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論文 |
論文
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Hayashi, Katsuhiro ; Niu, Xiaohui ; Tang, Xiaodong ; Singh, Vivek Ajit ; Asavamongkolkul, Apichat ; Kawai, Akira ; Yamamoto, Norio ; Shirai, Toshiharu ; Takeuchi, Akihiko ; Kimura, Hiroaki ; Miwa, Shinji ; Tsuchiya, Hiroyuki ; 林, 克洋 ; 山本, 憲男 ; 白井, 寿治 ; 武内, 章彦 ; 木村, 浩彰 ; 三輪, 真嗣 ; 土屋, 弘行
概要:
Total scapulectomy and reconstruction has been performed for scapular tumor, however, most of the reconstruction methods
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have resulted in poor functional outcomes and there is still room for improvement. Most of the reports of reconstruction after scapulectomy are from a single institution. In the present study, we investigated functional outcomes after total scapulectomy in a multicenter study in The Eastern Asian Musculoskeletal Oncology Group (EAMOG). Thirty-three patients who underwent total scapulectomy were registered at EAMOG affiliated hospitals. The patients were separated into no reconstruction group (n=8), humeral suspension group (n=15) and prosthesis group (n=10). Functional outcome was assessed by the Enneking score. One-way ANOVA was used to compare parameters between the patient groups. Complications included five local recurrences, one superficial infection, one dislocation and one clavicle protrusion. The average follow-up period was 43.5. months. The average active flexion range was 45.8° (0-120°), and 37.1° in abduction (0-120°). The mean total functional score was 22.9 out of 30 (15-29), which is a satisfactory score following resection of the shoulder girdle. There were significant differences in reconstruction methods for active range of motion. Bony reconstruction provided better range of motion in this study. There was a variety of reconstruction methods after scapulectomy in the eastern Asian countries. Although better functional score was obtained using scapular prosthesis or recycled bone and prosthesis composite grafting, postoperative function is still lower than preoperative function. Modified designed prosthesis with or without combination of recycle bone or allograft would restore the lost shoulder function in the future. © 2016 The Authors.<br />Embargo Period 12 months
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論文 |
論文
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Takeuchi, Akihiko ; Tsuchiya, Hiroyuki ; Niu, Xiaohui ; Ueda, Takafumi ; Jeon, Dae-Geun ; Wang, Edward H. M. ; Asavamongkolkul, Apichat ; Kusuzaki, Katsuyuki ; Sakayama, Kenshi ; Kang, Yong-Koo
概要:
Background Giant-cell tumor (GCT) of bone is a common primary benign tumor with high local recurrence and potential dist
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ant metastasis or malignant transformation. We haveinvestigated the clinical behavior of recurrent GCT of bone in the extremities. Methods We retrospectively reviewed 110 patients with recurrent GCTs of bone in the extremities treated by the Eastern Asian Musculoskeletal Oncology Group. The factors that affected the number of recurrences and distant metastasis were analyzed. Results The median interval between initial surgery and the first recurrence of GCTwas 16 months (2-180 months). All patients received additional surgery for first recurrence. Twenty-five patients had a second recurrence and 6 patients had a third recurrence. The mean interval between theinitial surgery and the first recurrence correlated withthe eventual number of recurrences-14.1 months for the repeated recurrence groups (two and three recurrences) and 28.3 months for the single recurrence group (p = 0.016). Campanacci grade did not correlate with repeated recurrence (p = 0. 446). The venue of the initial surgery did not correlate with recurrence but did affect preservation of the adjacent joint (chi-squared test; p =0.046). Campanacci grade II and III also correlated withsacrifice of the adjacent joint (p = 0.020). The incidence of lung metastasis and malignant transformation were 7.5% (8 out of 107 patients) and 2.7% (3 out of 110 patients), respectively. Repeat recurrence was associated with lung metastasis (p = 0.018). © The Japanese Orthopaedic Association 2011.
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