Does Microwave Ablation of the Tumor Edge Allow for Joint-sparing Surgery in Patients With Osteosarcoma of the Proximal Tibia?

Abstract

Background Joint-sparing surgery of a

What are the Oncologic and Functional Outcomes After Joint Salvage Resections for Juxtaarticular Osteosarcoma About the Knee?

“…All patients received neoadjuvant chemotherapy. The current study is a followup of earlier studies [23][24][25][26][27] and includes an additional nine patients and additional followup of a mean of 19 months for the patients included in the earlier studies.…”

“…When the tumor is more than 1 cm from the articular cartilage and cruciate ligaments, microwave ablation is used to ablate the tumor edge, and a transepiphyseal osteotomy is performed through the edge of the tumor to preserve more than 1 cm thickness of the epiphysis [23]. The resection margin is necrotic and the residual epiphysis is viable.…”

“…In addition, there have been attempts to improve contiguous joint function by means of intercalary resection after physeal distraction [5,6], transepiphyseal resection [13,30,32], or multiplanar osteotomy [4], preserving the entire or part of the articular surface. We have tried multiple adjuvant techniques including navigation [25,27], microwave ablation [23], and argon-based ablation [24] to aid joint-sparing tumor resection, with the goal of exploring a surgical strategy to maximize the chance of joint preservation with full consideration of a safe resection margin, important structures such as the ACL and PCL, articular cartilage, and subchondral bone reservation, and preservation of the joint. We previously reported the preliminary outcomes of these joint salvage procedures [23][24][25][26][27]; the current evaluation provides a larger patient group and a longer followup period.…”

“…We have tried multiple adjuvant techniques including navigation [25,27], microwave ablation [23], and argon-based ablation [24] to aid joint-sparing tumor resection, with the goal of exploring a surgical strategy to maximize the chance of joint preservation with full consideration of a safe resection margin, important structures such as the ACL and PCL, articular cartilage, and subchondral bone reservation, and preservation of the joint. We previously reported the preliminary outcomes of these joint salvage procedures [23][24][25][26][27]; the current evaluation provides a larger patient group and a longer followup period. In this study, we sought to ascertain whether our surgical strategy allows native joint salvage with acceptable limb function without compromising the oncologic outcomes.…”

CORR ® Tumor Board: Does Microwave Ablation of the Tumor Edge Allow for Joint-sparing Surgery in Patients with Osteosarcoma of the Proximal Tibia?

“…The article by Li et al [3] highlights the need for accurate imaging capable of detailing tumor extent to within a few millimeters in order to guide treatment. In their study, they imported both CT and MRI images into a navigation system to guide placement of the ablation needles and tumor resection.…”