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A 55-year-old male patient with chondrosarcoma at the left humerus (A) was managed with an intercalary allograft combined with an onlay type vascularized fibular graft (B). (C) Six year follow-up radiograph showed solid bone union at both proximal and distal host-allograft bone junctions (Courtesy of Dr. Joo-Yup Lee, Department of Orthopedic Surgery, The Catholic University of Korea, St. Vincent Hospital, Suwon; with permission).
Source publication
Structural allograft or recycled autograft bone transplantation has been performed for reconstruction of bone defects caused by bone tumor resection. Knowledge regarding advantages and disadvantages of bone reconstruction using an allograft or recycled autograft, other alternatives such as reconstruction with tumor prosthesis, the understanding of...
Similar publications
Background: Surgical and medical care for patients with bone and soft tissue tumors of the extremities continues to improve with advancement of chemotherapeutic strategies, surgical techniques, and understanding of pathogenesis. Aim and Objective: To Analysis of the results of lower limb preservation after neoplastic resection to reproduce an advis...
Citations
... 10) LSS involves a surgical process with wide excision of a malignant tumor, including an appropriate surgical margin, and reconstruction of the resultant bone and softtissue defects. 11,12) Various materials have been used for reconstruction, and the resection strategy may vary depending on the reconstruction method. Each technique of the LSS is accompanied by different complications in the long term; therefore, revisional surgeries are frequent. ...
... Each technique of the LSS is accompanied by different complications in the long term; therefore, revisional surgeries are frequent. [11][12][13] Ever since Austin Moore created a tumor prosthesis using a cobalt-chrome alloy in 1943, diverse metallic endoprostheses have been manufactured from vitallium, stainless steel, and polythene over the next few decades. 13) As the conservative treatments of musculoskeletal tumors have expanded since the 1970s, implantable options of mega prostheses have increased with the development of modular systems instead of custom-made prostheses and expandable prostheses for the pediatric pupulation. ...
... 14) A similar form of structural allograft from the same location can be used for skeletal defects after tumor resection. 12) However, allograft reconstructions are also associated with several complications. 12) There is a considerable possibility of nonunion between the patient's host bone and the allograft. ...
Background
In bone sarcomas, chemotherapy has improved the prognosis with advances in diagnostic and surgical technologies, which has led to attempts to save limbs. As early detection and multidisciplinary treatment have improved the survival rate, curative surgery is considered for selected patients with metastatic bone carcinomas. Limb salvage procedures may vary in relation to the reconstruction method, which is accompanied by different complications. To overcome them, we devised a novel concept, in-situ local tumor ablation and recycling machine based on radiofrequency (RF)-induced heating and intended experiments to demonstrate its feasibility.
Methods
The fresh femurs of 6-month-old pigs were used after removing the epiphyses; the distal parts were placed in a heating chamber. Fiber-optic temperature sensors were inserted in the metaphysis, meta-diaphysis, and diaphysis. Temperatures were measured six times each during heating at 27.12 MHz at various powers. Additionally, the compressive and bending stiffnesses were measured six times each for the unprocessed, RF-treated, and pasteurized bones, and the results were compared.
Results
Under 200 W power output, the temperatures at all measurement sites reached 70 ℃ or higher in 6 minutes, and the temperatures were maintained. The median compressive stiffness of RF-heated bones was 79.2% higher than that of pasteurized bones, but the difference was statistically insignificant. The median bending stiffness of RF-heated bones was approximately 66.3% of that of unprocessed bones, which was 20% higher than that of pasteurized bones.
Conclusions
The feasibility to rapidly attain and maintain temperatures for tumor ablation is shown, which favorably preserves bone stiffness through the in-situ local tumor ablation and recycling based on RF heating. The problem of nonuniform temperature distribution might be solved by an optimal design determined from simulation research and additional experiments.
... 그 외 숙주골과 동종골 불유합 못지 않게 주목해야 할 합병증 이 동종골 골절이다. 동종골 골절의 빈도는 12%-20%까지 다 양하게 보고되고 있다.10,13,17,24,25) Berrey 등 25) 은 동종골 골절의 70%가 수술 후 3년 이내에 발생한다고 보고하였다. 또한, 동종 골 골절을 세 가지 형태로 기술하였는데 제1형은 숙주와의 거부 반응과 연관된 동종골의 흡수, 제2형은 동종골 간부의 골절, 제 3형은 관절면을 침범하는 골절이다. ...
This study investigated the optimal design of a radio-frequency (RF) bone tumor ablation device to achieve uniform heating. In a previous study, we confirmed the feasibility of this device, which could heat all regions of the bone to 70 °C or higher and maintain this temperature for more than 30 min. However, the temperature in each part was non-uniform. To address this issue, the shape of the electrode must be modified to create a uniform electric field. The design of the electrode was optimized to reduce temperature deviations. It is difficult to analytically model the relationship between the shape of the electrode and the electric field. The electrode's design factors were fine-tuned using the Taguchi method, a robust design of experiment approach. The primary objective in this optimization was to maximize the signal-to-noise ratio for temperature in each component, aiming for higher values. After four trials, the signal-to-noise ratio increased in comparison with the initial modified shape from 68.3 to 98.6. The experiment was conducted using an experimental device fabricated using the optimal design factors. In comparison to the previous experiment, the temperature standard deviation per part over time decreased from 10.56 °C 4.28 °C. The experimental results demonstrated the validity of the proposed optimal design approach. In the future, the proposed method can be used to optimize the design factors when a product is advanced to develop a device that can be applied to the human body.
