Z Orthop Unfall 2019; 157(04): 401-410
DOI: 10.1055/a-0762-1071
Review/Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Bone Metastases – Pathophysiology, Diagnostic Testing and Therapy (Part 2)

Article in several languages: English | deutsch
Sebastian Koob
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn
,
Michael Kehrer
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn
,
Andreas Strauss
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn
,
Cornelius Jacobs
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn
,
Dieter Christian Wirtz
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn
,
Jan Schmolders
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn
› Author Affiliations
Further Information

Publication History

Publication Date:
07 January 2019 (eFirst)

Abstract

The second part of this review deals with the several options for the surgical therapy of bone metastases according to their anatomical site and the patientʼs individual prognosis. Although metastases to the bone – with few exceptions – are normally given palliative therapy, patients nowadays reach survival times of several months to years, depending on the underlying tumour entity. Scoring systems are suitable to estimate the patientʼs prognosis and fracture risk. The indication for operation has to be adapted to these parameters. In order to preserve a high quality of life, a limb saving procedure has to be aimed at. The options include the resection of the metastasis with stabilisation, the sole stabilisation of the affected bone, and wide resection with limb reconstruction using a modular tumor endoprosthesis. With todayʼs anaesthesiological peri- and intraoperative care, a vast number of surgical implants and bone augmentations are available. However, what is important is not the practicability of the procedure, but the oncological justification and patient-adapted selection of surgical therapy.