A hollow, custom-made prosthesis combined with a vascularized flap and bone graft for skeletal reconstruction after bone tumour resection

2021 ◽  
Vol 36 ◽  
pp. 56-60
Author(s):  
Giovanni Beltrami ◽  
Gabriele Ristori ◽  
Alberto Galeotti ◽  
Guido Scoccianti ◽  
Angela Tamburini ◽  
...  
Keyword(s):  
Bone Graft ◽  
Bone Tumour ◽  
Tumour Resection ◽  
Custom Made ◽  
Skeletal Reconstruction

scholarly journals The History of Bone Tumour Treatment and the State of the Art in Vienna

PRILOZI ◽  
2017 ◽  
Vol 38 (3) ◽  
pp. 31-38
Author(s):  
Rainer Kotz
Keyword(s):  
Bone Tumour ◽  
Bone Tumours ◽  
Tumour Resection ◽  
Parosteal Osteosarcoma ◽  
Knee Region ◽  
Surgical Methods ◽  
Custom Made ◽  
History Of ◽  
Adequate Surgery ◽  
Rotation Plasty

Abstract Purposes:Bone tumours have been a tragedy for the patient in any time period. In the majority of the cases it occurs in children or young adults. In the past the affected limbs could not be spared and the overall prognosis was poor. Methods:Chemotherapy successfully introduced for the purpose of overcoming the poor overall prognosis (Rosen and Jaffe) and tumour prostheses were invented for the purpose of salvaging the affected limbs (Marcove, Scales, Campanacci, Sivas, Salzer). According to the Vienna Tumour Registry in 1968, the first custom-made Vitallium prosthesis for the proximal femur was implanted in a parosteal osteosarcoma. Results: In Vienna, as a result of the successful chemotherapy the surgical methods for bone tumours changed to limb sparing methods also. A modular ceramic prosthesis for the proximal humerus was introduced by Salzer. From 1975 -1982 16 custom-made endoprosthesis (1) for the knee region were implanted which were replaced by the KMFTR in 1982 (2, Kotz modular femur tibia reconstruction system) which was introduced at the “2nd ISOLS” to an international group of experts. The successful system was followed by the HMRS (Howmedica modular resection system) in 1988. At that time, especially in children, the rotation-plasty of Borgreve was adopted for tumours of the knee region (2). A scientific survey of 70 patients with rotation-plasty until 1991 showed excellent clinical and oncologic results. Later a similar approach was used in upper extremity tumours as “resection replantation” with surprisingly good results. Sophisticated technologies with growing mechanisms allowed the use of endoprostheses even in children (3) for the purpose of substitution since the mutilating rotation-plasty in 1996. Conclusion: For almost 100 years efforts have been undertaken to improve the treatment of bone tumours. Surgery was aiming to keep the function of the limbs by tumour resection instead of amputation. Together with successful chemotherapy, which saves lives, an adequate surgery could stepwise salvage the function of the limb. Body integrity was the final aim for the diseased. Finally, by the effort of the International Societies like ISOLS and EMSOS the survival of malignant bone tumour patients improved from 20% to 80 % with good function quality by sophisticated operative techniques and improved tumour prostheses.

scholarly journals Intercalary reconstruction of femur after tumour resection: is a vascularized fibular autograft plus allograft a long-lasting solution?

2018 ◽  
Vol 100-B (3) ◽  
pp. 378-386 ◽  
Author(s):  
D. A. Campanacci ◽  
F. Totti ◽  
S. Puccini ◽  
G. Beltrami ◽  
G. Scoccianti ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Young Patients ◽  
Bone Tumour ◽  
Full Weight Bearing ◽  
Tumour Resection ◽  
Fibular Graft ◽  
Musculoskeletal Tumor Society ◽  
Long Term Outcome ◽  
The Mean

Aims After intercalary resection of a bone tumour from the femur, reconstruction with a vascularized fibular graft (VFG) and massive allograft is considered a reliable method of treatment. However, little is known about the long-term outcome of this procedure. The aims of this study were to determine whether the morbidity of this procedure was comparable to that of other reconstructive techniques, if it was possible to achieve a satisfactory functional result, and whether biological reconstruction with a VFG and massive allograft could achieve a durable, long-lasting reconstruction. Patients and Methods A total of 23 patients with a mean age of 16 years (five to 40) who had undergone resection of an intercalary bone tumour of the femur and reconstruction with a VFG and allograft were reviewed clinically and radiologically. The mean follow-up was 141 months (24 to 313). The mean length of the fibular graft was 18 cm (12 to 29). Full weight-bearing without a brace was allowed after a mean of 13 months (seven to 26). Results At final follow-up, the mean Musculoskeletal Tumor Society Score of 22 evaluable patients was 94% (73 to 100). Eight major complications, five fractures (21.7%), and three nonunions (13%) were seen in seven patients (30.4%). Revision-free survival was 72.3% at five, ten, and 15 years, with fracture and nonunion needing surgery as failure endpoints. Overall survival, with removal of allograft or amputation as failure endpoints, was 94.4% at five, ten, and 15 years. Discussion There were no complications needing surgical revision after five years had elapsed from surgery, suggesting that the mechanical strength of the implant improves with time, thereby decreasing the risk of complications. In young patients with an intercalary bone tumour of the femur, combining a VFG and massive allograft may result in a reconstruction that lasts a lifetime. Cite this article: Bone Joint J 2018;100-B:378–86.

scholarly journals Patella dislocation following distal femoral replacement after bone tumour resection

2014 ◽  
Vol 2014 (jul29 1) ◽  
pp. bcr2014205006-bcr2014205006 ◽  
Author(s):  
T. Akiyama ◽  
S. Kanda ◽  
A. Maeda ◽  
M. Endo ◽  
K. Saita
Keyword(s):  
Bone Tumour ◽  
Patella Dislocation ◽  
Tumour Resection ◽  
Distal Femoral Replacement

Porous Titanium Membranes Combined with Various Graft Materials Induce Exophytic Bone Formation in Rabbit Calvaria

2006 ◽  
Vol 309-311 ◽  
pp. 427-432 ◽  
Author(s):  
Y. Kim ◽  
Y.H. Kown ◽  
J.B. Park ◽  
J.H. Chung ◽  
H.N. Lim ◽  
...  
Keyword(s):  
Bone Formation ◽  
Bone Graft ◽  
Porous Titanium ◽  
Control Group ◽  
Bovine Bone ◽  
Graft Material ◽  
New Bone Formation ◽  
Freeze Dried ◽  
Custom Made ◽  
Human Cancellous Bone

The purpose of this study was to examine if the application of custom-made porous titanium membranes combined with bone graft materials promotes exophytic bone formation in rabbit calvaria. For this purpose, round decorticated calvaria sites were created using a round carbide bur. In the control group, rectangular parallelepiped-shaped porous titanium membranes (RPTMs) were placed on the decorticated sites and fixed with metal pins. In the experimental groups, RPTMs were filled with one of the following bone graft materials prior to fixing with metal pins: bovine bone mineral (BBM), demineralized freeze-dried human cortical bone (DFDB) or freeze-dried human cancellous bone (FDB). Animals were sacrificed at 8 and 12 weeks after surgery, and new bone formation was assessed by histomorphometric as well as statistical analysis. The results indicate that at 8 and 12 weeks, all the experimental groups demonstrated exophytic bone formation. At 12 weeks, DFDB group revealed the most new bone formation (p<0.05) and resorption of grafted materials (p<0.05). On the basis of these findings, we conclude that RPTMs may be used as an augmentation membrane for guided bone regeneration and DFDB as an effective bone-inducing graft material.

Adamantinoma of the Tibia Treated with a New Intramedullary Diaphyseal Segmental Defect Implant

2009 ◽  
Vol 37 (4) ◽  
pp. 1238-1245 ◽  
Author(s):  
AF Mavrogenis ◽  
VI Sakellariou ◽  
H Tsibidakis ◽  
PJ Papagelopoulos
Keyword(s):  
Bone Tumour ◽  
Distant Metastases ◽  
Tumour Resection ◽  
Segmental Defect ◽  
Anterior Tibial ◽  
Primary Bone ◽  
Radiolucent Lesion ◽  
The Right ◽  
Tibial Cortex ◽  
Fixation System

In this case report, a 75-year old male presented with a mass on the anterior surface of the mid-shaft of the right tibia. Imaging studies showed a well-circumscribed radiolucent lesion in the anterior tibial cortex, without soft tissue extension. Plain radiographs and computed tomography scan of the chest were negative. Histological diagnosis was consistent with adamantinoma, a rare primary bone tumour. Wide tumour resection of approximately 16 cm of the tibial diaphysis with a surrounding cuff of normal tissue was performed. The bone defect was reconstructed using an intramedullary diaphyseal segmental defect fixation system. At 26 months post-operatively the patient is alive with no evidence of local recurrence, distant metastases or implant failure. The intramedullary diaphyseal segmental defect fixation system is associated with excellent oncological and functional outcomes. Intra-operative modularity, ease of application, immediate post-operative stability and rapid rehabilitation are the major advantages of this diaphyseal prosthesis.

New perspectives on surgical accuracy analysis of image-guided bone tumour resection surgery

2020 ◽  
Vol 44 (5) ◽  
pp. 987-994 ◽  
Author(s):  
Yu Zhang ◽  
Qing Zhang ◽  
Leisheng Zhong ◽  
Lei Qiu ◽  
Lihui Xu ◽  
...  
Keyword(s):  
Bone Tumour ◽  
Tumour Resection ◽  
Accuracy Analysis ◽  
Image Guided

Vascularised fibular grafts as a salvage procedure in failed intercalary reconstructions after bone tumour resection of the femur

Injury ◽  
2014 ◽  
Vol 45 (2) ◽  
pp. 399-404 ◽  
Author(s):  
Domenico Andrea Campanacci ◽  
Serena Puccini ◽  
Giuseppe Caff ◽  
Giovanni Beltrami ◽  
Andrea Piccioli ◽  
...  
Keyword(s):  
Bone Tumour ◽  
Tumour Resection ◽  
Salvage Procedure

In Situ Tooth Replica Custom Implant: Rationale, Material, and Technique

2010 ◽  
Vol 36 (6) ◽  
pp. 435-450 ◽  
Author(s):  
Wael Aly Ghuneim
Keyword(s):  
Bone Graft ◽  
Load Distribution ◽  
Alveolar Bone ◽  
Bone Graft Substitute ◽  
Bone Surface ◽  
Tooth Socket ◽  
Custom Implant ◽  
Custom Made ◽  
Polymer Type

Abstract This study introduced a new concept of an in situ, custom-made, tooth replica dental implant. It was obtained by injecting a self-set, nonresorbable polymer type bone graft substitute into the tooth socket after extraction. Based on its cited properties, new composite bone cement Cortoss was suggested. The properties were reviewed and evaluated. The technique of application was described with a simulation model presented that appeared simple. Apparently, immediate duplication of tooth anatomy was achieved; thus, the concept might have the potentials of spontaneous adaptation and stabilization, preservation of alveolar bone, increasing implant-bone surface area, better load distribution, and bone stimulation. Modifications were also described to manage cases of resorbed alveolar bone as well as long-standing extracted teeth. Investigations were still required to assess the performance of the material and if modifications would be needed.

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