title: Percutaneous Long Bone Cementoplasty for Palliation of Malignant Lesions of the Limbs: A Systematic Review.
abstract: OBJECTIVE
  Percutaneous cementoplasty (PC) is rarely applied to long bone tumours, since cement is not considered to be sufficiently resistant to torsional forces. We reviewed the literature to understand the effects of percutaneous long bone cementoplasty (PLBC) in terms of analgesia, limb function and complications.
  
  
  METHODS
  This study followed the Cochrane's guidelines for systematic reviews of interventions. Inclusion criteria were (1) prospective/retrospective studies concerning PC; (2) cohort including at least ten patients; (3) at least one patient in the cohort undergoing PLBC; (5) published in English; (6) results not published by the same author more than once.
  
  
  RESULTS
  One thousand five hundred and ninety-eight articles were screened and 13 matched the inclusion criteria covering 196 PLBC patients. Pain improvement was high in 68.2% patients (σ = 0.2) and mild in 27.4% (σ = 0.2). Functional improvement was high in 71.9% patients (σ = 0.1) and mild in 6% (σ = 0.1). Use of PLBC correlated with pain reduction (P < 0.001). Secondary fractures occurred in 16 cases (8%, σ = 2.5); other complications in 2% cases. Percutaneous stabilisation (PS) was coupled with PLBC in 17% of cases without any subsequent fracture. PS was not associated with absence of secondary fracture (P = 0.08).
  
  
  CONCLUSIONS
  PLBC is safe, offering good pain relief and recovery of impaired limb function. Secondary fractures are uncommon and PS may reduce their occurrence. However, no evidence is currently available to support PS plus PLBC as compared to PLBC alone.
authors: Department of Radiology, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy. r.cazzato@unicampus.it.
authors: Roberto Luigi
authors: RL
authors: Cazzato
authors: Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33000, Bordeaux, France. j.palussiere@bordeaux.unicancer.fr.
authors: Jean
authors: J
authors: Palussière
authors: Department of Radiology, Institut Bergonié, 229 Cours de l'Argonne, 33000, Bordeaux, France. x.buy@bordeaux.unicancer.fr.
authors: Xavier
authors: X
authors: Buy
authors: Department of Medical Oncology, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy. denaro@unicampus.it.
authors: Vincenzo
authors: V
authors: Denaro
authors: Department of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy. d.santini@unicampus.it.
authors: Daniele
authors: D
authors: Santini
authors: Department of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy. g.tonini@unicampus.it.
authors: Giuseppe
authors: G
authors: Tonini
authors: Department of Radiology, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy. r.grasso@unicampus.it.
authors: Rosario Francesco
authors: RF
authors: Grasso
authors: Department of Radiology, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy. b.zobel@unicampus.it.
authors: Bruno Beomonte
authors: BB
authors: Zobel
authors: Department of Radiology, Humanitas Research Hospital, 20089, Rozzano, Milan, Italy. dario.poretti@humanitas.it.
authors: Dario
authors: D
authors: Poretti
authors: Department of Radiology, Humanitas Research Hospital, 20089, Rozzano, Milan, Italy. vittorio.pedicini@humanitas.it.
authors: Vittorio
authors: V
authors: Pedicini
authors: Department of Radiology, Humanitas Research Hospital, 20089, Rozzano, Milan, Italy. luca.balzarini@humanitas.it.
authors: Luca
authors: L
authors: Balzarini
authors: Department of Radiology, Humanitas Research Hospital, 20089, Rozzano, Milan, Italy. ezio.lanza@humanitas.it.
authors: Ezio
authors: E
authors: Lanza
mesh_terms: D001843:Bone Cements; D001859:Bone Neoplasms / Q000628:therapy*; D001842:Bone and Bones; D060826:Cementoplasty; D005121:Extremities; D006801:Humans; D010166:Palliative Care / Q000379:methods*
chemical_list: D001843:Bone Cements
keywords: Long bone; Pathological fracture; Percutaneous cementoplasty