Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Tumor 247 articles


Physeal Distraction for Joint Preservation in Malignant Metaphyseal Bone Tumors in Children

Michael Betz MD, Charles E. Dumont MD, Bruno Fuchs MD, G. Ulrich Exner MD

Physeal distraction facilitates metaphyseal bone tumor resection in children and preserves the adjacent joint. The technique was first described by Cañadell. Tumor resection procedures allowing limb-sparing reconstruction have been used increasingly in recent years without compromising oncologic principles.

High Long-term Local Control with Sacrectomy for Primary High-grade Bone Sarcoma in Children

Alexandre Arkader MD, Christine H. Yang BA, MS, Vernon T. Tolo MD

Sacrectomy may offer curative potential for primary sarcomas of the sacrum. However, it is unclear whether and to what extent sacrectomies achieve local control.

Length of Symptoms Before Referral: Prognostic Variable for High-grade Soft Tissue Sarcoma?

Bruce T. Rougraff MD, Jackie Lawrence MA, Kenneth Davis MS

It is commonly assumed patients with high-grade soft tissue sarcomas who are diagnosed and treated quickly after the first onset of symptoms fare better than those with longer symptoms before treatment. The literature contains no substantive data to support this assumption for soft tissue sarcomas, particularly for high-grade lesions.

Intralesional Excision versus Wide Resection for Giant Cell Tumor Involving the Acetabulum: Which is Better?

Wei Guo MD, PhD, Xin Sun MD, Jie Zang MD, Huayi Qu MD

Because of the anatomic complexity of the pelvis, there is no standard surgical treatment for giant cell tumors (GCTs) of the pelvic bones, especially in the periacetabular region. Treatment options include intralesional curettage with or without adjunctive techniques and wide resection. The best surgical treatment of a pelvic GCT remains controversial.

What are Estimated Reimbursements for Lower Extremity Prostheses Capable of Surgical and Nonsurgical Lengthening?

Eric R. Henderson MD, Andrew M. Pepper BS, G. Douglas Letson MD

Growing prostheses accommodate skeletally immature patients with bone tumors undergoing limb-preserving surgery. Early devices required surgical procedures for lengthening; recent devices lengthen without surgery. Expenses for newer expandable devices that lengthen without surgery are more than for their predecessors but overall reimbursement amounts are not known.

Giant Cell Tumor of Bone: Are We Stratifying Results Appropriately?

Thomas J. Kremen MD, Nicholas M. Bernthal MD, Mark A. Eckardt BS, Jeffrey J. Eckardt MD

There is no consensus as to which surgical approach to the treatment of giant cell tumor of bone is most appropriate or which patients are at a higher risk for recurrence or metastasis.

Extremity Soft Tissue Sarcoma Resections: How Wide Do You Need to Be?

David M. King MD, Donald A. Hackbarth MD, Andrew Kirkpatrick BS

Sarcomas require a wide margin of resection including a cuff of normal tissue to minimize the risk of local recurrence. The amount of tissue that constitutes a wide margin is unclear in the literature.

Does Adjunctive Chemotherapy Reduce Remission Rates Compared to Cortisone Alone in Unifocal or Multifocal Histiocytosis of Bone?

André Mathias Baptista MD, PhD, André Ferrari França Camargo MD, Olavo Pires Camargo MD, PhD, Vicente Odone Filho MD, PhD, Alejandro Enzo Cassone MD, PhD

Langerhans cell histiocytosis (LCH) is a rare disorder that can affect almost any organ, including bone. Treatment options include local corticosteroid infiltration in isolated bone lesions and oral corticosteroids and chemotherapy in multifocal bone lesions. Several studies show local corticosteroid injection in unifocal bone lesions heal in more than 75% of patients with minimal side effects. Therefore, it is unclear whether chemotherapy adds materially to the healing rate.

Aseptic Failure: How Does the Compress® Implant Compare to Cemented Stems?

Andrew C. Pedtke MD, Rosanna L. Wustrack MD, Andrew S. Fang MD, Robert J. Grimer FRCS, Richard J. O’Donnell MD

Failure of endoprosthetic reconstruction with conventional stems due to aseptic loosening remains a challenge for maintenance of limb integrity and function. The Compressimplant (Biomet Inc, Warsaw, IN, USA) attempts to avoid aseptic failure by means of a unique technologic innovation. Though the existing literature suggests survivorship of Compressand stemmed implants is similar in the short term, studies are limited by population size and followup duration.