Comparison of Percutaneous Techniques for Stabilization of Osteolytic Lesions of the Periacetabular Region Due to Metastatic Bone Disease.

Minimally invasive techniques for metastatic disease treatment in the periacetabular region of the pelvis have grown increasingly popular. Open surgical management of osteolytic lesions in the pelvis are associated with high perioperative complication rates that approach 30-36% and often require suspension of systemic treatment. Conservative measures, such as radiation treatment, can improve functional status in select patients while avoiding the morbidity of open surgical intervention; however, conservative measures do not address the problem of mechanical instability that can lead to pathologic fracture or loss of independence.

The influence of nerve surgical techniques at time of amputation on the prevalence of heterotopic ossification in transtibial amputees.

Background: Heterotopic ossification (HO) can form after amputation and may cause pain and functional impairment. We aimed to describe the prevalence of HO in a civilian population of transtibial amputees. We hypothesized that the decreased rate of symptomatic neuroma following active nerve surgery (Targeted Muscle Reinnervation (TMR) or Regenerative Peripheral Nerve Interface (RPNI)) may subsequently lead to a lower prevalence of HO compared to passive nerve surgery (i.

Pilot study on the in-vitro effect of radiation therapy on bending stiffness of intramedullary photodynamic implants.

Photodynamic implants are an increasingly popular minimally invasive option for the surgical treatment of metastatic bone disease. Following surgery, adjuvant radiation therapy (RT) is frequently administered to achieve better disease control and improve patient quality of life, but the role of RT in implant failures associated with photodynamic implants remains unclear. The aim of this study is to determine if the therapeutic RT range of 10-50 Gy affects the biomechanical properties of photodynamic implants.

What is the incidence and non-union rate of radiation-associated fractures? - A systematic review of the literature.

Background: Radiation-associated fractures (RAFs) are a challenging complication in oncologic patients, yet their incidence remains unknown and optimal management lacks consensus.

Aim: This review aimed to evaluate the incidence of RAFs in the trunk, pelvis, and extremities as well as non-union rates of surgical and non-surgical treatment.

Materials And Methods: A systematic review of PubMed and Embase databases was conducted.

Postoperative Complications of Intramedullary Nailing for Impending and Pathologic Fractures of the Humerus Due to Bone Metastases-A Systematic Review of the Literature.

Intramedullary nailing (IMN) is a common option for managing impending or pathologic fractures of the humerus secondary to metastatic disease. We sought to assess the (1) early complications, (2) failure rates and mechanisms, and (3) functional outcomes. A systematic review using the PubMed, Embase, and Cochrane databases was performed.

Tumor necrosis drives prognosis in osteosarcoma: No difference in chemotherapy response and survival between chondroblastic and osteoblastic osteosarcoma.

Introduction: The percentage of tumor necrosis is a crucial prognostic factor in osteosarcoma. Many studies adopt a 90 % cutoff based on osteoblastic osteosarcoma, but these findings are generalized to all conventional subtypes, including chondroblastic osteosarcoma. We sought to answer these questions: (1) Is tumor necrosis ≥90 % associated with better overall survival (OS) and disease-free survival (DFS) in osteoblastic and chondroblastic osteosarcoma? (2) Does the osteosarcoma subtype impact tumor necrosis? (3) Does the osteosarcoma subtype in "good" responders (tumor necrosis ≥90 %) affect OS and DFS?.

A Prospective Study of the IlluminOss Photodynamic Nail System for Pelvic Stabilization: Treatment of Impending and Actual Fractures from Metastatic Bone Disease, Multiple Myeloma, and Primary Bone Lymphoma.

Background: The stabilization of metastatic lesions in the periacetabular region can be successfully performed using percutaneous techniques. Photodynamic nails (PDNs) are among the available tools for stabilization. Data on postoperative complications and functional outcomes are, however, scarce.

Clinical, imaging and pathological features of extraskeletal myxoid chondrosarcoma.

Objective: To evaluate clinical and radiological features of extraskeletal myxoid chondrosarcomas (EMC).

Material And Methods: Our pathology database was queried for cases of EMCs. Tumor location, size, imaging appearance, presence of metastases, disease recurrence, and clinical outcome were documented.

Microbiology, Treatment, and Postoperative Outcomes of Gram-Negative Prosthetic Joint Infections-A Systematic Review of the Literature.

Introduction: Gram-negative prosthetic joint infections (PJIs) represent 10% to 25% of all PJIs and are associated with worse outcomes than gram-positive infections. We sought to assess the microbiology, surgical treatment, and outcomes of patients with gram-negative PJIs.

Methods: A systematic review using the PubMed and Embase databases was conducted.

The Impact of Social Determinants of Health on the Prognosis of Primary Bone Tumors: A Systematic Review.

Background: Although the prevalence of primary bone tumors (PBTs) was reported to be relatively low, they represent a difficult category of tumors for appropriate prediction, prevention, diagnosis, and treatment. Among different factors contributing to the prognosis and treatment outcomes of patients with these tumors, it is assumed that social determinants of health (SDOH) have not been well investigated nor applied in the process of decision making for these patients.

Methods: In this systematic review, databases including PubMed, Web of Science, Scopus, Embase, Science Direct, and CINAHL were used.

Pediatric Axial Ewing Sarcoma: A Retrospective Population-Based Survival Analysis.

Introduction: Ewing sarcomas of the axial skeleton represent a notable challenge for clinicians because of their aggressive presentation and tendency to obstruct neurovascular structures; however, little data exist regarding axial tumors in children. This study is the first population-based analysis assessing treatment regimens for axial Ewing sarcomas and their effects on cancer-specific survival and overall survival (OS).

Methods: Data from 2004 to 2019 were collected for all patients aged 1 to 24 years from the Surveillance, Epidemiology, and End Results (SEER) database.

Machine Learning-Assisted Decision Making in Orthopaedic Oncology.

» Artificial intelligence is an umbrella term for computational calculations that are designed to mimic human intelligence and problem-solving capabilities, although in the future, this may become an incomplete definition. Machine learning (ML) encompasses the development of algorithms or predictive models that generate outputs without explicit instructions, assisting in clinical predictions based on large data sets. Deep learning is a subset of ML that utilizes layers of networks that use various inter-relational connections to define and generalize data.

Assessing Pain and Functional Outcomes of Percutaneous Stabilization of Metastatic Pelvic Lesions via Photodynamic Nails: A Bi-Institutional Investigation of Orthopaedic Outcomes.

Background: Minimally invasive surgical interventions for metastatic invasion of the pelvis have become more prevalent and varied. Our group hypothesized that the use of percutaneous photodynamic nails (PDNs) would result in decreased pain, improved functional outcomes and level of ambulation, and decreased use of opioid pain medication.

Methods: We performed a retrospective chart review of patients with metastatic pelvic bone disease undergoing stabilization with PDNs (IlluminOss Medical) at 2 institutions.

A dynamic microRNA profile that tracks a chemotherapy resistance phenotype in osteosarcoma. Implications for novel therapeutics.

Osteosarcoma is a rare primary bone tumor for which no significant therapeutic advancement has been made since the late 1980s despite ongoing efforts. Overall, the five-year survival rate remains about 65%, and is much lower in patients with tumors unresponsive to methotrexate, doxorubicin, and cisplatin therapy. Genetic studies have not revealed actionable drug targets, but our group, and others, have reported that epigenomic biomarkers, including regulatory RNAs, may be useful prognostic tools for osteosarcoma.

Patient-Reported Outcomes After Intramedullary Nailing of Oncologic Impending or Pathologic Fractures With Carbon Fiber or Titanium Implant.

Introduction: Despite the benefits of intramedullary nailing (IMN) of impending or pathologic fractures in oncologic patients, literature on patient-reported outcomes (PROs) is scarce in patients treated with carbon fiber (CF) nails. Our study compared postoperative PROs after IMN with CF or titanium implants.

Methods: We conducted a retrospective propensity score-matched cohort study of patients treated at our institution with CF or titanium nails for impending or pathologic fractures from metastatic bone disease.

Factors associated with skeletal-related events in patients with bone metastatic melanoma: A retrospective study of 481 patients.

Objectives: Metastatic bone disease is estimated to develop in up to 17% of patients with melanoma, compromising skeleton integrity resulting in skeletal-related events (SREs), which impair quality of life and reduce survival. The objective of the study was to investigate (1) the proportion of melanoma patients developing SREs following diagnosis of bone metastasis and (2) the predictors for SREs in this patient cohort.

Methods: Four hundred and eighty-one patients with bone metastatic melanoma from two tertiary centers in the United States from 2008 to 2018 were included.

Wound vacuum-assisted closure temporization after tumor resection of soft tissue sarcomas-A cost analysis in a propensity-score matched population.

Background: Vacuum-assisted closure (VAC) temporization is a technique associated with high local control rates used in myxofibrosarcoma. We sought to compare the costs and postoperative outcomes of VAC temporization and single-stage (SS) excision/reconstruction.

Methods: We conducted a retrospective analysis of patients with myxofibrosarcoma surgically treated at our institution between 2000 and 2022.

Cemented and Press-fit Femoral Stems for the Management of Oncologic Femoral Tumors.

Background: Stem fixation in reconstruction after resection of femoral tumors is debated. Cemented stems offer immediate stability but risk aseptic loosening, while press-fit stems allow bone ingrowth but risk stress shielding and subsidence. Our retrospective review aimed to determine implant failure rates and their associated factors, as well as the rates of infection, debridement, and mortality for both fixation groups (cemented or press-fit stems) used in patients undergoing resection of femoral tumor disease and subsequent arthroplasty.

Postoperative Outcomes of Total Humerus Replacement for Oncologic Reconstruction of the Upper Limb: A Systematic Review of the Literature.

Background: Total humerus replacement (THR) is a reconstruction procedure performed after resection of massive humeral tumors. However, there is limited literature on the rates of failure and functional outcomes of this implant. Our study aimed to determine the main failure modes, implant survival, and postoperative functional outcomes of THR.

Incidence and survival outcomes of patients with high-grade appendicular bone sarcoma and isolated regional lymph node metastasis: A national cohort database study.

Background: While distant metastases in primary bone sarcomas have been extensively studied, the impact of isolated regional lymph node (LN) metastasis on survival remains unknown. In patients with primary bone sarcomas, we sought to assess the prevalence of isolated regional LN metastasis and the survival of this population.

Methods: A total of 6651 patients with histologically-confirmed high-grade osteosarcoma, Ewing sarcoma, or chondrosarcoma were retrieved from the SEER database.

Myositis ossificans mimicking bone surface osteosarcoma: case report with literature review.

Myositis ossificans, a benign tumor composed of spindle cells and osteoblasts, can clinically and radiologically mimic osteosarcoma. While recognition and accurate diagnosis of myositis ossificans can be a challenge, this is critical as it may allow a conservative surgical approach to maximize functional outcomes. Herein, we present a patient with surface myositis ossificans confirmed genetically by the presence of COL1A1::USP6 gene fusion, along with a literature review.

Wound-Healing Effects of Common Antineoplastic Agents and Perioperative Considerations for the Orthopaedic Surgeon.

In oncologic patients, optimal postoperative wound healing is crucial for the maintenance of systemic therapies and improved survival. Although several risk factors for postoperative wound complications have been identified, the clinical effect of new antineoplastic agents on wound healing remains uncertain. The available literature on the effect of antineoplastic agents in wound healing is complex to analyze because of other confounding risk factors such as radiation therapy and certain patient-specific variables.