In 1999, we developed a technique for biological
reconstruction after excision of a bone tumour, which involved using
autografts of the bone containing the tumour treated with liquid
nitrogen. We have previously reported the use of this technique
in 28 patients at a mean follow up of 27 months (10 to 54). In this study, we included 72 patients who underwent reconstruction
using this technique. A total of 33 patients died and three were
lost to follow-up, at a mean of 23 months (2 to 56) post-operatively,
leaving 36 patients available for a assessment at a mean of 101
months 16 to 163) post-operatively. The methods of reconstruction included
an osteo-articular graft in 16, an intercalary in 13 and, a composite
graft with prosthesis in seven. Post-operative function was excellent in 26 patients (72.2%),
good in seven (19.4%), and fair in three (8.3%) according to the
functional evaluation system of Enneking. No recurrent tumour occurred
within the grafts. The autografts survived in 29 patients (80.6%),
and the rates of survival at five and ten years were 86.1% and 80.6
%, respectively. Seven of 16 osteo-articular grafts (44%) failed
because of fracture or infection, but all the composite and intercalary
grafts survived. The long-term outcomes of
Aims. The use of
Resection of malignant bony tumours of the pelvis
creates large bone and soft-tissue defects, and is frequently associated
with complications such as wound dehiscence and deep infection.
We present the results of six patients in whom a rectus abdominis
myocutaneous (RAM) flap was used following resection of a malignant
tumour of the pelvis. Bony reconstruction was performed using a
constrained hip tumour prosthesis in three patients, vascularised
fibular graft in two and
For paediatric and adolescent patients with growth potential, preservation of the physiological joint by transepiphyseal resection (TER) of the femur confers definite advantages over arthroplasty procedures. We hypothesized that the extent of the tumour and changes in its extent after neoadjuvant chemotherapy are essential factors in the selection of this procedure, and can be assessed with MRI. The oncological and functional outcomes of the procedure were reviewed to confirm its safety and efficacy. We retrospectively reviewed 16 patients (seven male and nine female, mean age 12.2 years (7 to 16)) with osteosarcoma of the knee who had been treated by TER. We evaluated the MRI scans before and after neoadjuvant chemotherapy for all patients to assess the extent of the disease and the response to treatment.Aims
Methods
We analyzed the long-term outcomes of patients observed over ten years after resection en bloc and reconstruction with extracorporeal irradiated autografts This retrospective study included 27 patients who underwent resection en bloc and reimplantation of an extracorporeal irradiated autograft. The mean patient age and follow-up period were 31.7 years (9 to 59) and 16.6 years (10.3 to 24.3), respectively. The most common diagnosis was osteosarcoma (n = 10), followed by chondrosarcoma (n = 6). The femur (n = 13) was the most frequently involved site, followed by the tibia (n = 7). There were inlay grafts in five patients, intercalary grafts in 15 patients, and osteoarticular grafts in seven patients. Functional outcome was evaluated with the Musculoskeletal Tumor Society (MSTS) scoring system.Aims
Patients and Methods
The aims of this study were to evaluate the long-term outcome
of surgery for bone or soft-tissue metastases from renal cell carcinoma
(RCC) and to determine factors that affect prognosis. Between 1993 and 2014, 58 patients underwent surgery for bone
or soft-tissue metastases from RCC at our hospital. There were 46
men and 12 women with a mean age of 60 years (25 to 84). The mean
follow-up period was 52 months (1 to 257). The surgical sites included
the spine (33 patients), appendicular skeleton (ten patients), pelvis (eight
patients), thorax (four patients), and soft tissue (three patients).
The surgical procedures were Aims
Patients and Methods
The aims of this study were to analyse the long-term outcome
of vascularised fibular graft (VFG) reconstruction after tumour
resection and to evaluate the usefulness of the method. We retrospectively reviewed 49 patients who had undergone resection
of a sarcoma and reconstruction using a VFG between 1988 and 2015.
Their mean follow-up was 98 months (5 to 317). Reconstruction was
with an osteochondral graft (n = 13), intercalary graft (n = 12),
inlay graft (n = 4), or resection arthrodesis (n = 20). We analysed
the oncological and functional outcome, and the rate of bony union
and complications.Aims
Patients and Methods
We describe a method of reconstruction using tumour-bearing autograft treated by liquid nitrogen in 28 patients. The operative technique consisted of The limb function was rated as excellent in 20 patients (71.4%), good in three (10.7%), fair in three (10.7%), and poor in two (7.1%). At the final follow-up six patients had died at a mean of 19.8 months after the operation, while 21 remained free from disease with a mean follow-up of 28.1 months (10 to 54). One patient is alive with disease. Bony union was seen at a mean of 6.7 months after the operation in 26 patients. Complications were encountered in seven patients, including three deep infections, two fractures, and two local recurrences. All were managed successfully. Our results suggest that this is a simple and effective method of biological reconstruction.
