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Query: UMLS:C0029463 (osteosarcoma)
 16,637 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty patients with malignant or potentially malignant tumors (osteogenic sarcoma, giant-cell tumor, synovial-cell sarcoma, chondrosarcoma, and chondroblastoma) located in the proximal end of the tibia or distal end of the femur were treated by local resection and arthrodesis employing an intramedullary rod and autogenous segmental cortical grafts obtained from the same extremity. Use of a customized bent, fluted rod in the most recent cases provided more stable fixation. There was only one local recurrence. In properly selected patients, the method provided a stable extremity that permitted resumption of a vigorous life-style within approximately one year.
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PMID:Resection-arthrodesis for malignant and potentially malignant lesions about the knee using an intramedullary rod and local bone grafts. 19 62

Reconstruction in the skeletally immature patient following resection of osteosarcoma about the knee is a challenging problem. Salvaging of the limb with allogeneic or prosthetic replacement results in a shortened limb with functional limitations. Arthrodesis yields a stiff and shortened limb. The so-called growing prosthesis has a high complication rate and is still unproven. However, rotationplasty has been successfully used as a reconstructive technique following resection of these types of tumors in the skeletally immature patient. A limb with normal sensation and proprioceptions, adequate range of motion, and without leg-length discrepancies, functional limitations, or painful neuroma is to be expected. Although a prosthesis must be worn, these patients are active and participate in unrestricted physical activity. Cosmetic acceptance has not been a problem and complications are minimal. Thus, rotationplasty requires only a single operation and results in a highly functional limb.
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PMID:Rotationplasty as a reconstructive operation after tumor resection. 188 45

Between June 1985 and March 1990, 25 patients with primary malignant bone tumors, including 15 cases of osteogenic sarcoma, two cases of periosteal osteogenic sarcoma, six cases of chondrosarcoma, and two cases of malignant fibrous histiocytoma, were treated with limb-salvage procedures. Fourteen patients underwent limb salvage operations with tumor prosthesis arthroplasty, 6 with resection-arthrodesis, 4 with wide resection, and 1 with autoclaved autograft. Pre- and/or post-operative chemotherapy with or without radiotherapy was combined with these limb salvage operations. The average follow-up period was 25.2 months (6 to 52 months) since diagnosis. The estimated 3.5-year survival rate of the total 25 patients was 39.5% based on the Kaplan-Meier survival plot. In the 15 cases of osteogenic sarcoma, the estimated Kaplan-Meier 34-month survival rate was 46.2%. Seventeen patients who were followed up for more than 1 year were grouped by functional grading: 11 (65%) were excellent; 3 (18%) good; 2 fair (12%); and 1 poor. Complications occurred in 4 patients, 1 had a local recurrence, 2 had superficial wound infections, and 1 a loosening of the femoral stem. Metastases were shown in 15 case, and the most common location was the lung.
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PMID:Limb-salvage operations in primary malignant tumors of the bone--interim report. 196 35

Sacrifice of major growth plates during resection and fixed-length reconstruction of a limb in a skeletally immature child with osteosarcoma may result in a significant limb-length inequality as growth progresses. A limb-length discrepancy in the humerus may cause minor cosmetic problems but does not generally result in a significant functional deficit. In the lower extremity, tumors about the knee, including the distal femur and proximal tibia, usually present the dilemma of whether limb salvage by arthrodesis, osteoarticular allograft, or endoprosthetic replacement would result in a significant limb-length inequality and whether amputation of the extremity is a preferable procedure. The techniques of rotationplasty and an expandable endoprosthesis have been successfully used for treating skeletally immature patients with osteosarcoma of the distal femur. With regard to survival and function, the results obtained with these innovative methods are favorable compared with those of a high above-knee amputation.
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PMID:Limb-salvage surgery in the treatment of osteosarcoma in skeletally immature individuals. 198 5

The outcomes of 31 cases of limb salvage procedures for malignant bone tumors performed between 1974 and August 1988 were investigated. The age at operation ranged from 7 to 76. Thirteen cases were growing children under 15. The site of lesions were humerus in 6 cases, femur in 20, tibia in 3 and fibula in 2. Pathological diagnoses were osteosarcoma in 19, chondrosarcoma in 5 and others in 7. Reconstructive procedures were performed in 28 cases, consisting of endoprosthetic replacements in 18, vascularized fibula grafts in 6 and free autogenous bone grafts in 4. Two cases of osteosarcoma recurred, and amputations were performed. Six cases died of pulmonary metastases, while 22 cases (71%) are alive and free of disease. Functional results depended mainly on the size and site of resection rather than on the reconstructive procedures, and were generally good in the proximal femur and fibula, and poor in the distal femur and proximal tibia. Discrepancy in the length of lower limbs occurred in 8 cases of growing children; 5 of 6 vascularized fibula grafts showed thickening of the grafted bones, and one of them grew by 2.5 cm in length. Endoprosthetic replacements are adequate for hip and shoulder regions, and for low grade sarcoma which does not require chemotherapy or irradiation. Free autogenous bone grafts are good for narrow defect of bone, and cases of arthrodesis of joint. Vascularized fibula grafts are adequate for the upper limb, and lower limb of growing child.
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PMID:[Limb salvage procedures in malignant bone tumors of the extremities, with special reference to the various reconstructive procedures of bone defects]. 265 32

We describe a new method of reconstruction after resection of tumours of the proximal tibia by grafting and arthrodesis of the knee. Two separate vascularised bone grafts from the ipsilateral limb were used, one a gastrocnemius-pedicled femoral graft and the other a pedicled fibular graft. An anatomical study of the gastrocnemius-pedicled femoral graft was made. The method was shown to be practical and reproducible. One patient with osteosarcoma has a successful result with no recurrence at two-and-a-half years.
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PMID:A gastrocnemius-pedicled femoral bone graft in resection arthrodesis at the knee. 283 27

Stage 2 B malignant skeletal tumours are currently treated by amputation or disarticulation of the limb. The present paper describes a surgical technique for complete removal of the neoplasm and surrounding soft tissues by resection of a cylinder of the limb complete with skin. The resection of bone and adjacent soft tissues is extended sufficiently proximal and distal to the neoplasm to ensure complete removal of neoplastic tissue. The authors describe two cases; an osteosarcoma of the distal third of the femur and a malignant fibrous histiocytoma of the lower radius. After removing the affected cylinder of the limb, osteosynthesis is performed by one of a variety of methods. The main vessels and nerves are dealt with according to the findings revealed by pre-operative investigations or per-operative findings. If they have to be sacrificed, end to end suture is performed, but if main nerves can safely be spared (as in Case 1) it greatly enhances the functional prognosis. The value of this operation is that it is as radical as amputation while the aesthetic and functional results are equivalent to those of a resection-arthrodesis. The operation has therefore been designated segmental amputation.
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PMID:Segmental amputation with re-implantation in the treatment of malignant bone tumours of the limbs. 301 37

In a 20 year period the authors have seen 8 cases of osteoblastoma in patients less than 15 years old. Four were in the spine, three in the hand and one in the tibia. Three of the four limb osteoblastomas were lost to follow up after curettage, one of them after a recurrence. The fourth one was cured after 9 years. None of the spine lesions recurred after a follow up of from two to 14 years but two of them had a rigid kyphosis. It is concluded that osteoblastoma is normally benign in children. The pathological diagnosis may be difficult. In one the initial diagnosis had been of osteosarcoma. The treatment is based on complete excision. In the spine, it should be accompanied by arthrodesis.
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PMID:[Benign osteoblastoma in children. Apropos of 8 cases, 4 with spinal localization]. 623 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

Amputation remains the standard surgical management for patients with osteosarcoma. However, in carefully selected patients, eradication of the primary tumor can be achieved by En-Bloc resection of the affected bone preserving both anatomical and functional status. Our criteria for limb salvage procedures are that patients must: (1) be age 12 years or older, (2) have no angiographic or clinical evidence of neurovascular involvement, (3) have low-grade osteosarcoma and/or good response to preoperative chemotherapy, and (4) be compliant. Between November 1980 and October 1982, 32 patients with osteosarcoma of an extremity were seen. Eight patients ranging in age from 13 to 21 years underwent limb salvage procedures. Five of these had Tikhoff-Linberg procedures for upper extremity lesions, two had En-Bloc resections for distal femur lesions, and one patient had a segmental arthrodesis for a distal tibial lesion. Of these eight patients, two had low-grade parosteal osteosarcoma. Follow-up ranged from 10 to 28 months (median 16 months). The two patients with parosteal osteosarcoma received no further therapy, while the other six patients received multiple agent chemotherapy. One patient died at 18 months with bilateral pulmonary disease. None have had local recurrences. Two of the eight patients had minor skin necrosis, requiring revision subsequently. Three patients have had transient nerve palsy. All have had good functional results. With careful selection of patients by rigid criteria, limb salvage procedures can be a viable alternative to amputation.
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PMID:Limb salvage procedures for children with osteosarcoma: an alternative to amputation. 658 50


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