The Most Appropriate Reconstruction Method Following Giant Cell Tumor Curettage: A Biomechanical Approach | ||
The Archives of Bone and Joint Surgery | ||
مقاله 1، دوره 6، شماره 2، خرداد 2018، صفحه 85-89 اصل مقاله (437.26 K) | ||
نوع مقاله: EDITORIAL | ||
شناسه دیجیتال (DOI): 10.22038/abjs.2018.30154.1780 | ||
نویسندگان | ||
Azadeh Ghouchani1؛ Mohammad H. Ebrahimzadeh2؛ Gholamreza Rouhi* 1 | ||
1Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran | ||
2Orthopedic research center, Mashhad university of medical sciences, Mashhad, Iran | ||
چکیده | ||
Giant cell tumor (GCT) is a primary and benign tumor of bone, albeit locally aggressive in some cases, such as in the epi-metaphyseal region of long bones, predominantly the distal end of femur and proximal end of tibia (1). There are a variety of treatments for a bone affected by GCT, ranging from chemotherapy, radiotherapy, embolization, and cryosurgery, to surgery with the use of chemical or thermal adjuvant (2). Even with advances in new chemotropic drugs, surgery is still the most effective treatment for this kind of tumor (3). The surgery often involves defect reconstruction following tumor removal (4). The aims of treatment are removing the tumor and reconstructing the bone defect in order to decrease the risk of recurrence, and restore limb function, respectively. To achieve these goals, reconstruction is usually accompanied with PMMA bone cement infilling (4). The high heat generated during PMMA polymerization in the body can kill the remaining cancer cells, and hence the chance of recurrence decreases (5). In addition, filling the cavity with bone cement provides immediate stability, enabling patients to return to their daily activities soon (6). The major drawbacks of the technique of curettage and cementation is the high fracture risk, due to the early loading of the bone, and the insufficient fixation of the cement in the cavity (7). Hence, several methods have been developed to fix the bone cement in order to prevent the postoperative fracture. Pattijn et.al packed the cement with a titanium membrane which was attached to the periosteum with small screws (7). The membrane can make early normal functioning of patients possible, since it partially restore the strength and stiffness of the bone. Cement augmentation with internal fixation is another method to decrease the risk of postoperative fractures (6, 8, 9). | ||
کلیدواژهها | ||
Giant cell tumor؛ orthopedic biomechanics؛ finite element method | ||
مراجع | ||
1. Cowan RW, Singh G. Giant cell tumor of bone: a basic science perspective. Bone. 2013; 52(1):238-46. 2. Singh S, Singh M, Mak I, Ghert M. Expressional analysis of GFP-Tagged cells in an in vivo mouse model of giant cell tumor of bone. Open Orthop J. 2013; 7:109-13. 3. Wu PF, Tang JY, Li KH. RANK pathway in giant cell tumor of bone: pathogenesis and therapeutic aspects. Tumor Biol. 2015; 36(2):495-501. 4. Fraquet N, Faizon G, Rosset P, Phillipeau J, Waast D, Gouin F. Long bones giant cells tumors: treatment by curretage and cavity filling cementation. Orthop Traumatol Surg Res. 2009; 95(6):402-6. 5. Wada T, Kaya M, Nagoya S, Kawaguchi S, Isu K, Yamashita T, et al. Complications associated with bone cementing for the treatment of giant cell tumors of bone. J Orthop Sci. 2002; 7(2):194-8. 6. Toy PC, France J, Randall RL, Neel MD, Shorr RI, Heck RK. Reconstruction of noncontained distal femoral defects with polymethylmethacrylate and crossedscrew augmentation: a biomechanical study. J Bone Joint Surg Am. 2006; 88(1):171-8. 7. Pattijn V, Gelaude F, Sloten JV, Van Audekercke R. Medical image-based preformed titanium membranes for bone reconstruction. Med Imaging Syst Technol Methods General Anatomy. 2005; 5:43-78. 8. Murray PJ, Damron TA, Green JK, Morgan HD, Werner FW. Contained femoral defects: biomechanical analysis of pin augmentation in cement. Clin Orthop Relat Res. 2004; 420(1):251-6. 9. Randall RL, Weenig KN, West JR, Johnston JO, Bachus KN. Durability and strength of Steinmann pin augmentation in cemented tibial defects. Clin Orthop Relat Res. 2002; 397(1):306-14. 10. Bickels J, Meller I, Malawer M. The biology and role of cryosurgery in the treatment of bone tumors. In: Malawer MM, Sugarbaker PH, editors. Musculoskeletal cancer surgery. Netherlands: Springer; 2001. P. 135-45. 11. Malawer MM, Bickels J, Meller I, Buch RG, Henshaw RM, Kollender Y. Cryosurgery in the treatment of giant cell tumor: a long term followup study. Clin Orthop Relat Res. 1999; 359(1):176-88. 12. Pan KL, Chan WH. Curettage and cementation in giant cell tumour of the distal tibia using polypropylene mesh for containment: A. Malays Orthop J. 2010; 4(2):51-3. 13. Toy PC, Arthur S, Brown D, Heck RK. Reconstruction of noncontained proximal tibial defects with divergent screws and cement. Clin Orthop Relat Res. 2007; 459(1):167-73. 14. Uglialoro AD, Maceroli M, Beebe KS, Benevenia J, Patterson FR. Distal femur defects reconstructed with polymethylmethacrylate and internal fixation devices: a biomechanical study. Orthopedics. 2009; 32(8):561-67. 15. Bini S, Gill K, Johnston JO. Giant cell tumor of bone. Curettage and cement reconstruction. Clin Orthop Relat Res. 1995; 321(1):245-50. 16. Asavamongkolkul A, Pongkunakorn A, Harnroongroj T. Stability of subchondral bone defect reconstruction at distal femur: comparison between polymethylmethacrylate alone and steinmann pin reinforcement of polymethylmethacrylate. J Med Assoc Thai. 2003; 86(7):626-33. 17. Weiner M, Damron TA, Patterson FR, Werner FW, Mann KA. Biomechanical study of pins in cementing of contained proximal tibia defect. Clin Orthop Relat Res. 2004; 419(1):232-7. 18. Ruskin J, Caravaggi P, Beebe KS, Corgan S, Chen L, Yoon RS, et al. Steinmann pin augmentation versus locking plate constructs. J Orthop Traumatol. 2016; 17(3):249-54. 19. Brekelmans WA, Poort HW, Slooff TJ. A new method to analyse the mechanical behaviour of skeletal parts. Acta Orthop Scand. 1972; 43(5):301-17. 20. Kamal Z, Rouhi G. A parametric investigation of the effects of cervical disc prostheses with upward and downward nuclei on spine biomechanics. J Mech Med Biol. 2016; 16(2):1650092. 21. Chitsazan A, Herzog W, Rouhi G, Abbasi M. Alteration of strain distribution in distal tibia after triple arthrodesis: experimental and finite element investigations. J Med Biol Engin. 2017; 6(17):1-13. 22. Nourisa J, Rouhi G. Biomechanical evaluation of intramedullary nail and bone plate for the fixation of distal metaphyseal fractures. J Mech Behav Biomed Mater. 2016; 56(1):34-44. 23. Samsami S, Saberi S, Sadighi S, Rouhi G. Comparison of three fixation methods for femoral neck fracture in young adults: experimental and numerical investigations. J Med Biol Eng. 2015; 35(5):566-79. 24. Rouhi G, Vahdati A, Li X, Sudak L. A three dimensional computer model to simulate spongy bone remodelling under overload using a semimechanistic bone remodelling theory. J Mech Med Biol. 2015; 15(4):1550061. 25. Rouhi G, Tahani M, Haghighi B, Herzog W. Prediction of stress shielding around orthopedic screws: timedependent bone remodeling analysis using finite element approach. J Med Biol Eng. 2015; 35(4):545- 54. 26. Ghouchani A, Ebrahimzadeh MH, Rouhi G. Voxelbased finite element model of a reconstructed bone: simulating a bone tumor surgery. J Bioeng Biomed Sci. 2016; 6(5):47. 27. Ghouchani A, Ebrahimzadeh MH, Rouhi G. Predicting the risk of post-operative fracture of giant cell tumor using fully voxelised finite element models. 24th annual meeting of the Iranian orthopaedic association, September 26-30, Tehran, Iran; 2016. 28. Li J, Wodajo F, Theiss M, Kew M, Jarmas A. Computer simulation techniques in giant cell tumor curettage and defect reconstruction. Comput Sci Engin. 2013; 15(2):21-6. 29. Mosleh H, Rouhi G, Ghouchani A, Nourisa J, Bagheri N. Prediction of the fracture risk of reconstructed bone with cement using QCT based structural rigidity and finite element analysis. California: Orthopaedic Research Society Annual Meeting San Diego; 2017. 30. Ghouchani A, Rouhi G. The great need of a biomechanical-based approach for surgical methods of giant cell tumor: a critical review. J Med Biol Engin. 2017; 37(4):454-67. | ||
آمار تعداد مشاهده مقاله: 801 تعداد دریافت فایل اصل مقاله: 587 |