Treatment of Hydatid Disease of the Tibia by Using Poly-Methyl Methacrylate (PMMA) Bone Cements, Clinical Results of a Case Series

Document Type : Case Report

Authors

1 Orthopedic Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran

2 Orthopedic Research Center, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran

3 Orthopedic Research Center, Shahid Kamyab Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran

4 Research and Education Department, Razavi Hospital, Mashhad, IR Iran

10.30483/rijm.2015.118377

Abstract

Introduction: Bone is an uncommon site of involvement in hydatid disease; with the prevalence of 0.5-2% among bone lesions. Case Presentation: In this study, we report the treatment of 5 cases of hydatid disease of tibia by curettage of the lesion; wash with Betadine lotion and hypertonic saline and filling the cavity with poly methyl metacrylate (PMMA) bone cement. After operation, we continued treatment with oral mebendazole for 6 months. Conclusions: With the average 89 months follow-up, no recurrence of the diseases was found in the patients. It seems that using of cement and oral anti-parasitic, after extensive resection of the lesion is a proper treatment of bone hydatid disease.

Keywords


  1. 1.Morris BS, Madiwale CV, Garg A, Chavhan GB. Hydatid disease of bone: a mimic of other skeletal pathologies. Australas Radiol. 2002;46(4):431–4.

    1. Gossios KJ, Kontoyiannis DS, Dascalogiannaki M, Gourtsoyiannis NC. Uncommon locations of hydatid disease: CT appearances. Eur Radiol. 1997;7(8):1303–8.
    2. Savas L, Onlen Y, Akcali C, Aslan B, Pourbagher A, Tunc T, et al. Hydatid disease with atypical localization: 4 cases report. Scand J Infect Dis. 2004;36(8):613–5.
    3. Jellad A, Boudokhane S, Ezzine S, Ben Salah Z, Golli M. Femoral neuropathy caused by compressive iliopsoas hydatid cyst: a case report and review of the literature. Joint Bone Spine. 2010;77(4):371–2. 5. Song X, Liu D, Wen H. Diagnostic pitfalls of spinal echinococcosis. J Spinal Disord Tech. 2007;20(2):180–5.
    4. Hooper J, McLean I. Hydatid disease of the femur. Report of a case. J Bone Joint Surg Am. 1977;59(7):974–6.
    5. Charles RW, Govender S, Naidoo KS. Echinococcal infection of the spine with neural involvement. Spine (Phila Pa 1976). 1988;13(1):47–9.
    6. Islekel S, Ersahin Y, Zileli M, Oktar N, Oner K, Ovul I, et al. Spinal hydatid disease. Spinal Cord. 1998;36(3):166–70.
    7. Agarwal S, Kundu ZS, Singh S, Soni N. Hydatid Disease Of The Bone. Internet J Spine Surg. 2009;5(1):240–5.
    8. Amouian S, Tayebi N, Mohamadian Roshan NA. Retrospective study of 1759 cases of Hydatid cyst in Mashad University hospitals. Hakim Research Journal. 2005;4(7):7–13.
    9. Sadjjadi SM. Present situation of echinococcosis in the Middle East and Arabic North Africa. Parasitol Int. 2006;55 Suppl:S197–202.
    10. Yousofi H. Situation of hydatid cyst infection during last two decades (1985-2005) in Iran (Review of articles). Shahrekord Uni Med Sci J . 2008;1(10):78–88.
    11. Jellali MA, Zrig M, Zrig A, Mnif H, Hmida B, Abid A, et al. [Pathological humeral fracture revealing bone hydatic cyst]. Med Mal Infect. 2011;41(3):164–6.
    12. Moraux A, Kermarrec E, Czarnecki E, Boutry N, Demondion X, Cotten A. [Spinal infections: typical and atypical imaging features]. J Radiol. 2010;91(9 Pt 2):1049–56.
    13. Agarwal S, Shah A, Kadhi SK, Rooney RJ. Hydatid bone disease of the pelvis. A report of two cases and review of the literature. Clin Orthop Relat Res. 1992(280):251–5.
    14. Karray S, Zlitni M, Fowles JV, Zouari O, Slimane N, Kassab MT, et al. Vertebral hydatidosis and paraplegia. J Bone Joint Surg Br. 1990;72(1):84–8.
    15. Combalia A, Sastre-Solsona S. Hydatid cyst of gluteus muscle. Two cases. Review of the literature. Joint Bone Spine. 2005; 72(5):430–2.
    16. Merkle EM, Schulte M, Vogel J, Tomczak R, Rieber A, Kern P, et al. Musculoskeletal involvement in cystic echinococcosis: report of eight cases and review of the literature. AJR Am J Roentgenol. 1997;168(6):1531–4.
    17. Booz MK. The management of hydatid disease of bone and joint. J Bone Joint Surg Br. 1972;54(4):698–709.
    18. Pintilie DC, Panoza G, Hatmanu D, Fahrer M. Echinococcosis of the humerus. Treatment by resection and bone-grafting: A case report. J Bone Joint Surg Am. 1966;48(5):957–61.
    19. Mjoberg B, Pettersson H, Rosenqvist R, Rydholm A. Bone cement, thermal injury and the radiolucent zone. Acta Orthop Scand. 1984;55(6):597–600.
    20. Rock MG. Treatment of bone cysts and giant cell tumors. Curr opin Orthopaedic. 1990;1(1):423–34.
    21. Yildiz Y, Bayrakci K, Altay M, Saglik Y. The use of polymethylmethacrylate in the management of hydatid disease of bone. J Bone Joint Surg Br. 2001;83(7):1005–8.