Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Tumor 242 articles

Articles

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.

Has the Level of Evidence of Podium Presentations at the Musculoskeletal Tumor Society Annual Meeting Changed Over Time?

Daniel M. Lerman MD, Matthew G. Cable MD, Patrick Thornley BHSc, Nathan Evaniew MD, Gerard P. Slobogean MD, Mohit Bhandari MD, MSc, PhD, John H. Healey MD, R. Lor Randall MD, Michelle Ghert MD

Level of evidence (LOE) framework is a tool with which to categorize clinical studies based on their likelihood to be influenced by bias. Improvements in LOE have been demonstrated throughout orthopaedics, prompting our evaluation of orthopaedic oncology research LOE to determine if it has changed in kind.

What Is the Expected Learning Curve in Computer-assisted Navigation for Bone Tumor Resection?

Germán L. Farfalli MD, José I. Albergo MD, Lucas E. Ritacco MD, Miguel A. Ayerza MD, Federico E. Milano MSC, Luis A. Aponte-Tinao MD

Computer navigation during surgery can help oncologic surgeons perform more accurate resections. However, some navigation studies suggest that this tool may result in unique intraoperative problems and increased surgical time. The degree to which these problems might diminish with experience–the learning curve–has not, to our knowledge, been evaluated for navigation-assisted tumor resections.

Supplemental Bone Grafting in Giant Cell Tumor of the Extremity Reduces Nononcologic Complications

Joseph Benevenia MD, Steven M. Rivero MD, Jeffrey Moore MD, Joseph A. Ippolito BA, Daniel A. Siegerman MD, Kathleen S. Beebe MD, Francis R. Patterson MD

Giant cell tumors (GCTs) are treated with resection curettage and adjuvants followed by stabilization. Complications include recurrence, fracture, and joint degeneration. Studies have shown treatment with polymethylmethacrylate (PMMA) may increase the risk of joint degeneration and fracture. Other studies have suggested that subchondral bone grafting may reduce these risks.

Reconstruction After Hemipelvectomy With the Ice-Cream Cone Prosthesis: What Are the Short-term Clinical Results?

Irene Barrientos-Ruiz MD, Eduardo José Ortiz-Cruz MD, Manuel Peleteiro-Pensado MD

Reconstruction after internal hemipelvectomy resection likely provides better function than hindquarter amputation. However, many reconstruction methods have been used, complications with these approaches are common, and function often is poor; because of these issues, it seems important to investigate alternative implants and surgical techniques.

Do Patients After Chondrosarcoma Treatment Have Age-appropriate Bone Mineral Density in the Long Term?

Gerhard M. Hobusch MD, Thomas M. Tiefenboeck MD, Janina Patsch MD, Christoph Krall MD, Gerold Holzer MD

In long-term survivors of osteosarcoma and Ewing sarcoma treated with the addition of radio- and chemotherapy, low bone mineral density (BMD) and fractures have been observed, presumably resulting from these adjuvants. Because patients with chondrosarcoma usually are not treated with conventional adjuvant treatment, observation of low BMD in patients with chondrosarcoma presumably would be the result of other mechanisms. However, BMD in patients with a history of chondrosarcoma has not been well characterized.

Is Prophylactic Intervention More Cost-effective Than the Treatment of Pathologic Fractures in Metastatic Bone Disease?

Alan T. Blank MD, MS, Daniel M. Lerman MD, Neeraj M. Patel MD, MPH, Timothy B. Rapp MD

Metastatic bone disease is a substantial burden to patients and the healthcare system as a whole. Metastatic disease can be painful, is associated with decreased survival, and is emotionally traumatic to patients when they discover their disease has progressed. In the United States, more than 250,000 patients have metastatic bone disease, with an estimated annual cost of USD 12 billion. Prior studies suggest that patients who receive prophylactic fixation for impending pathologic fractures, compared with those treated for realized pathologic fractures, have decreased pain levels, faster postoperative rehabilitation, and less in-hospital morbidity. However, to our knowledge, the relative economic utility of these treatment options has not been examined.

Is Needle Biopsy Clinically Useful in Preoperative Grading of Central Chondrosarcoma of the Pelvis and Long Bones?

Pablo D. Roitman MD, Germán L. Farfalli MD, Miguel A. Ayerza MD, D. Luis Múscolo MD, Federico E. Milano MSC, Luis A. Aponte-Tinao MD

Central chondrosarcoma of bone is graded on a scale of 1 to 3 according to histological criteria. Clinically, these tumors can be divided into low-grade (Grade 1) and high-grade (Grade 2, Grade 3, and dedifferentiated) chondrosarcomas. Although en bloc resection has been the most widely used treatment, it has become generally accepted that in selected patients with low-grade chondrosarcomas of long bones, curettage is safe and effective. This approach requires an accurate preoperative estimation of grade to avoid under- or overtreatment, but prior reports have indicated that both imaging and biopsy do not always give an accurate prediction of grade.

What Are the Functional Outcomes After Total Sacrectomy Without Spinopelvic Reconstruction?

Piya Kiatisevi MD, Chaiwat Piyaskulkaew MD, Sombat Kunakornsawat MD, Bhasanan Sukunthanak MD

After total sacrectomy, many types of spinopelvic reconstruction have been described with good functional results. However, complications associated with reconstruction are not uncommon and usually result in further surgical interventions. Moreover, less is known about patient function after total sacrectomy without spinopelvic reconstruction, which may be indicated when malignant or aggressive benign bone and soft tissue tumors involved the entire sacrum.

What Happens to the Articular Surface After Curettage for Epiphyseal Chondroblastoma? A Report on Functional Results, Arthritis, and Arthroplasty

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

Chondroblastoma is an uncommon, benign, but locally aggressive bone tumor that occurs in the apophyses or epiphyses of long bones, primarily in young patients. Although some are treated with large resections, aggressive curettage and bone grafting are more commonly performed to preserve the involved joint. Such intralesional resection may result in damage to the growth plate and articular cartilage, which can result in painful arthritis. Prior studies have focused primarily on oncologic outcomes rather than long-term joint status and functional outcomes.