Niinimäki Riitta, Niinimäki Tuukka, Mølgaard Hansen Lene, Olsen Jørgen H, Pokka Tytti, Hasle Henrik, Harila-Saari Arja
Department of Pediatrics, Oulu University Hospital , Oulu , Finland.
Acta Oncol. 2014 Apr;53(4):481-5. doi: 10.3109/0284186X.2013.864049. Epub 2013 Dec 9.
Osteonecrosis (ON) is a potential sequel in patients treated for malignancies. The goal of this population-based register study was to determine the incidence of ON requiring total joint arthroplasty (TJA) in patients treated for solid tumors in childhood, adolescence, or early adulthood.
Patients diagnosed with a solid tumor before the age of 31 years were identified from the Finnish and Danish Cancer Registries. Patients with non-melanoma skin cancers and bone and connective tissue cancers were excluded. The data were combined with data from the National Hospital Discharge Registers and the Finnish Arthroplasty Registry. Data on the orthopedic procedures performed and the diagnosis codes given before the age of 40 years were retrieved.
Twenty-five of 18 542 (0.13%) patients had undergone TJA. The overall 20-year cumulative incidence of ON requiring TJA was 1% in patients treated for kidney cancer, followed by 0.5% in patients with breast cancer and 0.2% in patients with testicular cancer.
Severe ON requiring TJA is a rare sequel in children and young adults treated for solid tumors. It was observed most commonly in patients treated for renal, breast, or testicular cancer.
骨坏死（ON）是接受恶性肿瘤治疗患者的一种潜在后遗症。这项基于人群的登记研究的目的是确定在儿童期、青少年期或成年早期接受实体瘤治疗的患者中，需要进行全关节置换术（TJA）的骨坏死发生率。
从芬兰和丹麦癌症登记处识别出31岁之前被诊断为实体瘤的患者。排除非黑色素瘤皮肤癌以及骨与结缔组织癌患者。将这些数据与国家医院出院登记处和芬兰关节置换登记处的数据相结合。检索40岁之前进行的骨科手术数据和诊断编码。
18542例患者中有25例（0.13%）接受了全关节置换术。接受肾癌治疗的患者中，需要进行全关节置换术的骨坏死的20年累计发生率为1%，其次是乳腺癌患者为0.5%，睾丸癌患者为0.2%。
在接受实体瘤治疗的儿童和年轻人中，需要进行全关节置换术的严重骨坏死是一种罕见的后遗症。最常见于接受肾癌、乳腺癌或睾丸癌治疗的患者中。
