Over 10-year follow-up of functional outcome in patients with bone tumors reconstructed using distraction osteogenesis

Watanabe, Koji; Tsuchiya, Hiroyuki; Yamamoto, Norio; Shirai, Toshiharu; Nishida, Hiroyuki; Hayashi, Katsuhiro; Takeuchi, Akihiko; Matsubara, Hidenori; Nomura, Issei

doi:10.1007/s00776-012-0327-4

Cited by 58 publications

(59 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…21,28-31 Distraction osteogenesis with external fixation is also an established form of treatment but carries risks of increased time of treatment and pin-or wire-tract infections. 32,33 VFGs will remodel, hypertrophy, and unite to host bone in response to mechanical stresses, providing a biological reconstruction more resistant to infection, chemotherapy and radiotherapy, with low rates of late complications. [10][11][12][13][14] However, previous studies were limited by small numbers of patients, consequently subgroup analysis of patient and surgical parameters was difficult.…”

Section: Discussionmentioning

confidence: 99%

The vascularised fibular graft for limb salvage after bone tumour surgery

Hilven

Bayliss

Cosker

et al. 2015

The Bone & Joint Journal

View full text Add to dashboard Cite

Vascularised fibular grafts (VFGs ) are a valuable surgical technique in limb salvage after resection of a tumour. The primary objective of this multicentre study was to assess the risk factors for failure and complications for using a VFG after resection of a tumour. The study involved 74 consecutive patients (45 men and 29 women with mean age of 23 years (1 to 64) from four tertiary centres for orthopaedic oncology who underwent reconstruction using a VFG after resection of a tumour between 1996 and 2011. There were 52 primary and 22 secondary reconstructions. The mean follow-up was 77 months (10 to 195). In all, 69 patients (93%) had successful limb salvage; all of these united and 65 (88%) showed hypertrophy of the graft. The mean time to union differed between those involving the upper (28 weeks; 12 to 96) and lower limbs (44 weeks; 12 to 250). Fracture occurred in 11 (15%), and nonunion in 14 (19%) patients. In 35 patients (47%) at least one complication arose, with a greater proportion in lower limb reconstructions, non-bridging osteosynthesis, and in children. These complications resulted in revision surgery in 26 patients (35%). VFG is a successful and durable technique for reconstruction of a defect in bone after resection of a tumour, but is accompanied by a significant risk of complications, that often require revision surgery. Union was not markedly influenced by the need for chemo- or radiotherapy, but should not be expected during chemotherapy. Therefore, restricted weight-bearing within this period is advocated.

show abstract

Section: Discussionmentioning

confidence: 99%

The vascularised fibular graft for limb salvage after bone tumour surgery

Hilven

Bayliss

Cosker

et al. 2015

The Bone & Joint Journal

View full text Add to dashboard Cite

show abstract

“…[17][18][19][20] As such, the studies described herein provide important new information regarding potential clinical applications. 20 Based on previous studies, we observed that exposure to chemotherapy can occur preoperatively, postoperatively, and even simultaneously with bone repair/regeneration. 21 Therefore, to develop and standardize a mouse model for CDP toxicity we chose to perform the DO surgery simultaneously with the first of five daily CDP injections.…”

mentioning

confidence: 90%

“…During DO, bone formation process spatially well organized and temporally distinct from resorptive processes induced later. In addition, recent literature suggests that DO is emerging as an appropriate protocol for osteosarcoma patients and does provide significant benefit to to patients compared with other critical size defect repair procedures 17-20 . As such, the studies described herein provide important new information regarding potential clinical applications 20 .…”

Section: Introductionmentioning

confidence: 99%

“…In addition, recent literature suggests that DO is emerging as an appropriate protocol for osteosarcoma patients and does provide significant benefit to to patients compared with other critical size defect repair procedures 17-20 . As such, the studies described herein provide important new information regarding potential clinical applications 20 . Based on previous studies, we observed that exposure to chemotherapy can occur preoperatively, postoperatively, and even simultaneously with bone repair/regeneration 21 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cisplatin inhibits bone healing during distraction osteogenesis

et al. 2013

View full text Add to dashboard Cite

Osteosarcoma (OS) is the most common malignant bone tumor affecting children and adolescents. Many patients are treated with a combination of chemotherapy, resection, and limb salvage protocols. Surgical reconstructions after tumor resection include structural allografts, non-cemented endoprostheses, and distraction osteogenesis (DO), which require direct bone formation. Although cisplatin (CDP) is extensively used for OS chemotherapy, the effects on bone regeneration are not well studied. The effects of CDP on direct bone formation in DO were compared using two dosing regimens and both C57BL/6 (B6) and tumor necrosis factor receptor 1 knockout (TNFR1KO) mice, as CDP toxicity is associated with elevated TNF levels. Detailed evaluation of the five dose CDP regimen (2mg/kg/day), demonstrated significant decreases in new bone formation in the DO gaps of CDP treated versus vehicle treated mice (P<0.001). Further, no significant inhibitory effects from the 5 dose CDP regimen were observed in TNFR1KO mice. The two dose regimen significantly inhibited new bone formation in B6 mice. These results demonstrate that CDP has profound short term negative effects on the process of bone repair in DO. These data provide the mechanistic basis for modeling peri-operative chemotherapy doses and schedules and may provide new opportunities to identify molecules that spare normal cells from the inhibitory effects of CDP.

show abstract

“…Functional outcome would be better overtime. Watanabe et al reported functional score improved within 2 years after extremity tumor surgery and maintained after that [12]. Our cases are average 5 years follow-up and the functional score should be stabilized in most of the cases.…”

Section: Resultsmentioning

confidence: 51%

Factors that Influence Functional Outcome after Total or Subtotal Scapulectomy: Japanese Musculoskeletal Oncology Group (JMOG) Study

et al. 2014

Self Cite

View full text Add to dashboard Cite

BackgroundScapulectomy requires not only joint resection but also wide resection of the shoulder girdle muscles. Even the significance of reconstruction has not yet been determined because of the difficulties in comparing the different conditions. The purpose of this study was to investigate factors that influence functional outcomes after scapulectomy in a multicenter study.MethodsThis retrospective study comprised 48 patients who underwent total or subtotal scapulectomy and were followed for at least one year after surgery. Patients were registered at the Japanese Musculoskeletal Oncology Group affiliated hospitals. Soft tissue reconstruction for joint stabilization was performed when there was enough remaining tissue for reconstruction of the rotator cuff and tendons. In 23 cases, humeral suspension was performed. The average follow-up period was 61.9 months. Multivariate analysis was performed using the patient’s background to determine which factors influence the Enneking functional score or active range of motion.ResultsThe average functional score was 21.1 out of 30. Active shoulder range of motion was 42.7 degree in flexion, 39.7 degree in abduction, 49.6 degree of internal rotation and 16.8 degree of external rotation. The amount of remaining bone influenced functional outcome, which means that preserving the glenoid or the acromion lead to better function compared to total scapulectomy (p<0.01). Factors that influenced each functional measure include the amount of remaining bone, soft tissue reconstruction, the length of the resected humerus and nerve resection (p<0.05).ConclusionAlthough shoulder function was almost eliminated following total or subtotal scapulectomy, minimal resection of bone, and soft tissue reconstruction should lead to better function.

show abstract

Over 10-year follow-up of functional outcome in patients with bone tumors reconstructed using distraction osteogenesis

Abstract: Background The aim of this study was to investigate the long-term functional capabilities of patients who underwent bone distraction for the treatment of bone defects caused by bone tumor excision.

Cited by 58 publications

References 34 publications

The vascularised fibular graft for limb salvage after bone tumour surgery

The vascularised fibular graft for limb salvage after bone tumour surgery

Cisplatin inhibits bone healing during distraction osteogenesis

Factors that Influence Functional Outcome after Total or Subtotal Scapulectomy: Japanese Musculoskeletal Oncology Group (JMOG) Study

Contact Info

Product

Resources

About