Technique Reduces Pain and Is Safer Than Traditional Open Surgery; Findings Published in The Journal of Bone and Joint Surgery [11-March-2020] NEW YORK , March 11, 2020 /PRNewswire/ -- Thousands of patients whose cancer has spread to the bones could benefit from a new minimally invasive approach to fixing painful pelvic fractures, according to a st
| NEW YORK, March 11, 2020 /PRNewswire/ -- Thousands of patients whose cancer has spread to the bones could benefit from a new minimally invasive approach to fixing painful pelvic fractures, according to a study conducted by orthopedic oncology surgeons at Montefiore Medical Center
If cancer spreads from the primary location to the bones, it can cause them to weaken and eventually fracture. Pelvic fractures cause debilitating pain and make it extremely difficult to walk. Traditionally, surgeons perform a total hip replacement to reduce pain and improve quality of life. While this approach is often successful, it is major surgery and comes with risks, including significant blood loss, extended time under anesthesia, risk of infection, risk of dislocation and the need for a longer hospitalization. Orthopedic oncology surgeons at Montefiore are the first to use a novel approach called the “tripod” technique, for patients with pelvic lesions caused by cancer. This technique uses multiple screws that are placed through very small incisions, connecting the damaged bones and stabilizing the pelvis. It is called “tripod’ because the screws are placed in a tripod configuration to support the socket of the hip joint. “This approach goes against the conventional notion that bone affected by cancer is too weak and needs to be completely replaced,” said lead author Rui Yang, M.D., orthopedic surgeon, Montefiore, and assistant professor, Albert Einstein College of Medicine. “Our study shows that using this technique means patients don’t need to undergo a longer, more aggressive surgery. They recover and go home quicker, have less pain, and most importantly, can resume therapies targeted at treating their cancer.” This project is part of a larger research effort by the Division of Orthopaedic Oncology that includes the Musculoskeletal Oncology Research Laboratory, which performs basic and translational research as part of the National Cancer Institute-designated Albert Einstein Cancer Center. Their projects focus on rare primary bone and soft-tissue tumors, including osteosarcoma and synovial sarcoma. In addition, the Division of Orthopaedic Oncology routinely participates in a number of institutional and multi-center clinical studies spanning various aspects of orthopaedic oncology. The doctors have presented their findings at several national and international meetings, showing the “tripod” technique is safe, effective, and extremely well-tolerated by patients who were bedridden, in wheelchairs or using assistive devices to walk prior to the procedure. “We are pleased to find this technique results in better outcomes for our patients,” said co-author David Geller, M.D., orthopedic oncologist and vice-chairman, Strategy and Innovation, Orthopaedic Surgery, Montefiore and associate professor of Orthopedic Surgery and Pediatrics, Albert Einstein College of Medicine. “And we are surprised to find that despite conventional wisdom, many of our patients heal their fractures and experience new bone growth.” One patient who benefitted from the “tripod” technique is 58-year-old, 9/11 survivor, Nancy Toussaint. Nancy, who is the caregiver for her elderly parents, was running errands one day when she felt her hips “shift.” She managed the discomfort for a few weeks but decided to seek medical advice. Doctors discovered her pelvic bone had fractured as the result of cancer spreading throughout her body. Nancy underwent the “tripod” surgery in September to repair the pelvic fracture and is now undergoing cancer therapy. “Most of the patients in this study were able to get out of bed and bear weight on the same day as the surgery,” said Dr. Yang. “None of them needed a blood transfusion and there were no wound-healing issues. We hope that other surgeons will consider this approach so that patients have one less issue to deal with, while they undergo cancer treatment.” About Montefiore Health System About Albert Einstein College of Medicine
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