A Novel Rat Model to Simulate Positive Margins in the Wound Bed of a Resected Sarcoma.

Background: One reason for local recurrence is the presence of positive surgical margins after tumor resection. An animal model accurately representing the microtumor burden will improve our understanding of these surgical margins. Using a rat model, we report a new methodology for creating microscopic tumors.

Negative-Pressure Wound Therapy versus Standard Surgical Dressings after Malignant Tumor Resection: A Systematic Review and Meta-Analysis.

Background: Negative-pressure wound therapy offers many advantages over standard surgical dressings in the treatment of open wounds, including accelerated wound healing, cost savings, and reduced complication rates. Although contraindicated by device manufacturers in malignancy-resected wounds because of hypothesized risk of tumor recurrence, negative-pressure wound therapy is still applied postoperatively because of limited clinical support. The authors performed a systematic review with meta-analysis to compare negative-pressure wound therapy outcomes with those of standard surgical dressings on open wounds, with their null hypothesis stating there would be no outcome differences.

A Novel 3D Light Assisted Drawing (3D-LAD) Method to Aid Intraoperative Reproduction of Osteotomy Lines Surrounding a Bone Tumor During Wide Resection: An Experimental Study.

Introduction: Computer navigation and customized 3D-printed jigs improve accuracy during bone tumor resection, but such technologies can be bulky, costly, and require intraoperative radiation, or long lead time to be ready in OR.

Methods: We developed a method utilizing a compact, inexpensive, non-X-ray based 3D surface light scanner to provide a visual aid that helps surgeons accurately draw osteotomy lines on the surface of exposed bone to reproduce a well-defined preoperative bone resection plan. We tested the accuracy of the method on 18 sawbones using a distal femur hemimetaphyseal resection model and compared it with a traditional, freehand method.

A novel bone registration method using impression molding and structured-light 3D scanning technology.

Accurate bone registration is critical for computer navigation and robotic surgery. Existing registration systems are expensive, cumbersome, limited in accuracy and/or require intraoperative radiation. We recently reported a novel method of registration utilizing an inexpensive, compact, and X-ray-free structured-light 3D scanner.

Report on a novel bone registration method: A rapid, accurate, and radiation-free technique for computer- and robotic-assisted orthopedic surgeries.

Introduction: Computer- and robotic-assisted technologies have recently been introduced into orthopedic surgery to improve accuracy. Each requires intraoperative "bone registration," but existing methods are time consuming, often inaccurate, and/or require bulky and costly equipment that produces substantial radiation.

Methods: We developed a novel method of bone registration using a compact 3D structured light surface scanner that can scan thousands of points simultaneously without any ionizing radiation.

Hip disarticulation with pedicled total leg fillet flap for recurrent fungating sarcoma.

Soft tissue sarcomas may be treated with limb-sparing procedures in the majority of cases; however, certain cases involving significant tumor spread and fungation may call for amputation. In the thigh, hip disarticulation typically involves a pedicled gluteus maximus flap or a pedicled anterior quadriceps flap. In this case report, we describe a rare situation in which the anterior flap, posterior flap, and adductor flap musculature were contaminated with tumor; therefore, a hip disarticulation was performed applying a pedicled total leg fillet flap for closure.

Management of an Unusual Periprosthetic Giant Cell Tumor of Bone of the Proximal Tibia.

Giant cell tumor of bone is a relatively rare type of bone tumor, accounting for approximately 4.9% to 9% of all primary osseous neoplasms. Management options include intralesional curettage, or more uncommonly, wide resection.

A Rare Incidence of Pigmented Villonodular Synovitis of the Ankle in an Adolescent.

Pigmented villonodular synovitis mostly affects the knee and other large joints such as the hip. Although the disease is most commonly found in adult patients aged 30 to 40 years, rare cases in children and the elderly have been reported. We present the case of an 11-year-old female who was found to have biopsy-proven pigmented villonodular synovitis in her subtalar joint in 2012.

Surgical technique: Computer-generated custom jigs improve accuracy of wide resection of bone tumors.

Background: Manual techniques of reproducing a preoperative plan for primary bone tumor resection using rudimentary devices and imprecise localization techniques can result in compromised margins or unnecessary removal of unaffected tissue. We examined whether a novel technique using computer-generated custom jigs more accurately reproduces a preoperative resection plan than a standard manual technique.

Description Of Technique: Using CT images and advanced imaging, reverse engineering, and computer-assisted design software, custom jigs were designed to precisely conform to a specific location on the surface of partially skeletonized cadaveric femurs.

Surgical technique: Porous tantalum reconstruction for destructive nonprimary periacetabular tumors.

Background: Large bone loss and frequently irradiated existing bone make reconstructing metastatic and other nonprimary periacetabular tumors challenging. Although existing methods are initially successful, they may fail with time. Given the low failure rates of porous tantalum acetabular implants in other conditions with large bone loss or irradiated bone, we developed a technique to use these implants in these neoplastic cases where others might fail.

Effect of local alignment on compartmental patterns of knee osteoarthritis.

Background: Previous studies have shown that lower-extremity malalignment increases the risk and rate of progression of knee osteoarthritis. The authors of such studies have used full-length lower-extremity radiographs to quantify alignment. However, a radiograph that includes only the knee is commonly ordered for a patient with early symptoms of knee osteoarthritis.

Midfoot arthritis.

Foot and ankle complaints are commonly encountered in orthopedic practice. Midfoot arthritis has the potential to cause a significant amount of pain and disability. A variety of conditions can cause or lead to midfoot arthritis.