Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Tumor 246 articles


Lymphadenectomy and Histologic Subtype Affect Overall Survival of Soft Tissue Sarcoma Patients With Nodal Metastases

Chigusa Sawamura MD, MPH, Seiichi Matsumoto MD, PhD, Takashi Shimoji MD, PhD, Keisuke Ae MD, PhD, Atsushi Okawa MD, PhD

Lymph node metastases in patients with soft tissue sarcomas are rare and these metastases are frequently associated with certain histologic subtypes. The survival is believed to be poor if lymph node metastases occur and the potential benefit of lymphadenectomy is unclear.

A Novel Imaging System Permits Real-time in Vivo Tumor Bed Assessment After Resection of Naturally Occurring Sarcomas in Dogs

William C. Eward DVM, MD, Jeffrey K. Mito MD, PhD, Cindy A. Eward DVM, Jessica E. Carter, Jorge M. Ferrer PhD, David G. Kirsch MD, PhD, Brian E. Brigman MD, PhD

Treatment of soft tissue sarcoma (STS) includes complete tumor excision. However, in some patients, residual sarcoma cells remain in the tumor bed. We previously described a novel hand-held imaging device prototype that uses molecular imaging to detect microscopic residual cancer in mice during surgery.

Which Implant Is Best After Failed Treatment for Pathologic Femur Fractures?

Jonathan Agner Forsberg MD, Rikard Wedin MD, PhD, Henrik Bauer MD, PhD

Successful treatment of pathologic femur fractures can preserve a patient’s independence and quality of life. The choice of implant depends on several disease- and patient-specific variables; however, its durability must generally match the patient’s estimated life expectancy. Failures do occur, however, it is unclear which implants are associated with greater risk of failure.

Computer-assisted Tumor Surgery in Malignant Bone Tumors

Kwok Chuen Wong MD, Shekhar Madhukar Kumta MD

Small recent case series using CT-based navigation suggest such approaches may aid in surgical planning and improve accuracy of intended resections, but the accuracy and clinical use have not been confirmed.

Surgical Technique: Tibia Cortical Strut Autograft Interposition Arthrodesis After Distal Radius Resection

Michiel A. J. Sande MD, PhD, Niels H. W. Geldorp MSc, P. D. Sander Dijkstra MD, PhD, Antonie H. M. Taminiau MD, PhD

Distal radius reconstruction after en bloc tumor resection remains a surgical challenge. Although several surgical techniques, either reconstructing the wrist or achieving a stable arthrodesis, have been described, it is unclear to what degree these restore function.

Giant Cell Tumor With Pathologic Fracture: Should We Curette or Resect?

Lizz Heijden MSc, P. D. Sander Dijkstra MD, PhD, Domenico A. Campanacci MD, PhD, C. L. Max H. Gibbons MD, PhD, Michiel A. J. Sande MD, PhD

Approximately one in five patients with giant cell tumor of bone presents with a pathologic fracture. However, recurrence rates after resection or curettage differ substantially in the literature and it is unclear when curettage is reasonable after fracture.

Using the CUSUM Test to Control the Proportion of Inadequate Open Biopsies of Musculoskeletal Tumors

David J. Biau MD, PhD, Kurt R. Weiss MD, MSc, Rej S. Bhumbra PhD, FRCS (Tr & Orth), Darin Davidson MD, MSc, Chris Brown MD, PhD, Jay S. Wunder MD, MSc, Peter C. Ferguson MD, MSc

Biopsies of musculoskeletal tumors lead to alterations in treatment in almost 20% of cases. Control charts are useful to ensure that a process is operating at a predetermined level of performance, although their use has not been demonstrated in assessing the adequacy of musculoskeletal biopsies.

Joint-preserving Tumor Resection and Reconstruction Using Image-guided Computer Navigation

Kwok Chuen Wong MD, Shekhar Madhukar Kumta MD

Joint-preserving surgery is performed in select patients with bone sarcomas of extremities and allows patients to retain the native joint with better joint function. However, recurrences may relate to achieving adequate margins and there is frequently little room for error in tumors close to the joint surface. Further, the tumor margin on preoperative CT and/or MR images is difficult to transpose to the actual extent of tumor in the bone in the operating room.

Haptic Robot-assisted Surgery Improves Accuracy of Wide Resection of Bone Tumors: A Pilot Study

Fazel Khan MD, Andrew Pearle MD, Christopher Lightcap PhD, Patrick J. Boland MD, John H. Healey MD

Accurate reproduction of the preoperative plan at the time of surgery is critical for wide resection of primary bone tumors. Robotic technology can potentially help the surgeon reproduce a given preoperative plan, but yielding control of cutting instruments to a robot introduces potentially serious complications. We developed a novel passive (“haptics”) robot-assisted resection technique for primary bone sarcomas that takes advantage of robotic accuracy while still leaving control of the cutting instrument in the hands of the surgeon.