Uncemented Arthroplasty for Hip Pain and Fracture after Metastatic Disease and Multiple Myeloma: Case Series, Exploratory Graphical Analysis and Bayesian Network Modeling

Abstract

We are not aware of previous cases series of uncemented arthroplasty for hip pain or fracture secondary to metastatic disease or multiple myeloma. Objective: To describe a case series using a combination of narrative, graphical exploratory analysis and Bayesian Network modeling. Methods: Case series of 34 patients undergoing uncemented and hybrid arthroplasty procedures secondary to hip pain or fracture secondary to metastatic disease or multiple myeloma. Case series is presented using a narrative following Kempen’s reporting guidelines, exploratory graphical analysis and Bayesian Network modeling with a structure based on expert opinion and parameters inferred from the data. Most common tumors included gastrointestinal, multiple myeloma and breast. A total of 26.3% (n = 5) of all of our procedures were performed secondary to fractures. Most devices were total (n = 16, 84.2%) rather than partial, uncemented (n = 12, 63.2%) rather than hybrid. Average time between surgery and first walk was 20 days, average length of stay of 13 days, with average patient survival of 589 days. Only one infection was reported. Uncemented and hybrid arthroplasty devices did not differ in relation to time to walk as well as length of stay in this sample. Conclusion: Our model should be used as the prior for the addition of subsequent patient samples, thus personalizing its recommendations to other patient populations.