Reconstruction after resection has always been an urgent problem in the treatment of bone tumours.There are many methods that can be used to reconstruct bone defects;however,there are also many complications,and it is...Reconstruction after resection has always been an urgent problem in the treatment of bone tumours.There are many methods that can be used to reconstruct bone defects;however,there are also many complications,and it is difficult to develop a safe and effective reconstruction plan for the treatment of bone tumours.With the rapid development of digital orthopaedics,three-dimensional printing technology can solve this problem.The three-dimensional printing of personalised prostheses has many advantages.It can be used to print complex structures that are difficult to fabricate using traditional processes and overcome the problems of stress shielding and low biological activity of conventional prostheses.In this study,12 patients with bone tumours were selected as research subjects,and based on individualised reverse-engineering design technology,a three-dimensional model of each prosthesis was designed and installed using medical image data.Ti6Al4V was used as the raw material to prepare the prostheses,which were used to repair bone defects after surgical resection.The operation time was 266.43±21.08 minutes(range 180-390 minutes),and intraoperative blood loss was 857.26±84.28 mL(range 800-2500 mL).One patient had delayed wound healing after surgery,but all patients survived without local tumour recurrence,and no tumour metastasis was found.No aseptic loosening or structural fracture of the prosthesis,and no non-mechanical prosthesis failure caused by infection,tumour recurrence,or progression was observed.The Musculo-Skeletal Tumour Society(MSTS)score of limb function was 22.53±2.09(range 16-26),and ten of the 12 patients scored≥20 and were able to function normally.The results showed that three-dimensional printed prostheses with an individualised design can achieve satisfactory short-term clinical efficacy in the reconstruction of large bone defects after bone tumour resection.展开更多
Objective：Giant cell tumours（GCT） represent one of the most common benign tumours of bone. However, despite its benign nature they are aggressive lesions that have a tendency to recur. This study aims to report exp...Objective：Giant cell tumours（GCT） represent one of the most common benign tumours of bone. However, despite its benign nature they are aggressive lesions that have a tendency to recur. This study aims to report experience with the treatment of GCTs, and reviews the relationship between surgical management and clinical outcome. Methods：A retrospective review was performed with 70 patients （32 males and 38 females） who presented to our institution between 1991 and 2001 with GCT of bone. An evaluation of the oncological and functional results was conducted and patients were divided into three groups according to the treatment method; Group Ⅰ ：（46 patients） intralesional curettage and adjuvant therapy and packing with filling materials. Group Ⅱ ：（18 patients） en-bloc resection and arthrodesis or reconstruction. Group Ⅲ ：（6 patients） amputation. Results：The mean follow-up period was 10 years （range, 5-15 years）. The overall rate of local recurrence was 14%, 22% in Group Ⅰ, and only 4% in Group Ⅱ and Group Ⅲ. According to the Musculoskeletal Tumour Society（MSTS） score for functional outcome, the mean overall score for Group I was 27.9 （out of 30）, 15.9 for Group Ⅱ. Of note, the 9 patients within Group Ⅱ who received endoprosthetic reconstruction, the mean overall MSTS functional score was 25.5. Conclusion：Intralesional curettage with adjuvant therapies and filling agents is often associated with a relatively high recurrence rate, however joint function is well preserved. Patients with more extensive, biologically aggressive, and/or recurrent tumours are best treated with en-bloc resection.展开更多
Background: The diversity of benign jaw tumours may cause difficulty in a correct diagnosis and insti-tution of an appropriate treatment. Data on the prevalence of these tumours is scarce from the Afri-can continent. ...Background: The diversity of benign jaw tumours may cause difficulty in a correct diagnosis and insti-tution of an appropriate treatment. Data on the prevalence of these tumours is scarce from the Afri-can continent. We present a 19-year audit of benign jaw tumours and tumour-like lesions at a University teaching hospital in Nairobi, Kenya. Methods: Histo-pathological records were retrieved and re-examined from the Department of Oral and Maxillofacial pathology, University of Nairobi from 1992 to 2011. The jaw tumours were classified according to the latest WHO classification. Results: During the 19-year audit, 4257 biopsies were processed of which 597 (14.02%) were jaw tumours within an age range of between 4 to 86 years. There was greater number of odontogenic tumours 417 (69.85%) than the bone related lesions 180 (30.15%). Of the odontogenic tumours, the epithetlial and in the bone related types, the fibro-osseous lesions were frequent. Conclusion: Ameloblastoma and ossifying fibroma were the most frequent tumours reported in this audit. The information regarding the prevalence of these tumours is scarce from the continent and can be useful in early detection and management before they cause facial deformity.展开更多
BACKGROUND Bone lesions can present the multi-displinary team with a challenge by way of diagnosis as some lesions share many radiological and histological characteristics.Giant cell tumours of the bone(GCTB)are relat...BACKGROUND Bone lesions can present the multi-displinary team with a challenge by way of diagnosis as some lesions share many radiological and histological characteristics.Giant cell tumours of the bone(GCTB)are relatively common,benign bone tumours.Aneurysmal bone cysts(ABC)are less common benign osteolytic lesions that are histologically similar to GCTBs but produce blood filled cavities.Both GCTBs and ABCs are locally aggressive and are typically found on meta-epiphyseal regions of long bones with pelvic tumours being less common.CASE SUMMARY A 17-year old female presented with atraumatic right groin pain and was initially diagnosed with a GCTB on the right superior pubic ramus of the pelvis.The patient was treated successfully with a wide excision,curettage and bone graft and underwent open reduction and internal fixation of the right hemi-pelvis.Following further intra-operative histological investigations,the lesion was diagnosed as an ABC.CONCLUSION This patient has had an uncomplicated post-operative course,has returned to comfortable weight bearing and will be reviewed for minimum 5 yr in the outpatient setting to monitor for reoccurrence.展开更多
基金This study was supported by the National Natural Science Foundation of China(No.81904231).
文摘Reconstruction after resection has always been an urgent problem in the treatment of bone tumours.There are many methods that can be used to reconstruct bone defects;however,there are also many complications,and it is difficult to develop a safe and effective reconstruction plan for the treatment of bone tumours.With the rapid development of digital orthopaedics,three-dimensional printing technology can solve this problem.The three-dimensional printing of personalised prostheses has many advantages.It can be used to print complex structures that are difficult to fabricate using traditional processes and overcome the problems of stress shielding and low biological activity of conventional prostheses.In this study,12 patients with bone tumours were selected as research subjects,and based on individualised reverse-engineering design technology,a three-dimensional model of each prosthesis was designed and installed using medical image data.Ti6Al4V was used as the raw material to prepare the prostheses,which were used to repair bone defects after surgical resection.The operation time was 266.43±21.08 minutes(range 180-390 minutes),and intraoperative blood loss was 857.26±84.28 mL(range 800-2500 mL).One patient had delayed wound healing after surgery,but all patients survived without local tumour recurrence,and no tumour metastasis was found.No aseptic loosening or structural fracture of the prosthesis,and no non-mechanical prosthesis failure caused by infection,tumour recurrence,or progression was observed.The Musculo-Skeletal Tumour Society(MSTS)score of limb function was 22.53±2.09(range 16-26),and ten of the 12 patients scored≥20 and were able to function normally.The results showed that three-dimensional printed prostheses with an individualised design can achieve satisfactory short-term clinical efficacy in the reconstruction of large bone defects after bone tumour resection.
文摘Objective：Giant cell tumours（GCT） represent one of the most common benign tumours of bone. However, despite its benign nature they are aggressive lesions that have a tendency to recur. This study aims to report experience with the treatment of GCTs, and reviews the relationship between surgical management and clinical outcome. Methods：A retrospective review was performed with 70 patients （32 males and 38 females） who presented to our institution between 1991 and 2001 with GCT of bone. An evaluation of the oncological and functional results was conducted and patients were divided into three groups according to the treatment method; Group Ⅰ ：（46 patients） intralesional curettage and adjuvant therapy and packing with filling materials. Group Ⅱ ：（18 patients） en-bloc resection and arthrodesis or reconstruction. Group Ⅲ ：（6 patients） amputation. Results：The mean follow-up period was 10 years （range, 5-15 years）. The overall rate of local recurrence was 14%, 22% in Group Ⅰ, and only 4% in Group Ⅱ and Group Ⅲ. According to the Musculoskeletal Tumour Society（MSTS） score for functional outcome, the mean overall score for Group I was 27.9 （out of 30）, 15.9 for Group Ⅱ. Of note, the 9 patients within Group Ⅱ who received endoprosthetic reconstruction, the mean overall MSTS functional score was 25.5. Conclusion：Intralesional curettage with adjuvant therapies and filling agents is often associated with a relatively high recurrence rate, however joint function is well preserved. Patients with more extensive, biologically aggressive, and/or recurrent tumours are best treated with en-bloc resection.
文摘Background: The diversity of benign jaw tumours may cause difficulty in a correct diagnosis and insti-tution of an appropriate treatment. Data on the prevalence of these tumours is scarce from the Afri-can continent. We present a 19-year audit of benign jaw tumours and tumour-like lesions at a University teaching hospital in Nairobi, Kenya. Methods: Histo-pathological records were retrieved and re-examined from the Department of Oral and Maxillofacial pathology, University of Nairobi from 1992 to 2011. The jaw tumours were classified according to the latest WHO classification. Results: During the 19-year audit, 4257 biopsies were processed of which 597 (14.02%) were jaw tumours within an age range of between 4 to 86 years. There was greater number of odontogenic tumours 417 (69.85%) than the bone related lesions 180 (30.15%). Of the odontogenic tumours, the epithetlial and in the bone related types, the fibro-osseous lesions were frequent. Conclusion: Ameloblastoma and ossifying fibroma were the most frequent tumours reported in this audit. The information regarding the prevalence of these tumours is scarce from the continent and can be useful in early detection and management before they cause facial deformity.
文摘BACKGROUND Bone lesions can present the multi-displinary team with a challenge by way of diagnosis as some lesions share many radiological and histological characteristics.Giant cell tumours of the bone(GCTB)are relatively common,benign bone tumours.Aneurysmal bone cysts(ABC)are less common benign osteolytic lesions that are histologically similar to GCTBs but produce blood filled cavities.Both GCTBs and ABCs are locally aggressive and are typically found on meta-epiphyseal regions of long bones with pelvic tumours being less common.CASE SUMMARY A 17-year old female presented with atraumatic right groin pain and was initially diagnosed with a GCTB on the right superior pubic ramus of the pelvis.The patient was treated successfully with a wide excision,curettage and bone graft and underwent open reduction and internal fixation of the right hemi-pelvis.Following further intra-operative histological investigations,the lesion was diagnosed as an ABC.CONCLUSION This patient has had an uncomplicated post-operative course,has returned to comfortable weight bearing and will be reviewed for minimum 5 yr in the outpatient setting to monitor for reoccurrence.
