Abstract:
BACKGROUND:There is no consensus as to which surgical approach to the treatment of giant cell tumor of bone is most appropriate or which patients are at a higher risk for recurrence or metastasis. QUESTIONS/PURPOSES:Therefore, we asked: (1) Are there subsets of patients who are associated with a more recalcitrant disease course? And (2) are surgeons appropriately stratifying patients by identifying risk factors for increased local recurrence and pulmonary metastases? METHODS:We retrospectively reviewed the records of 230 patients with giant cell tumor of bone treated from 1980 to 2010, stratifying them by primary versus recurrent disease and by surgical treatment. From the records, we determined local recurrence, metastatic disease, and complications of treatment. The median follow up was 47 months (range, 0.1-312 months). RESULTS:Overall incidence of local recurrence was 10% and pulmonary metastasis was 2%. When stratified by surgical treatment, the incidence of local recurrence among patients undergoing intralesional curettage (12%) was greater than in those undergoing resection (2%). The incidence of local recurrence among primary tumors, independent of treatment, was 9%, whereas the incidence of local recurrence after treatment of recurrent lesions was 16%. The incidence of pulmonary metastases was similar, regardless of treatment or whether primary or recurrent. CONCLUSIONS:Our observations suggest there are subsets of patients with giant cell tumor of bone who are at higher risk of recurrence and should be clinically followed more closely. This should allow surgeons to provide patients with more informed expectations. LEVEL OF EVIDENCE:Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Kremen TJ Jr,Bernthal NM,Eckardt MA,Eckardt JJdoi
10.1007/s11999-011-2172-8subject
Has Abstractpub_date
2012-03-01 00:00:00pages
677-83issue
3eissn
0009-921Xissn
1528-1132journal_volume
470pub_type
杂志文章abstract::A method of surface replacement of the knee joint using an uncemented titanium-on-high-density-polyethylene prosthesis has been investigated in 61 patients. The results show that pain is relieved in the vast majority of cases. Overall, the joint range is marginally improved. Preoperative deformities can be considerabl...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1980-05-01 00:00:00
abstract::Habitual dislocation of the hip occurred in a nine-year-old girl. The nomenclature of the literature on this disorder and other related conditions is confusing. The following simple classification is therefore proposed: (1) recurrent dislocation (posttraumatic, nonvoluntary); (2) voluntary dislocation (nonhabitual, as...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-05-01 00:00:00
abstract::A cementless porous-coated femoral prosthesis with a long stem was implanted in seven patients who had untreated comminuted unstable intertrochanteric fractures of the femur associated with a posterior dislocation of the femoral head. The average age of the patients was 35 years (range, 25-52 years). The length of fol...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-04-01 00:00:00
abstract:UNLABELLED:Risk factors to explain the poor survival of patients with osteosarcoma of the pelvis are poorly understood. Therefore, we attempted to identify factors affecting survival and development of local recurrence and metastasis. We retrospectively reviewed 43 patients who had high-grade pelvic tumors and were tre...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-008-0495-x
更新日期:2009-02-01 00:00:00
abstract::This biographical sketch of Marshall R. Urist corresponds to the historic texts, The Classic: Bone Morphogenetic Protein, available at DOI 10.1007/s11999-009-1068-3; The Classic: A Morphogenetic Matrix for Differentiation of Cartilage in Tissue Culture, available at DOI 10.1007/s11999-009-1069-2; and The Classic: A Mo...
journal_title:Clinical orthopaedics and related research
pub_type: 传,历史文章,杂志文章
doi:10.1007/s11999-009-1067-4
更新日期:2009-12-01 00:00:00
abstract::This Classic article is a reprint of the original work by Virgil P. Gibney, Chapter XVIII. Operative Treatment in Chronic Articular Ostitis. An accompanying biographical sketch of Virgil P. Gibney, MD, is available at DOI 10.1007/s11999-009-1166-2 . The Classic Article is (c)1884 and is abridged from Gibney VP. Operat...
journal_title:Clinical orthopaedics and related research
pub_type: 传,古典文章,历史文章,杂志文章
doi:10.1007/s11999-009-1165-3
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Small recent case series using CT-based navigation suggest such approaches may aid in surgical planning and improve accuracy of intended resections, but the accuracy and clinical use have not been confirmed. QUESTIONS/PURPOSES:We therefore evaluated (1) the accuracy; (2) recurrences; and (3) function in pat...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-012-2557-3
更新日期:2013-03-01 00:00:00
abstract::Ten patients with femoral head fractures were evaluated with conventional hip radiographs, computed axial tomography (CT), and pelvic oblique radiographs. The CT scan was used to determine the plane of the fracture within the femoral head. The patient was then positioned with the fracture line parallel to the radiogra...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:As new Patient-Reported Outcomes Measurement Information System (PROMIS) instruments are incorporated into clinical practice, determining how large a change on these instruments represents a clinically relevant difference is important; the metric that describes this is the minimum clinically important differ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000000419
更新日期:2018-10-01 00:00:00
abstract::A 60-year-old man had severe unilateral wrist flexion contracture associated with psoriatic arthritis mutilans. Proximal row carpectomy provided realignment of the carpus. Arthrodesis occurred spontaneously in functional position. ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1980-11-01 00:00:00
abstract:BACKGROUND:Distal radius reconstruction after en bloc tumor resection remains a surgical challenge. Although several surgical techniques, either reconstructing the wrist or achieving a stable arthrodesis, have been described, it is unclear to what degree these restore function. DESCRIPTION OF TECHNIQUE:We describe an ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-012-2555-5
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Subungual exostosis is a relatively common benign bone tumor that occurs in the distal phalanges of the toes and can be a source of pain and nail deformity. There is controversy about the treatment of these lesions and there are few studies that have synthesized what is known and provided meaningful informat...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1007/s11999-013-3345-4
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:The ideal pedicle entry point for the thoracic spine is described as the base of the superior facet at the junction of the lateral and middle thirds of the pedicle. Investigators have reported its accuracy in curves less than 90 degrees . QUESTIONS/PURPOSES:Our aim was to measure the accuracy of this entry ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1280-1
更新日期:2010-07-01 00:00:00
abstract::Limb lengthening is not uncommon after total hip replacement and may cause subjective problems for patients. We have studied 150 total hip replacements to investigate the operative change in limb length. A radiologic evaluation is used and is shown to be accurate. One hundred forty-four limbs were lengthened an averag...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-07-01 00:00:00
abstract::Achondroplastic patients having lengthening surgery of the lower limbs were preoperatively evaluated from psychologic, functional, vascular, and endocrinometabolic points of view. Long-term research is required to determine effects of surgical correction of achondroplasia from both psychologic and various physical poi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1990-01-01 00:00:00
abstract::Thirty-two consecutive subtrochanteric fractures in 32 patients were stabilized using the Medoff sliding plate and were followed up prospectively for 1 year. Two patients died during the first postoperative year. Twenty-nine of the remaining 30 (97%) fractures united by 1-year followup. Two types of plate dynamization...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND:To improve ankle stability in patients who have experienced an ankle sprain with residual symptoms of instability and/or objective joint laxity, external supports (such as taping, bracing, and orthotic insoles) are used sometimes. However, available randomized trials have disagreed on whether restraints impr...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,meta分析
doi:10.1097/CORR.0000000000000946
更新日期:2020-02-01 00:00:00
abstract::In the treatment of congenital dislocation of the hip, reduction must be obtained and maintained to provide the proper stimulus for resumption of normal hip joint growth and development. Subluxation and avascular necrosis must be avoided, as degenerative joint disease is certain to occur. Acetabular dysplasia leads to...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-08-01 00:00:00
abstract:BACKGROUND:CT pulmonary angiography (CTPA) has become widely adopted to detect pulmonary embolism (PE) after total joint arthroplasty (TJA). CTPA is a sensitive tool, which has the ability to detect emboli that may be clinically insignificant. This may lead to iatrogenic harm from overtreatment. QUESTIONS/PURPOSES:The...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-3041-4
更新日期:2013-09-01 00:00:00
abstract::Reported herein is a rare case of a patient with a pathologic fracture through a cyst in the femoral neck that resulted in avascular necrosis of the femoral epiphysis. This type of necrosis is commonly understood to follow displaced fractures of the femoral neck in children, but has also been reported to follow undisp...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1994-07-01 00:00:00
abstract::In a series of delayed repair in 8 instances of avulsion fracture of the tibial attachment of the posterior cruciate ligament, 6 were isolated avulsion fractures of the tibial attachment of the posterior cruciate ligament and 2 were associated with the fractures of the tibial condyle. Staple fixation was used exclusiv...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1979-09-01 00:00:00
abstract::Few studies quantitate the cost of a quality well being as produced by arthroplasty surgery. The objective was to use the Quality of Well Being Index to calculate the cost per quality of well year in knee arthroplasty surgery. The difference in Quality of Well Being Index scores before and after the intervention was c...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1997-12-01 00:00:00
abstract::The collagens are products of a superfamily of closely related genes. Currently, there are 13 described collagens encompassing at least 25 separate genes. The collagen molecules can be categorized into four classes. Class I consists of molecules that form the banded collagen fibers that are readily seen by routine ele...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1992-09-01 00:00:00
abstract:BACKGROUND:Alternative dispute resolution (ADR) refers to techniques used to resolve conflicts without going to the courtroom. As healthcare and malpractice costs continue to rise, there is growing interest in tactics such as early apology, mediation, and arbitration in the medical arena. QUESTIONS/PURPOSES:(1) Why is...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2206-2
更新日期:2012-05-01 00:00:00
abstract::Tendinopathy is a common clinical problem with athletes and in many occupational settings. Tendinopathy can occur in any tendon, often near its insertion or enthesis where there is an area of stress concentration, and is directly related to the volume of repetitive load to which the tendon is exposed. Recent studies i...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1007/s11999-008-0286-4
更新日期:2008-07-01 00:00:00
abstract::The ability to forecast the course and outcome of severe mechanical trauma would aid clinicians in making decisions concerning the treatment of patients. Multifactorial regression models, developed from data obtained from 933 patients with polytrauma and shock, have a high predictive value. A two-part data sheet was d...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-05-01 00:00:00
abstract::To determine the vascular architecture of nontraumatic avascular necrosis of the femoral head (ANFH), 38 femoral heads procured from 31 ANFH patients were studied by microangiographic and histologic methods. Microangiography showed that the head was consistently stratified into three zones: the normal vascular, the re...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-04-01 00:00:00
abstract::This study was designed to determine the influence of laxity on clinical function after knee replacement. Using a recently developed computerized method, anteroposterior laxities were measured in 29 Insall-Burstein posterior stabilized, 25 Kinemax Condylar (posterior cruciate retaining), and 10 Oxford bicompartmental ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1994-08-01 00:00:00
abstract:BACKGROUND:Local drug delivery has substantial potential to prevent infections compared with systemic delivery. Although calcium sulfate (CaSO(4)) has been studied for local drug delivery and two types are commercially available, it is unknown whether they differentially release antibiotics. QUESTIONS/PURPOSES:We dete...
journal_title:Clinical orthopaedics and related research
pub_type:
doi:10.1007/s11999-011-1911-1
更新日期:2011-11-01 00:00:00
abstract::Chondrocytes are the single cellular component of hyaline cartilage. Under physiologic conditions, they show steady-state equilibrium between anabolic and catabolic activities that maintains the structural and functional integrity of the cartilage extracellular matrix. Implicit in the loss of cartilage matrix that is ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000144854.66565.8f
更新日期:2004-10-01 00:00:00