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Low-grade central osteosarcoma of distal femur, resembling fibrous dysplasia

World Journal of Orthopedics 2013年第4期4卷 327-332页

作者： Haris S Vasiliadis Christina Arnaoutoglou Sotiris Plakoutsis Michalis Doukas Anna Batistatou theodoros a xenakis Department of Orthopaedics University Hospital of Ioannina Department of Pathology University Hospital of Ioannina

We report a case of a 32 year-old male, admitted for a lytic lesion of the distal femur. One month after the first X-ray, clinical and imaging deterioration was evident. Open biopsy revealed fibrous dysplasia. Three months later, the lytic lesion had spread to the whole distal third of the femur reaching the articular cartilage. The malignant clinical and imaging features necessitated excision of the lesion and reconstruction with a custom-made total knee arthroplasty. Intraoperatively, no obvious soft tissue infiltration was evident. Nevertheless, an excision of the distal 15.5 cm of the femur including 3.0 cm of the surrounding muscles was finally performed. The histological examination of the excised specimen revealed central low-grade osteosarcoma. Based on the morphological features of the excised tumor, allied to the clinical findings, the diagnosis of low-grade central osteosarcoma was finally made although characters of a fibrous dysplasia were apparent. Central low-grade osteosarcoma is a rare, well-differentiated sub-type of osteosarcoma, with clinical, imaging, and histological features similar to benign tumours. Thus, initial misdiagnosis is usual with the condition commonly mistaken for fibrous dysplasia. Central low-grade osteosarcoma is usually treated with surgery alone, with rare cases of distal metastases. However, regional recurrence is quite frequent after close margin excision.

关键词： Osteosarcoma Fibrous dysplasia of bone Distal femur Custom-made total knee arthroplasty Tumour

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Modified porous tantalum rod technique for the treatment of femoral head osteonecrosis

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World Journal of Orthopedics 2015年第10期6卷 829-837页

作者： Emilios E Pakos Panayiotis Megas Nikolaos K Paschos Spyridon A Syggelos Antonios Kouzelis Georgios Georgiadis theodoros a xenakis Department of Orthopaedics and Biomechanics University of IoanninaMedical School Department of Ortho-paedic Surgery University Hospital of PatrasUniversity of PatrasMedical School Department of Anatomy HistologyEmbryologyUniversity of PatrasMedical School

AIM: To study a modified porous tantalum technique for the treatment of osteonecrosis of the femoral ***: The porous tantalum rod was combined with endoscopy,curettage,autologous bone grafting and use of bone marrow aspirates from iliac crest aspiration in 49 patients(58 hips) with a mean age of 38 *** majority of the patients had idiopathic osteonecrosis,followed by corticosteroid-induced *** hips were of Steinberg stage Ⅱ disease and 20 hips were of stage Ⅲ *** were followed for 5 years and were evaluated clinically with the Merle D'Aubigne and Postel score and *** primary outcome of the study was survival based on the conversion to total hip arthroplasty(THA).Secondary outcomes included deterioration of the osteonecrosis to a higher disease stage at 5 years compared to the preoperative period and identification of factors that were associated with *** Kaplan-Meier survival analysis was performed to evaluate the survivorship ofthe prosthesis,and the Fisher exact test was performed to test associations between various parameters with ***: No patient developed any serious intraoperative or postoperative complication including implant loosening or migration and donor site *** the 5-year follow up,1 patient died,7 patients had disease progression and 4 hips were converted to *** 5-year survival based on conversion to THA was 93.1% and the respective rate based on disease progression was 87.9%.Stage Ⅱ disease was associated with statistically significant better survival rates compared to stage Ⅲ disease(P = 0.04).The comparison between idiopathic and non-idiopathic osteonecrosis and between steroid-induced and non-steroid-induced osteonecrosis did not showed any statistically significant difference in survival *** clinical evaluation revealed statistically significantly improved Merle d'Aubigne scores at 12 mo postoperatively compared to the preoperative period

关键词： Avascular necrosis Femoral head Tantalum rod Survival Bone grafting

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