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 patients treated by computer-assisted tumor surgery (CATS). METHODS:From 2006 to 2009, we performed CATS in 20 patients with 21 malignant tumors. The mean age was 31 years (range, 6-80 years). CT and MR images for 18 cases were fused using the navigation software. Reconstructed two-dimensional/three-dimensional images were used to plan the bone resection. The achieved bone resection was compared with the planned one by assessing margins, dimensions at the level of bone resection, or fitting of CAD custom prostheses. Function was assessed with the Musculoskeletal Tumor Society (MSTS) score. The minimum followup was 31 months (mean, 39 months; range, 5-69 months). RESULTS:Histological examination of all resected specimens showed a clear tumor margin. The achieved bone resection matched the planned with a difference of ≤ 2 mm. The achieved positions of custom prostheses were comparable to the planned positions when merging postoperative with preoperative CT images in five cases. Three of the four patients with local recurrence had tumors at the sacral region. The mean MSTS score was 28 (range, 23-30). CONCLUSION:CATS with image fusion allows accurate execution of the intended bone resection. It may be beneficial to resection and reconstruction in pelvic, sacral tumors and more difficult joint-preserving intercalated tumor surgery. Comparative clinical studies with long-term followup are necessary to confirm its efficacy. 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
Wong KC,Kumta SMdoi
10.1007/s11999-012-2557-3subject
Has Abstractpub_date
2013-03-01 00:00:00pages
750-61issue
3eissn
0009-921Xissn
1528-1132journal_volume
471pub_type
杂志文章abstract::Clinicians have been concerned that fractures do not heal properly in individuals exposed to bisphosphonate treatment, a treatment that strongly affects bone metabolism. The current study attempted to clarify the long-term effects of clodronate (dichloromethylene bisphosphonate) treatment on fracture healing in growin...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200303000-00036
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND:Hybrid revision knee component fixation, in which cement is placed in the metaphysis combined with a cementless diaphyseal engaging stem, provides ease of insertion, possibly improved component alignment, and easier removal if required, compared with fully cemented prostheses. The literature suggests the tec...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1569-0
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Soft tissue sarcomas are often inappropriately excised without adequate preoperative planning. Inappropriate (unplanned) excisions may adversely affect local recurrence, distant metastasis, patient survival, and /or postoperative function once properly evaluated. QUESTIONS/PURPOSES:We asked whether the clin...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1392-7
更新日期:2010-11-01 00:00:00
abstract::Primary total hip arthroplasties were performed in 108 patients (116 hips) using a porous coated anatomic (PCA) hip system. Nineteen (22 hips) of 108 patients (116 hips) who had a subsidence of a PCA femoral stem more than 3 mm were studied for the time onset, the amount of stem subsidence, and outcomes. A minimum fol...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract::Vascular injury is one of the drastic complications that can arise from internal fixation of acetabular fractures. A 29-year-old, obese man sustained multiple trauma, including a displaced transverse acetabular fracture. Extreme obesity made adequate exposure to the posterior acetabular area difficult, causing placeme...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-04-01 00:00:00
abstract::Of 19 patients (24 hips) with LCPD treated between 1968 and 1974, 18 hips were treated by nonoperative methods (the abduction weight-bearing program as described by Petrie), and six hips were treated by Salter innominate osteotomy. Using Catterall's classification of the roentgenographic changes, 14 cases were rated g...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1980-07-01 00:00:00
abstract:UNLABELLED:To determine whether inferior vena cava (IVC) filter placement protects patients with musculoskeletal tumors from fatal pulmonary embolisms (PE), we retrospectively analyzed the records of 81 patients who underwent surgery for pelvic and lower extremity malignancies. All 81 patients received an IVC filter an...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-008-0607-7
更新日期:2009-01-01 00:00:00
abstract::The mechanism of injury and long-term effects in three cases suggest that a specific type of intercondylar injury of the femur, i.e., cleavage fracture, is caused by force transmitted through the patella. Treatment is conservative. The fracture does not appear to have been mentioned previously in the English literatur...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1981-10-01 00:00:00
abstract::Despite their increasing clinical use, mobile-bearing total knee replacements have not been well characterized biomechanically. An experimental and finite element analysis was done to assess the mobility and contact mechanics of a widely used rotating platform total knee replacement. Parameters that varied were axial ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200111000-00004
更新日期:2001-11-01 00:00:00
abstract::Percutaneous pelvic fixation is possible because intraoperative fluoroscopic imaging and other technologies have been refined. Anterior and posterior unstable pelvic ring disruptions are amenable to percutaneous fixation after closed manipulation or open reduction. Stable and safe fixation is achieved only after an ac...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-200006000-00004
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:The os peroneum is a sesamoid bone in the peroneus longus tendon. Fractures of the os peroneum are rare. Some authors recommend surgery for active patients. CASE DESCRIPTION:A 41-year-old male professional tennis coach sustained a minimally displaced fracture of the os peroneum. He was treated with restrict...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1007/s11999-011-1812-3
更新日期:2011-05-01 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::Many situations in revision THA require the exchange of a PE liner in the setting of a well-fixed cementless acetabular shell. Unfortunately, a replacement liner is not always available, the locking mechanism of the metal shell may be damaged or incompatible with the desired liner, or the shell is malpositioned. Revis...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000096805.78689.8b
更新日期:2003-12-01 00:00:00
abstract::Managing tumors of the proximal fibula may require en bloc resection of the fibular head with the attachment site for the lateral collateral ligament. These resections of the proximal fibula cause unavoidable knee instability. We describe a reconstructive technique intended to minimize that instability. We retrospecti...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000238781.19692.16
更新日期:2007-01-01 00:00:00
abstract::Sixteen human trabecular bone biopsies were obtained from sites located in the ilium and in the area of the greater trochanter of the femur. Patients ranged from 19 to 85 years old and included men and women. All bone surfaces observed contained osteoid. Flat, branched fibroblastic-like cells were observed lining bone...
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::This study compares biomechanical characteristics of interference screw fixation to "postfixation" (sutures tied over cancellous screw and washer) of bone-patellar tendon-bone grafts in porcine anatomic specimen knees. Maximum pull-out strength (ultimate failure load), displacement of the bone graft at 110 N of force,...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract::For reappraisal of total hip arthroplasty (THA) in the treatment of nontraumatic osteonecrosis (ON) of the femoral head, 29 hips in 23 patients with ON were surveyed in a comparison with 63 osteoarthritic (OA) hips treated in the same manner during the same period; the hips were selected according to the same criteria...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1989-07-01 00:00:00
abstract:BACKGROUND:Childhood obesity is associated with reduced quality of life, physical fitness, and a higher prevalence of lower extremity (LE) pain; however, it is unclear whether and how these factors are related. QUESTIONS/PURPOSES:For this study we asked if obese children with LE pain (LE+) had higher BMI-Z scores, low...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-012-2620-0
更新日期:2013-04-01 00:00:00
abstract::A locked pubic symphysis occasionally occurs after a lateral compression injury of the pelvic ring. One pubic bone becomes entrapped behind the contralateral pubis. Lateral compression pelvic injuries are well recognized, but a lateral compression pelvic injury resulting in a locked pubic symphysis is rare. We describ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-0788-8
更新日期:2009-08-01 00:00:00
abstract:UNLABELLED:While low-grade juxtacortical and low-grade intramedullary osteogenic sarcomas are histologically indistinguishable, they have been studied as separate entities. We retrospectively reviewed the clinical, radiographic, histologic features and treatment of 59 patients treated surgically to compare the rate of ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-008-0251-2
更新日期:2008-06-01 00:00:00
abstract::Periostitis in the athlete is a common overuse clinical entity often found in the lower extremity. An analogous overuse syndrome also may occur in the upper extremity. These 2 case reports describe the history, physical findings, radiographic changes, and treatment for periostitis of the upper extremity rarely seen in...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1996-03-01 00:00:00
abstract::This biographical sketch on Themistocles Gluck corresponds to the historic text, The Classic: Report on the positive results obtained by the modern surgical experiment regarding the suture and replacement of defects of superior tissue, as well as the utilization of re-absorbable and living tamponade in surgery (1891),...
journal_title:Clinical orthopaedics and related research
pub_type: 传,历史文章
doi:10.1007/s11999-011-1836-8
更新日期:2011-06-01 00:00:00
abstract::A previously validated three-dimensional finite element model was used to study how several total hip component design and surgical placement variables contribute to resisting the propensity for posterior dislocation in the case of leg crossing in an erectly seated position. The computational formulation incorporated ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199810000-00016
更新日期:1998-10-01 00:00:00
abstract::Calcified cartilage transplants induce bone formation. This process may be inhibited if the recipient is immunized by the transplant. To study the relation between the degree of antigen incompatibility between the donor and recipient and bone formation in more detail, chondrocytes isolated from cartilaginous epiphyses...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract:UNLABELLED:Ankle arthroplasty is increasingly used to treat advanced ankle arthritis. Earlier prostheses have given way to second-generation implants, on which we are accumulating medium-term data. The Scandinavian Total Ankle Replacement (STAR) is a three-component uncemented implant in wide use in Europe and the only...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-009-0971-y
更新日期:2010-04-01 00:00:00
abstract::Fusion indications in adult degenerative disk disease of the lumbosacral spine include isolated disk resorption, primary and secondary instability, recurrent disk herniation, and pseudarthrosis. Common to these indications are variable proportions of biomechanical insufficiency of the motion segment, instability, defo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1994-03-01 00:00:00
abstract::Eleven patients with chronic pain on the ulnar side of the wrist and roentgenographic evidence of a hypertrophic ulnar styloid nonunion were treated with subperiosteal excision of the nonunion fragment. This procedure relieved the localized pain without changing either radiocarpal or distal radioulnar joint stability....
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1988-03-01 00:00:00
abstract::Glomus tumors are benign vascular tumors composed of round to oval uniform cells associated with vascular structures, usually found in the soft tissue of the nail bend. A 24-year-old woman with a two-year history of progressive right elbow pain and swelling was found to have a histologically characteristic intraosseou...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-07-01 00:00:00
abstract::Nodules of fibrocartilage, calcified fibrocartilage, or bone may be found in the adult ligamentum nuchae. These are generally asymptomatic but may mimic fractures or, as in the case presented here, tumors. ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-10-01 00:00:00
abstract::The optimal reconstruction procedure after wide resection of bone tumors is debatable. We reviewed pasteurized intercalary autogenous bone graft combined with a vascularized fibula graft in 15 patients with malignant bone tumors, and assessed whether this procedure would improve bone union and function. The mean durat...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000246565.03833.73
更新日期:2007-03-01 00:00:00