Long term results of using frozen bone autograft for reconstruction after resection of osteosarcoma around the knee in children | ||||
| Sohag Medical Journal | ||||
| Article 2, Volume 21, Issue 1, January 2017, Page 13-21 PDF (686.77 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/smj.2017.38896 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Ahmed Kassem1; Norio Yamamoto2; Katsuhiro Hayashi2; Akihiko Takeuchi2; Shinji Miwa2; Ahmad Morsy1; Yasser Assaghir1; Mohammed Alameldeen1; Hiroyuki Tsuchiya2; Anis Shiha1 | ||||
| 1Department of Orthopedic Surgery,Faculty of Medicine,Sohag University Hospital, Egypt. | ||||
| 2Department of Orthopedic Surgery,Faculty of Medicine,Kanazawa University, Japan. | ||||
| Abstract | ||||
| Introduction: Limb salvage has become the standard practice in the management of osteosarcoma. Limb salvage surgery represents a challenge in skeletally immature patients in whom further growth is anticipated. Several options are available for limb reconstruction in children, we report the long term results of using the freezing technique by liquid nitrogen for treatment of lower limb osteosarcoma in children using different reconstruction techniques. Method: This study includes 24 children with lower limb osteosarcoma, average age was13±3.2 y (6-18 y), ten boys. The mean follow-up period was 87.3±44.7 m (28-224 m). In 14 cases the lesion was in the femur, in ten patients it was in the tibia. Joint sparing and intercalary freezing was carried in out in 15 cases, while in five cases, osteoarticular freezing was performed, and a composite technique with a tumor prosthesis was performed in four cases. Results: Ten patients remained disease-free, eleven patients lived with no evidence of disease, one was alive with the disease, and two patients died of the disease. Five- and ten -year rates of survival were 91.76%. Graft five and ten years survival rates were 91.48% and 83.3 % respectively. Function on the Enneking scale was excellent in 19 patients (79.1%), and good in three patient (12.5%), fair in one (4.1%), and poor in two patients (8.3%), mean MSTS score was 25±5.4 (6-30). Mean union time was 8.7 m±2.1m (6-12m). Mean MSTS score was higher among children who receive a joint sparing rather than a joint sacrificing resection; 27.2 versus 21.3. Complications were recurrence in three cases (12.5%), all recurrences were from soft tissue, collapse of the osteoarticular graft occurred in two cases (8.3%). Fracture of the graft occurred in two cases (8.3%), nonunion occurred in three cases (12.5%). Leg length discrepancy occurred in seven cases, mean difference was 21.8mm±8.3mm (7-31mm), lengthening was carried out in four cases and finally got had equal leg length, in three cases, shoe lefts were enough. Conclusion: Reconstruction by frozen bone autograft for osteosarcoma around knee in children is easy, effective, biological, low-cost, immediate mobilization of joints, possible cryo-immune effects, with excellent long term functional outcome and with less complication. | ||||
|
Supplementary Files
|
||||
| References | ||||
|
Hong AM, Millington S, Ahern V, McCowage G, Boyle R, Tattersall M. et al.: Limb preservation surgery with extracorporeal irradiation in the management of malignant bone tumor: the oncological outcomes of 101 patients. 2013 Oct; 24(10):2676-80.
2- Steinau HU, Daigeler A, Langer S, Steinsträsser L, Hauser J, Goertz O. et al..: Limb salvage in malignant tumors. Semin Plast Surg. 2010 Feb; 24(1):18-33.
3- Picardo NE, Blunn GW, Shekkeris AS, Meswania J, Aston WJ, Pollock RC, et al.: The medium-term results of the Stanmore non-invasive extendible endoprosthesis in the treatment of paediatric bone tumours. J Bone Joint Surg Br. 2012 Mar; 94(3):425-30.
4- Tsuchiya H., K. Tomita, K. Minematsu, Y. Mori, N. Asada, S. Kitano: Limb salvage using distraction osteogenesis. A classification of the technique. J. Bone Joint Surg. Br. 1997 May; 79(3):403-11.
5- Asada N, Tsuchiya H, Kitaoka K, Mori Y, Tomita K.: Massive autoclaved allografts and autografts for limb salvage surgery: a 1-8 year follow-up of 23 patients. Acta Orthop Scand. 1997 Aug; 68(4):392-5.
6-Manabe J, Ahmed AR, Kawaguchi N, Matsumoto S, Kuroda H.: Pasteurized autologous bone graft in surgery for bone and soft tissue sarcoma. Clin Orthop Relat Res. 2004 Feb;(419):258-66.
7- Yamamoto N, Tsuchiya H, Tomita K.: Effects of liquid nitrogen treatment on the proliferation of osteosarcomas and biomechanical
properties of normal bone. J Orthop Sci. 2003;8(3):374-80.
8-Jun Nishida, Tadashi Shimamura: Methods of reconstruction for bone defect after tumor excision: A review of alternatives.Med Sci Monit. 2008 Aug;14(8):RA107-13.
9- Goldstein RS, Hess PW.; Cryosurgical treatment of cancer. Vet Clin North Am. 1977 Feb;7(1):51-64.
10- Luis Aponte-Tinao, Miguel A. Ayerza, D. Luis Muscolo, Germán L. Farfalli: Survival, Recurrence, and Function After Epiphyseal Preservation and Allograft Reconstruction in Osteosarcoma of the Knee. Clin Orthop Relat Res. 2015 May;473(5):1789-96.
11- Yamamoto N, Tsuchiya H.: Chemotherapy for osteosarcoma: where does it come from? What is it? Where is it going?. Expert Opin Pharmacother. 2013 Nov;14(16):2183-93.
12- Yamamoto N, Tsuchiya H.:Clinical observations of caffeine-potentiated chemotherapy J Caffeine Res. 2011Sep;1:163–68.
13- Tsuchiya H, Nishida H, Srisawat P, Shirai T, Hayashi K, Takeuchi A, Yamamoto N, Tomita K.: Pedicle frozen autograft reconstruction in malignant bone tumors. J Orthop Sci. 2010 May;15(3):340-9..
14-Enneking WF, ed. Limb salvage in musculoskeletal oncology. New York: Churchill-Livingstone. 1987; 5–16.
15-Marcove RC, Miller TR.: The treatment of primary and metastatic localized bone tumors by cryosurgery. Surg Clin North Am. 1969 Apr;49(2):421-30.
16- Marcove RC. : A 17-year review of cryosurgery in the treatment of bone tumors. Clin Orthop. 1982 Mar;(163):231-4.
17-Marcove RC, Zahr KA, Huvos AG, Ogihara W.: Cryosurgery in osteogenic sarcoma: report of three cases. Comp Ther. 1984 Jan;10(1):52-60.
18- Garusi C, Calabrese L, Giugliano G, Mazzarol G, Podrecca S, Chiesa F, et al.: Mandible reconstruction and autogenous frozen bone graft:experimental study on rats. Microsurgery. 2001;21(4):131-4.
19- Takata M, Sugimoto N, Yamamoto N, Shirai T, Hayashi K, Nishida H, et al.:Activity of bone morphogenetic protein-7 after treatment at various temperatures: freezing vs. pasteurization vs. allograft. Cryobiology. 2011 Dec;63(3):235-9.
20-Nishida H, Tsuchiya H, Tomita K.: Re-implantation of tumour tissue treated by cryotreatment with liquid nitrogen induces anti-tumour activity against murine osteosarcoma. J Bone Joint Surg [Br]. 2008 Sep;90(9):1249-55.
21-Campanacci Laura, Nikolin Alì, José Manuel Pinto Silva Casanova, Jennifer Kreshak, and Marco Manfrini: Resurfaced Allograft-Prosthetic Composite for Proximal Tibial Reconstruction in Children Intermediate-Term Results of an Original Technique J Bone Joint Surg Am. 2015 Feb 4;97(3):241-50.
22-Jeon DG, Song WS, Kong CB, Cho WH, Cho SH, Lee JD, et al.: Role of surgical margin on local recurrence in high risk extremity osteosarcoma: a case-controlled study. Clin Orthop Surg. 2013 Sep; 5(3):216-24.
23- Yu XC, Xu M, Xu SF, Song RX.: Long-term outcomes of epiphyseal preservation and reconstruction with inactivated bone for distal femoral osteosarcoma of children. Orthop Surg. 2012 Feb; 4(1):21-7.
24- Dotan A, Dadia S, Bickels J, Nirkin A, Flusser G, Issakov J, et al.: Expandable endoprosthesis for limb-sparing surgery in children: long-term results. J Child Orthop. 2010 Oct;4(5):391-400.
25- Shimozaki S, YamamotoN, Shirai T, Nishida H, Hayashi K, Tanzawa Y,et al.: Pedicle versus free frozen autograft for reconstruction in malignant bone and soft tissue tumors of the lower extremities J Orthop Sci. 2014 Jan;19(1):156-63.
26-Tanazawa Y, Tsuchiya H, Shirai T, Hayashi K, Yo Z, and Tomita K. Histological examination of frozen autograft treated by liquid nitrogen removed after implantation J Orthop Sci. 2009 Nov;14(6):761-8.
27- Campanacci M, Capanna R, Stilli S.: Posterior hemiresection of the distal femur in parosteal osteosarcoma. Ital J Orthop Traumatol. 1982 Mar;8(1):23-8.
28- Chen W , Wu P, Chen C.F., Chung L.H., Liu C., Chen T. H.: High-Grade Osteosarcoma Treated With Hemicortical Resection and Biological Reconstruction Journal of Surgical Oncology. 2012 Jun 15;105(8):825-9.
29-Whelan JS, Bielack SS, Marina N, Smeland S, Jovic G, Hook JM et al.: EURAMOS-1, an international randomised study for osteosarcoma: results from pre-randomisation treatment. EURAMOS collaborators. Ann Oncol. 2015 Feb;26(2):407-14.
30- Miwa, S., et al. (2012). "A novel combined radiological method for evaluation of the response to chemotherapy for primary bone sarcoma." Journal of surgical oncology 106(3): 273-279. | ||||
|
Statistics Article View: 254 PDF Download: 157 |
||||
