Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Tumor 239 articles


Surgical Technique: Iliosacral Reconstruction With Minimal Spinal Instrumentation

Nader A. Nassif MD, Jacob M. Buchowski MD, Kelly Osterman RN, Douglas J. McDonald MD

Posterior pelvic ring reconstruction can be challenging and controversial. The choice regarding whether to reconstruct and how to reconstitute the pelvic ring is unclear. Many methods provide stability but often are technically difficult and require excessive dissection.

Orthopaedic Case of the Month: A 51-year-old Man with a Painless Wrist Mass

Razvan Nicolescu MD, Paul D. Clifford MD, Philip G. Robinson MD, Sheila A. Conway MD

Poor Long-term Clinical Results of Saddle Prosthesis After Resection of Periacetabular Tumors

J. A. Jansen MD, M. A. J. Sande PhD, P. D. S. Dijkstra PhD

The saddle prosthesis originally was developed to reconstruct large acetabular defects in revision hip arthroplasty and was used primarily for hip reconstruction after periacetabular tumor resections. The long-term survival of these reconstructions is unclear.

Constrained Total Hip Megaprosthesis for Primary Periacetabular Tumors

Takafumi Ueda MD, PhD, Shigeki Kakunaga MD, PhD, Satoshi Takenaka MD, PhD, Nobuhito Araki MD, PhD, Hideki Yoshikawa MD, PhD

Limb-salvage reconstruction for periacetabular malignant tumors is one of the most challenging problems in orthopaedic oncology. Reconstructive options include resection arthroplasty, endoprosthesis, allograft, recycled autobone graft, arthrodesis, and pseudarthrosis. However, no standard procedure exists because of rarity and clinical variability of the disease. We previously developed a megaprosthetic system with a constrained total hip mechanism (C-THA).

Can a Less Radical Surgery Using Photodynamic Therapy With Acridine Orange Be Equal to a Wide-margin Resection?

Takao Matsubara MD, Katsuyuki Kusuzaki MD, Akihiko Matsumine MD, Tomoki Nakamura MD, Akihiro Sudo MD

Wide-margin resections are an accepted method for treating soft tissue sarcoma. However, a wide-margin resection sometimes impairs function because of the lack of normal tissue. To preserve the normal tissue surrounding a tumor, we developed a less radical (ie, without a wide margin) surgical procedure using adjunctive photodynamic therapy and acridine orange for treating soft tissue sarcoma. However, whether this less radical surgical approach increases or decreases survival or whether it increases the risk of local recurrence remains uncertain.

Surgery Quality and Tumor Status Impact on Survival and Local Control of Resectable Liposarcomas of Extremities or the Trunk Wall

Piotr Rutkowski MD, PhD, Sławomir Trepka MD, PhD, Konrad Ptaszynski MD, PhD, Milena Kołodziejczyk MD, PhD

The 5-year survival rates for localized liposarcomas reportedly vary from 75% to 91% with histologic grade as the most important prognostic factor. However, it is unclear which other factors, including the initial surgery quality and recurrent tumors, influence survival in localized liposarcomas (LPS).

Surgical Resection of Relapse May Improve Postrelapse Survival of Patients With Localized Osteosarcoma

Kwok Chuen Wong FHKAM (Orth), Vincent Lee FHKAM (Paed), MRCP, Matthew M. K. Shing FHKAM (Paed), MRCPCH, Shekhar Kumta PhD

Despite neoadjuvant chemotherapy and wide surgical ablation, 15% to 25% of patients with primary osteosarcoma will relapse (local recurrence or metastases). Neither chemotherapy nor radiation therapy alone will render a patient disease-free without concomitant surgical ablation of relapse. We prefer excision of relapse when possible. However, it is unclear whether excision enhances survival.

Does Combined Open and Arthroscopic Synovectomy for Diffuse PVNS of the Knee Improve Recurrence Rates?

Matthew W. Colman MD, Jason Ye MD, Kurt R. Weiss, Mark A. Goodman MD, Richard L. McGough MD

Diffuse-type pigmented villonodular synovitis (PVNS) has a high local recurrence rate and as such can lead to erosive destruction of the involved joint. Multiple surgical modalities exist, but it is unknown which technique best minimizes local recurrence and surgical morbidity.

Orthopaedic Case of the Month: Painless Right Knee Mass in 32-year-old Man

Michael K. Merz MD, Mansooreh Eghtesadghalati MD, Michael E. Bresler MD, Yasser R. Farid MD, PhD

Treating Metastatic Disease: Which Survival Model Is Best Suited for the Clinic?

Jonathan Agner Forsberg MD, Daniel Sjoberg MA, Qing-Rong Chen PhD, Andrew Vickers PhD, John H. Healey MD

To avoid complications associated with under- or overtreatment of patients with skeletal metastases, doctors need accurate survival estimates. Unfortunately, prognostic models for patients with skeletal metastases of the extremities are lacking, and physician-based estimates are generally inaccurate.