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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XIV | Pages 55 - 55
1 Apr 2012
Berlin Ö Bergh P Dalen M Eriksson S Hagberg K Inerot S Gunterberg B Brånemark R
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Aim. The first osseointegrated transfemoral amputation prosthesis operation was performed in Gothenburg in 1990. The aim is improving quality of life for patients who cannot use conventional socket prosthesis. In 1999 the prospective OPRA-study (Osseointegrated Prosthesis for Rehabiliation of Amputees) was initiated with standardized surgery, equipment and rehabilitation program. Method. The surgery consists of a two-stage procedure. At the primary surgery (S1), a titanium screw (the fixture) is inserted into the remaining diaphyseal bone. The fixture is 80 mm long with a diameter of 16–20 mm (+0.5 mm increments). The patient is hospitalized 5-7 days. At the secondary surgery (S2), six months later, an abutment is inserted into the fixture. The abutment has a hexagonal press-fitting into the fixture and is secured by an abutment screw. The patient remains hospitalized 10–12 days. Gradual increase of load and activity is initiated over a 6 month period. Results. The OPRA study includes 51 patients with 55 implants. Follow-up time has been set to minimum 2 years. The OPRA study will be evaluated in June 2010. 32 of the 51 patients have been followed for 2 years or more. Four implants have been removed due to loosening/infection. No patient has been lost to follow-up. Preliminary data shows that the success rate so far is 93% (51/55). Conclusion. Development of this new concept has to be carefully monitored and controlled. Once a standard technique was developed a drop in the complication rate was noted. Although deep infection and fixture loosening is the most feared complication, so far the most encountered one is late deformation of the abutment due to overload since the patients activity level is significantly increased caused by the good prosthetic function allowing the patient to use the prosthesis 12–15 hours daily, 7 days a week


The Bone & Joint Journal
Vol. 106-B, Issue 8 | Pages 865 - 870
1 Aug 2024
Broida SE Sullivan MH Rose PS Wenger DE Houdek MT

Aims

Venous tumour thrombus (VTT) is a rare finding in osteosarcoma. Despite the high rate of VTT in osteosarcoma of the pelvis, there are very few descriptions of VTT associated with extrapelvic primary osteosarcoma. We therefore sought to describe the prevalence and presenting features of VTT in osteosarcoma of both the pelvis and the limbs.

Methods

Records from a single institution were retrospectively reviewed for 308 patients with osteosarcoma of the pelvis or limb treated between January 2000 and December 2022. Primary lesions were located in an upper limb (n = 40), lower limb (n = 198), or pelvis (n = 70). Preoperative imaging and operative reports were reviewed to identify patients with thrombi in proximity to their primary lesion. Imaging and histopathology were used to determine presence of tumour within the thrombus.


The Journal of Bone & Joint Surgery British Volume
Vol. 88-B, Issue 4 | Pages 531 - 535
1 Apr 2006
von Steyern FV Bauer HCF Trovik C Kivioja A Bergh P Jörgensen PH Foller̊s G Rydholm A

We retrospectively studied local recurrence of giant cell tumour in long bones following treatment with curettage and cementing in 137 patients. The median follow-up time was 60 months (3 to 166). A total of 19 patients (14%) had at least one local recurrence, the first was diagnosed at a median of 17 months (3 to 29) after treatment of the primary tumour. There were 13 patients with a total of 15 local recurrences who were successfully treated by further curettage and cementing. Two patients with a second local recurrence were consequently treated twice. At the last follow-up, at a median of 53 months (3 to 128) after the most recent operation, all patients were free from disease and had good function.

We concluded that local recurrence of giant cell tumour after curettage and cementing in long bones can generally be successfully treated with further curettage and cementing, with only a minor risk of increased morbidity. This suggests that more extensive surgery for the primary tumour in an attempt to obtain wide margins is not the method of choice, since it leaves the patient with higher morbidity with no significant gain with respect to cure of the disease.