Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Tumor 242 articles


Locking Buttons Increase Fatigue Life of Locking Plates in a Segmental Bone Defect Model

Marc Tompkins MD, David J. Paller MS, Douglas C. Moore MS, Joseph J. Crisco PhD, Richard M. Terek MD

Durability of plate fixation is important in delayed union. Although locking plates result in stronger constructs, it is not known if locking affects the fatigue life of a plate. Two locking screws on either side of the nonunion could decrease working length and increase strain in the plate. However, the reinforcing effect of the locking head on the plate may compensate, so that it is unclear whether locking reduces fatigue life.

Prophylactic Stabilization for Bone Metastases, Myeloma, or Lymphoma: Do We Need to Protect the Entire Bone?

Hasham M. Alvi MD, Timothy A. Damron MD

The current operative standard of care for disseminated malignant bone disease suggests stabilizing the entire bone to avoid the need for subsequent operative intervention but risks of doing so include complications related to embolic phenomena.

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.