Research Article
Year 2023,
Volume: 14 Issue: 1, 40 - 47, 01.01.2023
Abstract
References
- 1. Funovics PT, Panotopoulos J, Sabeti-Aschraf M, et al. Low-grade chondrosarcoma of bone: experiences from the Vienna Bone and Soft Tissue Tumour Registry. Int Orthop. 2011;35(7):1049-56.
- 2. Shemesh SS, Acevedo-Nieves JD, Pretell-Mazzini J. Treatment strategies for central low-grade chondrosarcoma of long bones: a systematic review of the literature and meta-analysis. Musculoskelet Surg. 2018;102(2):95-109.
- 3. Lee FY, Mankin HJ, Fondren G, et al. Chondrosarcoma of bone: an assessment of outcome. J Bone Joint Surg Am. 1999;81(3):326-38.
- 4. Campanacci DA, Scoccianti G, Franchi A, et al. Surgical treatment of central grade 1 chondrosarcoma of the appendicular skeleton. J Orthop Traumatol. 2013;14(2):101-7.
- 5. Shemesh SS, Pretell-Mazzini J, Quartin PAJ, et al. Surgical treatment of low-grade chondrosarcoma involving the appendicular skeleton: long-term functional and oncological outcomes. Arch Orthop Trauma Surg. 2019;139(12):1659-66.
- 6. Dierselhuis EF, Goulding KA, Stevens M, et al. Intralesional treatment versus wide resection for central low-grade chondrosarcoma of the long bones. Cochrane Database Syst Rev. 2019;3:CD010778.
- 7. Aarons C, Potter BK, Adams SC, et al. Extended intralesional treatment versus resection of low-grade chondrosarcomas. Clin Orthop Relat Res. 2009;467(8):2105-11.
- 8. Ahlmann ER, Menendez LR, Fedenko AN, et al. Influence of cryosurgery on treatment outcome of low-grade chondrosarcoma. Clin Orthop Relat Res. 2006;451:201-7.
- 9. Hanna SA, Whittingham-Jones P, Sewell MD, et al. Outcome of intralesional curettage for low-grade chondrosarcoma of long bones. Eur J Surg Oncol. 2009;35(12):1343-7.
- 10. Omlor GW, Lohnherr V, Hetto P, et al. Surgical therapy of benign and low-grade malignant intramedullary chondroid lesions of the distal femur: intralesional resection and bone cement filling with or without osteosynthesis. Strategies Trauma Limb Reconstr. 2018;13(3):163-70.
- 11. Omlor GW, Lohnherr V, Lange J, et al. Enchondromas and atypical cartilaginous tumors at the proximal humerus treated with intralesional resection and bone cement filling with or without osteosynthesis: retrospective analysis of 42 cases with 6 years mean follow-up. World J Surg Oncol. 2018;16(1):139.
- 12. Elder BD, Lo SF, Holmes C, et al. The biomechanics of pedicle screw augmentation with cement. Spine J. 2015;15(6):1432-45.
- 13. Flahiff CM, Gober GA, Nicholas RW. Pullout strength of fixation screws from polymethylmethacrylate bone cement. Biomaterials. 1995;16(7):533-6.
- 14. Linhardt O, Luring C, Matussek J, et al. Stability of pedicle screws after kyphoplasty augmentation: an experimental study to compare transpedicular screw fixation in soft and cured kyphoplasty cement. J Spinal Disord Tech. 2006;19(2):87-91.
- 15. Harris CA, White LM. Metal artifact reduction in musculoskeletal magnetic resonance imaging. Orthop Clin North Am. 2006;37(3):349-59, vi.
- 16. Eustace S, Goldberg R, Williamson D, et al. MR imaging of soft tissues adjacent to orthopaedic hardware: techniques to minimize susceptibility artefact. Clin Radiol. 1997;52(8):589-94.
- 17. Enneking WF. A system of staging musculoskeletal neoplasms. Clin Orthop Relat Res. 1986(204):9-24.
- 18. Enneking WF, Dunham W, Gebhardt MC, et al. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res. 1993(286):241-6.
- 19. Bauer HC, Brosjo O, Kreicbergs A, et al. Low risk of recurrence of enchondroma and low-grade chondrosarcoma in extremities. 80 patients followed for 2-25 years. Acta Orthop Scand. 1995;66(3):283-8.
- 20. Streitburger A, Ahrens H, Balke M, et al. Grade I chondrosarcoma of bone: the Munster experience. J Cancer Res Clin Oncol. 2009;135(4):543-50.
- 21. Wahnert D, Hofmann-Fliri L, Schwieger K, et al. Cement augmentation of lag screws: an investigation on biomechanical advantages. Arch Orthop Trauma Surg. 2013;133(3):373-9.
- 22. Meyer DC, Jacob HA, Pistoia W, et al. The use of acrylic bone cement for suture anchoring. Clin Orthop Relat Res. 2003(410):295-302.
- 23. Larsson S, Stadelmann VA, Arnoldi J, et al. Injectable calcium phosphate cement for augmentation around cancellous bone screws. In vivo biomechanical studies. J Biomech. 2012;45(7):1156-60.
- 24. Namdari S, Rabinovich R, Scolaro J, et al. Absorbable and non-absorbable cement augmentation in fixation of intertrochanteric femur fractures: systematic review of the literature. Arch Orthop Trauma Surg. 2013;133(4):487-94.
- 25. Jang JS, Lee SH, Rhee CH, et al. Polymethylmethacrylate-augmented screw fixation for stabilization in metastatic spinal tumors. Technical note. J Neurosurg. 2002;96(1 Suppl):131-4.
- 26. Toy PC, France J, Randall RL, et al. Reconstruction of noncontained distal femoral defects with polymethylmethacrylate and crossed-screw augmentation: a biomechanical study. J Bone Joint Surg Am. 2006;88(1):171-8.
Cortical Window Reconstruction With Cement Augmented Screw Fixation After Intralesional Curettage Of Low-Grade Chondrosarcomas: A Simple Method With Clinical Results
Abstract
Purpose:
Intralesional curettage with a local adjuvant is a reliable surgical method in the treatment of low-grade chondrosarcomas (LGC). In order to maintain stability, some authors recommend osteosynthesis following intralesional treatment. However, larger osteosynthesis materials may increase complications as well as disturbing postoperative MRI evaluation. In this study, we describe a simple method of cortical window reconstruction with cement-augmented screw fixation.
Methods:
22 patients with LGC were enrolled in this retrospective study who underwent surgical intervention between 2011-2021. All patients were treated in the same manner by intralesional curettage, cement augmentation and fixation with titanium screws embedded in the cement. The clinical outcome was assessed, using the MSTS Score.
Results:
The mean age at diagnosis was 44,5 and the mean follow up duration was 56,2 months. The mean long dimension of the cortical window was 4,8 cm for reconstructions with one screw and 6,2 cm for reconstructions with two screws. All of the patients showed excellent clinical outcomes with a mean MSTS score percentage of 91,3. We did not encounter any major complications postoperatively. On MRI evaluations, the image distortion due to thin titanium screw was minimal and cement bone interface was clearly visible without any disturbance.
Conclusion:
The convenient use of cement-augmented screw fixation may be a good tool for the reconstruction of cortical window in the treatment of intramedullary tumours of long bones and give a potential chance of obtaining better MRI images without any disturbances postoperatively.
Keywords
low grade chondrosarcomas cement augmented screw fixation intralesional curettage and cementation
References
- 1. Funovics PT, Panotopoulos J, Sabeti-Aschraf M, et al. Low-grade chondrosarcoma of bone: experiences from the Vienna Bone and Soft Tissue Tumour Registry. Int Orthop. 2011;35(7):1049-56.
- 2. Shemesh SS, Acevedo-Nieves JD, Pretell-Mazzini J. Treatment strategies for central low-grade chondrosarcoma of long bones: a systematic review of the literature and meta-analysis. Musculoskelet Surg. 2018;102(2):95-109.
- 3. Lee FY, Mankin HJ, Fondren G, et al. Chondrosarcoma of bone: an assessment of outcome. J Bone Joint Surg Am. 1999;81(3):326-38.
- 4. Campanacci DA, Scoccianti G, Franchi A, et al. Surgical treatment of central grade 1 chondrosarcoma of the appendicular skeleton. J Orthop Traumatol. 2013;14(2):101-7.
- 5. Shemesh SS, Pretell-Mazzini J, Quartin PAJ, et al. Surgical treatment of low-grade chondrosarcoma involving the appendicular skeleton: long-term functional and oncological outcomes. Arch Orthop Trauma Surg. 2019;139(12):1659-66.
- 6. Dierselhuis EF, Goulding KA, Stevens M, et al. Intralesional treatment versus wide resection for central low-grade chondrosarcoma of the long bones. Cochrane Database Syst Rev. 2019;3:CD010778.
- 7. Aarons C, Potter BK, Adams SC, et al. Extended intralesional treatment versus resection of low-grade chondrosarcomas. Clin Orthop Relat Res. 2009;467(8):2105-11.
- 8. Ahlmann ER, Menendez LR, Fedenko AN, et al. Influence of cryosurgery on treatment outcome of low-grade chondrosarcoma. Clin Orthop Relat Res. 2006;451:201-7.
- 9. Hanna SA, Whittingham-Jones P, Sewell MD, et al. Outcome of intralesional curettage for low-grade chondrosarcoma of long bones. Eur J Surg Oncol. 2009;35(12):1343-7.
- 10. Omlor GW, Lohnherr V, Hetto P, et al. Surgical therapy of benign and low-grade malignant intramedullary chondroid lesions of the distal femur: intralesional resection and bone cement filling with or without osteosynthesis. Strategies Trauma Limb Reconstr. 2018;13(3):163-70.
- 11. Omlor GW, Lohnherr V, Lange J, et al. Enchondromas and atypical cartilaginous tumors at the proximal humerus treated with intralesional resection and bone cement filling with or without osteosynthesis: retrospective analysis of 42 cases with 6 years mean follow-up. World J Surg Oncol. 2018;16(1):139.
- 12. Elder BD, Lo SF, Holmes C, et al. The biomechanics of pedicle screw augmentation with cement. Spine J. 2015;15(6):1432-45.
- 13. Flahiff CM, Gober GA, Nicholas RW. Pullout strength of fixation screws from polymethylmethacrylate bone cement. Biomaterials. 1995;16(7):533-6.
- 14. Linhardt O, Luring C, Matussek J, et al. Stability of pedicle screws after kyphoplasty augmentation: an experimental study to compare transpedicular screw fixation in soft and cured kyphoplasty cement. J Spinal Disord Tech. 2006;19(2):87-91.
- 15. Harris CA, White LM. Metal artifact reduction in musculoskeletal magnetic resonance imaging. Orthop Clin North Am. 2006;37(3):349-59, vi.
- 16. Eustace S, Goldberg R, Williamson D, et al. MR imaging of soft tissues adjacent to orthopaedic hardware: techniques to minimize susceptibility artefact. Clin Radiol. 1997;52(8):589-94.
- 17. Enneking WF. A system of staging musculoskeletal neoplasms. Clin Orthop Relat Res. 1986(204):9-24.
- 18. Enneking WF, Dunham W, Gebhardt MC, et al. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res. 1993(286):241-6.
- 19. Bauer HC, Brosjo O, Kreicbergs A, et al. Low risk of recurrence of enchondroma and low-grade chondrosarcoma in extremities. 80 patients followed for 2-25 years. Acta Orthop Scand. 1995;66(3):283-8.
- 20. Streitburger A, Ahrens H, Balke M, et al. Grade I chondrosarcoma of bone: the Munster experience. J Cancer Res Clin Oncol. 2009;135(4):543-50.
- 21. Wahnert D, Hofmann-Fliri L, Schwieger K, et al. Cement augmentation of lag screws: an investigation on biomechanical advantages. Arch Orthop Trauma Surg. 2013;133(3):373-9.
- 22. Meyer DC, Jacob HA, Pistoia W, et al. The use of acrylic bone cement for suture anchoring. Clin Orthop Relat Res. 2003(410):295-302.
- 23. Larsson S, Stadelmann VA, Arnoldi J, et al. Injectable calcium phosphate cement for augmentation around cancellous bone screws. In vivo biomechanical studies. J Biomech. 2012;45(7):1156-60.
- 24. Namdari S, Rabinovich R, Scolaro J, et al. Absorbable and non-absorbable cement augmentation in fixation of intertrochanteric femur fractures: systematic review of the literature. Arch Orthop Trauma Surg. 2013;133(4):487-94.
- 25. Jang JS, Lee SH, Rhee CH, et al. Polymethylmethacrylate-augmented screw fixation for stabilization in metastatic spinal tumors. Technical note. J Neurosurg. 2002;96(1 Suppl):131-4.
- 26. Toy PC, France J, Randall RL, et al. Reconstruction of noncontained distal femoral defects with polymethylmethacrylate and crossed-screw augmentation: a biomechanical study. J Bone Joint Surg Am. 2006;88(1):171-8.
There are 26 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Orthopaedics |
| Journal Section | Research Article |
| Authors | |
| Early Pub Date | November 15, 2022 |
| Publication Date | January 1, 2023 |
| Submission Date | October 23, 2022 |
| Published in Issue | Year 2023Volume: 14 Issue: 1 |
