title: Osteonecrosis requiring total joint arthroplasty is a rare sequel in children and young adults treated for solid tumors.
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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Pediatrics, Oulu University Hospital , Oulu , Finland.
authors: Riitta
authors: R
authors: Niinimäki
authors: Tuukka
authors: T
authors: Niinimäki
authors: Lene
authors: L
authors: Mølgaard Hansen
authors: Jørgen H
authors: JH
authors: Olsen
authors: Tytti
authors: T
authors: Pokka
authors: Henrik
authors: H
authors: Hasle
authors: Arja
authors: A
authors: Harila-Saari
mesh_terms: D000293:Adolescent; D000328:Adult; D019643:Arthroplasty, Replacement / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D010020:Osteonecrosis / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D011379:Prognosis; D012042:Registries; D055815:Young Adult