Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Tumor 245 articles

Articles

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.

What Is the Role of Allogeneic Cortical Strut Grafts in the Treatment of Fibrous Dysplasia of the Proximal Femur?

Bastiaan C. J. Majoor MD, Marleen J. M. Peeters-Boef MD, Michiel A. J. Sande MD, PhD, Natasha M. Appelman-Dijkstra MD, PhD, Neveen A. T. Hamdy MD, PhD, P. D. S. Dijkstra MD, PhD

Management of fibrous dysplasia of the proximal femur is a progressive, often recurrent condition of bone that can cause skeletal deformity, fractures, and pain. Allogeneic cortical strut grafting to minimize the risk of fracture or as part of fracture treatment is a promising treatment option, but evidence is scarce on the intermediate- to long-term results of this procedure and there are no data on factors associated with graft failure.

LUMiC® Endoprosthetic Reconstruction After Periacetabular Tumor Resection: Short-term Results

Michaël P. A. Bus MSc, Andrzej Szafranski MD, PhD, Simen Sellevold MD, Tomasz Goryn MD, PhD, Paul C. Jutte MD, PhD, Jos A. M. Bramer MD, PhD, M. Fiocco PhD, Arne Streitbürger MD, PhD, Daniel Kotrych MD, PhD, Michiel A. J. Sande MD, PhD, P. D. Sander Dijkstra MD, PhD

Reconstruction of periacetabular defects after pelvic tumor resection ranks among the most challenging procedures in orthopaedic oncology, and reconstructive techniques are generally associated with dissatisfying mechanical and nonmechanical complication rates. In an attempt to reduce the risk of dislocation, aseptic loosening, and infection, we introduced the LUMiCprosthesis (implantcast, Buxtehude, Germany) in 2008. The LUMiCprosthesis is a modular device, built of a separate stem (hydroxyapatite-coated uncemented or cemented) and acetabular cup. The stem and cup are available in different sizes (the latter of which is also available with silver coating for infection prevention) and are equipped with sawteeth at the junction to allow for rotational adjustment of cup position after implantation of the stem. Whether this implant indeed is durable at short-term followup has not been evaluated.

How Does the Level of Nerve Root Resection in En Bloc Sacrectomy Influence Patient-Reported Outcomes?

Olivier D. R. Wulfften Palthe MD, Matthew T. Houdek MD, Peter S. Rose MD, Michael J. Yaszemski MD, PhD, Franklin H. Sim MD, Patrick J. Boland MD, John H. Healey MD, Francis J. Hornicek MD, MS, PhD, Joseph H. Schwab MD, MS

For patients with sacral tumors, who are well enough for surgery, en bloc resection is the preferred treatment. Survival, postoperative complications, and recurrent rates have been described, but patient-reported outcomes often are not included in these studies.

Is It Possible and Safe to Perform Acetabular-preserving Resections for Malignant Neoplasms of the Periacetabular Region?

Ying-lee Lam FHKAM, Raymond Yau FHKAM, Kenneth W. Y. Ho FHKAM, Ka-lok Mak FHKAM, Sin-tak Fong FHKAM, Timothy Y. C. So FHKAM

Primary malignant tumors located near the acetabulum are usually managed by resection of the tumor with wide margins that include the acetabulum. These resections are deemed P2 resections by the Enneking and Dunham classification. There are various methods to perform the subsequent hip reconstruction. Unfortunately, there is no consensus as to the best management. In general, patients undergoing resection at this level will have substantial levels of pain and disability as measured by the Musculoskeletal Tumor Society (MSTS) scoring system. We believe there is a subset of patients whose tumors in this location can be resected while preserving all or most of the weightbearing acetabulum using navigation and careful surgical planning.