Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Tumor 239 articles


Surgical Technique: Extraarticular Knee Resection with Prosthesis–Proximal Tibia-extensor Apparatus Allograft for Tumors Invading the Knee

Rodolfo Capanna MD, Guido Scoccianti MD, Domenico Andrea Campanacci MD, Giovanni Beltrami MD, Pietro Biase MD

Intraarticular extension of a tumor requires a conventional extraarticular resection with en bloc removal of the entire knee, including extensor apparatus. Knee arthrodesis usually has been performed as a reconstruction. To avoid the functional loss derived from the resection of the extensor apparatus, a modified technique, saving the continuity of the extensor apparatus, has been proposed, but at the expense of achieving wide margins. In tumors involving the joint cavity, the entire joint complex including the distal femur, proximal tibia, the full extensor apparatus, and the whole inviolated joint capsule must be excised. We propose a novel reconstructive technique to restore knee function after a true extrarticular resection.

Perioperative Infection Rate in Patients with Osteosarcomas Treated with Resection and Prosthetic Reconstruction

Xin Li MD, Vincent M. Moretti MD, Adedayo O. Ashana BA, Richard D. Lackman MD

The incidence of perioperative infection after segmental tumor endoprosthetic replacement in previous reports varies from a high of 7.4% to a low of 2.6%. Appropriate antibiotic use for this group is unknown and controversial, whereas the relationship of antibiotic use and perioperative infection is unclear.

Simultaneous Nailing of Skeletal Metastases: Is the Mortality Really that High?

Bryan Moon MD, Patrick Lin MD, Robert Satcher MD, PhD, Valerae Lewis MD

The risk of death during simultaneous nailing of pathologic and impending fractures in patients with metastatic disease is believed to be so high that some authors have advocated a staged approach, especially for impending fractures. However, there are limited data to either support or refute the appropriateness of staging of multiple impending or pathologic fractures.

Alloprosthetic Composite is a Suitable Reconstruction After Periacetabular Tumor Resection

Davide Donati MD, Claudia Bella MD, Tommaso Frisoni MD, Luca Cevolani MD, Henry DeGroot MD

Resection of a tumor of the pelvis is most disabling when the acetabulum is excised and a durable reconstruction of the defect is hard to achieve. All available methods are associated with frequent complications. Few large series have been published, and fewer have focused entirely on complete resections of the acetabulum. The use of an allograft-prosthetic composite allows customization on the operating table. However, while such composites restore anatomy and function of the pelvis the use of pelvic allografts is controversial and the durability is unknown.

Does Delayed Reexcision Affect Outcome After Unplanned Excision for Soft Tissue Sarcoma?

Ilkyu Han MD, PhD, Hyun Guy Kang MD, PhD, Seung Chul Kang MD, Jay Rim Choi MD, Han-Soo Kim MD, PhD

Unplanned excision of a soft tissue sarcoma generally requires reexcision to achieve an adequate surgical margin. Many surgeons assume delay of definitive surgery adversely affects patient survival and local recurrence. However, no clear evidence of this assumption can be found in the literature.

Orthopaedic Case of the Month: Medial Knee Pain in a 69-year-old Man

Rej S. Bhumbra MBBS, PhD, FRCS (Tr & Orth), Monica Khanna FRCR, Brendan C. Dickson MSc, MD, FRCPC, Peter C. Ferguson MD, MSc, FRCSC

Recurrent Giant Cell Tumor of Long Bones: Analysis of Surgical Management

Frank M. Klenke MD, PhD, Doris E. Wenger MD, Carrie Y. Inwards MD, Peter S. Rose MD, Franklin H. Sim MD

Treatment of giant cell tumor of bone (GCT) often is complicated by local recurrence. Intralesional curettage is the standard of care for primary GCTs. However, there is controversy whether intralesional curettage should be preferred over wide resection in recurrent GCTs.