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Comments on: "Is rotator cuff repair appropriate in patients older than 60 years of age? Prospective, randomized trial in 103 patients with a mean four-year follow up" by A. Jacquot, C. Dezaly, T. Goetzmann, O. Roche, F. Sirveaux, D. Molé and the French Society of Shoulder and Elbow Surgery in Orthop Surg Res 2014;100(6 Suppl.):S333-8.

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Comments on: "Recession wedge trochleoplasty as an additional procedure in the surgical treatment of patellar instability with major trochlear dysplasia: early results" by M. Thaunat, C. Bessiere, N. Pujol, P. Boisrenoult, P. Beaufils, published in Orthop Traumatol Surg Res 2011;97(8):833-45.

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Preoperative, intraoperative, and immediate postoperative skeletal scintigraphy to locate and facilitate excision of an osteoid osteoma of the coronoid process.

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Expanding prostheses in conservative surgery for lower limb sarcoma

G Delepine1, N Delepine, J C Desbois

  • 1Service d'Orthopédie, Hôpital Henri Mondor, Créteil, France.

International Orthopaedics
|April 29, 1998
PubMed
Summary

Expanding prostheses effectively address leg length inequality in children after bone sarcoma resection, offering a viable alternative to amputation. Further development aims to minimize infection risks associated with repeat surgeries.

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Area of Science:

  • Orthopedic Surgery
  • Pediatric Oncology
  • Biomedical Engineering

Background:

  • Bone sarcoma resection in children often leads to leg length discrepancy due to growth cartilage removal.
  • Traditional treatments may necessitate amputation, impacting long-term function and growth.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of using expanding prostheses in children undergoing conservative resection of lower limb bone sarcomas.
  • To assess functional results and complications associated with these prostheses.

Main Methods:

  • A retrospective review of 28 expanding prostheses (tibial, total femur, distal femur) implanted between 1985-1996 in patients aged 5-18 years.
  • Analysis of patient demographics, sarcoma types (Ewing's, osteosarcoma, synovial sarcoma), prosthesis lengthening, functional outcomes (EMSOS criteria), and complications.

Main Results:

  • 21 patients achieved an average lengthening of 2.6 cm, with functional results rated excellent/very good in 16 cases.
  • Complications included infection in 5 patients, with one requiring amputation. Five patients died from the disease.
  • The prostheses demonstrated virtually unlimited lengthening potential and were suitable for children aged 5+.

Conclusions:

  • Expanding prostheses are a highly effective alternative to amputation for limb salvage in pediatric bone sarcoma patients.
  • The risk of infection necessitates further innovation, leading to the development of externally lengthenable prostheses to avoid repeat surgeries.