Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Tumor 241 articles


Aggressive Tibial Lesion in a 70-year-old Man

Jacob M. Kirsch MD, Andrew E. Rosenberg MD, Brian J. O’Hara MD, John A. Abraham MD

Does Competing Risk Analysis Give Useful Information About Endoprosthetic Survival in Extremity Osteosarcoma?

Reinhard Schuh MD, Alexandra Kaider MSc, Reinhard Windhager MD, Philipp T. Funovics MD

Conventional survival analysis for endoprosthetic complications does not consider competing events adequately. Patients who die of their disease are no longer at risk for complications; therefore, death as a competing event may alter survivorship estimates in the orthopaedic-oncological setting.

Survival of Modern Knee Tumor Megaprostheses: Failures, Functional Results, and a Comparative Statistical Analysis

Elisa Pala MD, Giulia Trovarelli MD, Teresa Calabrò MD, Andrea Angelini MD, Caterina N. Abati MD, Pietro Ruggieri MD, PhD

Modular megaprostheses are now the most common method of reconstruction after segmental resection of the long bones in the lower extremities. Previous studies reported variable outcome and failure rates after knee megaprosthetic reconstructions.

Should Fractures in Massive Intercalary Bone Allografts of the Lower Limb Be Treated With ORIF or With a New Allograft?

Luis A. Aponte-Tinao MD, Miguel A. Ayerza MD, D. Luis Muscolo MD, Germán L. Farfalli MD

Massive bone allografts have been used for limb salvage of bone tumor resections as an alternative to endoprostheses, although they have different outcomes and risks. There is no general consensus about when to use these alternatives, but when it is possible to save the native joints after the resection of a long bone tumor, intercalary allografts offer some advantages despite complications, such as fracture. The management and outcomes of this complication deserve more study.

What Are the Functional Outcomes of Endoprosthestic Reconstructions After Tumor Resection?

Nicholas M. Bernthal MD, Marcia Greenberg MS, PT, Kent Heberer MS, Jeffrey J. Eckardt MD, Eileen G. Fowler PhD, PT

The majority of published functional outcome data for tumor megaprostheses comes in the form of subjective functional outcome scores. Sparse objective data exist demonstrating functional results, activity levels, and efficiency of gait after endoprosthetic reconstruction in patients treated for orthopaedic tumors. Patients embarking on massive surgical operations, often in the setting of debilitating medical therapies, face mortality and a myriad of unknowns. Objective functional outcomes provide patients with reasonable expectations and a means to envision life after treatment. Objective outcomes also provide a means for surgeons to compare techniques, rehabilitation protocols, and implants.

What Is the Use of Imaging Before Referral to an Orthopaedic Oncologist? A Prospective, Multicenter Investigation

Benjamin J. Miller MD, MS, Raffi S. Avedian MD, Rajiv Rajani MD, Lee Leddy MD, Jeremy R. White MD, Judd Cummings MD, Tessa Balach MD, Kevin MacDonald MD

Patients often receive advanced imaging before referral to an orthopaedic oncologist. The few studies that have evaluated the value of these tests have been single-center studies, and there were large discrepancies in the estimated frequencies of unnecessary use of diagnostic tests.

Paley’s Multiplier Method Does Not Accurately Predict Adult Height in Children with Bone Sarcoma

Magdalena Maria Gilg MD, Christine Wibmer MD, Dimosthenis Andreou MD, Alexander Avian PhD, Petra Sovinz MD, Werner Maurer-Ertl MD, Per-Ulf Tunn MD, Andreas Leithner MD

The majority of patients with osteosarcoma and Ewing’s sarcoma are diagnosed before skeletal maturity. Paley’s multiplier is used for height prediction in healthy children, and has been suggested as a method to make growth predictions for children with osteosarcoma and Ewing’s sarcoma when considering limb salvage options. To our knowledge, no evaluation of this method in this particular patient group has been performed, but a temporary growth deficit has been observed in children undergoing chemotherapy.

Does Total Humeral Endoprosthetic Replacement Provide Reliable Reconstruction With Preservation of a Useful Extremity?

Hazem Wafa FRCSEd(Tr & Orth), Krishna Reddy FRCSEd(Tr & Orth), Robert Grimer DSc, Adesegun Abudu FRCS(Tr & Orth), Lee Jeys FRCS(Tr & Orth), Simon Carter FRCS, Roger Tillman FRCS(Tr & Orth)

Controversy exists regarding the ideal method of reconstruction after proximal humeral resection and several reconstructive techniques have been reported. The reconstructive options are very limited when resection of the entire humerus is required. One option is endoprosthetic reconstruction, but there have been few published studies on the outcome of total humeral endoprosthetic reconstruction.

Do Patients With Ewing’s Sarcoma Continue With Sports Activities After Limb Salvage Surgery of the Lower Extremity?

Gerhard Martin Hobusch MD, Nikolaus Lang MD, Reinhard Schuh MD, Reinhard Windhager MD, Jochen Gerhard Hofstaetter MD

Limb salvage surgery has evolved to become the standard method of treating sarcomas of the extremities with acceptable oncologic results. However, little information exists relative to the activity level or ability to participate in sports after tumor reconstructions.

Does Intraoperative Navigation Assistance Improve Bone Tumor Resection and Allograft Reconstruction Results?

Luis Aponte-Tinao MD, Lucas E. Ritacco MD, Miguel A. Ayerza MD, D. Luis Muscolo MD, Jose I. Albergo MD, Germán L. Farfall MD

Bone tumor resections for limb salvage have become standard treatment. Recently, computer-assisted navigation has been introduced to improve the accuracy of joint arthroplasty and possible tumor resection surgery; however, like with any new technology, its benefits and limitations need to be characterized for surgeons to make informed decisions about whether to use it.