Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Tumor 242 articles

Articles

Is Intralesional Treatment of Giant Cell Tumor of the Distal Radius Comparable to Resection With Respect to Local Control and Functional Outcome?

Robert W. Wysocki MD, Emily Soni MD, Walter W. Virkus MD, Mark T. Scarborough MD, Sue E. Leurgans PhD, Steven Gitelis MD

A giant cell tumor is a benign locally aggressive tumor commonly seen in the distal radius with reported recurrence rates higher than tumors at other sites. The dilemma for the treating surgeon is deciding whether intralesional treatment is adequate compared with resection of the primary tumor for oncologic and functional outcomes. More information would be helpful to guide shared decision-making.

Survival, Recurrence, and Function After Epiphyseal Preservation and Allograft Reconstruction in Osteosarcoma of the Knee

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

Bone tumor resections for limb salvage have become the standard treatment. Recently, intercalary tumor resection with epiphyseal sparing has been used as an alternative in patients with osteosarcoma. The procedure maintains normal joint function and obviates some complications associated with osteoarticular allografts or endoprostheses; however, long-term studies analyzing oncologic outcomes are scarce, and to our knowledge, the concern that a higher local recurrence rate may be an issue has not been addressed.

What Are the Functional Results and Complications From Allograft Reconstruction After Partial Hemipelvectomy of the Pubis?

S. Mohammed Karim MD, Matthew W. Colman MD, Santiago A. Lozano-Calderón MD, PhD, Kevin A. Raskin MD, Joseph H. Schwab MD, Francis J. Hornicek MD, PhD

In patients undergoing hemipelvectomies including resection either of a portion of the pubis or the entire pubis from the symphysis to the lateral margin of the obturator foramen while sparing the hip (so-called Dunham Type III hemipelvectomies), reconstructions typically are not performed given the preserved continuity of the weightbearing axis and the potential complications associated with reconstruction. Allograft reconstruction of the pelvic ring may, however, offer benefits for soft tissue reconstruction of the pelvic floor and hip stability, but little is known about these reconstructions.

How Much Tumor Surgery Do Early-career Orthopaedic Oncologists Perform?

Benjamin J. Miller MD, MS, Rajiv Rajani MD, Lee Leddy MD, Emily E. Carmody Soni MD, Jeremy R. White MD

There are few data on the types of procedures orthopaedic oncologists perform in their first years of practice. Because fellowships are graduating fellows each year and the number of tumor patients is limited, defining the practice patterns of early-career orthopaedic oncologists may help diminish early employment discontent and enhance workforce discussions.

Locally Aggressive Fibrous Dysplasia Mimicking Malignancy: A Report of Four Cases and Review of the Literature

Saravanaraja Muthusamy MD, Ty Subhawong MD, Sheila A. Conway MD, H. Thomas Temple MD

Fibrous dysplasia is a benign fibroosseous bone tumor that accounts for 5% to 10% of benign bone tumors. It can present as monostotic fibrous dysplasia (70% to 80%), polyostotic fibrous dysplasia (20% to 30%), McCune-Albright syndrome (2% to 3%), or Mazabraud’s syndrome in rare cases. Bone lesions in fibrous dysplasia arise in the medullary canal and usually are confined to the bone. Cortical destruction and extension into soft tissue usually indicates malignant transformation or secondary aneurysmal bone cyst formation. Locally aggressive fibrous dysplasia with cortical destruction and extension into soft tissue in the absence of these two possibilities is extremely rare. It is important for the treating physician to distinguish this entity from more aggressive or malignant tumors to avoid overtreating the patient for a benign condition or inattention to a malignant tumor.

Does Expression of Glucose Transporter Protein-1 Relate to Prognosis and Angiogenesis in Osteosarcoma?

Tadahiko Kubo MD PhD, Shoji Shimose MD PhD, Jun Fujimori MD PhD, Taisuke Furuta MD, Koji Arihiro MD PhD, Mitsuo Ochi MD PhD

The survival of patients who present with nonmetastatic extremity osteosarcoma has dramatically improved, but there are some patients who do not respond to chemotherapy. The ability to identify patients with a poorer prognosis might allow us to target different therapy for these patients. Glucose transporter protein-1 (Glut-1), one of the key factors in glucose metabolism, has been reported to be an independent prognostic factor in various tumors. However, little is known about the role of the Glut-1 pathway in osteosarcoma.

Antirotation Pins Improve Stability of the Compress Limb Salvage Implant: A Biomechanical Study

Raffi S. Avedian MD, Timothy Chen MD, Derek Lindsey MS, Ariel Palanca MD, David Mohler MD

Limb salvage implants that rely on compliant compression osseointegration to achieve bone fixation may achieve longer survivorship rates compared with traditional cemented or press-fit stemmed implants; however, failures resulting from rotational instability have been reported. The effect of using antirotation pins on the rotational stability of the fixation has not been well studied.

What Is the Effect of Advanced Age and Comorbidity on Postoperative Morbidity and Mortality After Musculoskeletal Tumor Surgery?

Koichi Ogura MD, Hideo Yasunaga MD, PhD, Hiromasa Horiguchi PhD, Kiyohide Fushimi MD, PhD, Hirotaka Kawano MD, PhD

Although the elderly population is increasing rapidly, little information is available regarding how the risk of postoperative mortality and morbidity increases when combined with age and comorbidity burden in patients undergoing musculoskeletal tumor surgery.

Thigh Pain in an 18-year-old Man

Frank Traub MD, PhD, Marilyn Heng MD, Brendan C. Dickson MD, MSc, Peter C. Ferguson MD, MSc

MicroRNA Regulates Vascular Endothelial Growth Factor Expression in Chondrosarcoma Cells

Xiaojuan Sun MD, PhD, Lei Wei MD, PhD, Qian Chen PhD, Richard M. Terek MD

Systemic treatments to prevent or treat chondrosarcoma metastasis are lacking and targeted therapy has yet to be developed. Hypoxia develops in tumors as they grow and hypoxia-related alterations in gene expression underlie some of the traits of cancer. One critical trait is the ability to induce sustained angiogenesis, which is usually related to expression of vascular endothelial growth factor (VEGF). A potential hypoxia-related mechanism resulting in altered gene expression involves microRNA. Little is known about microRNA expression in chondrosarcoma and its potential role in regulation of VEGF expression.