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Abstract
Background. 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.
Material and methods. 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.
Results. 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.
Conclusion. 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.
Acknowledgments
The authors would like to acknowledge Prof. Risto Sankila for his contribution to the data extraction from the Finnish Cancer Registry.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
This work was supported by grants from the Nona and Kullervo Väre Foundation, the Foundation for Paediatric Research, the Cancer Society of Northern Finland, the Alma and K.A. Snellman Foundation and the Finnish Medical Foundation. These foundations had no role in the study design, data collection, analysis and writing or in the decision to submit the manuscript.