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The Journal of Bone & Joint Surgery British Volume
Vol. 94-B, Issue 7 | Pages 982 - 988
1 Jul 2012
Puri A Gulia A Jambhekar N Laskar S

We analysed the outcome of patients with primary non-metastatic diaphyseal sarcomas who had en bloc resection with preservation of the adjoining joints and reconstruction with re-implantation of sterilised tumour bone after extracorporeal radiation (50 Gy). Between March 2005 and September 2009, 32 patients (16 Ewing’s sarcoma and 16 osteogenic sarcoma) with a mean age of 15 years (2 to 35) underwent this procedure. The femur was the most common site in 17 patients, followed by the tibia in 11, humerus in three and ulna in one. The mean resected length of bone was 19 cm (10 to 26). A total of 31 patients were available at a mean follow-up of 34 months (12 to 74). The mean time to union for all osteotomy sites was 7.3 months (3 to 28): metaphyseal osteotomy sites united quicker than diaphyseal osteotomy sites (5.8 months (3 to 10) versus 9.5 months (4 to 28)). There were three local recurrences, all in soft-tissue away from irradiated graft. At the time of final follow-up, 19 patients were free of disease, one was alive with disease and 11 had died of disease. The mean Musculoskeletal Tumor Society Score for 29 patients evaluated at the last follow-up was 26 (9 to 30).

Extracorporeal irradiation is an oncologically safe and inexpensive technique for limb salvage in diaphyseal sarcomas and has good functional results.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XIV | Pages 30 - 30
1 Apr 2012
Gulia A Puri A Agarwal M Laskar S Reddy K
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Introduction

We analyzed the results of extracorporeal radiated (ECRT) autogenous tumour bone for reconstruction of diaphyseal defects after tumour resection at our institute.

Methods

Sixteen diaphyseal bone tumours operated between March 2006 to March 2008 were reconstructed with ECRT bone after appropriate oncologic resection. These included 10 cases of Ewing's sarcoma, 5 of Osteosarcoma and 1 Adamantinoma. Nine involved femur, 5 tibia and 2 humerus. Suitable internal stabilisation (14 cases plate fixation, 2 intramedullary nails) was used after re-implanting ECRT bone. Average resection length was 18.9 cm (range, 11 to 30 cm).


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XIV | Pages 12 - 12
1 Apr 2012
Gulia S Arora B Puri A Gulia A laskar S Rangarajan V Shah S Basu S Medhi S Vora T Kurkure P Banavali S
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Background

Bone lesions in Ewing's sarcoma (ES/PNET) have been traditionally diagnosed with bone Scan. PET-scan is emerging as a promising investigative modality for detection of metastatic lesions. In this prospective study, we compare the utility of both to detect the metastatic sites.

Methods

One hundred and seventy five histologically proven cases of ESPNET from 2004-2009 were prospectively staged with bone scan and PET-scan with Breath- hold CT scan- thorax. The diagnostic value of PET-scan to pick up metastatic lesions was compared with bone scan.