• Title/Summary/Keyword: 관절종양

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Oncologic Results and Functional Assessment of Limb Salvage Surgery in Primary Bone Tumors Around the Shoulder Girdle (견관절 주위 원발성 골 종양에서 사지 구제술의 종양학적 결과 및 기능적 평가)

  • Lee, Sang-Hoon;Yoo, Jae-Ho;Oh, Joo-Han;Suh, Sung-Wook;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.3
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    • pp.96-105
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    • 2002
  • Purpose: The purpose of this study was to assess the oncologic results and functional outcomes of limb salvage surgery performed in patients of primary bone tumors of the shoulder girdle. Materials and Methods: Twenty-nine patients who underwent limb sparing resection for shoulder girdle neoplasm between 1982 and 2001 were analyzed. Follow up periods averaged 7 years and 1 month. Mean age of the patients was 35 (11~71) years. There were 14 males and 15 females. Primary malignant bone tumors of shoulder girdle (proximal humerus 21, scapula 3, both 1) were 23 cases; osteosarcomas 7, chondrosarcoma 14, parosteal osteosarcoma 1, hemangioendothelioma 1, and giant cell tumor of proximal humerus were 6 cases. Limb salvage surgery was performed by curettage and cementing in 7 patients, by cement molding arthroplasty in 10 patients, and by tumor prosthesis in 7 patients, by other method such as resection only, bone graft, arthrodesis in 5 patients. The Musculoskeletal Tumor Society functional rating system was used to assess functional outcomes. Results: One osteosarcoma and 2 chondrosarcoma patients died, and the survival of the salvaged limb was 88.6% at the final follow-up. There were 6 local recurrences, 2 lung metastases, 2 local recurrences and lung metastases. The functional outcome was 80%. There was statistically significant difference of functional results among the patients treated by cement filling (86%), cement molding arthroplasty and IM nailing (71%), and tumor prosthesis (83%). (p=0.034) There were three complications including 1 radial nerve palsy and 1 axillary nerve palsy, and 1 wound infection. Dislodgement of vascularized fibular graft in one patient was treated by internal fixation. Conclusion: Limb salvage surgery seems to be useful method to treat bone tumors of the shoulder girdle.

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Utility of Gait Analysis and Functional Assessment of Prosthetic Reconstruction in Bone Tumor around the Knee (슬관절 주위에 발생한 골종양 환자에서 종양 대치물을 이용한 재건술 후 기능적 평가 및 보행 분석의 유용성)

  • Lee, Jin-Ho;Seol, Young-Jun;Jung, Sung-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.2
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    • pp.51-58
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    • 2012
  • Purpose: This study attempts to know functional results and gait analysis usefulness in patients with bone tumor around knee joint tumors who underwent prosthesis knee joint reconstruction. Materials and Methods: Retrospective study was conducted with 7 patients out of 30 patients who underwent prosthesis knee joint reconstruction after wide marginal excision for bone tumor around knee in orthopedics of this hospital from 2001 to 2010. Functional assessment and gait analysis were perforemed. Results: For the SF-36 score, while 'role physical' and 'role emotional' items showed 100% (100 points) high scores individually, general health, physical function, vitality, and social function showed low scores. The mean score of MSTS was 88.1% (23.8 points [17-27]), indicating a relatively high score. For the gait analysis, mean gait velocity was 97.2 m/s, mean cadence was 105.6 step/min, mean stride length was 111.3 m, mean step length was 61.5 cm, swing phase was 39.8%cycle, stance phase was 60.1%cycle, mean single limb support was 37.1%cycle, mean double limb support was 13.0%cycle, and mean push off was 60.7%cycle. Conclusion: It is expected that prosthesis reconstruction after wide marginal excision for bone tumor around knee has relatively good functional results. Gait analysis was considered one of method which showed gait phase and assessed functional ability objectively by quantitative assessment post operative patient condition. It might help treatment and post operative rehabilitation planning with the functional assessment.

Extraskeletal Paraarticular Osteochondroma of the Knee - A Case Report - (슬관절에 발생한 골격골외 관절주변 골연골종 - 1례 보고 -)

  • Han, Chung-Soo;Park, Yong-Koo;Park, Hyun-Chul;Kim, Jin-Yong;Kwak, Sang-Joon;Park, Cheol-Hee;Park, Jin-Sung
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.2
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    • pp.146-150
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    • 2009
  • Osteochondromas typically arise from the metaphyseal ends of long bones. Extraskeletal paraarticular osteochondromas are unusual osteocartilaginous lesions that arise in the soft tissue adjacent to a joint with no bony continuity. We present a case of pathologically proven extraskeletal paraarticular synovial osteochondroma of the knee observed in 42-year-old female with a literature review.

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Localized Giant Cell Tumor in Knee Joint - 1 Case Report- (슬관절내에 발생한 국소형 거대 세포종 - 1예 보고 -)

  • Cho, Jin-Ho;Wang, Kook-Hyun
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.190-194
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    • 2007
  • Giant cell tumor is slow-growing, unilateral and solitary lesion that is most commonly seen in the digit of the hand, but occasionally occurs in the hips, ankles, toes and wrists and rarely in knee. We experienced 1 case of giant cell tumor in knee joint. That was excised arthroscopically and pathologically confirmed. So we report this case with a review of the literatures.

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Intraarticular Osteochondroma of the Phalanx of the Hand - A Case Report - (수지골에 발생한 관절내 골연골종 - 증례 보고 -)

  • Han, Chung-Soo;Pyo, Na-Sil;Lee, Jae-Hoon;Cho, Nam-Su;Park, Yong-Koo;Ryu, Kyung-Nam
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.2
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    • pp.88-91
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    • 2000
  • The osteochondroma is the most common benign bone tumor, which occupies 40% of the benign bone tumor. About 80% of lesions arise in the long bone of the extremities, particularly in the knee and the upper extremity. But the occurrence of an intraarticular osteochondroma is rare, especially in the interphalangeal joint. We report the case of a intraarticular osteochondroma which occurred at the interphalangeal joint of the hand in a 12-year-old male patient. The plain X-ray demonstrates an exostosis arising from intraarticular dorsal aspect of the proximal phalanx of the right middle finger. The excised mass was round, measuring $8{\times}3$mm in size and 1 mm in thickness with definite cartilage capsule.

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Early Imaging Findings of Hypertrophic Osteoarthropathy Mimicking Bone Metastasis from Extrathoracic Malignancy (뼈 전이로 오인될 수 있는 흉강 외 악성 종양으로 인한 비대성 골관절증의 초기 영상 소견)

  • Ji Yeon Hwang;Jang Gyu Cha;Yu Sung Yoon;Ahrim Moon
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1606-1612
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    • 2021
  • Hypertrophic osteoarthropathy (HOA) is a syndrome characterized by digital clubbing, periosteal bone formation, and synovial effusions. Secondary HOA is associated with intrathoracic malignancy in most cases; however, in rare cases, HOA can be caused by extrathoracic conditions. We report early ultrasound, computed tomography, magnetic resonance imaging, and bone scintigraphy findings of HOA in a patient with breast cancer. Its ambiguous clinical and imaging findings that mimicked malignant conditions are particularly interesting and informative.

Surgical Treatments of Osteosarcoma around the Knee in Children (소아 슬관절 주위 골육종의 수술적 치료)

  • Nam, Kwang-Woo;Lee, Sang-Hoon;Kim, Han-Soo;Oh, Joo-Han;Cho, Whan-Sung
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.1
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    • pp.1-12
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    • 2004
  • Purpose: The current study was performed to analyze the oncological and functional results, and the patient, the limb and the prosthesis survival of osteosarcoma around the knee in children according to the treatment options. Materials and Methods: From 1982 to 2002, 63 patients with osteosarcoma around the knee underwent surgical treatments before 16 years of age. Surgical treatment options were amputation, endoprosthetic replacement, and implantation of low heat-treated autogenous bone graft after wide resection of tumor. The mean age of patients was 11.5 years (4.4~16), and the mean follow-up period was 6.1 years (2.1~16.8). All patients had neoadjuvant and adjuvant chemotherapy. All endoprosthses were extendible types. Anatomical locations of osteosarcoma were distal femur in 40 patients, and proximal tibia in 23 patients. As regard to Enneking stage, 4 patients had stage $II_A$, 50 patients had stage $II_B$, and 9 patients had stage III tumors. Results: The 5 year survival rate of stage $II_B$ patients was 72.7% in amputation, 83.7% in endoprosthesis, and 100% in low heat-treated autogenous bone graft. The 5 year survival rate of salvaged limb was 84.4% in endoprosthesis, and 80% in low heat-treated autogenous bone graft. The survival rate of prosthesis was 92.7% at 5 years, 67.4% at 10 years in endoprosthesis, and 75% at 5 years in low heat-treated autogenous bone graft. Mean functional outcome scores were 8.7 points in amputation, 20.6 points in endoprosthesis, and 16 points in low heat-treated autogenous bone graft. Distant metastasis occurred 15.8% in amputation, 27% in endoprosthesis and local recurrence occurred 8.1% in endoprosthesis, 14.3% in low heat-treated autogenous bone graft. Major complications happened 26.3% in amputation, 35.1% in endoprosthesis, and 28.6% in low heat-treated autogenous bone graft. Conclusion: Limb salvage procedure had functionally better results than amputation in children with osteosarcoma around the knee. Reconstruction with endoprosthesis after resection of tumor had good results in children as adults. In certain circumstances as too small bone for endoprosthesis or minimal bony destruction or too skeletally immature patient, low heat-treated autogenous bone graft may be a good treatment option. Low heat-treated autogenous bone graft may be considered as not only a substitute for endoprosthesis but also a temporary method before endoprosthesis.

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