Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Tumor 247 articles


Endoprostheses Last Longer Than Intramedullary Devices in Proximal Femur Metastases

Norah Harvey MD, Elke R. Ahlmann MD, Daniel C. Allison MD, MBA, Lingjun Wang PA, Lawrence R. Menendez MD, FACS

The proximal femur is the most common site of surgery for bone metastases, and stabilization may be achieved through intramedullary fixation (IMN) or endoprosthetic reconstruction (EPR). Intramedullary devices are less expensive, less invasive, and may yield improved function over endoprostheses. However, it is unclear which, if either, has any advantages.

What Are Risk Factors for Local Recurrence of Deep High-grade Soft-tissue Sarcomas?

Chigusa Sawamura MD, MPH, Seiichi Matsumoto MD, PhD, Takashi Shimoji MD, PhD, Taisuke Tanizawa MD, Keisuke Ae MD, PhD

Patients with local recurrence of soft-tissue sarcomas have a poor overall survival. High-grade, soft-tissue sarcomas in deep locations may have a poorer prognosis regarding local recurrence than low-grade sarcomas or those located superficially. Although previous reports evaluated tumors at various depths, it is unclear what factors influence recurrence of deep, high-grade sarcomas.

Orthopaedic Case of the Month: Painful Lower-leg Mass in a 76-year-old Man

Prasad J. Sawardeker MD, MS, Check C. Kam MD, J. David Pitcher MD, H. Thomas Temple MD

Survival, Local Recurrence, and Function After Pelvic Limb Salvage at 23 to 38 Years of Followup

Courtney E. Sherman MD, Mary I. O’Connor MD, Franklin H. Sim MD

Malignant pelvic tumors frequently pose challenges to surgeons owing to complex pelvic anatomy and local extension. External hemipelvectomy frequently allows adequate margins but is associated with substantial morbidity and reduced function. Limb salvage is an alternative approach when adequate margins can be achieved, but long-term function and survival are unclear.

Similar Local Control between Phenol- and Ethanol-treated Giant Cell Tumors of Bone

Wei-Hsin Lin MD, Tsung-Yu Lan MD, Chih-Yu Chen MD, Karl Wu MD, Rong-Sen Yang MD

Giant cell tumors (GCTs) of bone often are treated with curettage, adjuvant therapy, and cementation. Phenol is a commonly used adjuvant associated with local control rates ranging from 9% to 25%. However, it is corrosive to the eyes, skin, and respiratory tract. Ethanol is readily available and does not cause chemical burns on contact, but it is unclear whether ethanol can achieve similar local control rates as phenol for treating GCTs.

Intercalary Femur Allografts Are an Acceptable Alternative After Tumor Resection

Luis Aponte-Tinao MD, Germán L. Farfalli MD, Lucas E. Ritacco MD, Miguel A. Ayerza MD, D. Luis Muscolo MD

With the improved survival for patients with malignant bone tumors, there is a trend to reconstruct defects using biologic techniques. While the use of an intercalary allograft is an option, the procedures are technically demanding and it is unclear whether the complication rates and survival are similar to other approaches.

Endothelin-1 Promotes Osteosarcoma Cell Invasion and Survival against Cisplatin-induced Apoptosis

Yuanting Zhao MD, Qiande Liao MD, Yong Zhu MD, Haitao Long MD

Endothelin-1 (ET-1) participates in a wide range of cancer-relevant processes including cell proliferation, inhibition of apoptosis, matrix remodeling, bone deposition, and metastases. Although ET-1 reportedly promotes osteosarcoma (OS) cell invasion, suggesting an important role of ET-1 in OS metastasis, the role of ET-1 in OS remains unclear.

Bizarre Parosteal Osteochondromatous Proliferation: A Locally Aggressive Benign Tumor

Jibu Joseph MRCS, David Ritchie FRCR, Elaine MacDuff FRCPath, Ashish Mahendra FRCS (Trauma & Orth)

Bizarre parosteal osteochondromatous proliferation (BPOP) is a benign lesion of bone, and numerous questions remain unresolved regarding its etiology, diagnosis, and treatment.

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.