3D Printing Guide Plate for Accurate Hemicortical Bone Resection in Low-Grade Bone Sarcoma

2020 ◽  
Author(s):  
Hongwei Wu ◽  
Xian'an Li ◽  
Shuo Yang ◽  
Jie Bu ◽  
Xuezheng Xu ◽  
...  
Keyword(s):  
3D Printing ◽  
Bone Sarcoma ◽  
Long Bone ◽  
Low Grade ◽  
Joint Function ◽  
Bone Resection ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Guide Plate ◽  
Post Operation

Abstract Background: Surgical resection and reconstruction for low grade bone sarcoma in the metaphysis of the long bone remains challenging. We hypothesize that 3D printing osteotomy guide plate could assist to accurately resect the tumor lesion and save the joint function without higher recurrence rate. Methods: From January 2017 to August 2019, ten patients with low-grade malignant bone tumor in metaphysis of the limbs were treated with hemicortical resection using 3D printing guide plate and biological reconstruction. Results: Four patients were paracorticular osteosarcoma, five cases had highly differentiated chondrosarcoma, and one case was a chondromyxoid fibroma. Two of the cases involved the proximal humerus, while eight cases involved the distal femur. There was neither post-operation infection, internal fixation loosening, nor fracture occurrence in any of the patients. The Musculoskeletal Tumor Society score averaged at 27.1, while the International Society of Limb Salvage imaging score examination averaged 87.8%. Conclusions: Here, we demonstrate that the 3D printing osteotomy guide plate assisted hemicortical bone resection is a beneficial strategy to effectively resect the primary low-grade malignant bone tumors in the metaphysis of long bone and restore excellent joint function.

scholarly journals 3D printing guide plate for accurate hemicortical bone tumor resection in metaphysis of distal femoral: a technical note

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hongwei Wu ◽  
Shuo Yang ◽  
Jianfan Liu ◽  
Linqin Li ◽  
Yi Luo ◽  
...  
Keyword(s):  
3D Printing ◽  
Distal Femur ◽  
Tumor Resection ◽  
Bone Sarcoma ◽  
Technical Note ◽  
Low Grade ◽  
Joint Function ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Guide Plate

Abstract Background Surgical resection and reconstruction for low-grade bone sarcoma in the metaphysis of the distal femur remain challenging. We hypothesized that 3D printing osteotomy guide plate could assist to accurately resect the tumor lesion and save the joint function. Methods From January 2017 to August 2019, five patients diagnosed with low-grade bone sarcoma in the metaphysis of the distal femur were treated with hemicortical resection using 3D printing guide plate. Autologous bone graft was inactivated in a high-temperature water bath and re-implanted in situ fixed with plate and screw. Patients were followed up from 17 to 33 months. The Musculoskeletal Tumor Society Score was used to evaluate the joint function. X-ray was used to evaluate the bone union. Results One patient was paracorticular osteosarcoma, and four cases had highly differentiated chondrosarcoma. All cases were involved in the metaphysis of the distal femur. Patients were followed up from 13 to 33 months, with an average of 23.6 months. There was neither post-operation infection, internal fixation loosening, nor fracture occurrence in any of the patients. The Musculoskeletal Tumor Society Score averaged at 28.1, while the International Society of Limb Salvage imaging score examination averaged 89.8%. Conclusions Here, we demonstrate that the 3D printing osteotomy guide plate-assisted hemicortical bone resection is a beneficial strategy to effectively resect the primary low-grade malignant bone tumors in the metaphysis of the distal femur and retained satisfied joint function.

scholarly journals Plastic lengthening amputation with vascularized bone grafts in children with bone sarcoma: a preliminary report

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Zhiqiang Zhao ◽  
Qinglin Jin ◽  
Xianbiao Xie ◽  
Yongqian Wang ◽  
Tiao Lin ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Young Patients ◽  
Bone Sarcoma ◽  
Postoperative Management ◽  
Functional Score ◽  
Leg Length ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Functional Scores ◽  
Distal Joint

Abstract Background At present, amputation was widely adopted for young patients when limb salvage was deemed risky with several surgical strategy such as rotationplasty. However, leg length discrepancies and unfavorable cosmetic results were indispensable complication of this strategy. The purpose of this study was to propose a novel reconstruction strategy and evaluate the early clinical and functional outcomes of the strategy. Methods Plastic lengthening amputation (PLA) has been developed by lengthening the stump to preserve one additional distal joint for fixing the artificial limb well. The surgical technique and postoperative management were documented, and the functional outcomes were compared with those of traditional amputation (TA). Six pairs of patients matched for age, sex, location, pathological type, and final prosthesis underwent individually designed plastic lengthening amputation with vascularized autografts or traditional amputation between January 2005 and December 2007. All patients were followed, and the locomotor index and the musculoskeletal tumor society score (MSTS) were used to describe and quantitatively grade limb functional outcomes after amputation. The complications and functional outcomes of the patients taken two kinds of procedures were compared. Results Twelve patients with osteosarcoma or Ewing’s sarcoma of either the femur or tibia were included in the study. Six patients underwent plastic lengthening amputations, three of whom also underwent vascular anastomosis. Patients were followed for an average of 48.17 months; bone healing required an average of 3.3 months. No local recurrence was found. The average postoperative locomotor index functional score of the affected limb was 32.67 ± 5.89 in the plastic lengthening amputation group while was 19.50 ± 7.87 in the traditional amputation group. The MSTS functional scores were 22.67 ± 1.33 and 24.17 ± 1.45 at 6 and 12 months for patients in PLA group while 17.00 ± 1.549 and 17.83 ± 1.64 at 6 and 12 months for patients in TA group. Conclusions Plastic lengthening amputations with vascularized autografts could preserve the knee joint to improve the function of the amputated limb in selected bone sarcoma patients.

scholarly journals Clinical outcomes of frozen autograft reconstruction for the treatment of primary bone sarcoma in adolescents and young adults

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoshihiro Araki ◽  
Norio Yamamoto ◽  
Katsuhiro Hayashi ◽  
Akihiko Takeuchi ◽  
Shinji Miwa ◽  
...  
Keyword(s):  
Young Adults ◽  
Clinical Outcomes ◽  
Bone Sarcoma ◽  
Adolescents And Young Adults ◽  
Appendicular Skeleton ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Primary Bone Sarcoma ◽  
Primary Bone

AbstractAge affects the clinical outcomes of cancer treatment, including those for bone sarcoma. Successful reconstruction using frozen autograft after excision of bone sarcoma has been reported; however, little is known about the clinical outcomes of frozen autograft reconstruction according to age. The purpose was to evaluate the clinical outcomes of the frozen autograft reconstruction focusing on skeletally mature adolescents and young adults (AYAs) that was 15 to 39 years of age. A total of 37 AYA patients with primary bone sarcoma on the appendicular skeleton were enrolled in this study. The mean follow-up period was 89 months. The graft survival (GS), overall survival (OS), recurrence-free survival (RFS), complications and the function were retrospectively evaluated using medical records. The 10-year GS, OS, and RFS rates were 76%, 84%, and 79%, respectively. Bone union was achieved with a rate of 94% within 1 year after surgery, and nonunion (n = 1) and fracture (n = 2) were infrequently observed. Graft removal was performed in 7 cases, and the most common reason for the removal was infection (n = 5). The Musculoskeletal Tumor Society score was excellent in 23 cases of the available 29 cases. Frozen autograft reconstruction for AYAs showed excellent clinical outcomes, although the long-term follow-up is required.

scholarly journals Surveillance Strategies for Sarcoma: Results of a Survey of Members of the Musculoskeletal Tumor Society

Sarcoma ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
David D. Greenberg ◽  
Brooke Crawford
Keyword(s):  
Soft Tissue ◽  
Radiation Exposure ◽  
Tumor Size ◽  
Surgical Margin ◽  
Bone Sarcoma ◽  
Histologic Grade ◽  
Public Health Issue ◽  
Evidence Based ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society

Background. Surveillance is crucial to oncology, yet there is scant evidence to guide strategies.Purpose. This survey identified sarcoma surveillance strategies for Musculoskeletal Tumor Society (MSTS) members and rationales behind them. Understanding current practice should facilitate studies to generate evidence-based surveillance protocols.Methods. Permission was granted by the Research and Executive Committee of the MSTS to survey members on surveillance strategies. First, the questionnaire requested demographic and clinical practice information. Second, the survey focused on clinicians’ specific surveillance soft tissue and bone sarcoma protocols.Results. 20 percent of MSTS members completed the survey. The primary rationale for protocols was training continuation, followed by published guidelines, and finally personal interpretation of the literature. 95% of the respondents believe that additional studies regarding appropriate surveillance protocols are needed. 87% reported patient concerns regarding radiation exposure from surveillance imaging. For soft tissue and bone sarcoma local recurrence, responders identified surgical margin, histologic grade, and tumor size as the most important factors. For metastases, important risk factors identified included histologic grade, tumor size, and histologic type. Protocols demonstrated wide variation.Conclusion. This survey demonstrates that surveillance strategies utilized by MSTS members are not evidence-based, providing rationale for multi-institutional studies. It also confirms the public health issue of excessive radiation exposure.

The long-term results of extendable endoprostheses of the humerus in children after the resection of a bone sarcoma

2020 ◽  
Vol 102-B (1) ◽  
pp. 64-71
Author(s):  
Yusuke Tsuda ◽  
Tomohiro Fujiwara ◽  
Jonathan D. Stevenson ◽  
Michael C. Parry ◽  
Roger Tillman ◽  
...  
Keyword(s):  
Bone Sarcoma ◽  
Long Term Results ◽  
Functional Score ◽  
Endoprosthetic Replacement ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Initial Surgery ◽  
The Mean

Aims The purpose of this study was to report the long-term results of extendable endoprostheses of the humerus in children after the resection of a bone sarcoma. Methods A total of 35 consecutive patients treated with extendable endoprosthetic replacement of the humerus in children were included. There were 17 boys and 18 girls in the series with a median age at the time of initial surgery of nine years (interquartile range (IQR) 7 to 11). Results The median follow-up time was 10.6 years (IQR 3.9 to 20.4). The overall implant survival at ten years was 75%. Complications occurred in 13 patients (37%). Subluxation at the proximal humerus occurred in 19 patients (54%) but only six (17%) were symptomatic. Subluxation was seen more commonly in children under the age of nine years (86%) than in those aged nine years or more (33%) (p = 0.002). Implant failure occurred in nine patients (26%): the most common cause was aseptic loosening (four patients, 11%). Lengthening of the implant was carried out in 23 patients (66%). At final follow up, three patients had a limb that was shortened by 5 cm or more. The mean Musculoskeletal Tumor Society (MSTS) functional score was 79% (73% to 90%). Conclusion Extendable endoprosthetic replacement is a reliable method of reconstructing humerus after excision of a bone sarcoma. Children who are less than nine years old have a high risk of subluxation. Cite this article: Bone Joint J 2020;102-B(1):64–71

scholarly journals Giant cell tumour of bone around the knee: a systematic review of the functional and oncological outcomes

2021 ◽  
Vol 6 (8) ◽  
pp. 641-650
Author(s):  
Joaquim Soares do Brito ◽  
André Spranger ◽  
Paulo Almeida ◽  
José Portela ◽  
Irene Barrientos-Ruiz
Keyword(s):  
Systematic Review ◽  
Giant Cell ◽  
Proximal Tibia ◽  
Giant Cell Tumour ◽  
Benign Neoplasm ◽  
Cell Tumour ◽  
Long Bone ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Oncological Outcomes

Giant cell tumour of bone (GCT) is a relatively rare, locally aggressive benign neoplasm observed in the long bone epiphyseal-metaphyseal regions of young adults. The optimal treatment strategy for these tumours remains controversial, and a huge amount of contradictory data regarding the functional and oncological outcomes can be found. Therefore, we performed a systematic review intended to investigate the functional and oncological outcomes after surgical treatment of GCTs arising around the knee, namely in the distal femur and proximal tibia. A trend towards better oncological control was found using wide resections, nonetheless, curettage-based techniques achieve a highly acceptable recurrence rate with overall better knee function. A slight advantage favouring proximal tibia GCTs regarding the Musculoskeletal Tumor Society (MSTS) score was also observed. Prospective studies comparing groups of more homogeneous patients, tumours, and treatment options should be developed to obtain more conclusive and definitive results regarding the optimal strategy for treating GCTs. Cite this article: EFORT Open Rev 2021;6:641-650. DOI: 10.1302/2058-5241.6.200154

scholarly journals Low-Grade Chondrosarcomas: Diagnosis and Treatment

2021 ◽  
Author(s):  
Ozgur Erdogan ◽  
serdar demiröz ◽  
emre kaya ◽  
güray altun ◽  
volkan gürkan
Keyword(s):  
High Speed ◽  
Tumor Location ◽  
Low Grade ◽  
Recurrence Rates ◽  
Intralesional Curettage ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Multiple Parameters ◽  
Treatment Type ◽  
High Speed Burr

Abstract Background: Multiple parameters are needed to distinguish between enchondroma and low-grade chondrosarcoma (LGCS). This study aimed to investigate the diagnosis, surgery type according to bone type, recurrence rates, and complications of LGCS in the appendicular and axial skeletons. Methods: A total of 52 surgically treated patients with LGCS, between March 2007 and May 2019, were retrospectively examined. Following diagnosis, the patients were operated on with intralesional curettage for long bones or wide local excision (WLE) for axial bones. The retrieved data included demographics, tumor location, surgical treatment type, local adjuvants, complications, and Musculoskeletal Tumor Society scores.Results: The final cohort included 52 patients (52 tumors; 35 female and 17 male). The male:female ratio was 1:2. The mean age was 44 ± 17 years. Forty of the tumors were treated with intralesional procedures (all with a high-speed burr and phenol), 6 with autograft, 8 with allograft, and 28 with cement augmentation, while 7 were treated with WLE.Conclusions: The use of phenol as an adjuvant may reduce recurrence rates. Using a putty graft alone may result in nonunion. Applying a thin layer of putty on the cementum can create callus tissue on the cementum. Even in the upper limb, plate and screw fixation should be used to prevent fractures in metaphyseal–diaphyseal curettages.

scholarly journals Validation of the Brazilian Version of the Musculoskeletal Tumor Society Rating Scale for Lower Extremity Bone Sarcoma

2013 ◽  
Vol 471 (12) ◽  
pp. 4020-4026 ◽  
Author(s):  
Daniel Cesar Seguel Rebolledo ◽  
João Ricardo Nickenig Vissoci ◽  
Ricardo Pietrobon ◽  
Olavo Pires de Camargo ◽  
Andre Mathias Baptista
Keyword(s):  
Lower Extremity ◽  
Rating Scale ◽  
Bone Sarcoma ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Brazilian Version

scholarly journals One-Stage Soft Tissue Reconstruction Following Sarcoma Excision: A Personalized Multidisciplinary Approach Called “Orthoplasty”

2020 ◽  
Vol 10 (4) ◽  
pp. 278
Author(s):  
Andrea Angelini ◽  
Cesare Tiengo ◽  
Regina Sonda ◽  
Antonio Berizzi ◽  
Franco Bassetto ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Lower Limbs ◽  
Surgical Approaches ◽  
Soft Tissue Reconstruction ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
One Stage ◽  
Unplanned Excision ◽  
Increased Risk ◽  
Toronto Extremity Salvage Score

Background and Objectives. Wide surgical resection is a relevant factor for local control in sarcomas. Plastic surgery is mandatory in demanding reconstructions. We analyzed patients treated by a multidisciplinary team to evaluate indications and surgical approaches, complications and therapeutic/functional outcomes. Methods. We analyzed 161 patients (86 males (53%), mean age 56 years) from 2006 to 2017. Patients were treated for their primary tumor (120, 75.5%) or after unplanned excision/recurrence (41, 25.5%). Sites included lower limbs (36.6%), upper limbs (19.2%), head/neck (21.1%), trunk (14.9%) and pelvis (8.1%). Orthoplasty has been considered for flaps (54), skin grafts (42), wide excisions (40) and other procedures (25). Results. At a mean follow-up of 5.3 years (range 2–10.5), patients continuously showed no evidence of disease (NED) in 130 cases (80.7%), were alive with disease (AWD) in 10 cases (6.2%) and were dead with disease (DWD) in 21 cases (13.0%). Overall, 62 patients (38.5%) developed a complication (56 minor (90.3%) and 6 major (9.7%)). Flap loss occurred in 5/48 patients (10.4%). The mean Musculoskeletal Tumor Society (MSTS) and Toronto Extremity Salvage Score (TESS) was 74.8 ± 14 and 79.1 ± 13, respectively. Conclusions. Orthoplasty is a combined approach effective in management of sarcoma patients, maximizing adequate surgical resection, limb salvaging and functional recovery. One-stage reconstructions are technically feasible and are not associated with increased risk of complications.

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