Chondroblastoma of the Femoral Head: A Case Series and Literature Review

2019 ◽  
Vol 03 (01) ◽  
pp. 002-007
Author(s):  
Tyler Hoskins ◽  
Laura Sonnylal ◽  
Ian O'Connor ◽  
Jay Patel ◽  
Kimona Issa ◽  
...  
Keyword(s):  
Femoral Head ◽  
Case Series ◽  
Bone Destruction ◽  
Treatment Method ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Local Bone ◽  
Primary Investigator ◽  
Proper Diagnosis

AbstractChondroblastoma is a rare bone tumor predominantly affecting patients during the first and second decades of life. The purpose of this case series is to assist clinicians in establishing a proper diagnosis and treatment method for patients presenting with chondroblastoma of the femoral head. Symptoms of this tumor in the hip joint can be nonspecific, resulting in the critical delay of a proper diagnosis. Due to the aggressive nature of this tumor, an early diagnosis is vital to prevent significant local bone destruction and the potential loss of a mobile hip. The authors present a series of three adolescent patients treated by the primary investigator between 2014 and 2017 for chondroblastoma of the femoral head to help illustrate several diagnostic and treatment principles and considerations for clinicians. The mean Musculoskeletal Tumor Society score at the latest follow-up was 26 points (range: 25–27). No local recurrence was reported in any patient and all individuals have returned to preoperative function, and are participating in daily activities and sports.

Reconstruction with Custom Unicondylar Hemiarthroplasty following Tumor Resection: A Case Series and Review of the Literature

2019 ◽  
Vol 33 (08) ◽  
pp. 818-824
Author(s):  
Joseph A. Ippolito ◽  
Megan L. Campbell ◽  
Brianna L. Siracuse ◽  
Joseph Benevenia
Keyword(s):  
Distal Femur ◽  
Weight Bearing ◽  
Tumor Resection ◽  
Case Series ◽  
Full Weight Bearing ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Optimal Function ◽  
Tumor Involvement

AbstractFor patients with tumors of the distal femur, options for limb salvage include tumor resection followed by reconstruction. While reconstruction commonly involves a distal femoral replacement, careful selection of patients with tumor involvement limited to a single condyle may be candidates for reconstruction with distal femur hemiarthroplasty. In these procedures, resection spares considerably more native anatomy. Three consecutive patients who underwent resection and reconstruction at the distal femur with custom unicondylar hemiarthroplasty are presented in this case series at a mean follow-up of 45 months (range, 26–78). In two cases, prostheses were utilized as a secondary procedure after failure of initial reconstruction. In one case, the custom prosthesis was utilized as the primary method of reconstruction. Mean Musculoskeletal Tumor Society disease-specific scores were 26.7 (range, 25–28). All patients achieved a return to full weight bearing, activities of daily living, and functional range of motion. In appropriately selected patients with tumors of the distal femur, reconstruction with custom unicondylar hemiarthroplasty provides benefits including optimal function postoperatively via preservation of tumor-free bone and ligamentous structures. Additionally, maintenance of greater bone stock may confer benefits to patients with pathology at a high likelihood for recurrence and need for subsequent procedures.

scholarly journals A newly revised pivot knee prosthesis for peri-knee malignant bone destruction tumor management

2020 ◽  
Author(s):  
jie tan ◽  
Qingyi Zhang ◽  
Wu Wu ◽  
Yaxing Li ◽  
Kai Huang ◽  
...  
Keyword(s):  
Knee Prosthesis ◽  
Good Condition ◽  
Bone Destruction ◽  
Operation Time ◽  
Good Alternative ◽  
Tumor Stage ◽  
Knee Score ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society

Abstract BackgroundThis study evaluated the effectiveness of a newly revised pivot knee prosthesis in patients with peri-knee malignant bone destruction tumors.MethodsMedical records of patients who were admitted to our hospital from January 2014 to February 2020 and underwent the newly revised pivot knee prosthesis operations were retrospectively collected and analyzed. Visual analogue scale (VAS), hospital special surgery (HSS) knee score, American knee society knee score (KSS), and ROM for pre-operation, discharge, and last follow-up were applied to assess the effectiveness of this surgery. Meanwhile, the results of musculoskeletal tumor society system (MTSS) and radiographs were observed and analyzed at last follow-up.ResultsThe average operation time was 174.0 ± 35.5 min, and intraoperative bleeding volume was 271.2 ± 127.3 ml. The follow-up time was 33.8 ± 14.9 months. The scores of VAS, HSS, and KSS at pre-operation, discharging, and last follow-up were all comparable (p༜0.05), ROM was only comparable between discharging and last follow-up (p༜0.05), while ROM between preoperative and discharging had no significance (p༞0.05). MTSS at last follow-up was22.6 ± 2.4. All patients were alive with their prosthesis in good condition except for one patient who underwent revision surgery for misalignment of prosthesis and two patients who died of systemic metastasis.ConclusionThe newly revised pivot knee prosthesis is a good alternative limb-salvage strategy for patients who suffered from bone destruction tumors, although patient tumor stage and health condition should be fully assessed before surgery to reduce the mortality rate of patients who are not eligible.

scholarly journals Surgical resection and reconstructive techniques using autologous femoral head bone-grafting in treating partial acetabular defects arising from primary pelvic malignant tumors

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Wei Sun ◽  
Pengfei Zan ◽  
Xiaojun Ma ◽  
Yingqi Hua ◽  
Jiakang Shen ◽  
...  
Keyword(s):  
Femoral Head ◽  
Surgical Resection ◽  
Bone Grafting ◽  
Malignant Tumors ◽  
Functional Evaluation ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Acetabular Defects ◽  
Reconstructive Techniques

Abstract Background The aim of this study is to present and evaluate surgical resection and reconstructive techniques using autologous femoral head bone-grafting in treating partial acetabular defects arising from primary pelvic malignant tumors. Methods From January 2009 until January 2015, a total of 20 primary pelvic malignancy cases involving the acetabulum were retrospectively investigated. Surgical resections and reconstructions were conducted based on the type of the tumor with custom osteotomy guides and autologous femoral head bone-grafting. In all cases, prosthesis survival period, complication occurrence, and clinical outcomes data were collected and analyzed. Results Thirteen male and 7 female patients with an average age of 48 years old (range 23-69 years old) were followed for a median of 69 months (range 48-112 months). Of these cases, 17 included chondrosarcomas and 3 additional patients with a malignant giant cell tumor of bone (MBGCT) as proven by pathology. During follow-up, 3 cases of chondrosarcoma recurred (15%), of which two cases received hemi-pelvic amputation, 1 case of MBGCT relapsed and developed pulmonary metastases. Two cases of acetabular prosthesis with an impending dislocation received closed reduction followed by 6 weeks of hip abduction brace fixation. One case of prosthesis loosening was revised. In another case a deep infection occurred with debridement and prosthesis removal. Musculoskeletal Tumor Society 1993 (MSTS-93) score was utilized to conduct functional evaluation: 13 cases were good, 6 were average and one was poor. Conclusion The precision of the osteotomies performed is likely crucial for this type of reconstructive strategy to be successful. The use of custom guides for acetabular osteotomies and femoral head reconstruction can improve functional outcomes with relatively low complications at the intermediate length of follow-up.

10 Years Follow up of Chondroblastoma Treated with Intralesional Curettage: A Retrospective Study

2020 ◽  
Author(s):  
Lei Yang ◽  
Panyi Yang ◽  
Daoxi Wang ◽  
Xiaodong Yang ◽  
Lang Li ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Case Series ◽  
Primary Treatment ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Intralesional Curettage ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
The Mean

Abstract Introduction: Chondroblastoma is a rare benign tumor mainly occurred in epiphyses and apophyses of long bones, and usually affects the young people. The primary treatment for chondroblastoma is intralesional curettage. The aim of this study was to evaluate the clinical and radiologic results of patients suffering chondroblastoma treated with intralesional curettage, electrocauterization of the cavity and bone grafting. Patients and Methods: From January 2000 to January 2010, 15 patients with chondroblastoma were treated with intralesional curettage and electrocauterization of the cavity, among which14 patients received bone grafting. After operation, patients were immobilized with splint for 4 weeks and followed up for at least 10 years. The recurrence was examined by clinical manifestation and X ray. The clinical outcome included complications and the Musculoskeletal Tumor Society Score (MSTS).Results: Totally, 15 patients with chondroblastoma were enrolled in our study, including 9 males and 6 females, with a mean age of 13 years old (range from 8 to 21 years). The most common chief compliant were pain and limited joint motion, others including local swelling and increased skin temperature. The mean duration of symptom was 5 months (range from 2-14 months). Tumors mostly affected the proximal humerus (7/15), distal femur (4/15), proximal femur (1/15), proximal tibia (2/15) and femoral head (1/15). Eight patients were undiagnosed or misdiagnosed before operation, only 7 patients with a consideration of chondroblastoma. With a mean follow up of 12years (range from 10-16 years) , two patients had complications of upper limb shortening and1 patient suffered re-operation due to tumor recurrence. The mean postoperative MSTS score was 28.1 (range, 24 to 30) points, which was significantly higher than the preoperative score of 17.6 (range, 12 to 21) points.Conclusion: Thorough curettage with electrocauterization and bone grafting has a good functional outcome in the treatment of chondroblastoma, but still has a low risk of recurrence and complications.Level of Evidence: Level IV, retrospective case series.

scholarly journals Custom-Made 3D-Printed Implants as Novel Approach to Reconstructive Surgery after Oncologic Resection in Pediatric Patients

2021 ◽  
Vol 10 (5) ◽  
pp. 1056
Author(s):  
Giovanni Beltrami ◽  
Gabriele Ristori ◽  
Anna Maria Nucci ◽  
Alberto Galeotti ◽  
Angela Tamburini ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Soft Tissues ◽  
Lower Limbs ◽  
Host Bone ◽  
Limb Salvage Surgery ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Custom Made ◽  
3D Printed

Recently, custom-made 3D-printed prostheses have been introduced for limb salvage surgery in adult patients, but their use has not been described in pediatric patients. A series of 11 pediatric patients (mean age 10.8 years; range 2–13) with skeletal tumors treated with custom-made implants for the reconstruction of bony defects is described. Patients were followed up every 3 months. Functional results were evaluated by the Musculoskeletal Tumor Society Score (MSTS) for upper and lower limbs. The mean follow-up was 25.7 months (range 14–44). Three patients died after a mean of 19.3 months postoperatively—two because of disease progression and the other from a previous malignancy. Three patients experienced complications related to soft tissues. One patient required device removal, debridement, and antibiotic pearls for postoperative infection. Partial osseointegration between grafts and host bone was observed within a mean of 4 months. At the final follow-up, mean MSTS score was 75%. 3D prostheses may yield biological advantages due to possible integration with the host bone and also through the use of vascularized flaps. Further research is warranted.

scholarly journals Clinical outcome of operative treatment in 18 cases of giant cell tumors of bones

2020 ◽  
Vol 10 (2) ◽  
pp. 67-71
Author(s):  
Suresh Pandey
Keyword(s):  
Clinical Outcome ◽  
Giant Cell ◽  
De Novo ◽  
Excellent Result ◽  
Giant Cell Tumors ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Non Union ◽  
Proximal Fibula

Background: Giant Cell Tumor of the bone (GCTB) has got variable outcome after the different methods of surgical treatment depending upon the site and grade of lesion and extent of tumor removal. This retrospective prospective analysis of operatively treated cases of GCTB of different sites aimed to highlight the clinical outcome. Methods: This was a prospective observational study of 18 cases of GCTB; proximal tibia (n=6), distal femur (n=5), distal radius (n=4), proximal femur (n=1), proximal fibula (n=1) and anterior arc of first rib (n=1) treated with different operative management with mean follow up of 53.61 months. Functional outcome with Musculoskeletal Tumor Society Score (MSTS), recurrence and complications were analyzed with at least 24 months of follow up. Results: There were 10 females and 8 males with average age at presentation 27.3 years (range 15-38). Average duration of symptom was 4.72 months. 2 were cases of recurrence previously op­erated and 16 were de novo cases. Mean MSTS was 84.27% with good to excellent result in 88%. There were no non-union, graft failure, metastasis, prosthetic failure or wound infection till at least 24 months of follow up in any of the cases. Conclusions: Extended curettage or reconstruction with auto graft in grade I and II tumor or en­doprosthesis in higher grade or recurrence of GCTB can give good to excellent functional result in majority of the cases.

Evaluation of Metatarsal Head Resurfacing Hemiarthroplasty in the Surgical Treatment of Hallux Rigidus: A Retrospective Study and Mid- to Long-Term Follow-up

2017 ◽  
Vol 11 (1) ◽  
pp. 22-31 ◽  
Author(s):  
Musa Uğur Mermerkaya ◽  
Erkan Alkan ◽  
Mehmet Ayvaz
Keyword(s):  
Surgical Treatment ◽  
Case Series ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Treatment Method ◽  
Hallux Rigidus ◽  
Retrospective Case ◽  
First Metatarsophalangeal Joint

Background. The aim of this study was to evaluate the mid- to long-term outcomes of metatarsal head resurfacing hemiarthroplasty in the surgical treatment of advanced-stage hallux rigidus. Methods. We performed a retrospective review of 57 consecutive patients (25 [43.9%] males, 32 [56.1%] females; mean age, 61.0 ± 6.4 years) who underwent first metatarsal head resurfacing hemiarthroplasty (HemiCAP) for hallux rigidus between August 2007 and September 2010. Sixty-five implantations were performed in 57 patients; 8 patients underwent bilateral procedures. All patients were clinically rated prior to surgery and at the final follow-up visit using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal scale and first metatarsophalangeal joint range of motion (MTPJ ROM). Results. The median follow-up duration was 81 (range = 8-98) months. The median preoperative AOFAS score was 34 (range = 22-59) points, which had increased to 83 (range = 26-97) points at the final follow-up visit (P < .001). The median preoperative first MTPJ ROM was 25° (range = 15° to 40°), which had increased to 75° (range = 30° to 85°) at the final follow-up visit (P < .001). Conclusions. First MTPJ hemiarthroplasty is an effective treatment method that recovers toe function and first MTPJ ROM, and provides good mid- to long-term functional outcomes. Levels of Evidence: Level IV: Retrospective case series

Long-term outcomes of an extracorporeal irradiated autograft for limb salvage operations in musculoskeletal tumours

2019 ◽  
Vol 101-B (9) ◽  
pp. 1151-1159 ◽  
Author(s):  
N. Oike ◽  
H. Kawashima ◽  
A. Ogose ◽  
H. Hatano ◽  
T. Ariizumi ◽  
...  
Keyword(s):  
Deep Infection ◽  
Long Term Outcomes ◽  
En Bloc ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Initial Surgery ◽  
Common Diagnosis ◽  
The Mean

Aims We analyzed the long-term outcomes of patients observed over ten years after resection en bloc and reconstruction with extracorporeal irradiated autografts Patients and Methods This retrospective study included 27 patients who underwent resection en bloc and reimplantation of an extracorporeal irradiated autograft. The mean patient age and follow-up period were 31.7 years (9 to 59) and 16.6 years (10.3 to 24.3), respectively. The most common diagnosis was osteosarcoma (n = 10), followed by chondrosarcoma (n = 6). The femur (n = 13) was the most frequently involved site, followed by the tibia (n = 7). There were inlay grafts in five patients, intercalary grafts in 15 patients, and osteoarticular grafts in seven patients. Functional outcome was evaluated with the Musculoskeletal Tumor Society (MSTS) scoring system. Results There were no recurrences in the irradiated autograft and the autograft survived in 24 patients (88.9%). Major complications included nonunion (n = 9), subchondral bone collapse (n = 4), and deep infection (n = 4). Although 34 revision procedures were performed, 25 (73.5%) and four (11.8%) of these were performed less than five years and ten years after the initial surgery, respectively. The mean MSTS score at the last follow-up was 84.3% (33% to 100%). Conclusion Considering long-term outcomes, extracorporeal irradiated autograft is an effective method of reconstruction for malignant musculoskeletal tumours Cite this article: Bone Joint J 2019;101-B:1151–1159

Functional and oncologic outcomes after excision of proximal femur primary bone tumors using a cost-effective indigenous prosthesis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e23500-e23500
Author(s):  
Ashish Gulia ◽  
Sri Harsha ◽  
Srinath Gupta ◽  
Ajay Puri
Keyword(s):  
Proximal Femur ◽  
Malignant Tumors ◽  
Weight Bearing ◽  
Distant Recurrence ◽  
Oncologic Outcomes ◽  
Implant Survival ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Early Return

e23500 Background: Proximal femur endoprosthetic replacement(PFER) has become aprimary treatment option for aggressive benign and malignant tumors of proximal femur allowing early return to weight bearing and improvement in functional status. We present our experience in these cases with respect to oncological outcomes, functional outcomes and implant survival. Methods: All cases were retrieved from our prospectively maintained surgical database. 98 patients(35 males and 63 females) with a mean age of 29 years(10– 69 years)were operated between August 2006 and September 2017. Median followup was 49 months(1 - 160 months).The diagnosis included osteosarcoma(18), Ewing’s sarcoma(38), chondrosarcoma(32), and GCT(8) synovial sarcoma (2) .They were evaluated by Musculoskeletal Tumor Society score, recurrence free survival, patient survival, and implant survival. Results: Mean resection length is 18.5cm (8 – 35cm). 8 patients underwent revision surgery,7 for mechanical (3 for aseptic loosening, 4 for dislocations and for implant failures), 1 for non mechanicalcause (infection) and 2 patients underwent amputation for local recurrence. One patient had dislocation recently for whom revision is adbvised. At last follow-up, out of 98 cases 6 were lost to follow up, 32 patients had died(28 due to disease and 4 due to other causes) and 60 are alive. There were 3 only local recurrences(3 alive-1 external hemipelvectomy, 1 excision, 1 definitive chemo radiation), 9 had both local and distant recurrence (1 alive – hip disarticulation for local, definitive cheomoradiation for distant recurrence), and 26 had distant recurrences(6 alive - 3 pulmonary metastetectomy,1 nodal metastasis, 1 lung metastasis and 1 bone metastasis treated with definitive cheomoradiation) . The 5year OS, LRFS,DRFS were 68.3,85.7,61.5% respectively. The mean Musculoskeletal Tumor Society score was 26(22 – 28). The implant survival was 87.4% at 5 years. Conclusions: The use of a PFER in the treatment of primary tumours of bone is oncologically safe and gives consistent and predictable results with low rates of complication. We found that low cost indigenous prosthesis (one fourth the cost of imported prosthesis) fare equivalent to existing imported prosthesis. This can immensely helpful in offering limb salvage in resource constraint settings.

scholarly journals Preliminary proposal: a classification system for reconstruction with autologous femoral head after periacetabular tumors resection

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Chunzhi Yi ◽  
Jiaqian Zheng ◽  
Ruoyu Li ◽  
Yun Lan ◽  
Mincong He ◽  
...  
Keyword(s):  
Femoral Head ◽  
Classification System ◽  
Malignant Tumors ◽  
Type A ◽  
Clinical Results ◽  
Type B ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Total Incidence ◽  
And Function

Abstract Background Although researchers have adopted various methods for the resection and reconstruction of periacetabular tumors, the total incidence rate of complications remains high. Aiming for preserving the acetabulum and reducing the risk of complications, we applied a surgery method using tumor-free autologous femoral head to reconstruct the defective acetabulum after resection of periacetabular tumors followed by performing a conventional total hip arthroplasty (THA). Moreover, we proposed a preliminary classification system for these surgery methods. Methods We retrospectively reviewed 6 patients treated with acetabulum reconstruction combined with autologous femoral head following peri-acetabulum resection between April 2010 and May 2018. All patients were diagnosed as periacetabular tumors including chondrosarcoma (n = 5) and chondroblastoma (n = 1). Clinical data such as age, diagnosis, complications, local recurrence or metastasis, and function (Musculoskeletal Tumor Society 1993, MSTS93) were documented. The average time of follow-up was 62.5 months (range, 17 to 106 months). Results A total of 5 patients survive with average MSTS93 score of 27.8 points (range, 26–30). One patient, suffering from multiple bone metastasis prior treatment, ended up dying. One who had received radiotherapy before surgery had poor incision healing. Further, a classification system was preliminary proposed in 2 patients involving the pubis (type A) and 4 patients involving ischium (type B). Conclusions Based on the results, we preliminary proposed a classification system for reconstruction with autologous femoral head after periacetabular low malignant tumors resection. The clinical results suggested that surgery methods involving pubis (type A) and ischium (Type B) are safe and feasible. However, further researches should be conducted to verify our classification system.

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