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Matthew R Moralle, Nicholas D Stekas, Mark C Reilly, Michael S Sirkin, Mark R Adams
INTRODUCTION: Chronic osteomyelitis is a disease that requires fastidious treatment to eliminate. However, when eradication is unable to be achieved through exhaustive modalities of antibiotic therapy and multiple debridements, significant resection of the infected bone and soft tissue must be considered, including amputation. Here we report of a salvage procedure for chronic osteomyelitis of the left tibia by employing a rotationplasty to avoid an above knee amputation and instead provide the patient with a below knee amputation...
April 2016: Journal of Orthopaedic Case Reports
Viviana Rota, Maria Grazia Benedetti, Yusuke Okita, Marco Manfrini, Luigi Tesio
Knee rotationplasty (KRP) is a type of surgery in which the rotated ankle serves as a new knee after being removed for bone tumor. Although this limb salvage surgery is rarely indicated in properly selected patients, it may offer functional advantages over transfemoral amputation, and more durable results compared with a prosthesis. The walking mechanics of adult patients after KRP is believed to be close to that of below-knee amputees. In this study, we evaluated steady-state walking of KRP patients from the viewpoint of the overall muscle power needed to keep the body centre of mass in motion...
September 28, 2016: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
Donald L Hamby, Justice Otchere, Brian L Chau, Shawn M Teran, Sarah E Humbert, Scott Strum
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Andrea Angelini, Andreas F Mavrogenis, Giulia Trovarelli, Stefano Ferrari, Piero Picci, Pietro Ruggieri
PURPOSES: Telangiectatic osteosarcoma (TOS) is a rare subtype of osteosarcoma. We analyzed (1) oncologic outcome in a large homogeneous series and (2) the role of prognostic factors on prognosis, local recurrence and metastasis. METHODS: Eighty-seven patients (47 males, 54 %) were retrospectively analyzed. All except 4 had extracompartmental disease, and ten patients had lung metastasis at diagnosis. Pathologic fracture was present in 27 cases (31 %). Seventy-eight patients were treated with neoadjuvant chemotherapy; nine had surgery as first treatment...
October 2016: Journal of Cancer Research and Clinical Oncology
M Shahid, N Albergo, T Purvis, K Heron, L Gaston, S Carter, R Grimer, L Jeys
We reviewed the oncological and functional outcomes of patients treated for a primary sarcoma possibly involving the knee joint and present an algorithm to guide treatment. The records of 76 patients who had a primary bone or soft tissue sarcoma possibly invading the knee between 1996 and 2012 were identified. Mean age and follow-up was 32 years (9-74) and 64 months (12-195), respectively. Patients were grouped according to the resection (Intra-articular [IAR] vs. Extra-articular [EAR] vs. Amputation/rotationplasty) for survival and functional outcomes...
May 27, 2016: European Journal of Surgical Oncology
Gang Han, Wen-Zhi Bi, Meng Xu, Jin-Peng Jia, Yan Wang
BACKGROUND: This meta-analysis compared survival and function in patients with limb osteosarcoma treated with limb-salvage surgery (LSS) versus amputation or rotationplasty. METHODS: Medline, Cochrane, EMBASE, and Google Scholar were searched until November 30, 2015 for studies reporting Musculoskeletal Tumor Society (MSTS) scores and survival rates in osteosarcoma patients. Differences between patients undergoing LSS versus ablative surgery were analyzed based on MSTS scores and postoperative survival rates...
August 2016: World Journal of Surgery
Benjamin K Potter
No abstract text is available yet for this article.
April 2016: Clinical Orthopaedics and related Research
Maria Grazia Benedetti, Yusuke Okita, Elena Recubini, Elisabetta Mariani, Alberto Leardini, Marco Manfrini
No abstract text is available yet for this article.
April 2016: Clinical Orthopaedics and related Research
Guntmar Gradl, Lukas K Postl, Ulrich Lenze, Josef Stolberg-Stolberg, Florian Pohlig, Hans Rechl, Markus Schmitt-Sody, Ruediger von Eisenhart-Rothe, Chlodwig Kirchhoff
BACKGROUND: Malignant bone tumors of the lower extremity are more frequently found in children and adolescents than in adults. Modern treatment regimens led to high limb salvage rates and offer the choice between endoprosthetic replacement and rotationplasty in many cases. Rotationplasty has proven to be an effective, highly functional option in short- and mid-term studies. Aim of this study was to assess long-term results regarding quality of life and functionality after rotationplasty and to compare the obtained results to a representative healthy German sample cohort...
2015: BMC Musculoskeletal Disorders
S Furtado, R J Grimer, P Cool, S A Murray, T Briggs, J Fulton, K Grant, C H Gerrand
Patients who have limb amputation for musculoskeletal tumours are a rare group of cancer survivors. This was a prospective cross-sectional survey of patients from five specialist centres for sarcoma surgery in England. Physical function, pain and quality of life (QOL) outcomes were collected after lower extremity amputation for bone or soft-tissue tumours to evaluate the survivorship experience and inform service provision. Of 250 patients, 105 (42%) responded between September 2012 and June 2013. From these, completed questionnaires were received from 100 patients with a mean age of 53...
September 2015: Bone & Joint Journal
Eric L Staals, Marco Colangeli, Nikolin Ali, José M Casanova, Davide M Donati, Marco Manfrini
BACKGROUND: Reconstruction of the distal femur after resection for malignant bone tumors in skeletally immature children is challenging. The use of megaprostheses has become increasingly popular in this patient group since the introduction of custom-made, expandable devices that do not require surgery for lengthening, such as the Repiphysis(®) Limb Salvage System. Early reports on the device were positive but more recently, a high complication rate and associated bone loss have been reported...
September 2015: Clinical Orthopaedics and related Research
Raza Askari, Masood Umer
OBJECTIVE: To present an early experience with the time-tested technique of Van Ness Rotationplasty to save distal lmbs. METHODS: Van Nes Rotationplasty for locally advanced lower extremity tumours. A reterorespective audit was conducted at Aga Khan University Hospital, Karachi, and comprised cases of bone and soft tissue sarcoma who underwent Van Ness Rotationplasty over seven years from January 2005 to December 2011. Demographic data, family history, past history, co-morbids, date since diagnosis, duration of symptoms, type of tumour, metastasis, pre-op and post-op functional status, recurrence and survival were collected...
December 2014: JPMA. the Journal of the Pakistan Medical Association
Masahide Fujiki, Shimpei Miyamoto, Fumihiko Nakatani, Akira Kawai, Minoru Sakuraba
Rotationplasty is used most often as a function-preserving salvage procedure after resection of sarcomas of the lower extremity; however, it is also used after infection of prosthetic knee joints. Conventional vascular management during rotationplasty is to preserve and coil major vessels, but recently, transection and reanastomosis of the major vessels has been widely performed. However, there has been little discussion regarding the optimal vascular management of rotationplasty after infection of prosthetic knee joints because rotationplasty is rarely performed for this indication...
2015: Case Reports in Orthopedics
Nicholas M Bernthal, Michael J Monument, R Lor Randall, Kevin B Jones
Rotationplasty is an alternative reconstructive strategy after sarcoma resection that often gets overlooked due to concerns about cosmesis. "Rotating" a distal segment 180 degrees and fixing it to a proximal segment leaves a highly-functional, durable reconstruction that functionally compares favorably to other limb-salvage techniques. Cosmetic outcomes have no discernible impact of the emotional and social functioning of cancer survivors following rotationplasty. This chapter discusses techniques of rotationplasty, as well as its oncologic, functional and emotional outcomes...
June 1, 2014: Operative Techniques in Orthopaedics
Rebecca Tate, Craig Gerrand, Juliet Hale
Reconstruction of the distal femur after resection for primary bone tumour in very young patients presents a considerable challenge. The risks and benefits of the available reconstructive options need to be carefully balanced. We report a case of osteosarcoma of the distal femur in a 4-year-old boy that was, unusually, treated by amputation and a tibial turn-up procedure; we discuss the rationale for the procedure and report the results at early follow-up.
January 2015: Journal of Pediatric Orthopedics. Part B
Luigi Tesio, Maria Grazia Benedetti, Viviana Rota, Marco Manfrini, Laura Perucca, Antonio Caronni
Rotationplasty (Borggreve-Van Nes operation) is a rare limb salvage procedure, most often applied to children presenting with sarcoma of the distal femur. In type A1 operation, the distal thigh is removed and the proximal tibia is axially rotated by 180°, remodeled, grafted onto the femoral stump, and then prosthetized. The neurovascular bundle is spared. The rotated ankle then works as a knee. The foot plantar and dorsal flexors act as knee extensors and flexors, respectively. Functional results may be excellent...
December 2014: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
Ashish Gulia, Ajay Puri, Manish Pruthi, Saral Desai
BACKGROUND: Periosteal osteosarcoma is an uncommon variant of osteosarcoma which constitutes less than 2% of all osteosarcomas. Whereas adequate surgical excision remains the cornerstone of treatment, the role of chemotherapy in this tumor is still unclear. Existing literature contains very few single center studies on the outcomes for periosteal osteosarcomas and any additional information will help in better understanding of these uncommon lesions. This study aims to evaluate the oncologic and functional outcomes of treatment of periosteal osteosarcoma treated at our institute...
May 2014: Indian Journal of Orthopaedics
Seung Han Shin, Keun-Ho Lee, Seung Pil Jang, Goo-Hyun Mun, Sung Wook Seo
In this study, we present the feasibility of intercalary limb resection and massive reconstruction for malignant tumors of lower extremity. Ten cases of lower extremity malignancies that had undergone concomitant bone (and/or joint) and soft-tissue reconstruction after wide excision exceeding two-thirds of the cross-sectional area of the affected limb were reviewed. All cases were indicated for amputation because of an expansive tumor, hematoma from a pathologic fracture, or previous unplanned excision, with or without critical structure involvement...
May 2014: Journal of Reconstructive Microsurgery
Ulrike Michaela Pirker-Frühauf, Jörg Friesenbichler, Katharina Rabitsch, Bernadette Liegl-Atzwanger, Thomas Bauernhofer, Reinhard Windhager, Andreas Leithner
Introduction. We present the extremely rare case of a patient with three metachronous osteosarcomas within 22 years without evident pulmonary manifestation of disease 30 years after first diagnosis. Case Presentation. In 1983, a high-grade osteosarcoma of the left distal femur was diagnosed in an 18-year-old Caucasian male. He received rotationplasty accompanied by pre- and postoperative chemotherapy. Ten years later, an osteoblastic osteosarcoma occurred in TH12. En bloc resection and pre- and postoperative chemotherapy followed...
2013: Case Reports in Orthopedics
Lisan G Scheepers, Joep O Storcken, Frans Rings, Yvette van Horn, Henk A Seelen
BACKGROUND AND AIM: Current leg prostheses in rotationplasty typically feature a thigh cuff, which, in cycling, may cause perspiration problems and friction-related abrasions of the skin. The aim has been to develop a socket-less prosthetic device for persons with a rotationplasty to be able to engage in high-intensity cycling without contracting abrasions. TECHNIQUE: The new device (Socket-Less Rotationplasty Prosthesis for Cycling) features a standard cycling shoe on the rotationplasty foot, replacing the conventional socket and thigh cuff...
April 2015: Prosthetics and Orthotics International
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