Computer navigation-aided joint-preserving resection and custom-made endoprosthesis reconstruction for bone sarcomas: long-term outcomes

Abstract. Background:. Computed tomography (CT) and magnetic resonance imaging (MRI) data can be fused to identify the tumor boundaries. This enables surgeons to set close but tumor-free surgical margins and excise the tumor more precisely. This study aimed to report our experience in performing com...

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Autores principales:	Li-Hui Xu, Qing Zhang, Hai-Tao Zhao, Feng Yu, Xiao-Hui Niu, Yan-Jie Yin, Xiu-Yuan Hao
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/26dbf6814bb0442fa266a9a214076b8f
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spelling	oai:doaj.org-article:26dbf6814bb0442fa266a9a214076b8f2021-11-25T07:57:20ZComputer navigation-aided joint-preserving resection and custom-made endoprosthesis reconstruction for bone sarcomas: long-term outcomes0366-69992542-564110.1097/CM9.0000000000001750https://doaj.org/article/26dbf6814bb0442fa266a9a214076b8f2021-11-01T00:00:00Zhttp://journals.lww.com/10.1097/CM9.0000000000001750https://doaj.org/toc/0366-6999https://doaj.org/toc/2542-5641Abstract. Background:. Computed tomography (CT) and magnetic resonance imaging (MRI) data can be fused to identify the tumor boundaries. This enables surgeons to set close but tumor-free surgical margins and excise the tumor more precisely. This study aimed to report our experience in performing computer navigation-aided joint-preserving resection and custom-made endoprosthesis reconstruction to treat bone sarcoma in the diaphysis and metaphysis of the femur and tibia. Methods:. Between September 2008 and December 2015, 24 patients with bone sarcomas underwent surgical resection and joint-sparing reconstruction under image-guided computer navigation. The cohort comprised 16 males and eight females with a median age of 19.5 years (range: 12–48 years). The tumor location was the femoral diaphysis in three patients, distal femur in 19, and proximal tibia in two. The tumors were osteosarcoma (n = 15), chondrosarcoma (n = 3), Ewing sarcoma (n = 3), and other sarcomas (n = 3). We created a pre-operative plan for each patient using navigation system software and performed navigation-aided resection before reconstructing the defect with a custom-made prosthesis with extracortical plate fixation. Results:. Pathological examination verified that all resected specimens had appropriate surgical margins. The median distance from the tumor resection margin to the joint was 30 mm (range: 13–80 mm). The median follow-up duration was 62.5 months (range: 24–134 months). Of the 24 patients, 21 remain disease free, one is alive with disease, and two died of the disease. One patient developed local recurrence. Complications requiring additional surgical procedures occurred in six patients, including one with wound hematoma, one with delayed wound healing, one with superficial infection, one with deep infection, and two with mechanical failure of the prosthesis. The mean Musculoskeletal Tumor Society score at the final follow-up was 91% (range: 80%–100%). The 5- and 10-year implant survival rates were 91.3% and 79.9%, respectively. Conclusions:. Computer navigation-aided joint-preserving resection and custom-made endoprosthesis reconstruction with extracortical plate fixation is a reliable surgical treatment option for bone sarcoma in the diaphysis and metaphysis of the femur and tibia.Li-Hui XuQing ZhangHai-Tao ZhaoFeng YuXiao-Hui NiuYan-Jie YinXiu-Yuan HaoWolters KluwerarticleMedicineRENChinese Medical Journal, Vol 134, Iss 21, Pp 2597-2602 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Li-Hui Xu Qing Zhang Hai-Tao Zhao Feng Yu Xiao-Hui Niu Yan-Jie Yin Xiu-Yuan Hao Computer navigation-aided joint-preserving resection and custom-made endoprosthesis reconstruction for bone sarcomas: long-term outcomes
description	Abstract. Background:. Computed tomography (CT) and magnetic resonance imaging (MRI) data can be fused to identify the tumor boundaries. This enables surgeons to set close but tumor-free surgical margins and excise the tumor more precisely. This study aimed to report our experience in performing computer navigation-aided joint-preserving resection and custom-made endoprosthesis reconstruction to treat bone sarcoma in the diaphysis and metaphysis of the femur and tibia. Methods:. Between September 2008 and December 2015, 24 patients with bone sarcomas underwent surgical resection and joint-sparing reconstruction under image-guided computer navigation. The cohort comprised 16 males and eight females with a median age of 19.5 years (range: 12–48 years). The tumor location was the femoral diaphysis in three patients, distal femur in 19, and proximal tibia in two. The tumors were osteosarcoma (n = 15), chondrosarcoma (n = 3), Ewing sarcoma (n = 3), and other sarcomas (n = 3). We created a pre-operative plan for each patient using navigation system software and performed navigation-aided resection before reconstructing the defect with a custom-made prosthesis with extracortical plate fixation. Results:. Pathological examination verified that all resected specimens had appropriate surgical margins. The median distance from the tumor resection margin to the joint was 30 mm (range: 13–80 mm). The median follow-up duration was 62.5 months (range: 24–134 months). Of the 24 patients, 21 remain disease free, one is alive with disease, and two died of the disease. One patient developed local recurrence. Complications requiring additional surgical procedures occurred in six patients, including one with wound hematoma, one with delayed wound healing, one with superficial infection, one with deep infection, and two with mechanical failure of the prosthesis. The mean Musculoskeletal Tumor Society score at the final follow-up was 91% (range: 80%–100%). The 5- and 10-year implant survival rates were 91.3% and 79.9%, respectively. Conclusions:. Computer navigation-aided joint-preserving resection and custom-made endoprosthesis reconstruction with extracortical plate fixation is a reliable surgical treatment option for bone sarcoma in the diaphysis and metaphysis of the femur and tibia.
format	article
author	Li-Hui Xu Qing Zhang Hai-Tao Zhao Feng Yu Xiao-Hui Niu Yan-Jie Yin Xiu-Yuan Hao
author_facet	Li-Hui Xu Qing Zhang Hai-Tao Zhao Feng Yu Xiao-Hui Niu Yan-Jie Yin Xiu-Yuan Hao
author_sort	Li-Hui Xu
title	Computer navigation-aided joint-preserving resection and custom-made endoprosthesis reconstruction for bone sarcomas: long-term outcomes
title_short	Computer navigation-aided joint-preserving resection and custom-made endoprosthesis reconstruction for bone sarcomas: long-term outcomes
title_full	Computer navigation-aided joint-preserving resection and custom-made endoprosthesis reconstruction for bone sarcomas: long-term outcomes
title_fullStr	Computer navigation-aided joint-preserving resection and custom-made endoprosthesis reconstruction for bone sarcomas: long-term outcomes
title_full_unstemmed	Computer navigation-aided joint-preserving resection and custom-made endoprosthesis reconstruction for bone sarcomas: long-term outcomes
title_sort	computer navigation-aided joint-preserving resection and custom-made endoprosthesis reconstruction for bone sarcomas: long-term outcomes
publisher	Wolters Kluwer
publishDate	2021
url	https://doaj.org/article/26dbf6814bb0442fa266a9a214076b8f
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Computer navigation-aided joint-preserving resection and custom-made endoprosthesis reconstruction for bone sarcomas: long-term outcomes

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