Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Tumor 242 articles


An Unusual Cause of Lumbar Radiculopathy

Jesse Even MD, Gregory Gasbarro MD, Liron Pantanowitz MD, James Kang MD, Kurt Weiss MD

Total Femur Replacement After Tumor Resection: Limb Salvage Usually Achieved But Complications and Failures are Common

Florian Sevelda MD, Reinhard Schuh MD, Jochen Gerhard Hofstaetter MD, Martina Schinhan MD, Reinhard Windhager MD, Philipp Theodor Funovics MD

Primary bone or soft tissue tumors of the femur sometimes present with severe and extensive bone destruction, leaving few limb-salvage options other than total femur replacement. However, there are few data available regarding total femur replacement and, in particular, regarding implant failures.

A High-grade Sarcoma Arising in a Patient With Recurrent Benign Giant Cell Tumor of the Proximal Tibia While Receiving Treatment With Denosumab

Luis A. Aponte-Tinao MD, Nicolas S. Piuzzi MD, Pablo Roitman MD, German L. Farfalli MD

A giant cell tumor of bone is a primary benign but locally aggressive neoplasm. Malignant transformation in a histologically typical giant cell tumor of bone, without radiotherapy exposure, is an uncommon event, occurring in less than 1% of giant cell tumors of bone. Although surgery is the standard initial treatment, denosumab, a monoclonal antibody drug that inhibits receptor activator of nuclear factor-κB ligand (RANKL), has shown considerable activity regarding disease and control of symptoms in patients with recurrence, unresectable, and metastatic giant cell tumors of bone.

What Is the Outcome of Allograft and Intramedullary Free Fibula (Capanna Technique) in Pediatric and Adolescent Patients With Bone Tumors?

Matthew T. Houdek MD, Eric R. Wagner MD, Anthony A. Stans MD, Alexander Y. Shin MD, Allen T. Bishop MD, Franklin H. Sim MD, Steven L. Moran MD

After bone tumor resection, reconstruction for limb salvage surgery can be challenging because of the resultant large segmental bony defects. Structural allografts have been used to fill these voids; however, this technique is associated with high complication rates. To circumvent the complications associated with this procedure, massive bony allografts have been supplemented with an intramedullary vascularized free fibula. However, few studies have examined the outcomes using this technique in the pediatric and adolescent populations.

Are Allogeneic Blood Transfusions Associated With Decreased Survival After Surgery for Long-bone Metastatic Fractures?

Stein J. Janssen MD, Yvonne Braun MD, John E. Ready MD, Kevin A. Raskin MD, Marco L. Ferrone MD, Francis J. Hornicek MD, MS, PhD, Joseph H. Schwab MD, MS

Previous studies have shown that perioperative blood transfusion increases cancer recurrence and decreases patient survival after resection of primary malignancies. The question arises whether this association also exists in patients with already disseminated disease undergoing surgery for metastatic long-bone fractures.

Synthetic Mesh Improves Shoulder Function After Intraarticular Resection and Prosthetic Replacement of Proximal Humerus

Xiaodong Tang MD, Wei Guo MD, PhD, Rongli Yang MD, Shun Tang MD, Tao Ji MD

Shoulder function often is limited after tumor resection and endoprosthetic replacement of the proximal humerus. This is partly attributable to the inability to reliably reattach rotator cuff tendons to the prosthesis and achieve adequate shoulder capsule repair with a metallic prosthesis. An option to attain these goals is to use synthetic mesh for the reconstruction, although the value of this method has not been well documented in the literature.

What is the Proportion of Patients With Multiple Hereditary Exostoses Who Undergo Malignant Degeneration?

Cory M. Czajka MD, Matthew R. DiCaprio MD

Multiple hereditary exostoses is an autosomal-dominant skeletal disorder that has a wide-ranging reported risk of malignant degeneration to chondrosarcoma.

Hydroxyapatite-coated Collars Reduce Radiolucent Line Progression in Cemented Distal Femoral Bone Tumor Implants

Melanie J. Coathup BSc, PhD, Anish Sanghrajka MBBS, BS, William J. Aston BSc, MBBS, Panagiotis D. Gikas MBBS, BSc, MD, PhD, Robin C. Pollock MBBS, BSc, Stephen R. Cannon MA, MCh Orth, John A. Skinner MBBS, Timothy W. R. Briggs MBBS, MChOrth, Gordon W. Blunn BSc, PhD

Aseptic loosening of massive bone tumor implants is a major cause of prosthesis failure. Evidence suggests that an osteointegrated hydroxyapatite (HA)-coated collar would reduce the incidence of aseptic loosening around the cemented intramedullary stem in distal femoral bone tumor prostheses. Because these implants often are used in young patients with a tumor, such treatment might extend the longevity of tumor implants.We asked whether (1) HA-coated collars were more likely to osteointegrate; (2) HA collars were associated with fewer progressive radiolucent lines around the stem-cement interface; and (3) HA-coated collars were associated with less bone loss at the bone-shoulder implant junction?

Intramedullary Nailing of Femoral Diaphyseal Metastases: Is it Necessary to Protect the Femoral Neck?

Bryan Moon MD, Patrick Lin MD, Robert Satcher MD, PhD, Justin Bird MD, Valerae Lewis MD

Intramedullary nailing is the accepted form of treatment for impending or pathologic fractures of the femoral diaphysis. Traditional teaching promotes the use of a cephalomedullary nail so that stabilization is provided for the femoral neck in the event that a future femoral neck metastasis develops. However, that approach may add cost, surgical time, blood loss, and added radiation exposure to staff members, and there is limited evidence in the literature that supports this practice.