Imaging of intramedullary tumour spread in osteosarcoma. A comparison of techniques

O'flanagan, S. J.; Stack, John D.; McGee, Heather M.; Dervan, P.; Hurson, B.

doi:10.1302/0301-620x.73b6.1955451

Cited by 79 publications

(32 citation statements)

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“…Magnetic resonance imaging permits a more accurate preoperative determination of tumor extent [41]. In concert with improved surgical techniques, intercalary resection, and limb salvage have become the safe treatment in majority of primary malignancies [8,21].…”

Section: Discussionmentioning

confidence: 99%

Biological reconstruction using massive bone allograft with intramedullary vascularized fibular flap after intercalary resection of humeral malignancy

Wang

Pei

et al. 2011

Journal of Surgical Oncology

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Section: Discussionmentioning

confidence: 99%

Biological reconstruction using massive bone allograft with intramedullary vascularized fibular flap after intercalary resection of humeral malignancy

Wang

Pei

et al. 2011

Journal of Surgical Oncology

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“…MRI is currently the imaging modality of choice for the evaluation and staging of bone tumors [6,15,16]. Alteration of pulse sequences can enable distinction between various soft tissues, and flexibility of imaging planes can produce images in three dimensions [13,17].…”

Section: Discussionmentioning

confidence: 99%

Osteosarcoma near joints: Assessment and implications

et al. 2005

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“…Advances in imaging techniques permit an accurate preoperative determination of the tumor extent in metadiaphyseal locations, thereby allowing intercalary resection and joint preservation in selected cases, which may result in superior function [27]. Intercalary reconstruction of the tibia is performed either by biologic or synthetic means.…”

Section: Introductionmentioning

confidence: 99%

Is There Benefit to Free Over Pedicled Vascularized Grafts in Augmenting Tibial Intercalary Allograft Constructs?

Manfrini

Bindiganavile

Say

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background Intercalary reconstruction of tibial sarcomas with vascularized fibula autografts and massive bone allografts is reliable with predictable long-term results. However, inadequate data exist comparing free and pedicled vascularized fibula autografts in combination with a massive bone allograft in patients undergoing intercalary tibia reconstructions. Questions/Purposes Among patients undergoing largesegment intercalary allografting, we sought to compare supplemental free vascularized fibular autografts with supplemental pedicled vascularized fibular autografts, in terms of (1) oncologic results, (2) complications associated with surgery, (3) Musculoskeletal Tumor Society (MSTS) scores, and (4) surgical time. Methods Between 1994 and 2013, we treated 320 patients, younger than 40 years, with tibial sarcomas. Thirty-five patients (11%) underwent amputations. One hundred ninetyfive patients (61%) were treated with intraarticular resection of the tibia, which constituted 104 tumor endoprostheses, 63 proximal tibia allograft prosthetic composites, 21 osteoarticular allografts, and seven arthrodeses with allografts. Ninety patients (28%) underwent joint-sparing intercalary reconstruction. Forty-one (13%) of these 90 patients were treated with allografts alone, two (1%) with vascularized fibula grafts, and 47 (15%) with intercalary allografts supplemented by autografts (free fibular autografts, 22 patients, 7%; pedicled fibular autografts, 25 patients, 8%). During the study period, we used free vascularized fibular autografts in association with massive bone allograft for a resection longer than 12 cm with a very small periarticular residual segment. The choice for using a pedicled fibula harvested in the ipsilateral leg initially was for patients having only diaphyseal resections and the indication was later extended to intraepiphyseal osteotomies with a small periarticular residual segment. The goals of this study are to present the long-term results in this group of patients and compare their results based on the type of vascularized fibula harvest. There were 33 male and 14 female patients with mean age of 14 ± 6 years. The median followup was 84 months This study was supported by Italian Ministry of Health (Grant Minsal RF-2010-2321501 (range, 7-231 months). No patients were lost to followup before 1 year. Four patients died and were not available for followup after 18 months. The mean tibia resection length was 15 ± 4 cm and mean length of the harvested vascularized fibula was 18 ± 4 cm. Results Overall 5-and 10-year oncologic survival rates in this study were 87% ± 5% and 83% ± 6% respectively. With the numbers available, we observed no difference in survivorship free from death from disease between the study groups (85% ± 8% [95% CI, 174-232 months] of the free vascularized group versus 82% ± 8% [95% CI, 148-206 months] of the pedicled fibula graft group; p = 0.741). At last followup, 40 patients had no evidence of disease and seven had died of disease. Local recurrence was observed in two pa...

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Imaging of intramedullary tumour spread in osteosarcoma. A comparison of techniques

Cited by 79 publications

References 0 publications

Biological reconstruction using massive bone allograft with intramedullary vascularized fibular flap after intercalary resection of humeral malignancy

Biological reconstruction using massive bone allograft with intramedullary vascularized fibular flap after intercalary resection of humeral malignancy

Osteosarcoma near joints: Assessment and implications

Is There Benefit to Free Over Pedicled Vascularized Grafts in Augmenting Tibial Intercalary Allograft Constructs?

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