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Orthopaedics Oncology

Olivier D R van Wulfften Palthe, Stein J Janssen, Jay S Wunder, Peter C Ferguson, Guo Wei, Peter S Rose, Micheal J Yaszemski, Franklin H Sim, Patrick J Boland, John H Healey, Francis J Hornicek, Joseph H Schwab
BACKGROUND CONTEXT: Patient reported outcomes are becoming increasingly important when investigating results of patient and disease management. In sacral tumor patients symptoms can vary substantially, therefore no single questionnaire can adequately account for the full spectrum of symptoms and disability. PURPOSE: The purpose of this study is to analyze redundancy within the current sacral tumor survey and make a recommendation for an updated version based on the results and patient and expert opinions...
November 14, 2016: Spine Journal: Official Journal of the North American Spine Society
Małgorzata Tomaszewska-Kowalska, Krzysztof Kołomecki, Maria Wieloch-Torzecka
: Surgical site infections on surgical wards are the most common cause of postoperative complications. Prevalence of surgical site infections depends on the surgical specialization. Analysis of the causes of surgical site infections allows to conclude that microorganisms from the patient's own microbiota - Gram-negative rod-shaped bacteria from the family Enterobacteriacae and from the patient's skin microbiota - Gram-positive cocci - Staphylococcus are the most common agents inducing surgical site infections...
October 1, 2016: Polski Przeglad Chirurgiczny
Q M J van der Vliet, N R Paulino Pereira, S J Janssen, F J Hornicek, M L Ferrone, J A M Bramer, C N van Dijk, J H Schwab
BACKGROUND: It would be helpful for the decision-making process of patients with metastatic bone disease to understand which patients are at risk for worse quality of life (QOL), pain, anxiety, and depression. Normative data, and where these stand compared with general population scores, can be useful to compare and interpret results of similar patients or patient groups, but to our knowledge, there are no such robust data. QUESTIONS/PURPOSES: We wished (1) to assess what factors are independently associated with QOL, pain interference, anxiety, and depression in patients with metastatic bone disease, and (2) to compare these outcomes with general US population values...
October 17, 2016: Clinical Orthopaedics and related Research
Daan Botje, Guus Ten Asbroek, Thomas Plochg, Helen Anema, Dionne S Kringos, Claudia Fischer, Cordula Wagner, Niek S Klazinga
BACKGROUND: Hospitals are under increasing pressure to share indicator-based performance information. These indicators can also serve as a means to promote quality improvement and boost hospital performance. Our aim was to explore hospitals' use of performance indicators for internal quality management activities. METHODS: We conducted a qualitative interview study among 72 health professionals and quality managers in 14 acute care hospitals in The Netherlands. Concentrating on orthopaedic and oncology departments, our goal was to gain insight into data collection and use of performance indicators for two conditions: knee and hip replacement surgery and breast cancer surgery...
October 13, 2016: BMC Health Services Research
Daniel Esau
When first described in 1958, Burkitt lymphoma was considered by many to be an African curiosity. However, over the next few decades, over 10,000 publications on Burkitt lymphoma would influence many facets of oncology research including immunology, molecular genetics, chemotherapy, and viral oncology. At the time of discovery, its distribution in equatorial Africa was unique; it was where a child was born and lived, and not what race they were, that conveyed the greatest incidence risk. Its association with Epstein-Barr virus brought attention to the possibility that oncogenesis may be influenced by viruses...
September 28, 2016: Journal of Medical Biography
Blaine T Manning, Rachel M Frank, Nathan G Wetters, Bernard R Bach, Aaron G Rosenberg, Brett R Levine
Knee-related complaints are among the most commonly encountered conditions by orthopaedic surgeons. Knee pathology varies widely and includes arthritis, deformities, fractures, infections, neuromuscular disorders, oncologic diseases, and soft-tissue injury. While nonoperative treatment modalities (activity modification, medications, injections, and physical therapy) are typically used as primary interventions, surgical treatment may ultimately become necessary. The purpose of this review is to discuss the most common open approaches to the knee, with an emphasis on surgically relevant anatomy for each approach...
September 2016: Bulletin of the Hospital for Joint Diseases
Kyle R Duchman, Benjamin J Miller
BACKGROUND: The majority of orthopaedic trainees pursue additional subspecialty training at the conclusion of residency. Although national trends indicate that fellowship-trained surgeons are more frequently performing cases in their defined subspecialties, this may not be the case for recently trained tumor fellows. Prior work has established that low tumor case volume is a significant stressor for recently trained tumor fellows. Given the relative rarity of musculoskeletal tumors, it is important for prospective trainees to have clear expectations for the proportion of specialty-specific procedures early during their careers...
August 10, 2016: Clinical Orthopaedics and related Research
Lucinda C C Gosling, Alison B Rushton
OBJECTIVES: The aim of this study was to identify the symptom presentation of adult knee primary bone tumours from onset to Consultant diagnosis, from combined patient and healthcare professional perspectives. MATERIALS AND METHODS: A qualitative study using in-depth semi-structured interviews recruited a purposive sample of adult patients with a knee primary bone tumour (n = 8) and healthcare professionals with expertise in orthopaedic oncology (n = 6). Following informed consent, recorded interviews explored participants' experiences of symptom presentation...
July 17, 2016: Manual Therapy
Alexander R Willis, Joseph A Ippolito, Francis R Patterson, Joseph Benevenia, Kathleen S Beebe
BACKGROUND: Customizable orthopaedic implants are often needed for patients with primary malignant bone tumors due to unique anatomy or complex mechanical problems. Currently, obtaining customizable orthopaedic implants for orthopaedic oncology patients can be an arduous task involving submitting approval requests to the Institutional Review Board (IRB) and the Food and Drug Administration (FDA). There is great potential for the delay of a patient's surgery and unnecessary paperwork if the submission pathways are misunderstood or a streamlined protocol is not in place...
2016: SpringerPlus
Thomas F Bendtsen, Stephen Haskins, Jens Aage Kølsen Petersen, Jens Børglum
It has been suggested for many years that regional anaesthesia is advantageous in high-risk patients, either as the sole anaesthetic or in combination with general anaesthesia. Regional techniques are safe and even more so when guided by ultrasound. In the high-risk patient population, ultrasound-guided regional anaesthesia (UGRA) can help decrease risk of perioperative morbidity and improve short-term as well as long-term outcomes, particularly in the orthopaedic, vascular, oncologic and chronic pain patient populations...
June 2016: Best Practice & Research. Clinical Anaesthesiology
Vivek Ajit Singh, Lim Ming Yong, Anushya Vijayananthan
BACKGROUND: Deep vein thrombosis (DVT) has been independently associated with both malignant diseases and orthopaedic surgery. Therefore, orthopaedic oncology patients may be at a high risk for thromboembolic events. However, less emphasis is given to this group of patients compared to the patients undergoing total hip and knee replacement. The objective of this study is to determine the incidence of DVT and their risk factors in patients undergoing orthopaedic oncology lower limb surgery without prophylaxis...
2016: SpringerPlus
Yi-Dan Zhang, Wei Guo, Rong-Li Yang, Xiao-Dong Tang, Tai-Qiang Yan, Tao Ji
OBJECTIVE: To introduce a new classification of Enneking type IV pelvic tumors involving the sacrum and a corresponding system of standardized surgical approaches and procedures for resection of such tumors, and to investigate the feasibility and therapeutic effect of the new system. METHODS: Data on 59 patients treated between February 2003 and February 2013 by standardized surgical approaches and procedures were retrospectively reviewed. The study subjects comprised 28 male and 31 female patients with a mean age at diagnosis of 36 years (range, 2-72 years)...
May 2016: Orthopaedic Surgery
Sophie Piperno-Neumann, Marie-Cécile Le Deley, Françoise Rédini, Hélène Pacquement, Perrine Marec-Bérard, Philippe Petit, Hervé Brisse, Cyril Lervat, Jean-Claude Gentet, Natacha Entz-Werlé, Antoine Italiano, Nadège Corradini, Emmanuelle Bompas, Nicolas Penel, Marie-Dominique Tabone, Anne Gomez-Brouchet, Jean-Marc Guinebretière, Eric Mascard, François Gouin, Aurélie Chevance, Naïma Bonnet, Jean-Yves Blay, Laurence Brugières
BACKGROUND: Based on preclinical data for the antitumour effect of zoledronate in osteosarcoma, we assessed whether zoledronate combined with chemotherapy and surgery improved event-free survival in children and adults with osteosarcoma. METHODS: In this randomised, multicentre, open-label, phase 3 trial (OS2006), patients aged between 5 years and 50 years with newly diagnosed high-grade osteosarcoma were randomly assigned to receive standard chemotherapy with or without ten zoledronate intravenous infusions (four preoperative and six postoperative)...
August 2016: Lancet Oncology
Y Li, Y Sun, H C Shan, X H Niu
OBJECTIVE: To evaluate the safety and efficacy of microwave ablation combined with curettage in the treatment of long bone metastases. METHODS: From April 2010 to June 2015, 38 patients with long bone metastases were adopted, who all underwent microwave ablation combined with curettage with 40 lesions involved in Department of Orthopaedic Oncology, Beijing Jishuitan Hospital. There were 22 males and 16 females with an average age of 58.3 years (range from 32 to 83 years)...
May 24, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Stein J Janssen, Joost T P Kortlever, John E Ready, Kevin A Raskin, Marco L Ferrone, Francis J Hornicek, Santiago A Lozano-Calderon, Joseph H Schwab
BACKGROUND: Proximal femoral fractures resulting from metastatic disease often require surgical management. Few studies have compared surgical techniques, and physicians' preferred strategies vary. This study compared revision and complication rates among surgical strategies. METHODS: The study consisted of a retrospective review of electronic medical records of 417 consecutive patients with proximal femoral metastasis or multiple myeloma who underwent intramedullary nailing (n = 302), endoprosthetic reconstruction (n = 70), and open reduction and internal fixation (n = 45) between 1999 and 2014 at two orthopaedic oncology centers...
July 2016: Journal of the American Academy of Orthopaedic Surgeons
Patricia Schneider, Nathan Evaniew, Juan Sebastian Rendon, Paula McKay, R Lor Randall, Robert Turcotte, Roberto Vélez, Mohit Bhandari, Michelle Ghert
INTRODUCTION: Orthopaedic oncology researchers face several obstacles in the design and execution of randomised controlled trials, including finite fiscal resources to support the rising costs of clinical research and insufficient patient volume at individual sites. As a result, high-quality research to guide clinical practice has lagged behind other surgical subspecialties. A focused approach is imperative to design a research programme that is economical, streamlined and addresses clinically relevant endpoints...
2016: BMJ Open
Bradley Schoch, Thomas Shives, Bassem Elhassan
Scapulectomy can dramatically alter glenohumeral function and the ability of patients to conduct activities of daily living. In oncologic cases, treatment of the tumor can compromise local musculature, making successful reconstruction difficult to achieve. Depending on the resection level, local musculature may be inadequate to restore shoulder range of motion and/or glenohumeral stability. Surgeons have attempted to address these issues via soft-tissue repairs, allograft replacement, and prosthetic replacement, with variable success...
June 2016: Journal of the American Academy of Orthopaedic Surgeons
F Wilken, I J Banke, M Hauschild, S Winkler, K Schott, M Rudert, R V Eisenhart-Rothe
BACKGROUND: The reconstruction of the extensor mechanism around the knee is an essential part of tumorresection and tumor arthroplasty in orthopaedic oncology for functional rehabilitation of quality of life and daily activities. OBJECTIVES: Operative procedures, treatment options and management of complications with reconstruction of the extensor mechanism after tumor resection around the knee depend on the type of arthroplasty. MATERIALS AND METHODS: Description of the different treatment option for extensor deficiency divided into infra- and suprapatellar modalities...
May 2016: Der Orthopäde
S Evans, Z Khan, L Jeys, R Grimer
INTRODUCTION: A chordoma is a slow growing malignant tumour of notochordal origin. A tumour with histological features that are identical to those of a chordoma may arise outside the axial skeleton. To date, there is little in the literature documenting their clinical course. METHODS: Our large orthopaedic oncology database was used to document the clinical course of extra-axial chordoma. RESULTS: Over a 30-year period, 131 patients diagnosed with a chordoma were treated at our unit...
May 2016: Annals of the Royal College of Surgeons of England
Michaël P A Bus, Andrzej Szafranski, Simen Sellevold, Tomasz Goryn, Paul C Jutte, Jos A M Bramer, M Fiocco, Arne Streitbürger, Daniel Kotrych, Michiel A J van de Sande, P D Sander Dijkstra
BACKGROUND: Reconstruction of periacetabular defects after pelvic tumor resection ranks among the most challenging procedures in orthopaedic oncology, and reconstructive techniques are generally associated with dissatisfying mechanical and nonmechanical complication rates. In an attempt to reduce the risk of dislocation, aseptic loosening, and infection, we introduced the LUMiC(®) prosthesis (implantcast, Buxtehude, Germany) in 2008. The LUMiC(®) prosthesis is a modular device, built of a separate stem (hydroxyapatite-coated uncemented or cemented) and acetabular cup...
March 28, 2016: Clinical Orthopaedics and related Research
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