Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Tumor 241 articles

Articles

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.

What Sport Activity Levels Are Achieved in Patients After Resection and Endoprosthetic Reconstruction for a Proximal Femur Bone Sarcoma?

Gerhard M. Hobusch MD, Jakob Bollmann CM, Stephan E. Puchner MD, Nikolaus W. Lang MD, Jochen G. Hofstaetter MD, Philipp T. Funovics MD, MSc, Reinhard Windhager MD

Limited information is available about sports activities of survivors after resection and reconstruction of primary malignant bone tumors with megaprostheses. Because patients often ask what activities are possible after treatment, objective knowledge about sports activities is needed to help assess the risks of sports participation and to help guide patients’ expectations.

Survival in Mesenchymal Chondrosarcoma Varies Based on Age and Tumor Location: A Survival Analysis of the SEER Database

Brian A. Schneiderman MD, Stephanie A. Kliethermes PhD, Lukas M. Nystrom MD

Studies suggest that mesenchymal chondrosarcoma is associated with a poorer prognosis and a higher proportion of extraskeletal tumors than conventional chondrosarcoma. However, these investigations have been small heterogeneous cohorts, limiting analysis of prognostic factors.

What Are the Conditional Survival and Functional Outcomes After Surgical Treatment of 115 Patients With Sacral Chordoma?

Tao Ji MD, Wei Guo MD, PhD, Rongli Yang MD, Xiaodong Tang MD, Yifei Wang MD, Lin Huang MD

Conditional survival is a measure of prognosis for patients who have already survived for a specific period of time; however, data on conditional survival after sacrectomy in patients with sacral chordoma are lacking. In addition, because sacral tumors are rare and heterogeneous, classifying them in a way that allows physicians to predict functional outcomes after sacrectomy remains a challenge.

What Factors Are Associated With Failure of Compressive Osseointegration Fixation?

Ryland Kagan MD, Jacob Adams MD, Caroline Schulman BE, Rachel Laursen BS, Karina Espana BS, Jung Yoo MD, Yee-Cheen Doung MD, James Hayden MD, PhD

Compressive osseointegration is as an alternative to traditional intramedullary fixation. Two- to 10-year survivorship and modes of failure have been reported; however, as a result of relatively small numbers, these studies are limited in their ability to identify risk factors for failure.