Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Tumor 239 articles


Giant Cell Tumor of Bone: Risk Factors for Recurrence

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

Many surgeons treat giant cell tumor of bone (GCT) with intralesional curettage. Wide resection is reserved for extensive bone destruction where joint preservation is impossible or when expendable sites (eg, fibular head) are affected. Adjuvants such as polymethylmethacrylate and phenol have been recommended to reduce the risk of local recurrence after intralesional surgery. However, the best treatment of these tumors and risk factors for recurrence remain controversial.

Case Report: Common Femoral Artery Ligation after Sarcoma Resection in an Infant

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

Vascular reconstruction in infants constitutes a surgical challenge and is indicated frequently for acute occlusions. With the presence of a subacute vascular occlusion, including that produced by tumor resection, collateral circulation develops quickly. Thus a surgeon can consider tumor and vessel resection, without the need for vascular reconstruction.

Adductor Myocutaneous Flap Coverage for Hip and Pelvic Disarticulations of Sarcomas with Buttock Contamination

Michael L. Marfori MD, Edward H. M. Wang MD, MSc

Hip disarticulation and hemipelvectomy are alternatives to limb-salvage procedures for patients with extensive tumors of the upper thigh and buttocks. In cases when neither the conventional posterior gluteus maximus flap nor the anterior quadriceps flap can be used because of the location of the tumor, a medial adductor myocutaneous flap may be an alternative.

Curettage and Cryosurgery for Low-grade Cartilage Tumors Is Associated with Low Recurrence and High Function

David G. Mohler MD, Richard Chiu MS, David A. McCall MD, Raffi S. Avedian MD

Chondrosarcomas of bone traditionally have been treated by wide or radical excision, procedures that may result in considerable lifelong disability. Grade 1 chondrosarcomas have little or no metastatic potential and are often difficult to distinguish from painful benign enchondromas. Curettage with adjuvant cryosurgery has been proposed as an alternative therapy for Grade 1 chondrosarcomas given the generally better function after the procedure. However, because it is an intralesional procedure, curettage and cryosurgery may be associated with higher rates of recurrence.

MFH of Bone and Osteosarcoma Show Similar Survival and Chemosensitivity

Dae-Geun Jeon MD, Won Seok Song MD, Chang-Bae Kong MD, Jung Ryul Kim MD, Soo-Yong Lee MD

Patients with malignant fibrous histiocytoma of bone (MFH-B) and osteosarcoma reportedly have comparable survival rates, despite the lesser chemosensitivity of patients with MFH-B compared with those with osteosarcoma.

Office-based Core Needle Biopsy of Bone and Soft Tissue Malignancies: An Accurate Alternative to Open Biopsy with Infrequent Complications

Sheila C. Adams MD, Benjamin K. Potter MD, David J. Pitcher MD, H. Thomas Temple MD

Biopsy is a critical step in the diagnosis of musculoskeletal malignancy. As an alternative to open biopsy, percutaneous core needle biopsy techniques have been developed. As many studies combine office-based, image-guided, and operative biopsies, the accuracy of office-based core needle biopsy is not well documented.

Curettage and Graft Alleviates Athletic-Limiting Pain in Benign Lytic Bone Lesions

Vincent M. Moretti MD, Rachel L. Slotcavage MD, Eileen A. Crawford MD, Richard D. Lackman MD, Christian M. Ogilvie MD

Solitary bone cysts (SBC), nonossifying fibromas (NOF), and fibrous dysplasia (FD) create benign intramedullary lytic bone lesions. They are typically asymptomatic and treated conservatively. We present a series of lesions that caused performance-limiting pain in young athletes, a symptom phenomenon and possible treatment indication that has been poorly described in the literature.

Multiplanar Osteotomy with Limited Wide Margins: A Tissue Preserving Surgical Technique for High-grade Bone Sarcomas

Raffi S. Avedian MD, Rex C. Haydon MD, PhD, Terrance D. Peabody MD

Limb-salvage surgery has been used during the last several decades to treat patients with high-grade bone sarcomas. In the short- and intermediate-term these surgeries have been associated with relatively good function and low revision rates. However, long-term studies show a high rate of soft tissue, implant, and bone-related complications. Multiplanar osteotomy with limited wide margins uses angled bone cuts to resect bone tumors with the goal of complete tumor removal while sparing host tissue although its impact on local recurrence is not known.

Extraarticular Knee Resection for Sarcomas with Preservation of the Extensor Mechanism: Surgical Technique and Review of Cases

Pawel Zwolak MD, Stefanie P. Kühnel MD, Bruno Fuchs MD, PhD

Sarcomas in or contaminating the knee are rare but extremely challenging to treat. Complete resection of the joint is necessary, and often the entire extensor mechanism is removed as well. Reconstruction of the knee is challenging, and the resulting function may be compromised.