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https://www.readbyqxmd.com/read/28245614/gene-expression-in-osteolysis-review-on-the-identification-of-altered-molecular-pathways-in-preclinical-and-clinical-studies
#1
REVIEW
Francesca Veronesi, Matilde Tschon, Milena Fini
Aseptic loosening (AL) due to osteolysis is the primary cause of joint prosthesis failure. Currently, a second surgery is still the only available treatment for AL, with its associated drawbacks. The present review aims at identifying genes whose expression is altered in osteolysis, and that could be the target of new pharmacological treatments, with the goal of replacing surgery. This review also aims at identifying the molecular pathways altered by different wear particles. We reviewed preclinical and clinical studies from 2010 to 2016, analyzing gene expression of tissues or cells affected by osteolysis...
February 25, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28238012/two-revision-surgeries-on-cemented-custom-made-tumor-prostheses
#2
Yukihiro Yoshida, Yuki Okamura, Mamoru Akita, Masashi Taniguchi, Toshio Kojima, Eiji Osaka, Yasuaki Tokuhashi
We performed revision surgery in 2 patients for stem fracture of a cemented tumor prosthesis that occurred more than 25 years after the initial surgery. For revision, the global modular replacement system (GMRS) was used. However, as bone cement in the bone could not be adequately removed, stems with respective diameters of 11 and 12.5 mm were used. In revision surgery for cemented tumor prostheses, adequate removal of residual bone cement is optimal. However, when there is a risk of fracture, it may be appropriate to insert a thicker stem after reaming the femoral canal as much as possible, and then fix the stem using the cement-in-cement method...
February 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/28198595/free-microvascular-rotationplasty-with-nerve-repair-for-rhabdomyosarcoma-in-a-18-month-old-patient
#3
Alberto Pérez-García, Marta Salom, María Eloísa Villaverde-Doménech, Francisco Baixauli, Eduardo Simón-Sanz
Rotationplasty is a limb-sparing surgical option in lower limb malignancies. Sciatic or tibial nerve encasement has been considered an absolute contraindication to this procedure. We report a case of an 18-month-old girl with a rhabdomyosarcoma that affected the leg and popliteal fossa, with neurovascular involvement. Knee and proximal leg intercalary resection was performed followed by reconstruction with free microvascular rotationplasty and neurorraphy from tibial division of sciatic nerve to sural and tibial nerves, and from saphenous nerve to superficial peroneal nerve...
February 15, 2017: Microsurgery
https://www.readbyqxmd.com/read/28194713/use-of-compressive-osseointegration-endoprostheses-for-massive-bone-loss-from-tumor-and-failed-arthroplasty-a-viable-option-in-the-upper-extremity
#4
Krista A Goulding, Adam Schwartz, Steven J Hattrup, R Lor Randall, Donald Lee, Damian M Rispoli, Daniel M Lerman, Christopher Beauchamp
BACKGROUND: Endoprostheses using principles of compressive osseointegration have shown good survivorship in several studies involving the lower extremity; however, no series to our knowledge have documented the use of this technology in the management of massive bone loss in the upper limb. QUESTIONS/PURPOSES: (1) What proportion of upper extremity implants using compressive osseointegration fixation principles achieved durable short-term fixation, and what were the modes of failure? (2) What surgical complications resulted from reconstruction using this technique? METHODS: A multiinstitutional retrospective review identified nine patients (five women; four men) who underwent 13 endoprosthetic replacements between 2003 and 2014 using compressive osseointegration (Compliant(®) Pre-stress Device [CPS]; Biomet Inc, Warsaw, IN, USA) in the upper extremity, including two proximal humeri, two humeral diaphyses, seven distal humeri, and two proximal ulna...
February 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28188337/giant-cell-tumor-of-the-bone-aggressive-case-initially-treated-with-denosumab-and-intralesional-surgery
#5
Donald von Borstel, Roberto A Taguibao, Nicholas A Strle, Joseph E Burns
Giant cell tumor of the bone (GCTB) is a locally aggressive benign tumor, which has historically been treated with wide surgical excision. We report a case of a 29-year-old male with histology-proven GCTB of the distal ulna. The initial imaging study was a contrast-enhanced magnetic resonance imaging (MRI) examination of the left wrist, which was from an outside facility performed before presenting to our institution. On the initial MRI, the lesion had homogenous T2-hyperintense and T1-hypointense signal with expansive remodeling of the osseous contour...
April 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28161138/prognosis-of-advanced-tenosynovial-giant-cell-tumor-of-the-knee-diagnosed-during-total-knee-arthroplasty
#6
Pengfei Lei, Rongxin Sun, Hao Liu, Jianxi Zhu, Ting Wen, Yihe Hu
BACKGROUND: Tenosynovial giant cell tumor (TGCT) is a relatively rare disease often misdiagnosed as osteoarthritis. Synovectomy or arthroplasty is the recommended treatment option, but recurrence is common after surgery. This study aimed to determine the prognosis of patients with advanced TGCT that was diagnosed incidentally during total knee arthroplasty (TKA) for osteoarthritis and treated by synovectomy. METHODS: From January 2008 to July 2011, TGCT was diagnosed incidentally in 10 patients (a total of 11 individual knees) undergoing posterior-stabilized TKA for an initial diagnosis of osteoarthritis...
January 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28138720/the-dual-mobility-cup-in-muscular-skeletal-oncology-rationale-and-indications
#7
Carmine Zoccali, Dario Attala, Alessandra Scotto di Uccio, Barbara Rossi, Gennaro Scotto, Roberto Biagini
PURPOSE: Because of the improvement of medical therapy and the corresponding increase in life expectancy, orthopaedic surgeons are obliged to perform more wide resections rather than intramedullary stabilization nailing for patients affected by tumours of the hip compared to the past. Wide resection often causes joint instability, so prosthetic reconstruction presents a higher risk of dislocation than in primary osteoarthritis cases. The aim of the present paper is to classify the indications for the dual mobility cup (DMC) hip prosthesis based on the anatomic structures involved in the disease and to analyse the rationale to reduce the risk of dislocation...
January 31, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28121720/the-use-of-integra%C3%A2-dermal-regeneration-template-for-the-orbital-exenteration-socket-a-novel-technique
#8
Cem Ozgonul, Ana Beatriz Diniz Grisolia, Hakan Demirci
PURPOSE: Integra® dermal regeneration template is a bilayer membrane system that acts as a scaffold for regenerating dermal skin cells. It is used for wound reconstruction following burns, extensive injuries, and a large tumor excision in multiple parts of the body. The dermal layer is made of porous matrix of bovine tendon collagen and glycosaminoglycan. The epidermal layer is made of polysiloxane layer. In this study, the authors evaluated the use of Integra® dermal regeneration template for the immediate reconstruction of the orbital exenteration socket...
January 23, 2017: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28106524/the-utility-of-3d-printing-for-surgical-planning-and-patient-specific-implant-design-for-complex-spinal-pathologies-case-report
#9
Ralph J Mobbs, Marc Coughlan, Robert Thompson, Chester E Sutterlin, Kevin Phan
OBJECTIVE There has been a recent renewed interest in the use and potential applications of 3D printing in the assistance of surgical planning and the development of personalized prostheses. There have been few reports on the use of 3D printing for implants designed to be used in complex spinal surgery. METHODS The authors report 2 cases in which 3D printing was used for surgical planning as a preoperative mold, and for a custom-designed titanium prosthesis: one patient with a C-1/C-2 chordoma who underwent tumor resection and vertebral reconstruction, and another patient with a custom-designed titanium anterior fusion cage for an unusual congenital spinal deformity...
January 20, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28101196/denosumab-treatment-of-inoperable-or-locally-advanced-giant-cell-tumor-of-bone
#10
Aneta Borkowska, Tomasz Goryń, Andrzej Pieńkowski, Michał Wągrodzki, Ewelina Jagiełło-Wieczorek, Paweł Rogala, Milena Szacht, Piotr Rutkowski
Giant cell tumor of bone (GCTB) is an osteolytic, locally aggressive tumor that rarely metastasizes and typically occurs in the bones. At present, the primary treatment for GCTB is curettage with local adjuvants. Giant cells express receptor activator of nuclear factor-κB ligand (RANKL). Denosumab, a RANKL inhibitor appears to present an effective therapeutic option in advanced cases of GCTB. The aim of the present study was to confirm the efficacy of denosumab in large group of patients with locally advanced GCTB...
December 2016: Oncology Letters
https://www.readbyqxmd.com/read/28060092/functional-reconstruction-of-nonsegmental-mandibular-defect-with-fresh-frozen-bone-graft-and-delayed-implants-placement
#11
Tommaso Bucci, Pier Francesco Nocini
The loss of teeth and the alveolar bone secondary to resection of mandibular tumors may lead to unfavorable esthetic and functional results with a significant impairment of mastication.The authors report a 53-year-old patient with recurrence of ameloblastoma who was submitted to marginal mandibulectomy. Bone defect was immediately reconstructed using fresh frozen bone graft and 9 months after reconstruction 3 dental implants were inserted in the grafted bone. After 6 months, dental rehabilitation was achieved using a fixed implant-supported prosthesis...
January 5, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28052811/short-term-outcomes-of-mandibular-reconstruction-in-oncological-patients-using-a-cad-cam-prosthesis-including-a-condyle-supporting-a-fibular-free-flap
#12
Achille Tarsitano, Salvatore Battaglia, Valerio Ramieri, Piero Cascone, Leonardo Ciocca, Roberto Scotti, Claudio Marchetti
PURPOSE: Condylar reconstruction and replacement using alloplastic materials currently attracts much surgical interest. The major challenge is to functionally reconstruct the anatomical region; this is crucial in terms of correct mandibular function. The goal of the present study was to evaluate the clinical outcomes of and complications experienced by a series of oncological patients who underwent computer-aided design/computer-aided manufacturing (CAD/CAM) condylar reconstruction following resection-disarticulation of the mandible...
December 16, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28005771/ocular-reconstruction-using-bone-anchored-implants-in-irradiated-facial-deformities-after-tumor-extirpation
#13
Mansher Singh, Raquel Minasian, Matthew Jackson, E J Caterson
BACKGROUND: Surgical resection of ocular malignancies can result in complex craniofacial defects that can be difficult to reconstruct with conventional reconstruction techniques. Craniofacial prosthesis supported by bone-anchored implants has evolved as a reliable alternative in such scenarios. METHODS: The authors describe a patient who underwent extensive facial resection secondary to squamous cell carcinoma resulting in significant facial deformities. A bone-anchored osseointegrated implant was used to perform facial reconstruction...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28005762/jaw-in-a-day-state-of-the-art-in-maxillary-reconstruction
#14
Christopher M Runyan, Vishal Sharma, David A Staffenberg, Jamie P Levine, Lawrence E Brecht, Leonard H Wexler, David L Hirsch
BACKGROUND: Reconstruction of maxillary defects following tumor extirpation is challenging because of combined aesthetic and functional roles of the maxilla. One-stage reconstruction combining osseous free flaps with immediate osseointegrated implants are becoming the standard for mandibular defects, and have similar potential for maxillary reconstruction. METHODS: A woman with maxillary Ewing sarcoma successfully treated at age 9 with neoadjuvant chemotherapy, right hemimaxillectomy, and obturator prosthetic reconstruction presented for definitive reconstruction, complaining of poor obturator fit, and hypernasality...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27989047/results-of-contemporary-valve-surgery-in-patients-with-carcinoid-heart-disease
#15
Thomas Kuntze, Tamer Owais, Maria-Anna Secknus, Daniel Kaemmerer, Richard Baum, Evaldas Girdauskas
BACKGROUND: Carcinoid tumor is a slow-growing type of neuroendocrine tumor, originating from enterochromaffin cells and secreting mainly serotonin. The diagnosis is based on clinical symptoms, hormone blood levels, radiological and nuclear imaging, and histological confirmation. However, most patients have metastases at the time of diagnosis because the clinical signs often remain unnoticed or are attributed to other abdominal conditions. In up to 50% of patients the endocardium is affected due to a hormonally active tumor profile...
May 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27984686/-surgical-treatment-of-malignant-primary-tumors-of-the-pelvis-on-ennekings-zone-ii
#16
A M González-Pérez, C Arvinius, J García-Coiradas, R García-Maroto, J L Cebrian-Parra
INTRODUCTION: Surgical treatment of malignant bone tumors of the pelvis with periacetabular involvement is constantly evolving. Even though acetabular reconstructions improve quality of life without impairing cancer control, they are not complication free. Our purpose is to describe the functional outcomes and surgical complications of different reconstructive techniques for Enneking zone II tumors. MATERIAL AND METHODS: Fifteen patients underwent surgery for malignant pelvic bone tumors between 2002 and 2012...
May 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/27956077/modular-cementless-prosthetic-reconstruction-after-resection-of-lower-extremity-malignant-tumor
#17
Senol Bekmez, Mehmet Ayvaz, Altug Yucekul, Mazhar Tokgozoglu
INTRODUCTION: The aim of the study is to report the preliminary clinical and functional outcomes of a modular cementless tumor resection prosthesis system (Megasystem-C(®), Waldemar Link GmbH&Co. KG, Hamburg, Germany) in patients undergoing limb salvage surgery with wide resection in a lower extremity primary or metastatic malignant bone tumor. MATERIAL AND METHODS: Fifty-two consecutive patients (33 male and 19 female; mean age 37.1 years (range, 16 to 79) with primary or metastatic lower extremity malignant bone tumor who underwent wide resection and reconstruction with cementless Megasystem-C(®) system were included in the study...
December 2016: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/27955655/short-to-long-term-follow-up-of-total-femoral-replacement-in-non-oncologic-patients
#18
Andreas Toepfer, Norbert Harrasser, Isabel Petzschner, Florian Pohlig, Ulrich Lenze, Ludger Gerdesmeyer, Dominik Pförringer, Marcel Toepfer, Marc Beirer, Moritz Crönlein, Ruediger von Eisenhart-Rothe, Heinz Mühlhofer
BACKGROUND: Compromised bone stock and heavily impaired structural integrity after multiple endoprosthetic revision surgeries can lead to a comparable condition as encountered in musculoskeletal tumor surgery. Total femoral replacement (TFR) can restore femoral integrity and allow patients to resume ambulation. Even though several authors reported their results of TFR, so far many questions are still on debate: Which patients are at risk to experience low functional outcome? Do complications and clinical outcome after TFR depend on the indication for the surgery (e...
December 12, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27930584/risk-of-infection-is-associated-more-with-drain-duration-than-daily-drainage-volume-in-prosthesis-based-breast-reconstruction-a-cohort-study
#19
Cheng-Feng Chen, Shou-Fong Lin, Chen-Fang Hung, Pesus Chou
In prosthesis-based breast reconstruction, drains are used to prevent seroma formation and to reduce the risk of infection. However, prolonged drainage increases the risk of ascending infection. Although the volume often accepted for drain removal is ≤30 mL per day, the optimal timing to remove the drain for best clinical outcome remains controversial.We did a retrospective cohort study of 569 patients of prosthesis-based breast reconstruction with infection rate as the outcome variable; drain duration and last daily drainage volume as the main independent variables...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27915374/long-term-functional-and-radiological-outcomes-of-allograft-hip-prosthesis-composite-a-fourteen%C3%A2-year-follow-up-study
#20
Arnaud Dubory, Eric Mascard, Méryl Dahan, Philippe Anract, Charles Court, Stéphane Boisgard, Brice Viard, Gilles Missenard
PURPOSE: Allograft hip composite prosthesis (APC) is a type of reconstruction after resection of the proximal femur. This study aimed to assess long-term outcomes after an APC reconstruction. MATERIALS AND METHODS: Forty-six patients were retrospectively included (14 revision total hip replacements, 30 primary malignant bone tumors, two metastasis). RESULTS: The mean length of femoral bone resection was 16.4 cm (7 to 27). With a mean follow-up of 14...
December 3, 2016: International Orthopaedics
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