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Kobayashi Y, Tsukamoto S, Kurokawa H, Nitta Y, Honoki K, Kido A, Ueno Y, Taniguchi A, Tanaka Y. En bloc resection and reconstruction using a talar prosthesis for malignant talar bone tumor: a surgical technique. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2024:10.1007/s00590-024-04056-9. [PMID: 39126461 DOI: 10.1007/s00590-024-04056-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Accepted: 07/31/2024] [Indexed: 08/12/2024]
Abstract
En bloc resection is required for treatment of intermediate-grade talar tumors with extraosseous extension (Enneking stage 3) and malignant talar tumors without intra-articular invasion (Enneking stages IA and IIA). After resection, reconstruction options include tibiocalcaneal fusion, frozen autograft, and talar prosthesis; however, a talar prosthesis is preferable because it preserves ankle range of motion, does not cause leg length discrepancy, and is associated with good long-term outcomes. To the best of our knowledge, en bloc resection and reconstruction of a malignant talar tumor has not been previously reported in detail. We report a detailed surgical technique for en bloc resection of a malignant talar bone tumor using combined anterior and lateral approaches followed by reconstruction using a talar prosthesis.
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Affiliation(s)
- Yusuke Kobayashi
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-cho, Kashihara-City, Nara, 634-8521, Japan
| | - Shinji Tsukamoto
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-cho, Kashihara-City, Nara, 634-8521, Japan.
| | - Hiroaki Kurokawa
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-cho, Kashihara-City, Nara, 634-8521, Japan
| | - Yuji Nitta
- Department of Diagnostic Pathology, Nara Medical University, 840, Shijo-cho, Kashihara-City, Nara, 634-8521, Japan
| | - Kanya Honoki
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-cho, Kashihara-City, Nara, 634-8521, Japan
| | - Akira Kido
- Department of Rehabilitation Medicine, Nara Medical University, 840, Shijo-cho, Kashihara-City, Nara, 634-8521, Japan
| | - Yuki Ueno
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-cho, Kashihara-City, Nara, 634-8521, Japan
| | - Akira Taniguchi
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-cho, Kashihara-City, Nara, 634-8521, Japan
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-cho, Kashihara-City, Nara, 634-8521, Japan
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Tsukamoto S, Mavrogenis AF, Honoki K, Kido A, Tanaka Y, Fujii H, Takakura Y, Tanaka Y, Errani C. Reconstruction after Talar Tumor Resection: A Systematic Review. Curr Oncol 2022; 29:9788-9800. [PMID: 36547183 PMCID: PMC9777178 DOI: 10.3390/curroncol29120769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/01/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022] Open
Abstract
This systematic review investigated the functional outcomes and complications of reconstruction methods after talar tumor resection. A systematic search of PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases identified 156 studies, of which 20 (23 patients) were ultimately included. The mean Musculoskeletal Tumor Society scores in the groups reconstructed using tibiocalcaneal fusion (n = 17), frozen autograft (n = 1), and talar prosthesis (n = 5) were 77.6 (range 66-90), 70, and 90 (range 87-93), respectively. Regarding complications, sensory deficits were observed in one patient (6%) and venous thrombosis in two patients (12%) in the tibiocalcaneal fusion group, while osteoarthritis was observed in one patient (100%) in the frozen autograft group. No complications were observed in the talar prosthesis group. Reconstruction with talar prosthesis seems preferable to conventional tibiocalcaneal fusion after talar tumor resection because it offers better function and fewer complications. However, as this systematic review included only retrospective studies with a small number of patients, its results require re-evaluation in future randomized controlled trials with larger numbers of patients.
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Affiliation(s)
- Shinji Tsukamoto
- Department of Orthopaedic Surgery, Nara Medical University, Nara 634-8521, Japan
- Correspondence: ; Tel.: +81-744-22-3051
| | - Andreas F. Mavrogenis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, 11527 Athens, Greece
| | - Kanya Honoki
- Department of Orthopaedic Surgery, Nara Medical University, Nara 634-8521, Japan
| | - Akira Kido
- Department of Rehabilitation Medicine, Nara Medical University, Nara 634-8521, Japan
| | - Yuu Tanaka
- Department of Rehabilitation Medicine, Wakayama Professional University of Rehabilitation, Wakayama 640-8222, Japan
| | - Hiromasa Fujii
- Department of Orthopaedic Surgery, Nara Medical University, Nara 634-8521, Japan
| | - Yoshinori Takakura
- Department of Orthopaedic Surgery, Nishi Nara Central Hospital, Nara 631-0022, Japan
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, Nara 634-8521, Japan
| | - Costantino Errani
- Orthopaedic Oncology Service, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
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Huang J, Xie F, Tan X, Xing W, Zheng Y, Zeng C. Treatment of Osteosarcoma of the Talus With a 3D-Printed Talar Prosthesis. J Foot Ankle Surg 2021; 60:194-198. [PMID: 33162293 DOI: 10.1053/j.jfas.2020.01.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 01/17/2020] [Accepted: 01/20/2020] [Indexed: 02/03/2023]
Abstract
A 31-year-old male was diagnosed with osteoblastic osteosarcoma of the talus. Limb-salvage surgery for talar osteosarcoma was performed by replacing the intact talus with a 3D-printed talar prosthesis made from medical-grade titanium. The prosthesis had 3 tunnels for simulating the ligaments around the talus. At the last follow-up, the functional and clinical outcomes were excellent. Our patient achieved 93% restoration of the Musculoskeletal Tumor Society functional score as well as a Toronto Extremity Salvage Score of 93 points, and there was no local recurrence or distant metastasis. A 3D-printed talar prosthesis showed excellent functional and clinical outcomes for a patient with osteosarcoma of the talus. A 3D-printed implant is a feasible option for patients with osteosarcoma of the foot.
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Affiliation(s)
- Jihui Huang
- Surgeon, Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China; Surgeon, Department of Orthopedics, Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong, China
| | - Fengjiao Xie
- Registered Nurse, Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Xinyu Tan
- Surgeon, Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Weirong Xing
- Professor, Musculoskeletal Disease Center, Jerry L. Pettis Memorial Veterans Affairs Medical Center, Loma Linda, CA; Professor, Department of Medicine, Loma Linda University, Loma Linda, CA
| | - Yushi Zheng
- Practicing Physician, Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Canjun Zeng
- Professor, Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China.
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Jeong J, Jeong YJ, Kang DY, Cho K. Osteosarcoma of talus with heterotopic ossifications and lung metastases. Clin Pract 2020; 10:1216. [PMID: 32266055 PMCID: PMC7132138 DOI: 10.4081/cp.2020.1216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 01/16/2020] [Indexed: 11/26/2022] Open
Abstract
Osteosarcoma is the most common malignant bone tumor and is known to occur mainly in the metaphyses of long bones. However, a few cases of osteosarcoma in talus have been reported in older patients. We experienced an osteosarcoma of an 80-year-old male patient with a talus which is rarely reported and evaluated disease patterns with four different imaging modalities.
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Affiliation(s)
- Jieun Jeong
- Department of Nuclear Medicine, Dong-A University Medical Center, Busan
| | - Young Jin Jeong
- Department of Nuclear Medicine, Dong-A University Medical Center, Busan.,College of Medicine, Busan
| | - Do-Young Kang
- Department of Nuclear Medicine, Dong-A University Medical Center, Busan.,College of Medicine, Busan
| | - Kook Cho
- College of General Education, Dong-A University, Busan, South Korea
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SL B, A S, J M, R B. Tumours of the talus - A pictorial review. J Clin Orthop Trauma 2020; 11:410-416. [PMID: 32405200 PMCID: PMC7211828 DOI: 10.1016/j.jcot.2020.03.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 03/27/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Primary bone tumours of the talus are a rare entity and seldom described in the literature. Due to this, often the diagnosis and management of such cases are delayed. This study aims to describe a spectrum of lesions identified within our department and provide a pictorial review with the goal to aid radiologists in the evaluation and diagnosis of such lesions. MATERIALS & METHODS A retrospective study was conducted within our department, identifying all talar lesions, confirmed on histopathological and radiological diagnosis. RESULTS Results revealed 75 cases of talar lesions. Benign tumours formed the bulk of the lesions identified accounting for 85% of all cases. The most common benign tumour was chondroblastoma (n = 23). Malignant tumours were detected in 6 cases. Other lesions included osteomyelitis and avascular necrosis. CONCLUSION We present a variety of tumours and tumour-like conditions of the talus. Radiologists as well as orthopaedic surgeons need to be aware of such lesions, to prompt early diagnosis and initiate management in timely fashion.
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Affiliation(s)
- Boo SL
- Department of Orthopaedics, Royal Orthopaedic Hospital, Birmingham, UK
| | - Saad A
- Department of Orthopaedics, Royal Orthopaedic Hospital, Birmingham, UK
| | - Murphy J
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, UK
| | - Botchu R
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham, UK,Corresponding author. Department of Musculoskeletal Radiology, The Royal Orthopedic Hospital, Bristol Road South Northfield, Birmingham, UK.
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Kamal AF, Simorangkir D, Oesman I. Osteosarcoma of the talus treated with extraarticular resection " total talectomy" and reconstruction using fibular bone graft: A case report. Ann Med Surg (Lond) 2018; 35:33-37. [PMID: 30263116 PMCID: PMC6156740 DOI: 10.1016/j.amsu.2018.09.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 09/12/2018] [Accepted: 09/14/2018] [Indexed: 11/05/2022] Open
Abstract
Introduction In most cases, osteosarcoma occurs in the metaphysis of long bones such as femur, tibia, or humerus. Meanwhile, osteosarcoma of the talus is extremely rare. Presentation of case We presented a case of a thirty-eight-year-old male patient with osteosarcoma of the talus treatedwith limb salvage surgery. That procedure consists of wide excision as extra-articular resection“ totaltalectomy” followed by challenging reconstruction of the defect using fibular graft and followed by internal fixation and arthrodesis. We did an extraarticular resection of the talus, which consists of total talectomy and excision of the distal tibia and fibula. An ipsilateralnon vascularized fibular graft as harvested and placed in a horizontal plane to bridge the distal tibia and fibula to the navicular. The graft was fixated using 7.5mm cannulated headless screw and was followed by arthrodesis across the distal tibia and fibula to the calcaneus. Discussion Options for surgical treatment for osteosarcoma of the talus islimb salvage surgery. Extraarticular resection “total talectomy” and reconstruction using fibular bone grafttechnique creates a good functional outcome and no signs of local recurrence were found during one-yearfollow-up Conclusion Extraarticular resection and reconstruction using fibular bone graftis a good technique for management of osteosarcoma of the talus. Osteosarcoma of the talus is extremely rare.The accurate diagnosis can be complicated by subtle clinical features. Patients with osteosarcoma of the talus could be considered for limb salvage surgery. The limb salvage surgery consists of extra-articular resection total talectomy and reconstruction with fibular graft.
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Affiliation(s)
- Achmad Fauzi Kamal
- Department of Orthopaedic and Traumatology Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Damiarta Simorangkir
- Department of Orthopaedic and Traumatology Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Ihsan Oesman
- Department of Orthopaedic and Traumatology Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
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Bahamonde Munoz L, Escudero Heldt M. Massive Chondroblastoma of the Talus: Treatment With En Bloc Talectomy and Tibiocalcaneal Arthrodesis: Long-Term Follow-up of a Case. Foot Ankle Spec 2017; 10:274-277. [PMID: 27798068 DOI: 10.1177/1938640016676339] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
UNLABELLED Chondroblastomas are benign bone tumors that are usually located at epiphyseal regions of long bones, and are rarely located at the talus. The usual treatment consists of curettage and filling of the bone defect with bone either bone grafts or some other material, such as cement. The authors present a case of a massive chondroblastma of the talus, extending outside of bone boundaries and with a huge soft tissue mass and invasion of the adjacent calcaneus. Management included an en bloc talectomy through a double medial and lateral approach, and curettage and filling with cement of the calcaneal extension. Reconstruction was done by means of a tibiocalcaneal arthrodesis. At 11 years of follow-up, no tumor recurrence has occurred, and the AOFAS functional score is 83 out of 100 points. LEVELS OF EVIDENCE Level IV: Therapeutic.
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Affiliation(s)
- Luis Bahamonde Munoz
- Hospital Clinico, University of Chile, Independencia, Santiago (LBM).,Foot and Ankle Unit, Hospital Clinico, University of Chile, Independencia, Santiago (MEH)
| | - Mario Escudero Heldt
- Hospital Clinico, University of Chile, Independencia, Santiago (LBM).,Foot and Ankle Unit, Hospital Clinico, University of Chile, Independencia, Santiago (MEH)
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Salunke AA, Chen Y, Tan J, Chen X, Pearce C, Puhaindran M. Osteosarcoma of the talus misdiagnosed as ankle arthritis: a case report. J Orthop Surg (Hong Kong) 2016; 24:128-31. [PMID: 27122529 DOI: 10.1177/230949901602400129] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We present a 65-year-old man with osteosarcoma of the talus that was misdiagnosed as osteoarthritis. The patient eventually underwent below-knee amputation and adjuvant chemotherapy.
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Affiliation(s)
- A A Salunke
- Department of Orthopedics, Pramukswami Medical College, Karamsad, Anand, Gujrat, India
| | - Y Chen
- Department of Orthopaedic Surgery, National University Hospital, Singapore
| | - J Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - X Chen
- Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore
| | - C Pearce
- Department of Orthopaedic Surgery, Alexandra Hospital (JHS), Singapore
| | - M Puhaindran
- Division of Musculoskeletal Oncology, National University Hospital Singapore, Singapore
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Osteosarcoma of the hands and feet: a distinct clinico-pathological subgroup. Virchows Arch 2012; 462:109-20. [PMID: 23212264 DOI: 10.1007/s00428-012-1339-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 10/12/2012] [Accepted: 11/02/2012] [Indexed: 11/12/2022]
Abstract
Osteosarcomas of hands or feet are rare, and seemingly these cases differ in presentation and behavior compared to those in usual locations. The clinico-pathological presentation of patients with osteosarcomas of the hand or foot was studied and compared with published cases. Forty osteosarcomas were identified among 4,221 cases, representing 0.95 % of all osteosarcomas. Thirty of these were well documented. Mean age at diagnosis was 43 years (hands) and 36 years (feet) and male-female ratio was 1.2:1 and 2.0:1, respectively. In the hand, 62 % of the osteosarcomas presented in the metacarpals and 23 % in the phalanges, and only two cases occurred in the carpal bones. Distribution in the foot was tarsal bones 56 %, metatarsal bones 33 %, and phalanges 11 %.Of the cases in the hand 54 % were of high grade and of those in the foot 71 %. Survival of osteosarcomas of the hand or foot was 81 %. Only patients with high-grade osteosarcoma died of the disease. Histological grade was the only significant variable related to survival. High-grade osteosarcoma of the hand or feet should be treated similar to those in conventional sites. Osteosarcomas of hands or feet are rare and in a relative high proportion are of low grade. Survival in high-grade cases is comparable to that in conventional sites.
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