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Thursday, March 19, 1998

Periarticular reconstruction using distraction osteogenesis after en bloc tumor resection

Periarticular reconstruction can be accomplished by distraction osteogenesis in patients with malignant or aggressive bone tumors, according to a study presented Thursday in scientific exhibit 93.

"Functional evaluation rated 10 patients in the study as excellent, three good and two fair," said Hiroyuki Tsuchiya, MD, of Kanazawa, Japan. There was no local tumor recurrence.

One to two weeks following tumor excision, a fixator combined with or without intramendullary nailing was applied and distraction was started at a speed of 0.5 to 1.00 millimeters per day, Dr. Tsuchiya said.

Among the 15 patients, ages 9 to 43, there were nine osteosarcomas, five giant-cell tumor of bone, and one Ewing's sarcoma. Nine patients had lesions located in the proximal tibia; five patients had lesions in the distal femur; and one patient had a lesion in the proximal femur. Distraction osteogenesis was performed on seven patients during postoperative chemotherapy.

Results of the study shows that the epiphysis could be preserved for seven patients, unilateral epiphysis for two patients and thin articular surface for six patients. Dr. Tsuchiya noted that the ipsilateral patella's articular surface was used to reconstruct the joint after unilateral epiphyseal resection, said Dr. Tsuchiya.

Reconstruction in this study was limited to diaphyseal reconstruction and arthrodesis. However, metaphyseal and epiphyseal defects can be reconstructed with this method as well, making it beneficial for selected patients with a prognosis of long survival and for growing children. The nine complications were successfully treated with surgical or conservative therapy.

"Intramedullary nailing was found useful for shortening the external fixation period," Dr. Tsuchiya noted. Co-authors of the study with Dr. Tsuchiya are Katsuro Tomita, MD; Koji Minematsu, MD; Yoshihiko Mori, MD; Naohiro Asada, MD; and Shinji Kitane, MD, all from Kanazawa, Japan.

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1998 Academy News Mar.19 Index C

Last modified 04/March/1998