Aims. Dislocation of the hip remains a major complication after periacetabular tumour resection and endoprosthetic reconstruction. The position of the acetabular component is an important modifiable factor for surgeons in determining the
Aims. The
Aims. To evaluate mid-to long-term patient-reported outcome measures (PROMs) of endoprosthetic reconstruction after resection of malignant tumours arising around the knee, and to investigate the
Aims. Rotating-hinge knee prostheses are commonly used to reconstruct the distal femur after resection of a tumour, despite the projected long-term burden of reoperation due to complications. Few studies have examined the factors that influence their failure and none, to our knowledge, have used competing
Aims. There is an increased
Aims. There is a lack of evidence about the
Aims. Although internal hemipelvectomy is associated with a high incidence of morbidity, especially wound complications, few studies have examined rates of wound complications in these patients or have identified factors associated with the consequences. The present study aimed to: 1) determine the rate of wound and other complications requiring surgery after internal hemipelvectomy; and 2) identify factors that affect the rate of wound complications and can be used to stratify patients by
Aims. The aim of this study was to determine the
Aims. The aim of this study was to analyse a group of patients with
non-metastatic Ewing’s sarcoma at presentation and identify prognostic
factors affecting the development of local recurrence, in order
to assess the role of radiotherapy. Patients and Methods. A retrospective review of all patients with a Ewing’s sarcoma
treated between 1980 and 2012 was carried out. Only those treated
with chemotherapy followed by surgery and/or radiotherapy were included.
Patients were grouped according to site (central or limb) for further
analysis of the prognostic factors. Results. A total of 388 patients were included in the study. Of these,
60 (15%) developed local recurrence at a mean median of 27 months
(. sd. 24, range 7 to 150) and the five-year local recurrence-free
survival (5yrLRFS) was 83%. For central tumours, the size of the
tumour and histological response to chemotherapy were found to be
significant factors for local recurrence. For limb tumours, local
recurrence was affected by intralesional and marginal resections,
but not by the histological response to chemotherapy. Radiotherapy
in those with a marginal resection reduced the
There is currently no standard follow up protocol for patients who have been diagnosed with and treated for high-grade osteosarcoma. We therefore investigated the possibility of creating a
It is important to be able to identify patients
with an increased
Aim. To estimate the
Introduction. Local recurrence of Giant cell tumours of bone (GCT) is considered the main complication of surgical treatment (50%). Intra-lesional curettage with adjuvants like phenol or polymethylmethacrylate (PMMA) is recommended as initial treatment, decreasing the
Between 1966 and 2001, 1254 patients underwent excision of a bone tumour with endoprosthetic replacement. All patients who had radiotherapy were identified. Their clinical details were retrieved from their records. A total of 63 patients (5%) had received adjunctive radiotherapy, 29 pre-operatively and 34 post-operatively. The mean post-operative Musculoskeletal Tumor Society scores of irradiated patients were significantly lower (log-rank test, p = 0.009). The infection rate in the group who had not been irradiated was 9.8% (117 of 1191), compared with 20.7% (6 of 29) in those who had pre-operative radiotherapy and 35.3% (12 of 34) in those who radiotherapy post-operatively. The infection-free survival rate at ten years was 85.5% for patients without radiotherapy, 74.1% for those who had pre-operative radiotherapy and 44.8% for those who had post-operative radiotherapy (log-rank test, p <
0.001). The ten-year limb salvage rate was 89% for those who did not have radiotherapy and 76% for those who did (log-rank test, p = 0.02). Radiotherapy increased the
A number of
We studied 153 patients with non-metastatic chondrosarcoma of bone to determine the
Aim. To investigate the effectiveness of silver coated prostheses in preventing periprosthetic infection in a high-risk group. Methods. We have used silver coated prostheses in 48 endoprosthetic replacements in whom there would be a high expected
Previously, we showed that case-specific non-linear
finite element (FE) models are better at predicting the load to failure
of metastatic femora than experienced clinicians. In this study
we improved our FE modelling and increased the number of femora
and characteristics of the lesions. We retested the robustness of
the FE predictions and assessed why clinicians have difficulty in
estimating the load to failure of metastatic femora. A total of
20 femora with and without artificial metastases were mechanically
loaded until failure. These experiments were simulated using case-specific
FE models. Six clinicians ranked the femora on load to failure and
reported their ranking strategies. The experimental load to failure
for intact and metastatic femora was well predicted by the FE models (R. 2. =
0.90 and R. 2. = 0.93, respectively). Ranking metastatic
femora on load to failure was well performed by the FE models (τ =
0.87), but not by the clinicians (0.11 <
τ <
0.42). Both the
FE models and the clinicians allowed for the characteristics of
the lesions, but only the FE models incorporated the initial bone
strength, which is essential for accurately predicting the risk
of fracture. Accurate prediction of the
We performed a prospective genotype-phenotype study using molecular screening and clinical assessment to compare the severity of disease and the
We hypothesised that the use of computer navigation-assisted
surgery for pelvic and sacral tumours would reduce the