Solitary breast cancer metastasis to pelvic bone treated with a unique method of surgery combined with local doxorubicin administration

Treatment of bone metastasis is a major challenge for current and future orthopedic and oncology specialists. For the treatment of single metastases, there is a continuing search for effective local treatments that do not affect the whole patient. The current report describes the case of single breast cancer metastasis to the pelvic bone in a 50-year-old woman treated surgically by bone osteotomy combined with local doxorubicin application. The presence of cancer cells was confirmed by histopathological examination. After 6 months, the same defect was operated on again and a successful therapeutic result was confirmed by negative tumor pathology tests. The bone defect caused by osteotomy was reconstructed with allogenic bone grafts that healed completely over 14 months. To the best of our knowledge, this report is the first to combine the removal bone metastasis with direct local cytostatic drug administration without the use of a specific carrier, followed by successful bone reconstruction 6 months later using bone allografts. Thus, single bone metastasis may be successfully treated with resection and local cytostatic administration, enabling bone reconstruction in the postoperative period. The potential benefits of such treatments must be evaluated by considering the potential risks involved, including necrosis of surrounding soft tissues and general reactions to the chemotherapy. No data has been available until now regarding the risk of cancer disease generalization being influenced by such treatments, but patient quality of life can be improved significantly by the successful removal of a solitary bone metastasis. The present case report supports the continuation of research on improving local cytostatic drug administration during the treatment of bone metastasis

Impact of Varied Factors on Iron, Nickel, Molybdenum and Vanadium Concentrations in the Knee Joint

The aim of this study was to determine the concentrations of iron, nickel, molybdenum, and vanadium in the knee joint. We also examined the relationships between the concentrations of these metals in the knee joint and the influence of varied factors on the concentration of Fe, Ni, Mo, and V. The study of these trace elements is important, because these elements are used alone and in combination in diet supplements, and they are components of biomaterials implanted in medicine. The study materials, consisting of the spongy bone, cartilage, meniscus, anterior cruciate ligament (ACL), and infrapatellar fat pad, were obtained from 34 women and 12 men from northwestern Poland. The concentrations of Ni, Fe, Mo, and V were determined using spectrophotometric atomic absorption in inductively coupled argon plasma (ICP-AES). We found significantly higher Mo concentrations in the ACL of women than men. There was a significant difference in the Mo concentration in the spongy bone between patients from cities with fewer than 100,000 inhabitants and patients from cities with more than 100,000 residents. Iron concentrations in the spongy bone were higher in non-smoking patients and those who did not consume alcohol. Vanadium concentrations were higher in the infrapatellar fat pads in abstainers. In patients who had not undergone arthroscopy surgery, V concentration was lower in cartilage. The concentrations of V in the cartilage and infrapatellar fat pad were higher in osteoporotic patients than in non-osteoporotic patients. There were significant differences in Fe concentrations in the meniscus, with the lowest in osteoporotic patients. We noted lower Mo concentrations in the spongy bone of patients with rheumatoid arthritis. Furthermore, we noted some new interactions among metals in the studied structures of the knee joint. The results reported in this study show the influence of gender, place of residence, smoking, consumption of alcohol, arthroscopy surgery, osteoporosis, and rheumatoid arthritis on the Fe, Ni, Mo, and V concentrations in the studied structures of the knee joint

Concentration of Selected Elements in the Infrapatellar Fat Pad of Patients with a History of Total Knee Arthroplasty

In the period of long development, the human body adapted to specific concentrations of trace elements. Any changes in the trace element content manifesting in a deficiency or excess of metals in the human body may impair the functioning of the skeletal and articular system and of the organs, and may also predispose the body to the development of diseases, i.e., osteoporosis. Our study aimed to analyze the concentrations of calcium (Ca), magnesium (Mg), fluorides (F-), and lead (Pb) in the infrapatellar fat pad (Hoffa’s fat pad) of subjects who had undergone a total knee replacement (TKR) surgery. We also endeavored to establish how concentration levels of those elements are affected by selected biological and environmental factors. The studied group comprised 48 residents of Western Pomerania Province: 34 women (n = 34) aged 56–87 and 12 men (n = 12) aged 59–85. Concentration levels of Ca, Mg, and Pb were established using inductively coupled plasma-atomic emission spectrometry (ICP-AES). A Thermo Orion ion-selective electrode was applied for measuring F- concentration. Subjects aged 75–87 showed higher Mg concentration values than those aged 56–74. Big city residents and smokers were found to have higher infrapatellar fat pad Mg concentration than their non-smoking counterparts and small town dwellers. Of all the elements whose concentrations we analyzed in our studies, only magnesium was found to correlate with smoking, place of residence, and age. Our findings regarding the quantities of selected elements in the infrapatellar fat pad may be used for the interpretation and analysis of biological, morphological, and mechanical changes in the human body

Phosphorus Concentration in Knee Joint Structures of Patients Following Replacement Surgery

The aim of the study was to assess phosphorus (P) concentration in structures of the knee joint—including the tibial spongy bone, articular cartilage, meniscus, anterior cruciate ligament, and infrapatellar fat pad (Hoffa’s fat pad)—of patients following knee joint replacement. The study also aimed to assess the influence of selected biological and environmental factors on P concentration in studied parts of the knee joint. Phosphorus concentration was determined using inductively coupled plasma-atomic emission spectrometry (ICP-AES). Statistically significant differences in P concentration were found between different elements of the knee joint. The highest P concentration was measured in the spongy bone (72,746.68 mg kg−1 dw) and the lowest in the Hoffa’s fat pad (1203.19 mg kg−1 dw). P levels were unaffected by gender, age, BMI, place of residence, smoking, or alcohol consumption. Data on P concentration in the osteoarticular elements of the knee may be useful in the interpretation and evaluation of biochemical, morphological, and mechanical changes occurring in the body

The Effect of Risk Factors on the Levels of Chemical Elements in the Tibial Plateau of Patients with Osteoarthritis following Knee Surgery

The aim of this study was to evaluate the aforementioned chemical elements in tibial plateau samples obtained during knee arthroplasty. The gender-specific analysis of chemical element levels in the bone samples revealed that there were statistically significant differences in the concentration of Pb and Se/Pb ratio. The contents of elements in the tibial plateau in the patients with osteoarthritis (OA) can be arranged in the following descending order: F− > K > Zn > Fe > Sr > Pb > Mn > Se > Cd > THg. We observed statistical significant effects of environmental factors including smoking, seafood diet, and geographical distribution on the levels of the elements in tibial bone. Significant positive correlation coefficients were found for the relationships K-Cd, Zn-Sr, Zn-F−, THg-Pb, Pb-Cd, Se-Se/Pb, Se-Se/Cd, Se/Pb-Se/Cd, Pb-Cd/Ca, Cd-Cd/Ca, and F−-F−/Ca·1000. Significant negative correlations were found for the relationships THg-Se/Pb, Pb-Se/Pb, Cd-Se/Pb, K-Se/Cd, Pb-Se/Cd, Cd-Se/Cd, THg-Se/THg, Pb-Se/THg, Se-Pb/Cd, Zn-Cd/Ca, and Se/Cd-Cd/Ca. The results reported here may provide a basis for establishing reference values for the tibial plateau in patients with OA who had undergone knee replacement surgery. The concentrations of elements in the bone with OA were determined by age, presence of implants, smoking, fish and seafood diet, and sport activity