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Sarcoma. 1997 December; 1(3-4): 167–174. doi: 10.1080/13577149778263. | PMCID: PMC2395364 |
Copyright © 1997 Hindawi Publishing Corporation. The Geometric Osteotomy: Joint Preservation in Juxta-Articular Surface Bone Neoplasms Eric L. Masterson, 1 Riccardo Ferracini, 1 Aileen M. Davis, 1,2 Jay S. Wunder, 1,2 and Robert S. Bell  1,2,31 University Musculoskeletal Oncology Unit, Mount Sinai Hospital, 600 University Avenue, Suite 476, Toronto, M5G 1X5, Canada, 2 University of Toronto, Toronto, Canada, 3 Princess Margaret Comprehensive Cancer Centre, Toronto, Canada, This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. To present the oncologic and functional results of a consecutive series of patients treated by geometric
osteotomy and allograft reconstruction for juxta-articular surface bone neoplasms. Patients. Twelve consecutive patients (mean age 28 years) underwent excision of benign aggressive or malignant
juxta-articular surface bone neoplasms. In each case, only part of the circumference of the bone was excised, and the joint
surface was preserved and kept in continuity with the remainder of the bone. The defects were filled with allograft or
autograff, and internally fixed as appropriate. Methods. Patients were eligible for the study if they had a histologically proven, primary tumour of bone adjacent to a
joint such that the turnout could be completely excised with a partial cortical resection and preservation of the joint. The
database at the University Musculoskeletal Oncology Unit was used to identify all cases. Patient demographics and
oncologic results were recorded. Functional assessment was performed using the Musculoskeletal Tumor Society rating
scale and the Toronto Extremity Salvage Score. Results. Nine tumours were about the knee and three were in the proximal humerus. Negative margins were achieved in
all cases. No patient had metastatic disease at a mean follow-up of 56.5 months. There was one local recurrence and this
was managed by conversion to a Van Nes rotationplasty. Functional results were excellent in the proximal humeral cases
and in cases about the knee where the stabilizing ligaments were preserved. Cases with post-operative knee instability were
less successful but none the less were well controlled with bracing. Discussion. This technique offers an alternative to joint excision and prosthetic replacement in
a group of young patients. The Full Text of this article is available as a PDF (798K). These references are in PubMed. This may not be the complete list of references from this article. - Okada K, Frassica FJ, Sim FH, Beabout JW, Bond JR, Unni KK. Parosteal osteosarcoma. A clinicopathological study. J Bone Joint Surg Am. 1994 Mar;76(3):366–378. [PubMed]
- Enneking WF, Springfield D, Gross M. The surgical treatment of parosteal osteosarcoma in long bones. J Bone Joint Surg Am. 1985 Jan;67(1):125–135. [PubMed]
- Kavanagh TG, Cannon SR, Pringle J, Stoker DJ, Kemp HB. Parosteal osteosarcoma. Treatment by wide resection and prosthetic replacement. J Bone Joint Surg Br. 1990 Nov;72(6):959–965. [PubMed]
- Boriani S, Bacchini P, Bertoni F, Campanacci M. Periosteal chondroma. A review of twenty cases. J Bone Joint Surg Am. 1983 Feb;65(2):205–212. [PubMed]
- Alman BA, De Bari A, Krajbich JI. Massive allografts in the treatment of osteosarcoma and Ewing sarcoma in children and adolescents. J Bone Joint Surg Am. 1995 Jan;77(1):54–64. [PubMed]
- O'Connor MI, Sim FH, Chao EY. Limb salvage for neoplasms of the shoulder girdle. Intermediate reconstructive and functional results. J Bone Joint Surg Am. 1996 Dec;78(12):1872–1888. [PubMed]
- Enneking WF, Dunham W, Gebhardt MC, Malawar M, Pritchard DJ. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res. 1993 Jan;(286):241–246. [PubMed]
- Davis AM, Wright JG, Williams JI, Bombardier C, Griffin A, Bell RS. Development of a measure of physical function for patients with bone and soft tissue sarcoma. Qual Life Res. 1996 Oct;5(5):508–516. [PubMed]
- Weiner SD, Scarborough M, Vander Griend RA. Resection arthrodesis of the knee with an intercalary allograft. J Bone Joint Surg Am. 1996 Feb;78(2):185–192. [PubMed]
- Nixon JE. Prostheses in the management of bone cancer. Br Med J (Clin Res Ed). 1983 Jul 23;287(6387):245–246. [PubMed]
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