CORR Insights®: Does Adding Femoral Lengthening at the Time of Rotation Hip Transposition After Periacetabular Tumor Resection Allow for Restoration of Limb Length and Function? Interim Results of a Modified Hip Transposition Procedure

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ajay Puri
Keyword(s):  
Tumor Resection ◽  
Limb Length ◽  
Femoral Lengthening ◽  
And Function

scholarly journals Replantation of Spinous Process-lamina Complex in the Treatment of Cervical Spine Tumor : Two Cases Report and Literature Review

2021 ◽  
Author(s):  
Xu Jiahui ◽  
Ma Bin ◽  
Wang Chenggang
Keyword(s):  
Spinous Process ◽  
Tumor Resection ◽  
Good Health ◽  
Structure And Function ◽  
Anatomical Structure ◽  
Spine Tumor ◽  
Posterior Element ◽  
Cervical Spine Tumor ◽  
And Function

Abstract Purpose: The primary aim of our study was to prove that the replantation of spinous process-lamina complex is beneficial to restore the anatomical structure and function of the spine, and to find if it can reduce postoperative complications.Methods: We report two cases of cervical intraspinal tumor, whose postoperative pathological diagnosis, Respectively, are Neurilemmoma and meningioma. They all underwent the resection and replantation of spinous process-lamina complex, in which the resected spinous process-lamina complex was replanted at the end of the procedure, allowing a complete reconstruction of the posterior element of the spinal canal. Results：After the surgery, the symptoms were relieved, and no dysfunction of upper limbs and sphincter was observed. The tumors were benign pathologically and were diagnosed as Neurilemmoma and meningioma. The patient recovered and at 6-month follow-up had no complaints and in good health.Conclusion: After tumor resection, the replantation of spinous process-lamina complex is beneficial to restore the anatomical structure and function of the spine.

Gait and function in patients with a femoral endoprosthesis after tumor resection

2002 ◽  
Vol 73 (4) ◽  
pp. 439-446 ◽  
Author(s):  
J Christiaan Rompen ◽  
S John Ham ◽  
Jan P K Halbertsma ◽  
Jim R Van Horn
Keyword(s):  
Tumor Resection ◽  
And Function

scholarly journals Postural asymmetries in transfemoral amputees

2011 ◽  
Vol 35 (2) ◽  
pp. 171-180 ◽  
Author(s):  
Ignacio Gaunaurd ◽  
Robert Gailey ◽  
Brian J Hafner ◽  
Orlando Gomez-Marin ◽  
Neva Kirk-Sanchez
Keyword(s):  
Chronic Conditions ◽  
Limb Length Discrepancy ◽  
Structure And Function ◽  
Limb Length ◽  
Body Structure ◽  
Trunk Flexion ◽  
Length Discrepancy ◽  
Transfemoral Amputees ◽  
And Function ◽  
Hip Extension

Background: Postural asymmetries are thought to lead to impairment of body structure and function such as muscle imbalance, gait asymmetry and possible chronic conditions, which result in limitation of mobility and restriction of daily activity for transfemoral amputees (TFAs). Despite the potential clinical impact, postural asymmetries have not been confirmed or quantified in TFAs.Objectives: To identify the presence of postural asymmetries in TFAs utilizing clinical evaluation measures.Study design: An observational cross-sectional study in which participants were evaluated at a single time point without intervention or follow-up.Methods: Forty-seven unilateral TFAs were measured for standing limb length, pelvic innominate inclination (PII), lateral trunk flexion and hip extension.Results: Limb length discrepancy was present in 66% of participants and 57% had a short prosthetic limb. PII was greater than has been reported in the literature, and the shorter the prosthetic lower limb, the greater the PII on the amputated side (r = −0.422, p = 0.004). Limb length discrepancy and decreased lateral trunk flexion accounted for 26% of the variance in amputated side PII.Conclusion: Three postural measurements, namely leg length, pelvic innominate inclination and hip extension, were found to differ between the intact and amputated limb in this study sample.Clinical relevanceClinicians should include postural assessment as part of their routine evaluation of TFAs in an effort to achieve postural symmetry and reduce the risk of chronic conditions associated with impairment of body structure and function.

scholarly journals Total Elbow Arthroplasty

2011 ◽  
Vol 5 (1) ◽  
pp. 115-123 ◽  
Author(s):  
Joaquin Sanchez-Sotelo
Keyword(s):  
Tumor Resection ◽  
Distal Humerus ◽  
Total Elbow Arthroplasty ◽  
Posttraumatic Osteoarthritis ◽  
Elbow Arthroplasty ◽  
Augmentation Techniques ◽  
Humerus Fractures ◽  
Distal Humerus Fractures ◽  
And Function ◽  
Spectrum Of Indications

Total elbow arthroplasty has continued to evolve over time. Elbow implants may be linked or unlinked. Unlinked implants are attractive for patients with relatively well preserved bone stock and ligaments, but many favor linked implants, since they prevent instability and allow replacement for a wider spectrum of indications. Inflammatory arthropathies such as rheumatoid arthritis represent the classic indication for elbow arthroplasty. Indications have been expanded to include posttraumatic osteoarthritis, acute distal humerus fractures, distal humerus nonunions and reconstruction after tumor resection. Elbow arthroplasty is very successful in terms of pain relief, motion and function. However, its complication rate remains higher than arthroplasty of other joints. The overall success rate is best for patients with inflammatory arthritis and elderly patients with acute distal humerus fractures, worse for patients with posttraumatic osteoarthritis. The most common complications of elbow arthroplasty include infection, loosening, wear, triceps weakness and ulnar neuropathy. When revision surgery becomes necessary, bone augmentation techniques provide a reasonable outcome.

scholarly journals The Experimental Study on Promoting the Ilizarov Distraction Osteogenesis by the Injection of Liquid Alg/nHAC Biocomposites

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Xinhui Liu ◽  
Di Yu ◽  
Jieyan Xu ◽  
Chao Zhu ◽  
Qingling Feng ◽  
...  
Keyword(s):  
Distraction Osteogenesis ◽  
Bone Healing ◽  
Tumor Resection ◽  
Limb Lengthening ◽  
Limb Length ◽  
Biomechanical Test ◽  
Bone Trabecula ◽  
General Observation ◽  
Percentage Area ◽  
Limb Length Inequality

Limb lengthening is frequently utilized in treating limb length inequalities, angulation deformities, nonunions, complex fractures, and deficiencies after tumor resection in more recent year. The procedure of limb lengthening pioneered by Ilizarov is now a widely accepted method for correcting limb length inequality and short stature as well as for bridging large defects in long bones. In order to promote bone healing during distraction osteogenesis and reduce the complications caused by limb lengthening pioneered, an alginate/nanohydroxyapatite/collagen (Alg/nHAC) composite was fabricated. General observation, histologically morphological observations, X-ray examination, biomechanical test, bone density, and the percentage area of bone trabecula were used to assay the ability of Alg/nHAC composite to promote bone healing. The present study demonstrates that the injection of liquid Alg/nHAC composites can significantly promote distraction osteogenesis. Alg/nHAC composite is promising for clinical application, solving the healing problem of backbone osteotomy and the fixing problem of metaphyseal backbone.

scholarly journals Preservation of the Epiphysis and Growth Plate in the Surgical Management of Femoral Osteosarcoma in a Skeletally Immature Patient by Intercalary Resection and Biological Reconstruction: A Case Report

2019 ◽  
Vol 12 (2) ◽  
pp. 513-522
Author(s):  
Yuhei Yoda ◽  
Sayaka Iwai Yamaguchi ◽  
Toru Hirozane ◽  
Naofumi Asano ◽  
Atsuhito Seki ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Growth Plate ◽  
Plate Fixation ◽  
Tumor Resection ◽  
Limb Length Discrepancy ◽  
Limb Length ◽  
Limb Salvage Surgery ◽  
Skeletally Immature ◽  
Biological Reconstruction ◽  
Length Discrepancy

Osteosarcoma arises most frequently in the metaphysis around the knee and its management by limb salvage surgery in skeletally immature pediatric patients is extremely challenging. Common reconstructive methods such as endoprosthetic or biological reconstruction are not fully capable of dealing with durability-related and growth-related problems and their functional outcomes are not as good as those seen in adult cases. A definitive limb salvaging procedure in children that outperforms amputation or rotationplasty has not yet been established. Herein, we report a case of stage IV osteosarcoma in the femur of a 7-year-old boy that was safely managed with intercalary resection preserving the distal femoral growth plate and epiphysis, followed by biological reconstruction using a frozen tumor-devitalized autograft. Good response to preoperative chemotherapy and the diaphyseal location of the tumor enabled us to perform a tumor resection that spared the growth plate and preserved the native knee joint structure. Plate fixation over the growth plate was terminated by removing the locking screws in the epiphysis after 44 months, which restored growth capacity to some extent. At 50 months postoperatively, no recurrence or progression of the disease was observed. The patient uses an extension shoe and reports having little discomfort in his daily life despite having a restricted range of motion and limb length discrepancy. In conclusion, limb salvage with biological reconstruction in skeletally immature patients can provide an acceptable functional outcome, including minimized limb length discrepancy, if critical damage to the growth plate and articular components can be avoided.

scholarly journals Long-term outcome in pediatric surgical bypass grafting after traumatic injury and tumor resection: retrospective cohort analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Stephanie Kampf ◽  
Madeleine Willegger ◽  
Christopher Dawoud ◽  
Gerhard Fülöp ◽  
Philipp Lirk ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Traumatic Injury ◽  
Tumor Resection ◽  
Limb Length ◽  
Bypass Grafting ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Vascular Bypass

AbstractVascular bypass surgery in children differs significantly from adults. It is a rarely performed procedure in the setting of trauma and tumor surgery. Besides technical challenges to reconstruct the small and spastic vessels, another concern in bypass grafting is the adequate limb length growth over time. The primary aim of this study was to assess long-term outcome after pediatric bypass grafting, in a single academic center, focusing on potential effects on limb development. In this retrospective cohort analyses we included all pediatric patients undergoing vascular bypass grafting at our department between 2002 and 2017. All patients ≤ 18 years suffered a traumatic injury or underwent a tumor resection of the lower or upper limb. The youngest female patient was 0.4 years, the youngest male patient was 3.5 years. During the observation period, 33 pediatric patients underwent vascular repair, whereby 15 patients underwent bypass grafting. Median overall follow-up was 4.7 years (IQR ± 9). 8 patients (53%) had a traumatic injury (traumatic surgery group) and 7 patients had a planned orthopedic tumor resection (orthopedic surgery group). In 13/15 (87%) a great saphenous vein (GSV) graft and in 2/15 (13%) a Gore-Tex graft was used for bypassing. Both Gore-Tex grafts showed complete occlusion 12 and 16 years after implantation. No patient died in the early postoperative phase (< 30 days), however 3/7 (43%) in the orthopedic group died during follow-up. Revision surgery had to be performed in 1/15 (7%) patients. A functional use of the extremity was reported in all patients. Normal limb length growth according to the contralateral site, and therefore bypass growth, could be documented in 14/15 patients. Children are surgically challenging. In our study, surgery by a specialized vascular surgery team using GSV grafts led to adequate limb length and bypass growth, and we observed no functional restrictions.

scholarly journals CBMS-04 SIGNIFICANT ROLE OF HYPOXIA IN THE EXPRESSION AND FUNCTION OF OSTEOPONTIN IN CD44-HIGHLY EXPRESSED GLIOMA STEM-LIKE CELLS IN TUMOR PROGRESSION OF GLIOBLASTOMA

2019 ◽  
Vol 1 (Supplement_2) ◽  
pp. ii5-ii5
Author(s):  
Masahiro Nishikawa ◽  
Akihiro Inoue ◽  
Yoshihiro Ohtsuka ◽  
Saya Ozaki ◽  
Shirabe Matsumoto ◽  
...  
Keyword(s):  
Tumor Progression ◽  
Hypoxia Inducible Factor ◽  
Tumor Resection ◽  
Signal Pathways ◽  
Moderate Hypoxia ◽  
Cd44 Expression ◽  
Hypoxic Conditions ◽  
Tumor Periphery ◽  
Tumor Tissues ◽  
And Function

Abstract The poor prognosis of glioblastoma multiforme (GBM) may be due to the surviving glioma stem-like cells (GSCs) in the tumor periphery after tumor resection. We demonstrated that CD44-expressed GSCs existed much more in the tumor periphery of high invasive (HI) type GBM than low invasive (LI) type GBM. The HI type was significantly associated with worse outcome, but how GSCs with high CD44 expression relate to tumor progression remains unknown. In this study, we investigated effects of hypoxia on CD44-directed signal pathways, leading to tumor invasion and proliferation in GBM. We focused on the CD44 ligand osteopontin (OPN) because it is known hypoxia affects the interaction of CD44 and OPN which promotes stemness and proliferation of cancer stem cells. We examined mRNA expressions of hypoxia inducible factor (HIF)-1a, HIF-2a, CD44 and OPN in tumor tissues of GBM and investigated effects of hypoxia (1%O2:severe or 5%O2:moderate) on the expression of these molecules using cultured GSCs that were established from tumor tissues showing high CD44 expression in the periphery of GBMs. In addition, we analyzed the effects of OPN on invasive, migratory and proliferative activities of GSCs under the hypoxic conditions. OPN was much higher expressed in the tumor periphery of LI type GBM than HI type GBM. Severe hypoxia significantly increased the expressions of HIF-1a and CD44 but did not OPN. On the other hands, moderate hypoxia promoted the expressions of HIF-2a and OPN. Knockdown of HIF-2a significantly inhibited OPN expression. In addition, the more OPN was expressed in the cultured GSCs under moderate hypoxia, the more the GSCs proliferated and decreased their invasive and migratory activities. In conclusion, GSCs existing in the tumor periphery of GBM can migrate or proliferate by changing CD44-directed signal pathways. Moderate hypoxia promoted HIF-2a/OPN/CD44 pathway, resulting in phenotypic transition to high proliferative tumors.

scholarly journals Masas cardíacas, utilidad de la ecocardiografía transesofágica durante el intraperioperatorio

2020 ◽  
Vol 49 (4) ◽  
pp. 538-547
Author(s):  
Fernando Dominella ◽  
Luis Masco ◽  
Silvina Longo
Keyword(s):  
Breast Cancer ◽  
Cardiac Tumor ◽  
Heart Valves ◽  
Renal Tumor ◽  
Heart Defects ◽  
Tumor Resection ◽  
Atrial Myxoma ◽  
Surgical Team ◽  
Post Cardiopulmonary Bypass ◽  
And Function

We present our experience in cardiac tumor resection surgery in adult patients: 30 subjects with sternotomy approach with later diagnosis of myxomas (12), fibroelastomas (7), sarcomas (4), cardiac methastasis of a breast cancer and cardiac invasion of renal tumor (6), and 3 with videothroacoscopic approach with diagnosis of atrial myxoma (2) and intraventricular sarcoma (1). We highlight the usefulness of TEE as an essential monitor in this subtype of cardiac surgery in allowing location confirmation and completion of resection. Likewise as anesthesiologists and active participants of the surgical team, we were able to document absence of residual heart defects, lesions or perforations or dysfunction of heart valves. Evaluation of preexisting anatomy and function and post Cardiopulmonary Bypass ventricular function and circulation were important in early diagnosis of complications.

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