Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Tumor 239 articles

Articles

Is It Appropriate to Treat Sarcoma Metastases With Intramedullary Nailing?

Bryan S. Moon MD, Dwayne J. Dunbar MS, Patrick P. Lin MD, Robert L. Satcher MD, Justin E. Bird MD, Valerae O. Lewis MD

Patients with primary bone and soft tissue sarcoma are at risk for skeletal metastases. Although uncommon, these metastases can result in impending or pathologic fractures. Intramedullary nailing traditionally has been an accepted form of palliative treatment for patients with metastatic carcinoma, but we could find no studies that report specifically on intramedullary nailing of metastatic sarcoma lesions.

Are Recently Trained Tumor Fellows Performing Less Tumor Surgery? An Analysis of 10 Years of the ABOS Part II Database

Kyle R. Duchman MD, Benjamin J. Miller MD, MS

The majority of orthopaedic trainees pursue additional subspecialty training at the conclusion of residency. Although national trends indicate that fellowship-trained surgeons are more frequently performing cases in their defined subspecialties, this may not be the case for recently trained tumor fellows. Prior work has established that low tumor case volume is a significant stressor for recently trained tumor fellows. Given the relative rarity of musculoskeletal tumors, it is important for prospective trainees to have clear expectations for the proportion of specialty-specific procedures early during their careers. In addition, knowledge of anticipated specialty case volume is important to optimize fellowship training and to provide guidance for meeting the public health requirements for orthopaedic oncology.

What are the Functional Results, Complications, and Outcomes of Using a Custom Unipolar Wrist Hemiarthroplasty for Treatment of Grade III Giant Cell Tumors of the Distal Radius?

Baichuan Wang MD, PhD, Qiang Wu MD, PhD, Jianxiang Liu MD, PhD, Songfeng Chen PhD, Zhicai Zhang MD, PhD, Zengwu Shao MD, PhD

A giant cell tumor (GCT) of bone presenting in the distal radius is rare, however, when they occur, Campanacci Grade III tumors can present formidable reconstructive challenges. They are associated with a high local recurrence rate with intralesional treatment, therefore approaches to reconstruct the wrist after en bloc resection warrant study.

Developing an Evidence-based Followup Schedule for Bone Sarcomas Based on Local Recurrence and Metastatic Progression

Cara Cipriano MD, Anthony M. Griffin MSc, Peter C. Ferguson MD, Jay S. Wunder MD

The potential for local recurrence and pulmonary metastasis after treatment of primary bone sarcomas necessitates careful patient followup; however, minimal data exist regarding the incidence and timing of these events, and therefore an evidence-based surveillance protocol has not been developed.

Reliability and Validity of a Japanese-language and Culturally Adapted Version of the Musculoskeletal Tumor Society Scoring System for the Lower Extremity

Shintaro Iwata MD, Kosuke Uehara MD, Koichi Ogura MD, Toru Akiyama MD, Yusuke Shinoda MD, Tsukasa Yonemoto MD, Akira Kawai MD

The Musculoskeletal Tumor Society (MSTS) scoring system is a widely used functional evaluation tool for patients treated for musculoskeletal tumors. Although the MSTS scoring system has been validated in English and Brazilian Portuguese, a Japanese version of the MSTS scoring system has not yet been validated.

Hypotensive Epidural Anesthesia Reduces Blood Loss in Pelvic and Sacral Bone Tumor Resections

Alex K. Freeman BSc, MBChB, Chris J. Thorne MBChB, C. Louie Gaston MD, Richard Shellard FRCA, Tom Neal FRCA, Michael C. Parry MD, FRCS, Robert J. Grimer FRCS, Lee Jeys MSc, FRCS

Resection of pelvic and sacral tumors can cause severe blood loss, complications, and even postoperative death. Hypotensive epidural anesthesia has been used to mitigate blood loss after elective arthroplasty, but to our knowledge, it has not been studied as an approach that might make resection of pelvic and sacral tumors safer.

A Novel System for the Surgical Staging of Primary High-grade Osteosarcoma: The Birmingham Classification

Lee M. Jeys MSc, FRCS, Chris J. Thorne MBChB, Michael Parry MD, FRCS, Czar Louie L. Gaston MD, Vaiyapuri P. Sumathi MD, FRCPath, J. Robert Grimer FRCS

Chemotherapy response and surgical margins have been shown to be associated with the risk of local recurrence in patients with osteosarcoma. However, existing surgical staging systems fail to reflect the response to chemotherapy or define an appropriate safe metric distance from the tumor that will allow complete excision and closely predict the chance of disease recurrence. We therefore sought to review a group of patients with primary high-grade osteosarcoma treated with neoadjuvant chemotherapy and surgical resection and analyzed margins and chemotherapy response in terms of local recurrence.

Proximal Tibia Reconstruction After Bone Tumor Resection: Are Survivorship and Outcomes of Endoprosthetic Replacement and Osteoarticular Allograft Similar?

Jose I. Albergo MD, Czar L. Gaston MD, Luis A. Aponte-Tinao MD, Miguel A. Ayerza MD, D. Luis Muscolo MD, Germán L. Farfalli MD, Lee M. Jeys FRCS, Simon R. Carter FRCS, Roger M. Tillman FRCS, Adesegun T. Abudu FRCS, Robert J. Grimer FRCS

The proximal tibia is one of the most challenging anatomic sites for extremity reconstructions after bone tumor resection. Because bone tumors are rare and large case series of reconstructions of the proximal tibia are lacking, we undertook this study to compare two major reconstructive approaches at two large sarcoma centers.

How Often Does Spindle Failure Occur in Compressive Osseointegration Endoprostheses for Oncologic Reconstruction?

Lauren H. Goldman MD, Lee J. Morse MD, Richard J. O’Donnell MD, Rosanna L. Wustrack MD

Compressive osseointegration is a promising modality for limb salvage in distal femoral oncologic tumors. However, few studies have explored short-term survival rates in a large patient cohort of distal femur compressive endoprostheses or highlighted the risk factors for spindle failures.

What Are the Functional Results and Complications With Long Stem Hemiarthroplasty in Patients With Metastases to the Proximal Femur?

Joel R. Peterson MA, Alexander P. Decilveo BA, Ian T. O’Connor BS, Ivan Golub BS, James C. Wittig MD

Traditional treatments for pathological fractures of the proximal femur resulting from metastatic bone disease include fixation with intramedullary nailing supplemented with polymethylmethacrylate, osteosynthesis with a plate-screw construct and polymethylmethacrylate, or endoprosthetic reconstruction. Despite the frequent practice of these treatments, treatment outcomes have not been rigorously compared. In addition, very few studies examine specific approaches to endoprosthetic reconstruction such as long stem hemiarthroplasty.