Malawer limb salvage surgery for large chondrosarcoma of scapula with functional outcome – A case report

2020 ◽  
Vol 4 (2) ◽  
pp. 76
Author(s):  
Supratim Bhattacharyya ◽  
KP Kunhi Mohammed ◽  
PrafullaKumar Das ◽  
BharatBhusan Satpathy
Keyword(s):  
Case Report ◽  
Functional Outcome ◽  
Limb Salvage ◽  
Salvage Surgery ◽  
Limb Salvage Surgery

scholarly journals Functional Outcome in Sarcomas Treated With Limb-Salvage Surgery or Amputation

Sarcoma ◽  
1998 ◽  
Vol 2 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Rikke Johansen ◽  
Ole S. Nielsen ◽  
Johnny Keller
Keyword(s):  
Functional Outcome ◽  
Limb Salvage ◽  
Salvage Surgery ◽  
Univariate Analysis ◽  
Soft Tissue Sarcomas ◽  
Post Treatment ◽  
Limb Salvage Surgery ◽  
Functional Evaluation ◽  
Functional Scores

Purpose.In all patients treated at the Centre for Bone and Soft Tissue Sarcomas of Aarhus the functional outcome is prospectively evaluated by use of the Enneking system for the functional evaluation after surgical treatment of tumours of the musculoskeletal system. This system has been accepted by the Musculoskeletal Tumour Society and the International Symposium on Limb Salvage.Patients/methods.In the present study the functional outcome after limb-salvage surgery (89 patients) and amputation (58 patients) was compared. In the limb-salvage group the treatment was surgery alone in 50% and surgery combined with either radiotherapy in 39% or chemotherapy in 11%. Inclusion criteria were: Deep seated extremity sarcomas, age >14 years, more than 1 year post-treatment follow-up time and alive at the end of the study. Median age was 49 years (range 14–88 years). Median tumour diameter was 8 cm (range 1–20 cm), median follow-up time was 4.8 years (range 1–11 years). Wilcoxon andχ2-tests were used for statistical analyses.Results.The two groups were comparable according to age, sex, size of tumour, type of tumour, location of tumour, as well as post-treatment follow-up time. The functional scores were significantly higher after limb-salvage surgery as compared to amputation, the median scores being 85 and 47, respectively (p<0.001). A similar difference was observed if the Enneking scores were subdivided into general health-related scores and extremity-related scores. No association was found between functional scores and the following factors by use of univariate analysis: size of tumour, radiation therapy, localization of tumour and surgical margin.Discussion.We conclude that this study indicates that limb-salvage surgery is associated with a better functional outcome than that observed after amputation. However, whether this also indicates a difference in quality of life needs further studies.

scholarly journals Can Orthopedic Oncologists Predict Functional Outcome in Patients with Sarcoma after Limb Salvage Surgery in the Lower Limb? A Nationwide Study

Sarcoma ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Sjoerd Kolk ◽  
Kevin Cox ◽  
Vivian Weerdesteyn ◽  
Gerjon Hannink ◽  
Jos Bramer ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Limb Salvage ◽  
Lower Limb ◽  
Salvage Surgery ◽  
Limb Salvage Surgery ◽  
Toronto Extremity Salvage Score ◽  
Patient Reported ◽  
Functional Scores ◽  
Mri Scans ◽  
Preoperative Status

Accurate predictions of functional outcome after limb salvage surgery (LSS) in the lower limb are important for several reasons, including informing the patient preoperatively and, in some cases, deciding between amputation and LSS. This study aimed to elucidate the correlation between surgeon-predicted and patient-reported functional outcome of LSS in the Netherlands. Twenty-three patients (between six months and ten years after surgery) and five independent orthopedic oncologists completed the Toronto Extremity Salvage Score (TESS) and the RAND-36 physical functioning subscale (RAND-36 PFS). The orthopedic oncologists made their predictions based on case descriptions (including MRI scans) that reflected the preoperative status. The correlation between patient-reported and surgeon-predicted functional outcome was “very poor” to “poor” on both scores (r2values ranged from 0.014 to 0.354). Patient-reported functional outcome was generally underestimated, by 8.7% on the TESS and 8.3% on the RAND-36 PFS. The most difficult and least difficult tasks on the RAND-36 PFS were also the most difficult and least difficult to predict, respectively. Most questions had a “poor” intersurgeon agreement. It was difficult to accurately predict the patient-reported functional outcome of LSS. Surgeons’ ability to predict functional scores can be improved the most by focusing on accurately predicting more demanding tasks.

scholarly journals Demography and Short Term Functional Outcome of Soft Tissue Sarcoma Treated with Limb Salvage Surgery

2020 ◽  
Vol 16 (4) ◽  
pp. 238-245
Author(s):  
Suresh Pandey
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Functional Outcome ◽  
Limb Salvage ◽  
Negative Correlation ◽  
Salvage Surgery ◽  
Demographic Data ◽  
Functional Score ◽  
Limb Salvage Surgery ◽  
Positive Correlation

Background: Limb salvage surgery with or without radiotherapy and/or chemotherapy is the mainstay of treatment of Soft Tissue Sarcoma (STS). Though, many studies are found regarding the demographics and result of such malignancy from other parts of the world, such data is not available from our country. This study aimed to analyze the demographic data and functional outcome of STS treated with limb salvage surgery. Methods: It is a retrospective review of 16 cases of soft tissue sarcoma of extremities and trunk managed with limb salvage surgery followed by adjuvant radiotherapy and/or chemotherapy in indicated cases from 2012 to 2017. Demographic data and functional score after 2 years of surgery were analysed and presented. Results: There were 14 male and 2 female cases of STS with mean age of 32.88 years. The most common STS was liposarcoma (37.5%) followed by rhabdomyosarcoma (25%) and synovial sarcoma (18.8%). Extremity and lower limb were the most common sites. Mean MSTS functional score at the last follow up was 24.56 (81.83%) with range from 19-29 (63.33%-96.66%). There were good to excellent results in 13 cases (81.25%) and moderate result in 3 cases (18.75%) according to MSTS functional score. There was positive correlation of MSTS with age, radiotherapy, chemotherapy and negative correlation with grade of tumor. Conclusions: This study showed good to excellent functional results in 81.25% of cases as per Musculoskeletal Tumor Society Score (MSTS) with positive correlation with radiotherapy, chemotherapy, age and negative correlation with grade of tumor.

scholarly journals Temporal hemiarthroplasty for distal femoral osteosarcoma in early childhood: a case report

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Jungo Imanishi ◽  
Masayuki Tanabe ◽  
Taisei Kurihara ◽  
Tomoaki Torigoe ◽  
Jun Kikkawa ◽  
...  
Keyword(s):  
Case Report ◽  
Limb Salvage ◽  
Salvage Surgery ◽  
Limb Length ◽  
Limb Salvage Surgery ◽  
Induced Membrane ◽  
Prosthetic Reconstruction ◽  
Custom Made ◽  
Distal Femoral Resection ◽  
Femoral Resection

Abstract Background Prosthetic reconstruction for distal femoral osteosarcoma is challenging for younger children. We herein report a successful case of limb-sparing surgery for a younger patient with distal femoral osteosarcoma requiring osteo-articular resection. Case presentation A 5-year-old girl with high-grade conventional osteosarcoma in the left distal femur underwent a series of surgeries. After three cycles of neoadjuvant chemotherapy, limb-salvage surgery was planned because femoral rotationplasty had been refused. At 6 years and 2 months old, distal femoral resection and temporary spacer insertion using a 7-mm-diameter intramedullary nail and molded polymethylmethacrylate was performed. At 7 years and 8 months old, secondary surgery was performed because the first spacer had been dislocated and the residual femur became atrophic. The distal end of the residual femur was removed by 1 cm, but the periosteum and induced membrane around polymethylmethacrylate was preserved. In order to stabilize the spacer against the tibia, a custom-made ceramic spacer with a smooth straight 8-mm-diameter stem was utilized. The bone-spacer junction was fixed with polymethylmethacrylate and then covered with the preserved periosteum and induced membrane. After surgery, the bone atrophy improved. At 9 years and 7 months old, the second spacer was removed because it had loosened, and the knee joint was reconstructed using a custom-made growing femoral prosthesis with a curved porous 8.5-mm-diameter stem. Cancellous bone tips from the proximal tibia were grafted around the bone-prosthesis junction underneath the induced membrane. At 10 years and 5 months old, the patient was able to walk unsupported and a radiograph showed further thickening of the cortex of the residual femur without any stress shielding. Although having 5 cm of limb length discrepancy, the patient and her mother were satisfied with the function. The MSTS score was 24 out of 30 points. Repeated limb length extensions are planned. Conclusions This case report provides an example of limb-salvage surgery after distal femoral resection in a small child. The use of a temporary spacer utilizing partial cementation and preservation of the periosteum and induced membrane appears to afford a viable limb-salvage option after distal femoral resection for younger children.

scholarly journals Functional Outcome in Limb-Salvage Surgery for Soft Tissue Tumours of the Foot and Ankle

Sarcoma ◽  
1997 ◽  
Vol 1 (2) ◽  
pp. 67-74 ◽  
Author(s):  
Nigel R. Colterjohn ◽  
Aileen M. Davis ◽  
Brian O'Sullivan ◽  
Charles N. Catton ◽  
Jay S. Wunder ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Functional Outcome ◽  
Limb Salvage ◽  
Local Control ◽  
Salvage Surgery ◽  
Limb Salvage Surgery ◽  
Foot And Ankle ◽  
Soft Tissue Tumours ◽  
Limb Preservation ◽  
Good Functional Outcome

Discussion. Thirty of 36 patients (83%) presenting with foot and ankle STS or fibromatosis were candidates for limb preservation. With excellent local control and good functional outcome demonstrated in this study, limb salvage should be a primary goal in the management of selected patients with STS and fibromatosis of the foot and ankle.

scholarly journals Temporal Hemiarthroplasty for Distal Femoral Osteosarcoma in Early Childhood: A Case Report

2020 ◽  
Author(s):  
Jungo Imanishi ◽  
Masayuki Tanabe ◽  
Taisei Kurihara ◽  
Tomoaki Torigoe ◽  
Jun Kikkawa ◽  
...  
Keyword(s):  
Case Report ◽  
Limb Salvage ◽  
Salvage Surgery ◽  
Limb Length ◽  
Limb Salvage Surgery ◽  
Induced Membrane ◽  
Prosthetic Reconstruction ◽  
Custom Made ◽  
Distal Femoral Resection ◽  
Femoral Resection

Abstract Background: Prosthetic reconstruction for distal femoral osteosarcoma is challenging for younger children. We herein report a successful case of limb-sparing surgery for a younger patient with distal femoral osteosarcoma requiring osteo-articular resection. Case Presentation: A 5-year-old girl with high-grade conventional osteosarcoma in the left distal femurunderwent a series of surgeries. After three cycles of neoadjuvant chemotherapy, limb salvage surgery was planned because femoral rotationplasty had been refused. At 6 years and 2 months old, distal femoral resection and temporary spacer insertion using a 7-mm-diameter intramedullary nail and molded polymethylmethacrylate was performed. At 7 years and 8 months old, secondary surgery was performed because the first spacer had been dislocated and the residual femur became atrophic. The distal end of the residual femur was removed by 1 cm, but the periosteum and induced membrane around polymethylmethacrylate was preserved. In order to stabilize the spacer against the tibia, a custom-made ceramic spacer with a smooth straight 8-mm-diameter stem was utilized. The bone-spacer junction was fixed with polymethylmethacrylate, and then covered with the preserved periosteum and induced membrane. After surgery, the bone atrophy improved. At 9 years and 7 months old, the second spacer was removed because it had loosened, and the knee joint was reconstructed using a custom-made growing femoral prosthesis with a curved porous 8.5-mm-diameter stem. Cancellous bone tips from the proximal tibia were grafted around the bone-prosthesis junction underneath the induced membrane. At 10 years and 5 months old, the patient was able to walk unsupported and a radiograph showed further thickening of the cortex of the residual femur without any stress shielding. Although having 5 cm of limb length discrepancy, the patient and her mother were satisfied with the function. The MSTS score was 24 out of 30 points. Repeated limb length extensions are planned.Conclusions: This case report provides an example of limb salvage surgery after distal femoral resection in a small child. The use of a temporary spacer utilizing partial cementation and preservation of the periosteum and induced membrane appears to afford a viable limb-salvage option after distal femoral resection for younger children.

scholarly journals Temporal hemiarthroplasty for distal femoral osteosarcoma in early childhood: A case report

2020 ◽  
Author(s):  
Jungo Imanishi ◽  
Masayuki Tanabe ◽  
Taisei Kurihara ◽  
Tomoaki Torigoe ◽  
Jun Kikkawa ◽  
...  
Keyword(s):  
Case Report ◽  
Limb Salvage ◽  
Salvage Surgery ◽  
Limb Length ◽  
Limb Salvage Surgery ◽  
Induced Membrane ◽  
Prosthetic Reconstruction ◽  
Custom Made ◽  
Distal Femoral Resection ◽  
Femoral Resection

Abstract Background: Prosthetic reconstruction for distal femoral osteosarcoma is challenging for younger children. We herein report a successful case of limb-sparing surgery for a younger patient with distal femoral osteosarcoma requiring osteo-articular resection.Case Presentation: A 5-year-old girl with high-grade conventional osteosarcoma in the left distal femur underwent a series of surgeries. After three cycles of neoadjuvant chemotherapy, limb salvage surgery was planned because femoral rotationplasty had been refused. At 6 years and 2 months old, distal femoral resection and temporary spacer insertion using a 7-mm-diameter intramedullary nail and molded polymethylmethacrylate was performed. At 7 years and 8 months old, secondary surgery was performed because the first spacer had been dislocated and the residual femur became atrophic. The distal end of the residual femur was removed by 1 cm, but the periosteum and induced membrane around polymethylmethacrylate was preserved. In order to stabilize the spacer against the tibia, a custom-made ceramic spacer with a smooth straight 8-mm-diameter stem was utilized. The bone-spacer junction was fixed with polymethylmethacrylate, and then covered with the preserved periosteum and induced membrane. After surgery, the bone atrophy improved. At 9 years and 7 months old, the second spacer was removed because it had loosened, and the knee joint was reconstructed using a custom-made growing femoral prosthesis with a curved porous 8.5-mm-diameter stem. Cancellous bone tips from the proximal tibia were grafted around the bone-prosthesis junction underneath the induced membrane. At 10 years and 5 months old, the patient was able to walk unsupported and a radiograph showed further thickening of the cortex of the residual femur without any stress shielding. Although having 5 cm of limb length discrepancy, the patient and her mother were satisfied with the function. The MSTS score was 24 out of 30 points. Repeated limb length extensions are planned.Conclusions: This case report provides an example of limb salvage surgery after distal femoral resection in a small child. The use of a temporary spacer utilizing partial cementation and preservation of the periosteum and induced membrane appears to afford a viable limb-salvage option after distal femoral resection for younger children.

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