Orthopaedics Oncology

Introduction Artificial intelligence (AI) models using large language models (LLMs) and non-specific domains have gained attention for their innovative information processing. As AI advances, it's essential to regularly evaluate these tools' competency to maintain high standards, prevent errors or biases, and avoid flawed reasoning or misinformation that could harm patients or spread inaccuracies. Our study aimed to determine the performance of Chat Generative Pre-trained Transformer (ChatGPT) by OpenAI and Google BARD (BARD) in orthopedic surgery, assess performance based on question types, contrast performance between different AIs and compare AI performance to orthopedic residents...

Aneurysmal bone cyst (ABC) is a non-malignant, locally destructive, blood-filled lesion in the bone that tends to grow aggressively. A young girl presented with a rapid recurrence after aggressive surgery of a large symptomatic sacral-spinal ABC. After a multidisciplinary tumour board, she was successfully treated with sclerotherapy and monthly intravenous denosumab. The patient has maintained asymptomatic for over 36 months now and has returned to full activity and strength. She never required surgery and has had radiologic resolution of the lesions...

The purpose of this study was to identify trends in the use of functional outcome measures within orthopedic oncology. The search engine, PubMed, was reviewed for all articles over an 11-year period from 2011 to 2021 from five major journals that publish in the field of orthopedic oncology. The functional outcome measures used in the articles were recorded along with study date, study design, clinical topic/pathology, and level of evidence. Out of 5968 musculoskeletal tumor-focused articles reviewed, 293 (4...

INTRODUCTION: Preoperative anxiety and depression symptoms among older surgical patients are associated with poor postoperative outcomes, yet evidence-based interventions for anxiety and depression have not been applied within this setting. We present a protocol for randomised controlled trials (RCTs) in three surgical cohorts: cardiac, oncological and orthopaedic, investigating whether a perioperative mental health intervention, with psychological and pharmacological components, reduces perioperative symptoms of depression and anxiety in older surgical patients...

INTRODUCTION: Myxofibrosarcoma also known as myxoid malignant fibrous histiocytoma is a rare soft tissue sarcoma that has a predilection for the elderly (beyond the 6th decade). CLINICAL OBSERVATION: We report a case of a 64 years old patient that presented gradual appearance of huge tumor on her left buttock. Radiologic examination (MRI) concluded to MFS. There was no evidence of systemic involvement. The patient was directed in an oncology center, where the diagnostis of MFS was confirmed through surgical biopsy...

INTRODUCTION: Malignant tumors afflicting the sub-condylar area and ascending ramus of the mandible without mucosal involvement are extremely rare. Traditional approaches such as lip-split-cheek flap and Visor flap would prove sub-optimal and excessive for such limited lesions and entail salivary contamination and mental nerve sacrifice. To circumvent these limitations, we developed a surgical approach that achieves wide, extra-oral exposure to the condyle and ascending ramus and permits controlled resection, affording protection to the facial nerve branches and mental nerve, while avoiding salivary contamination...

BACKGROUND: The objective of this study was to assess the complication and re-operation rates, evaluate the risk of non-union, and describe the functional outcomes at last follow-up in children and adolescents after lower-limb malignant tumour resection and reconstruction using the induced-membrane technique. HYPOTHESIS: Weight-bearing resumption 6 weeks after the second stage of the induced-membrane procedure promotes bone healing. MATERIAL AND METHODS: The study included 13 patients (9 with osteosarcoma, 3 with Ewing's sarcomas, and 1 with alveolar sarcoma) managed between 2000 and 2020 by oncological femoral or tibial resection followed, at a distance from adjuvant chemotherapy, by reconstruction using the induced-membrane technique...

INTRODUCTION AND OBJECTIVE: Venous thromboembolism (VTE) is one of the most important and life-threatening complications in orthopaedic surgery. According to current scientific reports, there are several variables that can affect the severity of CVD, including the site of the pathology or the type of treatment implemented. The aim of the study was to analyze the risk of VTE depending on the location of the pathology, as well as to evaluate the impact of surgical treatment compared to conservative management...

Hereditary multiple exostosis (HME) is a rare genetic disorder characterized by multiple bony spurs or lumps, commonly affecting the long bones. This case report exposes the clinical presentation, diagnosis, and management of HME in a 28-year-old female nurse, who initially presented with persistent bilateral knee pain. After extensive evaluation involving orthopaedic and oncology specialists, the diagnosis of HME was made. Despite the discovery of multiple exostoses, the patient reported improvement following a tailored physiotherapy regimen...

BACKGROUND: Academic medical centers greatly benefit from retaining their physicians; that ensures continuity in patient care, enhances resident education, and maintains a pool of experienced clinicians and researchers. Despite its importance, little research has been published on the retainment of academic faculty in orthopaedics. To address this gap, this study investigates the demographic trends of academic orthopaedic surgeons from 2016 to 2022. By analyzing data pertaining to gender distribution, years of practice, research productivity, and institutional rankings, we aimed to gain insights into the factors influencing faculty retainment, institution changes, and new entrants into academic orthopaedics...

Endometriosis is a disorder that commonly affects females of reproductive age and is defined as the presence of endometrial glands or stroma outside the uterine cavity. Patients typically present with cyclical pain during menses. Endometriosis can be characterized as endopelvic or extrapelvic depending on the sites involved. We report a case of a 40-year-old, right-hand-dominant, female who presented with a painful mass in her right proximal forearm. She was ultimately diagnosed with intramuscular endometriosis and underwent surgical excision...

UNLABELLED: Osteoarthritis (OA) is one of the fast-growing disability-related diseases worldwide, which has significantly affected the quality of patients' lives and brings about substantial socioeconomic burdens in medical expenditure. There is currently no cure for OA once the bone damage is established. Unfortunately, the existing radiological examination is limited to grading the disease's severity and is insufficient to precisely diagnose OA, detect early OA or predict OA progression...

BACKGROUND: The incidence and histological type of spinal cancer is diverse. It is our role as physicians to explore the epidemiology of spinal cancers so that several projections can be made. Resource allocation, cost analyses, and the requirement of rehabilitation facilities all need to be considered.The objective of this paper is to provide an account of the acute spinal oncological admissions to the National Spinal Injuries Unit (NSIU) in both 2010 and 2020 with the hypothesis that upward trends will be noted...

BACKGROUND: Bone metastasis in advanced cancer is challenging because of pain, functional issues, and reduced life expectancy. Treatment planning is complex, with consideration of factors such as location, symptoms, and prognosis. Prognostic models help guide treatment choices, with Skeletal Oncology Research Group machine-learning algorithms (SORG-MLAs) showing promise in predicting survival for initial spinal metastases and extremity metastases treated with surgery or radiotherapy. Improved therapies extend patient lifespans, increasing the risk of subsequent skeletal-related events (SREs)...

OBJECTIVE: Despite advancements in spinal metastasis surgery techniques and the rapid development of multidisciplinary treatment models, we aimed to explore the clinical efficacy of spinal metastasis surgery performed by a combined NOMS decision system-utilizing multidisciplinary team and Revised Tokuhashi scoring system, compared with the Revised Tokuhashi scoring system. METHODS: Clinical data from 102 patients with spinal metastases who underwent surgery at three affiliated hospitals of Zunyi Medical University from December 2017 to June 2022 were analysed...

3D printing technologies have evolved tremendously over the last decade for uses in orthopaedic surgical applications, including being used to manufacture implants for spine, upper extremity, foot and ankle, oncologic, and traumatic reconstructions. Materials used for 3D-printed orthopaedic devices include metals, degradable and nondegradable polymers, and ceramic composites. There are 2 primary advantages for use of 3D printing technologies for orthopaedics: first, the ability to create complex porous lattices that allow for osseointegration and improved implant stability and second, the enablement of complex geometric designs allowing for patient-specific devices based on preoperative imaging...

BACKGROUND: Currently there is limited literature available on fungating soft tissue sarcoma and its effect of outcomes. In the current study we evaluated the surgical management and oncologic outcomes of patient with fungating soft tissue sarcoma. MATERIALS AND METHODS: This was a retrospective observational study of patients with fungating sarcoma between January 2015 till January 2019 at a tertiary cancer care centre. A total of 59 patients were considered of which 16 had metastasis at presentation...

Limb salvage surgery has revolutionized the approach to bone tumors in orthopedic oncology, steering away from historical amputations toward preserving limb function and enhancing patient quality of life. This transformative shift underscores the delicate balance between tumor eradication and optimal postoperative function. Primary and metastatic bone tumors present challenges in early detection, differentiation between benign and malignant tumors, preservation of function, and the risk of local recurrence...

A young male in his mid-teen years presented with severe back pain for 3 months and was subsequently diagnosed with osteoid osteoma in the left superior articular process of the L4 vertebra. Initial treatment with non-steroidal anti-inflammatory drugs provided temporary relief. Due to concerns about scoliosis progression along with unrelieved pain, a multidisciplinary team recommended endoscopic excision of the osteoid osteoma. The procedure resulted in complete pain relief and an improvement in the scoliosis curve from 22° of Cobb's angle to 12 degrees at the 8-month follow-up...

BACKGROUND: Resident training programs in the US use the Orthopaedic In-Training Examination (OITE) developed by the American Academy of Orthopaedic Surgeons (AAOS) to assess the current knowledge of their residents and to identify the residents at risk of failing the Amerian Board of Orthopaedic Surgery (ABOS) examination. Optimal strategies for OITE preparation are constantly being explored. There may be a role for Large Language Models (LLMs) in orthopaedic resident education. ChatGPT, an LLM launched in late 2022 has demonstrated the ability to produce accurate, detailed answers, potentially enabling it to aid in medical education and clinical decision-making...