Acta Scientific Orthopaedics (ISSN: 2581-8635)

Review Article Volume 3 Issue 7

Reconstruction of Bone Defects after Tumor Resection Using Present Methods (Mini-Review). Bone Reconstruction Algorithm

Evgeniya Anastasieva* and IA Kirilova

Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan, Novosibirsk, Russian Federation

*Corresponding Author: Evgeniya Anastasieva, Ph.D. Candidate, Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan, Novosibirsk, Russian Federation.

Received: April 07, 2020; Published: June 04, 2020

×

Abstract

The replacement of large bone defects after segmental bone resections in patients with bone tumors is an actual problem in orthopedics. The main difficulty it causes especially in cases of disturbance of normal biomechanics. Especially when the “gold standard” of reconstruction with bone autograft is not possible, because of the defect, which can be so extensive that any autograft stock will be not enough. Therefore, allografts based on demineralized bone with optimal properties for osteoregeneration can become the necessary alternative for bone replacement. Nowadays composite materials is possible to be programmed to have the specific properties by changing its compound. After concluding the results of the literature analysis, we revealed that the allograft in combination with additional components is comparable by its effectiveness with autograft.
As an additional component to improve osteoregeneration mesenchymal stem cells of both bone marrow and adipose tissue can be used. However, it is noteworthy that the analyzed studies did not reveal the influence of stem cells on the tumor recurrence. So, the authors tell about necessity of further researches. Some authors still prefer traditional methods of bone traction despite obtaining own satisfactory results of defects reconstruction with allografts. Such opinion is based on proven effectiveness of the method, structural stability of construction during treatment period and ability to adjust the process of bone regeneration at any stage.
Our goal was to analyze publications over the recent 10 years, which report about results of experiments and clinical studies with performing massive bone reconstruction after bone tumor resection using auto- and allografts, or other technique. Based on the literature analysis we have updated our previous algorithm for graft selection in replacement of large bone defects after segmental bone resections.

Keywords: Bone Tumors; Osteooncology; Orthopedics; Bone Defect; Bone Reconstruction; Bone Resection; Bone Autograft; Bone Allograft

×

References

  1. Qu H., et al. “Reconstruction of segmental bone defect of long bones after tumor resection by devitalized tumor-bearing bone”. World Journal of Surgical Oncology 13 (2015): 282.
  2. Guerado E and Caso E. “Challenges of bone tissue engineering in ortho paedic patients”. World Journal of Orthopedics 2 (2017): 87-98.
  3. Glatt V., et al. “A Concert between biology and biomechanics: the influence of the mechanical environment on bone healing”. Frontiers in Physiology 7 (2016): 678.
  4. Elefteriou F., et al. “Control of Bone Remodeling by the Peripheral Sympathetic Nervous System”. Calcified Tissue International 1 (2014): 140-151.
  5. Muramatsu K., et al. “Stimulation of neo-angiogenesis by combined use of irradiated and vascularized living bone graft for oncological reconstruction”. Surgical Oncology 3 (2012): 223-229.
  6. Kazarezov MV., et al. “ [Orthopedics and reconstructive surgery]”. Novosibirsk: NNIITO, NGO “BREEZE” (2008): 448.
  7. Balberkin AV and Shavyrin DA. “[Clinic, diagnostics and surgical treatment of bone tumors of the knee joint region (literature review)]”. Sarkomy Kostei, Myagkikh Tkanei I Opukholi Kozhi Sarcomas of Bone, Soft Tissue and Skin Tumors 1 (2013): 15-23.
  8. Terskov AJu., et al. “ [Our tactics in diagnostics and treatment of patients with giant cell tumor of bone]”. Orthopedic Genius 2 (2013): 67-71.
  9. Dittrich C., et al. “ESMO/ASCO Recommendations for a Global Curriculum in Medical Oncology”. ESMO Open5 (2016): e000097.
  10. Fritzsche H., et al. “ [Benign tumours and tumour-like lesions of the bone: general treatment principles]”. Orthopade6 (2017): 484-497.
  11. Hillmann A and Gösling T. “[Benign bone tumors. General principles]”. Unfallchirurg10 (2014): 873-882.
  12. Leavey PJ. “Important principles in Ewing sarcoma treatment”. Pediatric Blood Cancer12 (2014): 2149-2150.
  13. Mavrogenis AF., et al. “State-of-the-art approach for bone sarcomas”. European Journal of Orthopaedic Surgery and Traumatology 1 (2015): 5-15.
  14. Panagopoulos GN., et al. “Intercalary reconstructions after bone tumor resections: a review of treatments”. European Journal of Orthopaedic Surgery and Traumatology 6 (2017): 737-746.
  15. Borzunov DY., et al. “Reconstruction by bone transport after resection of benign tumors of tibia: A retrospective study of 38 patients”. The Indian Journal of Orthopaedics 5 (2015): 516-522.
  16. Puri A., et al. “Reconstruction of the elbow and forearm for Ewing sarcoma of ulna: A new biological technique”. International Journal of Shoulder Surgery 2 (2016): 85-88.
  17. Puri A. “Limb salvage in musculoskeletal oncology: Recent advances”. Indian Journal of Plastic Surgery 2 (2014): 175-184.
  18. Puri A and Gulia A. “Management of extremity soft tissue sarcomas”. The Indian Journal of Orthopaedics 45 (2011): 301-306.
  19. Tikhilov RM., et al. “ [Surgical treatment for giant cell tumor of the bones]”. Herzen Journal of Oncology1 (2017): 5-11.
  20. Ramphal R., et al. “Adolescent and young adult cancer: principles of care”. Current Oncology 3 (2016): 204-209.
  21. Sadovoj MA., et al. “ [Surgical treatment of bone tumors in children]”. Travmatologiya Zhene Ortopediya 2 (2007): 134-137.
  22. Nisichenko DV., et al. “ [Subtotal resection of the tibia at the Research Institute of Pediatric Oncology and Hematology FGBI “RCRC. n.a. N.N. Blokhin” of the Ministry of Health of Russia]”. Sarkomy Kostei, Myagkikh Tkanei I Opukholi Kozhi 1 (2017): 52-58.
  23. Nieminen J., et al. “Orthopaedic reconstruction of complex pelvic bone defects. Evaluation of various treatment methods”. Scandinavian Journal of Surgery 1 (2013): 36-41.
  24. Ryzhikov DV., et al. “Repair of defects and osteosynthesis of long bones in children with osteoclastoma”. AIP Conference Proceedings1 (2016): 020059.
  25. Ivanova MV., et al. “ [Endoprosthetics of the shoulder joint with a metastatic lesion of the proximal humerus on the background of immunosuppressive therapy]”. Issledovaniya I Praktika V Meditsine1 (2017): 58-62.
  26. Khan Z., et al. “Tumours of the foot and ankle”. Foot3 (2015): 164-172.
  27. Gupta S.K., et al. “Principles of rotationplasty”. The Journal of the American Academy of Orthopaedic Surgeons 10 (2012): 657-667.
  28. Malviya A and Gerrand C. “Evidence for orthopaedic surgery in the treatment of metastatic bone disease of the extremities: a review article”. Palliative Medicine 6 (2012): 788-796.
  29. Piccioli A., et al. “Bone metastases of unknown origin: epidemiology and principles of management”. Journal of Orthopaedics and Traumatology 2 (2015): 81-86.
  30. Cheng D., et al. “Efficacy of limb salvage with primary tumor resection simultaneously for solitary bone metastasis in limbs”. World Journal of Surgical Oncology 1 (2015): 31.
  31. Gösling T and Becker-Schiebe M. “[Surgical treatment of skeletal metastases]”. Unfallchirurg 4 (2015): 347-363.
  32. Scolaro JA and Lackman RD. “Surgical management of metastatic long bone fractures: principles and techniques”. The Journal of the American Academy of Orthopaedic Surgeons 2 (2014): 90-100.
  33. Wessling M., et al. “ [Basic principles of surgical treatment of bone metastases]”. Zeitschrift fur Orthopadie und Unfallchirurgie 3 (2013): 303-314.
  34. Aponte-Tinao L.A., et al. “The principles and applications of fresh frozen allografts to bone and joint reconstruction”. Orthopedic Clinics of North America 2 (2014): 257-269.
  35. Kirilova IA., et al. “ [Comparative Characteristics of Materials for Bone Grafting: Composition and Properties]. Khirurgiya Pozvonochnika 3 (2012):72-83.
  36. Podorozhnaya V.T., et al. “[Allogeneic bone materials: structure, properties, application]”. Izvestiya Vysshikh Uchebnykh Zavedenii Fizika 12-3 (2013):14-20.
  37. Gharedaghi M., et al. “Evaluation of Clinical Results and Complications of Structural Allograft Reconstruction after Bone Tumor Surgery”. The Archives of Bone and Joint Surgery 3 (2016): 236-242.
  38. Zamiri B., et al. “Reconstruction of human mandibular continuity defects with allogenic scaffold and autologous marrow mesenchymal stem cells”. Journal of Craniofacial Surgery 4 (2013): 1292-1297.
  39. Ayerza M.A., et al. “Structural allograft reconstruction of the foot and ankle after tumor resections”. Journal of Musculoskeletal Surgery 2 (2016):149-156.
  40. Chen W.M., et al. “High-grade osteosarcoma treated with hemicortical resection and biological reconstruction”. Journal of Surgical Oncology 8 (2012): 825-829.
  41. Gouron R. “Surgical technique and indications of the induced membrane procedure in children”. Orthopaedics and Traumatology Surgery and Research Journal 1 (2016): S133-S139.
  42. Halim A.S., et al. “Long-term outcome of free fibula osteocutaneous flap and massive allograft in the reconstruction of long bone defect”. Journal of Plastic Reconstructive and Aesthetic Surgery 12 (2015): 1755-1762.
  43. Han G., et al. “Reconstruction using massive allografts after resection of extremity osteosarcomas the study design: A retrospective cohort study”. International Journal of Surgery 21 (2015): 108-111.
  44. Houdek M.T., et al. “What Is the Outcome of Allograft and Intramedullary Free Fibula (Capanna Technique) in Pediatric and Adolescent Patients with Bone Tumors?” Clinical Orthopaedics and Related Research 3 (2016): 660-668.
  45. Li J., et al. “Image navigation assisted joint saving surgery for treatment of bone sarcoma around knee in skeletally immature patients”. Surgical Oncology 3 (2014): 132-139.
  46. Farfalli GL., et al. “Clinical and functional outcomes of tibial intercalary allografts after tumor resection”. Orthopedics 3 (2012): e391-e396.
  47. Nogueira Drumond JM. “Benign bone tumors and tumorlike bone lesions: treatment update and new trends”. Revista Brasileira de Ortopedia 5 (2015): 386-390.
  48. Wang W., et al. “Allogeneic bone transplantation for pelvic reconstruction of large skeletal defects after tumor resection”. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi3 (2014): 331-334.
  49. Gouron R., et al. “Bone defect reconstruction in children using the induced membrane technique: a series of 14 cases”. Orthopaedics and Traumatology: Surgery and Research 7 (2013): 837-843.
  50. King J.J., et al. “Allograft-prosthetic composite reverse total shoulder arthroplasty for reconstruction of proximal humerus tumor resections”. Journal of Shoulder and Elbow Surgery 1 (2016): 45-54.
  51. Mikailov IM., et al. “ [Results of the proximal humerus endoprosthetic reconstruction after tumour resection]. Travmatologiya I Ortopediya Rossii 4 (2014): 27-35.
  52. Tikhilov R.M., et al. “ [Shortand middle-term results of hip arthroplasty for tumors of the proximal femur]”. Travmatologiya I Ortopediya Rossii 2 (2014): 14-21.
  53. Müller D.A., et al. “Allograft-prosthetic composite versus megaprosthesis in the proximal tibia. What works best?” Injury4 (2016): S124-S130.
  54. Al Gheshyan F., et al. “Comparison of gait parameters in distal femoral replacement using a metallic endoprosthesis versus allograft reconstruction”. Journal of Orthopaedics 1 (2015): S25-S30.
  55. Kotela A., et al. “Revision knee arthroplasty in patients with inherited bleeding disorders: a single-center experience”. Medical Science Monitor 23 (2017): 129-137.
  56. Rudert M., et al. “Impaction bone grafting for the reconstruction of large bone defects in revision knee arthroplasty”. Operative Orthopädie and Traumatologie 1 (2015): 35-46.
  57. Sakellariou VI and Babis GC. “Management bone loss of the proximal femur in revision hip arthroplasty: Update on reconstructive options”. World Journal of Orthopedics 5 (2014): 614-622.
  58. Nakamura K., et al. “Tumor-induced osteomalacia caused by a massive phosphaturic mesenchymal tumor of the acetabulum: A case report”. Modern Rheumatology (2016): 1-5.
  59. Avril P., et al. “Mesenchymal stem cells increase proliferation but do not change quiescent state of osteosarcoma cells: Potential implications according to the tumor resection status”. Journal of Bone Oncology 1 (2016): 5-14.
  60. Kong Y., et al. “The bone marrow microenvironment is similarly impaired in allogeneic hematopoietic stem cell transplantation patients with early and late poor graft function”. Bone Marrow Transplant2 (2016): 249-255.
  61. Glennie RA., et al. “A systematic review with consensus expert opinion of best reconstructive techniques after osseous en bloc spinal column tumor resection”. Spine20 (2016): S205-S211.
  62. Balaev PI and Borzunov DJu. “[Possibilities of bone reconstruction according to G.A. Illizarov in the recovery treatment of patients with primary tumors of the lower leg]”. Sibirskii Onkologicheskii Zhurnal55 (2013): 59-64.
  63. Khira YM and Badawy HA. “Pedicled vascularized fibular graft with Ilizarov external fixator for reconstructing a large bone defect of the tibia after tumor resection”. Journal of Orthopaedics and Traumatology 2 (2013): 91-100.
  64. Bus MP., et al. “Intercalary allograft reconstructions following resection of primary bone tumors: a nationwide multicenter study”. Journal of Bone and Joint Surgery American4 (2014): e26.
  65. Wu Z., et al. “Three-dimensional virtual bone bank system for selecting massive bone allograft in orthopaedic oncology”. International Orthopaedics 6 (2015):1151-1158.
  66. Gorbatov RO., et al. “ [Precision personalized implants to replace bone defects for treatment of patients with osteoonkology]”. Sovremennye Problemy Nauki I Obrazovaniya 6 (2016): 247.
  67. Kang S., et al. “The MRI appearances of cancellous allograft bone chips after the excision of bone tumours”. The Bone and Joint Journal 97-B.1 (2015): 121-128.
×

Citation

Citation: Evgeniya Anastasieva and IA Kirilova. “Reconstruction of Bone Defects after Tumor Resection Using Present Methods (Mini-Review). Bone Reconstruction Algorithm". Acta Scientific Orthopaedics 3.7 (2020): 02-08.



Member In




News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is July 25, 2020.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of “Best Article of the Issue”.
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.
  • Contact US