Reconstruction of Multiple Myeloma Lesions Around the Pelvis and Acetabulum

Overview

Journal Eur J Orthop Surg Traumatol

Specialty Orthopedics

Date 2014 Oct 20

PMID 25326868

Citations 6

Authors

Vasileios I Sakellariou

Andreas F Mavrogenis

Olga Savvidou

Franklin H Sim

Panayiotis J Papagelopoulos

Affiliations

Soon will be listed here.

Abstract

Multiple myeloma is a malignancy of monoclonal plasma cells (plasma cells are of B-lymphocyte lineage of the hematopoietic system). It is the second most prevalent blood malignancy after non-Hodgkin's lymphoma. It accounts for approximately 1 % of all malignancies and 2 % of all cancer deaths. Bony involvement is very common; the incidence of pelvic and periacetabular involvement in MM is reported to be around 6 %. Lytic lesions comprise a hallmark of multiple myeloma, which may be complicated with pathologic fractures in a substantial percentage of patients. Pelvic and periacetabular bony involvement of multiple myeloma is associated with some unique characteristics regarding the biomechanics of this specific anatomical region, the morbidity, the overall survival, and prognosis, which all reflect to impairment of quality of life. In this paper, we review the special features of multiple myeloma lesions around the pelvis and acetabulum and present an algorithm of management with the use of current surgical techniques.

Citing Articles

Multiple Myeloma (Part 2) - Update on The Approach to Bone Disease.

Guedes A, Becker R, Teixeira L Rev Bras Ortop (Sao Paulo). 2023; 58(3):368-377.

PMID: 37396088 PMC: 10310422. DOI: 10.1055/s-0043-1770150.

Joint-sparing reconstruction for extensive periacetabular metastases: Literature review and a novel minimally invasive surgical technique.

Araneta K, Rizkallah M, Boucher L, Turcotte R, Aoude A J Bone Oncol. 2022; 34:100428.

PMID: 35479667 PMC: 9035412. DOI: 10.1016/j.jbo.2022.100428.

Total Hip Arthroplasty with a Cementless Acetabular Component and Impaction Bone Grafting for Dysplastic Osteoarthritis Complicated by Multiple Myeloma.

Ogawa R, Hirao M, Umezu T, Yanagimoto S Case Rep Orthop. 2022; 2022:3939356.

PMID: 35190780 PMC: 8858054. DOI: 10.1155/2022/3939356.

Clinical outcomes and complications of surgical interventions for multiple myeloma lesions in the extremities and pelvis: A retrospective clinical study.

Topkar O, Erol B Acta Orthop Traumatol Turc. 2021; 55(2):159-165.

PMID: 33847579 PMC: 11229620. DOI: 10.5152/j.aott.2021.20130.

Prevention of bone disease and early detection of impending fractures in multiple myeloma patients can reduce morbidity and mortality: the necessity of interdisciplinary state-of-the-art treatment.

Herget G, Wasch R, Klein L, Schmal H, Terpos E, Engelhardt M Haematologica. 2020; 105(4):859-861.

PMID: 32238466 PMC: 7109744. DOI: 10.3324/haematol.2019.245423.

References

Greipp P, San Miguel J, Durie B, Crowley J, Barlogie B, Blade J . International staging system for multiple myeloma. J Clin Oncol. 2005; 23(15):3412-20. DOI: 10.1200/JCO.2005.04.242. View

Stanley A, Young A . Primary prevention of venous thromboembolism in medical and surgical oncology patients. Br J Cancer. 2010; 102 Suppl 1:S10-6. PMC: 3315366. DOI: 10.1038/sj.bjc.6605600. View

Ratasvuori M, Wedin R, Keller J, Nottrott M, Zaikova O, Bergh P . Insight opinion to surgically treated metastatic bone disease: Scandinavian Sarcoma Group Skeletal Metastasis Registry report of 1195 operated skeletal metastasis. Surg Oncol. 2013; 22(2):132-8. DOI: 10.1016/j.suronc.2013.02.008. View

DAntonio J, Capello W, Borden L, Bargar W, Bierbaum B, Boettcher W . Classification and management of acetabular abnormalities in total hip arthroplasty. Clin Orthop Relat Res. 1989; (243):126-37. View

Palumbo A, Sezer O, Kyle R, Miguel J, Orlowski R, Moreau P . International Myeloma Working Group guidelines for the management of multiple myeloma patients ineligible for standard high-dose chemotherapy with autologous stem cell transplantation. Leukemia. 2009; 23(10):1716-30. DOI: 10.1038/leu.2009.122. View

Ai L, Sun C, Zhang L, Zhou S, Chu Z, Qin Y . Inhibition of BDNF in multiple myeloma blocks osteoclastogenesis via down-regulated stroma-derived RANKL expression both in vitro and in vivo. PLoS One. 2012; 7(10):e46287. PMC: 3471864. DOI: 10.1371/journal.pone.0046287. View

Sun W, Li J, Li Q, Li G, Cai Z . Clinical effectiveness of hemipelvic reconstruction using computer-aided custom-made prostheses after resection of malignant pelvic tumors. J Arthroplasty. 2011; 26(8):1508-13. DOI: 10.1016/j.arth.2011.02.018. View

Utzschneider S, Schmidt H, Weber P, Schmidt G, Jansson V, Durr H . Surgical therapy of skeletal complications in multiple myeloma. Int Orthop. 2010; 35(8):1209-13. PMC: 3167427. DOI: 10.1007/s00264-010-1127-0. View

Richardson P . Newer treatment options for patients in first relapse. From the Multiple Myeloma Research Foundation. Oncology (Williston Park). 2006; 20(6):633-8. View

10.

Harrington K . The management of acetabular insufficiency secondary to metastatic malignant disease. J Bone Joint Surg Am. 1981; 63(4):653-64. View

11.

Goranova-Marinova V, Goranov S, Pavlov P, Tzvetkova T . Serum levels of OPG, RANKL and RANKL/OPG ratio in newly-diagnosed patients with multiple myeloma. Clinical correlations. Haematologica. 2007; 92(7):1000-1. DOI: 10.3324/haematol.10943. View

12.

Kumar S, Lee J, Lahuerta J, MORGAN G, Richardson P, Crowley J . Risk of progression and survival in multiple myeloma relapsing after therapy with IMiDs and bortezomib: a multicenter international myeloma working group study. Leukemia. 2011; 26(1):149-57. PMC: 4109061. DOI: 10.1038/leu.2011.196. View

13.

Kitagawa Y, Ek E, Choong P . Pelvic reconstruction using saddle prosthesis following limb salvage operation for periacetabular tumour. J Orthop Surg (Hong Kong). 2006; 14(2):155-62. DOI: 10.1177/230949900601400210. View

14.

Kastritis E, Zervas K, Symeonidis A, Terpos E, Delimbassi S, Anagnostopoulos N . Improved survival of patients with multiple myeloma after the introduction of novel agents and the applicability of the International Staging System (ISS): an analysis of the Greek Myeloma Study Group (GMSG). Leukemia. 2009; 23(6):1152-7. DOI: 10.1038/leu.2008.402. View

15.

Durie B . The role of anatomic and functional staging in myeloma: description of Durie/Salmon plus staging system. Eur J Cancer. 2006; 42(11):1539-43. DOI: 10.1016/j.ejca.2005.11.037. View

16.

Lee W, Wu W . Bilateral hip pain as presentation of multiple myeloma. Emerg Med J. 2011; 29(3):181. DOI: 10.1136/emermed-2011-200743. View

17.

Tillman R, Myers G, Abudu A, Carter S, Grimer R . The three-pin modified 'Harrington' procedure for advanced metastatic destruction of the acetabulum. J Bone Joint Surg Br. 2007; 90(1):84-7. DOI: 10.1302/0301-620X.90B1.19892. View

18.

Scharschmidt T, Lindsey J, Becker P, Conrad E . Multiple myeloma: diagnosis and orthopaedic implications. J Am Acad Orthop Surg. 2011; 19(7):410-9. DOI: 10.5435/00124635-201107000-00004. View

19.

Fisher N, Patton J, Grimer R, Porter D, Jeys L, Tillman R . Ice-cream cone reconstruction of the pelvis: a new type of pelvic replacement: early results. J Bone Joint Surg Br. 2011; 93(5):684-8. DOI: 10.1302/0301-620X.93B5.25608. View

20.

Walker R . Pelvic reconstruction/total hip arthroplasty for metastatic acetabular insufficiency. Clin Orthop Relat Res. 1993; (294):170-5. View