Endoprosthetic replacement of the proximal tibia for oncological conditions.

Aims: The proximal tibia (PT) is the anatomical site most frequently affected by primary bone tumours after the distal femur. Reconstruction of the PT remains challenging because of the poor soft-tissue cover and the need to reconstruct the extensor mechanism. Reconstructive techniques include implantation of massive endoprosthesis (megaprosthesis), osteoarticular allografts (OAs), or allograft-prosthesis composites (APCs).

Extra-abdominal desmoid tumor fibromatosis: a multicenter EMSOS study.

Background: Extra-abdominal desmoid tumor fibromatosis (DTF) is a rare, locally aggressive soft tissue tumour. The best treatment modality for this patient cohort is still object of debate.

Questions/purpose: This paper aimed to (1) to compare the outcomes of DTF after different treatment modalities, (2) to assess prognostic factors for recurrence following surgical excision, and (3) to assess prognostic factors for progression during observation.

Multimodal Treatment in Pelvic Ewing Sarcoma: A Prognostic Factor Analysis.

Background: Although multidisciplinary therapies have improved local control and overall survival in Ewing sarcoma (ES), the prognosis of pelvic lesions remains markedly worse than that of limb ES.

Methods: We retrospectively evaluated the influence of the type of local treatment, margins, necrosis and sacrum involvement on overall survival (OS) and disease-free survival (DFS) in a series of 21 non-metastatic pelvic ES.

Results: The average follow-up was 46.

Liposarcoma: Clinico-pathological analysis, prognostic factors and survival in a series of 307 patients treated at a single institution.

Background And Objectives: Liposarcoma (LPS) is a malignant mesenchymal tumor and the most common soft tissue sarcoma. Four different subtypes are described: well differentiated (WD) LPS or atypical lipomatous tumor (ALT), dedifferentiated (DD) LPS, myxoid LPS, and pleomorphic LPS (PLS). The objective of the study was to investigate prognostic factors and clinical outcome of liposarcoma.

Allograft Reconstruction of the Extensor Mechanism after Resection of Soft Tissue Sarcoma.

Introduction: Soft tissue tumors around the knee joint still pose problems for the excision and subsequent reconstruction.

Methods: In the 6 included patients the soft tissue sarcoma has its base on the anterior surface of the extensor mechanism and expands towards the skin. The entire extensor apparatus (quadriceps tendon, patella, and patellar tendon) was resected and replaced by a fresh-frozen allograft.

Modular Endoprostheses for Nonneoplastic Conditions: Midterm Complications and Survival.

The use of modular endoprostheses is a viable option to manage both tumor resection and severe bone loss due to nonneoplastic conditions such as fracture sequelae, failed osteoarticular grafts, arthroplasty revisions, and periprosthetic fractures. We sought to investigate both midterm complications and failures occurred in 87 patients who underwent a megaprosthetic reconstruction in a nonneoplastic setting. After a mean follow-up of 58 (1-167) months, overall failure-free survival was 91.

Modular megaprosthesis reconstruction for oncological and non-oncological resection of the elbow joint.

Background: Reconstruction of large bone defects around the elbow joint is surgically demanding due to sparse soft tissue coverage, complex biomechanics and the close proximity to neurovascular structures. Modular megaprostheses are established reconstruction tools for the elbow, but only small case series have been reported in the literature.

Methods: Thirty-six patients who underwent reconstruction of the elbow joint with a modular megaprosthesis were reviewed retrospectively.

Allograft-prosthetic composite versus megaprosthesis in the proximal tibia-What works best?

Modular megaprosthesis (MP) and allograft-prosthetic composite (APC) are the most commonly used reconstructions for large bone defects of the proximal tibia. The primary objective of this study was to compare the two different techniques in terms of failures and functional results. A total of 42 consecutive patients with a mean age of 39.

Pre-operative diclofenac HPβCD for pain control of needle biopsy in musculoskeletal neoplasm: preliminary results.

Needle biopsy is the main standard method used for diagnosis of musculoskeletal tumors of the limbs and superficial trunk. Pain control during this procedure is through the use of Local Anaestetic (L.A.

Comparison between single-and double-bundle anterior cruciate ligament reconstruction: a prospective, randomized, single-blinded clinical trial.

Background: Double-bundle ACL reconstruction popularity is increasing with the aim to reproduce native ACL anatomy and improve ACL reconstruction outcome. However, to date, only a few randomized clinical studies have been published.

Purpose: The aim of this study was to prospectively compare the clinical results of single- and double-bundle ACL reconstruction.

Rotational position of femoral and tibial components in TKA using the femoral transepicondylar axis.

Proper femoral and tibial component rotational positioning in TKA is critical for outcomes. Several rotational landmarks are frequently used with different advantages and limitations. We wondered whether coronal axes in the tibia and femur based on the transepicondylar axis in the femur would correlate with anteroposterior deformity.

The effects of different tensioning strategies on knee laxity and graft tension after double-bundle anterior cruciate ligament reconstruction.

Background: Double-bundle anterior cruciate ligament reconstruction replicates the 2 functional bundles of the native ligament, the posterolateral and the anteromedial, to control anteroposterior and rotational laxity.

Hypothesis: Double-bundle anterior cruciate ligament reconstruction laxity should be affected by the way grafts are tensioned.

Study Design: Controlled laboratory study.

Total knee arthroplasty using a pie-crusting technique for valgus deformity.

Unlabelled: Valgus deformity correction with total knee arthroplasty is challenging. We hypothesized selective release of the tight lateral structures (pie-crusting technique), and of the lateral retinaculum in case of patellar maltracking, would obtain and maintain correction of the frontal plane deformity, restore patellar tracking and function, and avoid the complications of the extensive releases, including lateral condyle avascularity and residual lateral instability. We followed 48 patients with 53 valgus knees who underwent TKA and were followed a minimum of 5 years (mean, 8 years; range, 5-12 years).

Double-bundle "anatomic" anterior cruciate ligament reconstruction: a cadaveric study of tunnel positioning with a transtibial technique.

Purpose: The aim of this study was to examine whether a double-bundle anterior cruciate ligament (ACL) reconstruction with a transtibial approach could position the tibial and femoral tunnels accurately in the native bundle attachments.

Methods: In 21 fresh-frozen knees the tibial and femoral attachments of the anteromedial (AM) and posterolateral (PL) bundles were outlined. The AM tibial tunnel guidewire was drilled with the 65 degree Howell tibial guide (Arthrotek, Warsaw, IN) located against the femur in the extended knee.

Single-and double-incision double-bundle ACL reconstruction.

Double-bundle anterior cruciate ligament (ACL) reconstruction is intended to replicate the anatomy and the function of the anteromedial and posterolateral bundles of the native ACL to improve patients' satisfaction and knee stability. We prospectively assigned 75 consecutive patients with an isolated ACL lesion to one of three sequential groups of 25 patients each. Group I received a single-bundle, single-incision transtibial ACL reconstruction.

Validation of the 65 degrees Howell guide for anterior cruciate ligament reconstruction.

Purpose: To study in cadaver knees the position of the tibial tunnel in anterior cruciate ligament (ACL) reconstruction using the 65 degrees Howell guide (Arthrotek, Ontario, CA).

Type Of Study: Controlled laboratory study in vitro.

Methods: Twenty-one fresh-frozen cadaver knees were used.

Femoral attachment of the anterior cruciate ligament.

Endoscopic anterior cruciate ligament (ACL) reconstruction is one of the most popular orthopaedic procedures. Correct tunnel positioning is a prerequisite to success. Current surgical techniques are unable to duplicate the complex anatomy and function of the native ACL.

Anterior cruciate ligament reconstruction with double-looped semitendinosus and gracilis tendon graft directly fixed to cortical bone: 5-year results.

Forty-three patients who had undergone an anterior cruciate ligament (ACL) reconstruction using a doubled semitendinosus and gracilis graft were prospectively reviewed at 5-year follow-up. All had suffered subacute or chronic tears of the ligament. At surgery, the femoral tunnel was drilled first through the antero-medial portal.