management of these patients. These data can improve the surgeon-patient communication and guide further studies on patients' survival and complications with respect to surgery.

AB - INTRODUCTION:Carbon fiber reinforced (CFR) implants have been proposed for the treatment of fractures or impending fractures of the long bones in the oncology patient. Aim of this study is to present the largest cohort of oncology patients operated by CFR nailing by the Italian Orthopaedic Society (SIOT) Bone Metastasis Study Group.METHODS:53 adult oncology patients were operated on with a CFR-PEEK nail. All the data from adjuvants therapies were collected. Bone callus formation, response to radiotherapy, relapse or progression of the osteolysis were recorded. Hardware survival and failure, breakage and need for implant revision were also analysed.RESULTS:Anatomical implantation of nails include humerus (n = 35), femur (n =11) and tibia (n = 7). The most frequent tumors affecting the bone were myeloma (n = 13), breast (n = 11), lung (n = 8), and renal cell cancer (n = 7). Acrylic cement reinforcement was used in 2 patients. One patient was subjected to electrochemotherapy after nail insertion. Intraoperative and early postoperative complications occurred in 13.2% and 7.54% of patients respectively. Eight patients had local progression and one developed a stress fracture proximally to the distal static screw. Radiographic union occurred in 14 patients; one screw loosening was recorded.DISCUSSION:There is currently a lack of solid evidence on the clinical use of CFR nails in oncologic patients. This is the first and largest study of CFR nailing, with the longest available follow up.CONCLUSIONS:Implant related complications and surgery-related morbidity should be taken into account in the decision-making process for the surgical management of these patients. These data can improve the surgeon-patient communication and guide further studies on patients' survival and complications with respect to surgery.

KW - Carbon fiber

KW - Metastasis

KW - Nail

KW - Primary bone tumor

KW - Radiotherapy

KW - Soft tissue sarcoma

U2 - 10.1016/S0020-1383(17)30659-9

DO - 10.1016/S0020-1383(17)30659-9

M3 - Article

VL - 48

SP - S55-S59

JO - Injury

JF - Injury

SN - 0020-1383

IS - suppl 3

ER -