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Query: UMLS:C0003090 (arthrodesis)
 8,374 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cryosurgery combined with routine "second look" biopsy has been previously reported in our initial series of 25 cases and has been demonstrated to be a promising modality in the treatment of giant cell tumors of bone. Further refinement of this surgical technique by more careful preliminary curettage has now significantly improved the rate of local tumor control and has markedly reduced the incidence of associated complications. While the problems of infection, fracture, delayed bone healing and local tumor recurrence have not been completely eliminated, our experience with 27 additional cases shows that it has been possible to develop a highly reliable procedure for the eradication of tumor while usually preserving joint motion and avoiding arthrodesis or amputation. The 1.9% malignancy rate is much lower than the previously reported papers by Hutter and Jaffe.
Cancer 1978 Mar
PMID:Cryosurgery in the treatment of giant cell tumors of bone. A report of 52 consecutive cases. 63 82

The authors discuss seven cases of parosteal tumors treated conservatively by diaphyseal and metaphyseal hemiresection with cortical autograft reconstruction. This treatment yielded excellent clinical and functional results without having to resort to resection and arthrodesis or prosthetic replacement. The slow growth and low malignancy of these tumors make the use of this technique possible even at the risk of local recurrence, which, if discovered early, can still be treated by further conservative procedures.
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PMID:Diaphyseal and metaphyseal hemiresection with autograft reconstruction in the treatment of lowgrade tumors of the long bones. 189 19

We performed metabolic studies of gait in eighteen patients who had had above-the-knee amputation, block resection and arthrodesis of the knee, or block resection and rotationplasty for a malignant tumor of the distal end of the femur or the proximal end of the tibia. According to the measurement of consumption of oxygen, the patients who had had rotationplasty walked most efficiently. Those who had had arthrodesis used more oxygen and walked at a slower rate.
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PMID:Comparative assessment of gait after limb-salvage procedures. 222 27

From 1974 to 1983 in the Netherlands Cancer Institute, 21 patients with desmoid tumours were treated with radiation therapy. Nineteen patients were irradiated postoperatively (11 patients had micro- or macroscopic residual disease, 8 patients treated for recurrent disease had narrow surgical margins), 2 patients with inoperable tumours were treated with radiation alone. The entire involved muscle received a dose of 40 Gy, while a boost of 20 Gy was delivered to the tumour bed. Local control was achieved in 19 out of 21 patients, with an actuarial 5 year disease-free survival of 90%. No relation could be found between the amount of tumour present and local control. With careful set-up of treatment fields and long-term physical therapy, complications like fibrosis, ankylosis and oedema could be minimised. These excellent results with radiotherapy for minimal residual tumour, or even for macroscopic tumour, makes mutilating surgery unnecessary.
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PMID:The role of radiotherapy in the treatment of desmoid tumours. 377 74

The records of twenty-three patients with a primary benign or malignant osseous neoplasm of the cervical spine were reviewed in an attempt to clarify the most appropriate diagnostic and treatment methods for such tumors. Thirteen patients had a benign tumor and ten patients had a malignant tumor. Nineteen patients had been followed for two to eighteen years (average, six years), and four had died from the malignant disease between one and five months after its discovery. In addition to surgery, medical treatment in the ten patients with a malignant tumor included radiation therapy in seven and chemotherapy in two. Surgical treatment consisted of an anterior and posterior partial resection combined with an arthrodesis in four patients; an anterior partial resection in three, two with an arthrodesis; a posterior partial resection and an arthrodesis in two; and a biopsy but no further treatment in one patient. The duration of survival ranged from one to five months for four patients and from two to three years for four, and was eight and sixteen years in two patients. Two of the thirteen patients with a benign tumor received radiation therapy. Surgical treatment included both an anterior and a posterior resection with arthrodesis in four, an anterior resection in three (with arthrodesis in two), a posterior resection in four (with arthrodesis in three), and a biopsy without surgical resection in two. At follow-up, twelve patients were pain-free and had a solid arthrodesis, although one had required a repeat excision posteriorly. One patient with Gorham's disease (diffuse hemangiomatosis) died. During the period of thirty years (1953 to 1983) when these patients were seen, both the diagnostic methods available and the surgical approaches used have changed. Our present opinion is that all primary osseous lesions of the cervical spine should be carefully defined by arteriography, tomography, bone-scanning, computed tomographic scanning, and myelography in order to properly plan the surgical approach. Total excision of suspect malignant lesions is not attempted, but a major intralesional excision should be carried out to decompress neural and vascular structures and to obtain a biopsy specimen, followed by an arthrodesis to stabilize the spine. For both malignant and benign tumors, an anterior resection should be performed if the tumor is located anteriorly, and a posterior approach should be used if the tumor is predominantly in the posterior vertebral elements. Both of these procedures should be combined with an arthrodesis.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Primary neoplasms of the cervical spine. Diagnosis and treatment of twenty-three patients. 395 73

The authors report 17 cases of primary tumors of the knee treated by wide resection, removing "en bloc" the entire epiphysis in 14 cases and in the remaining 3 most of the epiphysis. The series consisted of 8 giant cell tumors of which 6 were followed for between three and fifteen years, and for 9 tumors of moderate malignancy amongst which 1 fibrosarcoma, 1 parosteal osteosarcoma and 3 cartilaginous tumors which were followed between five and fourteen years. All were free of metastatic spread except 1 fibrosarcoma whose resection was debatable. Arthrodesis was carried out on all but 2 patients received prosthesis. The arthrodeses were made by autogenous grafts protected in 11 cases by intramedullary rod, in 1 case by a plate, and in 3 cases by both. The series contains one amputation and three fractures necessitated secondary grafting with replacement of rod in two cases. The results are analysed in carcinological and technical shemes. The value of resection and the importance of grafting over the arthrodesis are emphasised. In the long term, resection-arthrodesis means the conservation of a stable and functional limb, permitting an active life one year postoperatively. Massive prosthesis are only exceptionally indicated.
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PMID:[Resection-reconstruction of the knee for bone tumor (author's transl)]. 645 11

A 3-month-old white female presented with a bone-forming lesion of the soft tissue of the left cheek. Skeletal survey revealed numerous associated radiographic abnormalities, predominantly involving the phalanges. Mineral metabolism and endocrine function were within normal limits. Multiple operations were performed over a 17-year period for palliation of sequelae arising from inability to open the mouth due to ankylosis of the temporomandibular joint by the progressively ossifying lesion. Histologically, the pathologic material had features resembling those of periosteal grafts, with all stages of membranous bone formation and a tendency for more mature lesions later in the course. .The clinico-pathologic features are those of fibrodysplasia ossificans progressiva (FOP). The differential diagnosis of this rare condition from other bone-forming lesions of the soft tissue such as myositis ossificans, extra-skeletal osteosarcoma and osseous metaplasia is discussed.
Cancer 1981 Aug 15
PMID:Fibrodysplasia ossificans progressiva: a distinctive bone-forming lesion of the soft tissue. 694 42

Giant cell tumor of bone is a challenging surgical problem due to its mostly aggressive growth with tendency to recur locally, to develop in rare instances pulmonary metastases without histologic evidence of malignant changes, and due to its potential to dedifferentiate into a frankly malignant tumor in a limited number of patients. It is treated in many different ways because of the difficulties in finding a type of treatment with the best functional results without compromising oncologic results. This paper describes 19 patients with giant cell tumor of bone. Following 19 procedures (including 6 intracapsular resections [curettage]) in 17 patients in our hospital only 2 recurrences (10.5%) occurred, both after curettage. Functional results after curettage without recurrence were favorable. Marginal or wide resections did not result in any recurrence, but were functionally inferior to curettage; an exception to the latter was the resection-arthrodesis of the distal radius in one patient.
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PMID:Giant cell tumor of bone: oncologic and functional results. 799 Apr 80

During the last decade, many clinical investigators at various cancer centers have reported the efficacy of various chemotherapeutic agents in the treatment of osteosarcoma. The regimens using high-dose methotrexate (HDMTX) with citrovorum factor rescue are now considered to be one of the most effective treatments of choice. From December 1989 to May 1991, sixteen patients with Enneking's stage (Enneking et al., 1980) IIB osteosarcoma of the extremities were treated with a high-dose methotrexate regimen. After two cycles of preoperative chemotherapy, an operation was performed; either limb salvage or amputation. The resected lesions were examined pathologically and classified according to Huvos' criteria. On pathological examination, 8 (50%) cases showed Grade IV; 1 (6.25%) Grade III; 4 (25%) Grade II; and 3 (18.75%) Grade I. The types of surgery performed were tumor prosthesis replacement (11); wide resection with or without reconstruction (2); resection and arthrodesis (1); and amputation (2).
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PMID:Pathological responses to preoperative high-dose methotrexate chemotherapy in osteosarcoma--experience in Korea cancer hospital. 839 28

A patient with a malignant tumor of the proximal end of the humerus or glenoid may be treated with limb-sparing resection or with amputation. Although the oncologic and functional characteristics of shoulder amputations have been documented, little has been written comparing reconstructive options following limb salvage and amputation about the shoulder. This article reviews oncologic and functional outcome of patients who have had a malignant skeletal tumor adjacent to the shoulder and who have been treated with amputation or limb salvage combined with arthrodesis or an allograft/prosthetic reconstruction.
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PMID:Function after amputation, arthrodesis, or arthroplasty for tumors about the shoulder. 853 94


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