Computer navigation-aided joint-preserving resection and custom-made endoprosthesis reconstruction for bone sarcomas:long-term outcomes

作     者：Li-Hui Xu Qing Zhang Hai-Tao Zhao Feng Yu Xiao-Hui Niu 

作者机构：Department of Orthopedic Oncology SurgeryBeijing Ji Shui Tan HospitalPeking UniversityBeijing 100035China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2021年第134卷第21期

页      面：2597-2602页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Bone sarcoma Computer-assisted navigation Joint-preserving resection Custom-made endoprosthesis 

摘      要：Background:Computed tomography(CT)and magnetic resonance imaging(MRI)data can be fused to identify the tumor *** enables surgeons to set close but tumor-free surgical margins and excise the tumor more *** study aimed to report our experience in performing computer navigation-aided joint-preserving resection and custom-made endoprosthesis reconstruction to treat bone sarcoma in the diaphysis and metaphysis of the femur and ***:Between September 2008 and December 2015,24 patients with bone sarcomas underwent surgical resection and joint-sparing reconstruction under image-guided computer *** cohort comprised 16 males and eight females with a median age of 19.5 years(range:12-48 years).The tumor location was the femoral diaphysis in three patients,distal femur in 19,and proximal tibia in *** tumors were osteosarcoma(n=15),chondrosarcoma(n=3),Ewing sarcoma(n=3),and other sarcomas(n=3).We created a pre-operative plan for each patient using navigation system software and performed navigation-aided resection before reconstructing the defect with a custom-made prosthesis with extracortical plate ***:Pathological examination verified that all resected specimens had appropriate surgical *** median distance from the tumor resection margin to the joint was 30 mm(range:13-80 mm).The median follow-up duration was 62.5 months(range:24-134 months).Of the 24 patients,21 remain disease free,one is alive with disease,and two died of the *** patient developed local *** requiring additional surgical procedures occurred in six patients,including one with wound hematoma,one with delayed wound healing,one with superficial infection,one with deep infection,and two with mechanical failure of the *** mean Musculoskeletal Tumor Society score at the final follow-up was 91%(range:80%-100%).The 5-and 10-year implant survival rates were 91.3%and 79.9%,***:Computer naviga