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Department of Orthopaedic and Traumatology, Faculty of Medicine Universitas Indonesia/Cipto mangunkusumo Hospital, jakarta, Indonesia
Achmad Fauzi Kamal, Sigit Daru Cahayadi, Reza Abidin Shihab, and Didi Saputra Ramang
International Journal of Surgery Case Reports, ISSN: 22102612, Published: May 2022 Elsevier BV
Ludwig Andre Pontoh, Ismail Hadisoebroto Dilogo, Achmad Fauzi Kamal, Wahyu Widodo, and Jessica Fiolin
International Journal of Surgery Case Reports, ISSN: 22102612, Published: May 2022 Elsevier BV
Achmad Fauzi Kamal and Riko Satriyo Wibowo
International Journal of Surgery Case Reports, ISSN: 22102612, Published: April 2022 Elsevier BV
Iwan Setyadi, Toto Sudiro, Bambang Hermanto, Prima Rizky Oktari, Achmad Fauzi Kamal, Ahmad Jabir Rahyussalim, Bambang Suharno, and Sugeng Supriadi
Sains Malaysiana, ISSN: 01266039, Pages: 883-894, Published: March 2022 Penerbit Universiti Kebangsaan Malaysia (UKM Press)
Magnesium-Carbonate Apatite (Mg-xCA) is one of the potential magnesium composites to be developed as an alternative biodegradable implant material. Several attempts were made to optimize its characteristics. In this study, Mg-xCA (x = 0, 5, 10, and 15% wt) was prepared by powder metallurgy through warm compaction (WC) and further densified by 2 sintering process methods, namely conventional sintering (CS) and spark plasma sintering (SPS). The characterization included density test, XRD test, microstructure test (OM and SEM-EDS-Mapping), microhardness test, and electrochemical test. The SPS process improves the characteristics of Mg-xCA better than the CS process. The SPS process can increase the relative density by about 0.7-2.4%, increase the hardness by about 2-13%, and reduce the corrosion rate by about 32-49% compared to the initial condition before sintering (WC). The SPS structure has a lower oxygen elemental content than the CS structure. The sintered process with SPS is considered effective for the fabrication of Mg-xCA powder-based composites compared to the CS process.
Acta medica Indonesiana, ISSN: 01259326, Pages: 142-150, Published: 1 January 2022
Achmad Fauzi Kamal and Didi Saputra Ramang
International Journal of Surgery Case Reports, ISSN: 22102612, Published: August 2021 Elsevier BV
INTRODUCTION Osteofibrous dysplasia is a relatively rare disease, exclusively found in children, affecting the tibial diaphysis. Various management approaches are already available, but an internationally approved management guideline is not yet established. There is a major concern in the current management of wide excision technique as it frequently results in massive bone defect. CASE PRESENTATION Here we present a case of osteofibrous dysplasia on a 10-year-old girl in Cipto Mangunkusumo Hospital with chief complaint of mild persistent pain of her lower leg since two years before with slight bowing deformity. The radiograph and histopathological examination support the diagnosis of osteofibrous dysplasia. She was managed with en-bloc resection (wide excision) of the tumor, followed with reconstruction using biomaterials substitute; combination between demineralized bone matrix (BonegenerR) and bone substitute "hydroxyapatite and calcium sulphate" and internal fixation using plate and screw. RESULTS Clinical and radiological evaluation showed successful improvement and outcome. The patient showed progressive functional outcomes and achieved functional score of 100% LEFS at 3 years follow-up. The plate and screw was removed at 48 weeks after adequate callus formation andradiological union was achieved. CONCLUSION Simple reconstruction using biomaterial bone substitute not only created new bone formation with good stability, but also enabled patient to have an improved quality of life. This method is recommended to overcome the massive bone defect after tumor resection in osteofibrous dysplasia patient.
Suprayitno Wardoyo, Achmad Fauzi Kamal, Muhammad Aris Furqon, Jonathan Grantomo, and Witantra Dhamar Hutami
International Journal of Surgery Case Reports, ISSN: 22102612, Published: April 2021 Elsevier BV
Achmad Fauzi Kamal, Irsan Abubakar, and Thariqah Salamah
Annals of Medicine and Surgery, ISSN: 20490801, Published: April 2021 Elsevier BV
Achmad Fauzi Kamal, Fahmi Anshori, and Evelina Kodrat
International Journal of Surgery Case Reports, ISSN: 22102612, Published: March 2021 Elsevier BV
Highlights • Challenging diagnostic regarding diagnosis of Osteofibrous dysplasia and Osteofibrous dysplasia-like adamantinoma.• There is controversy spectrum disease between adamantinoma and OFD-like adamantinoma and OFD in children.• Histopathology and immunohistochemical staining for diagnostic OFD, OFD-like adamantinoma and adamantinoma.
Didik Librianto, Ismail Hadisoebroto Dilogo, Achmad Fauzi Kamal, Ifran Saleh, Fachrisal Ipang, and Dina Aprilya
Orthopedic Research and Reviews, eISSN: 11791462, Pages: 275-280, Published: 2021 Informa UK Limited
Background Kyphosis in spondylitis tuberculosis (STb) is more than just a cosmetic issue. It has a potentially detrimental effect on both spine-associated structures and cardiopulmonary function. It can be corrected in any stage of STb; however, the corrective surgery is challenging, especially in the late case, in which the additional stiffness of the spine can come into consideration. To date, the cantilever technique is still a gold standard for sagittal plane deformity correction. However, no study to date has explored its effectiveness for thoracolumbar kyphotic deformity, especially that caused by spondylitis tuberculosis. Methods This is a retrospective study of 16 consecutive cases of spondylitis tuberculosis with thoracolumbar kyphosis that underwent corrective surgery in our center in the period of 2020–2021. We aim to evaluate the effectiveness of the cantilever technique that we use for kyphotic correction in thoracolumbar STb patients. Results At the 3-months follow-up, the mean Cobb angle was 14.6°±10.27°, with the mean gain of 20.90°±12.00° and positively correlate with the thoracolumbar kyphosis (TLK) correction (68.69%, r = 0.654, p = 0.001). The mean thoracic kyphosis, lumbar lordosis, and sagittal vertebral axis were 30.6°±13.08°, 39.4°±16.02°, and 1.4±4.09 cm, respectively, with sagittal Cobb difference of 12.70±9.85. Conclusion The kyphotic Cobb angle reduction by cantilever technique in the thoracolumbar area significantly improved the thoracolumbar kyphosis and realign the spinal sagittal axis. Thus, the cantilever technique remains the gold standard for sagittal plane deformity correction which can be applied for kyphotic deformity correction in thoracolumbar STb cases.
Achmad Fauzi Kamal, Didi Saputra Ramang, and Marcel Prasetyo
Advances in Orthopedics, ISSN: 20903464, eISSN: 20903472, Volume: 2021, Published: 2021 Hindawi Limited
Malignant musculoskeletal tumour may cause considerable burden to general health. The fast growth combined with the tumour characteristics and its invasion capability resulted in the poor prognosis of malignant musculoskeletal tumour. Malignant musculoskeletal tumour may cause significant disability by destroying normal tissue that plays important role in body kinematics. Thromboembolism, including deep vein thrombosis, pulmonary embolism, and other kinds of venous thromboembolism, is one of the most underestimated complications of musculoskeletal tumour. Normally, thrombosis ensues when pathologic factors overcame the body hemostatic regulatory capabilities, which will predispose the body to the formation of thrombus. Venous thromboembolism in musculoskeletal tumour may develop as a result of interaction between the tumour pathologic capabilities and its interaction with normal bodily functions. In this study, we reviewed the burden of musculoskeletal tumour and its complication on global health. Then, the review will focus on the pathologic and clinical aspect of thromboembolism in malignant musculoskeletal tumour, including pathophysiology, diagnosis, and treatment based on recent findings and literature.
Yogi Prabowo, Iwan Setiawan, Achmad Fauzi Kamal, Evelina Kodrat, and Muhammad Luqman Labib Zufar
International Journal of Surgical Oncology, ISSN: 20901402, eISSN: 20901410, Volume: 2021, Published: 2021 Hindawi Limited
Background.Multimodality treatment, incorporating neoadjuvant chemotherapy and adjuvant chemotherapy, is the standard management plan for osteosarcoma that increases the overall survival (OS) rate. However, data regarding prognostic factors affecting the histopathological response following neoadjuvant chemotherapy is limited. Patients and Methods. We retrospectively reviewed patients diagnosed with osteosarcoma in our center between 2008 and 2018. We classified patient characteristics according to gender, age, tumor size, site and stage at diagnosis, site of metastasis, type of surgery, necrosis rate based on the Huvos grading system, and the number of neoadjuvant chemotherapy cycles. We divided response to neoadjuvant chemotherapy into poor responder for patients with Huvos grades 1 and 2 and good responder for patients with Huvos grades 3 and 4. We also documented patients’ survival and follow-up information. Results. We reviewed 64 patients within 5–65 years of age, dominated by men (62.5%). The distal femur (53.1%) was the most common site of osteosarcoma. Fifteen (23.4%) patients had a good response while 49 (76.6%) patients were poor responders to neoadjuvant chemotherapy based on the Huvos grading system. Based on multivariate analysis, gender ( p = 0.012), age ( p = 0.029), symptom duration ( p = 0.004), and tumor enlargement after neoadjuvant chemotherapy ( p < 0.001) were significantly associated with histopathological response. A scoring system was proposed integrating these significant variables (age > 20 years = 1 point, female gender = 1 point, symptom duration > 12 weeks = 1 point, and increased tumor size after neoadjuvant chemotherapy = 2 points). This scoring system divides patients into two groups with a total score of more than two predicting a poor responder to neoadjuvant chemotherapy. Conclusions. Age, gender, symptoms duration, and tumor size after neoadjuvant chemotherapy are the prognostic features that affect the histopathological response to neoadjuvant chemotherapy in patients with osteosarcoma.
Ahmad Jabir Rahyussalim, Aldo Fransiskus Marsetio, Achmad Fauzi Kamal, Sugeng Supriadi, Iwan Setyadi, Pancar Muhammad Pribadi, Wildan Mubarok, and Tri Kurniawati
Journal of Nanomaterials, ISSN: 16874110, eISSN: 16874129, Volume: 2021, Published: 2021 Hindawi Limited
Suitable biomechanical properties with a degradation rate parallel to normal bone healing time are vital characteristics for biodegradable implant material in orthopaedics. Magnesium (Mg) is a natural micronutrient as well as biodegradable metal with biomechanical characteristics close to that of the human bone, while carbonate apatite (CO3Ap) is a biological apatite with good osteoconductivity which allows bone healing without forming fibrotic tissue. We fabricated a Mg-CO3Ap composite with various content ratios by powder metallurgy, various milling times (3, 5, and 7 hours) at 200 RPM, warm compaction at 300°C and pressure of 265 MPa, sintering at 550°C, holding time of 1 hour, heating rate of 5°C/minutes, and room atmosphere cooling. Specimens were successfully created and had a density comparable to that of the human bone (1.95-2.13 g/cm3). Good biocompatibility was found on Mg-10% CO3Ap composite (66.67% of viable cells). Nevertheless, its biomechanical properties and corrosion resistance were inferior to the human bone. Additionally, the materials of the composites make the surrounding environment alkaline. Interparticle consolidation and grain size were dissatisfactory due to microstructural pores presumably formed by the Mg(OH)2 layer and oxidation process during sintering. However, alkaline condition caused by the material corrosion by-product might be beneficial for bone healing and wound healing process. Modifications on fabrication parameters are needed to improve interparticle consolidation, refine grain size, improve biomechanical strength, reduce corrosion products, and improve the degradation rate.
KevinJonathan Adhimulia, Latsarizul Alfariq, and AchmadFauzi Kamal
Formosan Journal of Surgery, ISSN: 1682606X, eISSN: 22135413, Pages: 28-31, Published: January-February 2021 Medknow
Telangiectatic osteosarcoma (TOS) is a rare malignant bone tumor. The main clinical and radiological significance of the case presentation is TOS can be easily misdiagnosed as a benign lesion such as an aneurysmal bone cyst (ABC). In this case, we present 63-year-old male with a large mass in the left leg. Imaging modalities were obtained in this patient to define the diagnosis. In this atypical case of TOS, relatively old age presentation, slow-progressing lesion, well-demarcated lesion, and lack of periosteal reaction further accentuate the similarity between TOS and ABC or other benign lesion causing high rate misdiagnosis of TOS. The histopathological examination will finally differentiate TOS from ABC.
A.F. Kamal, W. Widodo, M.W. Kuncoro, I.W.A.M. Karda, Y. Prabowo, G. Singh, L.D. Liastuti, Trimartani, E.U. Hutagalung, I. Saleh, S.D.A.L. Tobing, B. Gunawan, I.H. Dilogo, A.M.T. Lubis, A. Kurniawan, A.J. Rahyussalim, I. Oesman, N.N.P.P.S. Ifran, W. Latief, M.T. Wijaya, M.D. Ivansyah, M.R.A. Primaputra, A.Y. Reksoprodjo, A. Hendriarto, K.M.A. Novriandi, Z. Alaztha, A.F. Canintika, and A.H.R. Sitanggang
Annals of Medicine and Surgery, ISSN: 20490801, Pages: 87-91, Published: December 2020 Elsevier BV
Background To date, no recommendations have been published on when and how to start again carrying out elective, non-urgent surgery on COVID-19-negative patients after the epidemic peak has been reached in a given country or region and the pressure on healthcare facilities, healthcare workers and resources has been released by so far that elective surgery procedures can be safely and ethically programmed again. This study aims to investigate whether elective orthopaedic surgery will increase the risk of developing COVID-19. Materials and methods This was a combined retrospective and prospective studies performed at a national tertiary hospital in Jakarta, Indonesia. Subjects were patients who underwent elective orthopaedic surgeries at our institution from April to May 2020. Those who were previously infected with COVID-19 from polymerase chain reaction (PCR) reverse transcriptase (RT) examination obtained via nasopharynx and oropharynx swab, as well as those who were reluctant to participate were excluded from the study. Results A total of 35 subjects (mean age 32.89 ± 17.42) were recruited. Fifteen (42.9%) subjects were male, and 20 subjects (57.1%) were female. Mean duration of surgery was 240 min with the longest and shortest duration of 690 and 40 min, respectively. General anaesthesia was performed in the majority of cases in 18 surgeries (51.4%) with local anaesthesia as the least in 2 surgeries (5.7%). Length of stay of our study was 6 days of average. None of the patients developed symptoms suggestive of COVID-19 infection. Conclusion We found that elective orthopaedic surgery may not be associated with increased cases of COVID-19 cases. However, our study was limited by short duration of follow-up. Further studies are required in order to investigate the affect of undergoing elective surgery and the number of COVID-19 cases.
Achmad Fauzi Kamal, Putri Amalia Isdianto, Ali Abdullah, and Evelina Kodrat
Human Pathology: Case Reports, eISSN: 22143300, Published: September 2020 Elsevier BV
Abstract Introduction Hyperparathyroidism is a condition caused by hyperactivity of parathyroid glands. It can cause a lytic bone lesion which similar to a Giant Cell Tumor (GCT) and is hard to differ from it. The common terms for these tumor-like bone lesions are osteitis fibrosa cystica or brown tumor and they represent the end stage of bone remodeling process in prolonged hyperparathyroidism. Case presentation A 53-year-old female complained about pain around her right shoulder. Radiographic appearance showed that there are multiple lytic lesions on right proximal humerus and some other bones. Histopathology revealed that it was most consistent to GCT of the bone. Patient underwent tumor resection surgery and shoulder hemiarthroplasty. Post-operative evaluation showed that there was an increased level of serum calcium and ionized calcium, but decreased level of phosphate. Parathyroid hormone level was high. Patient was suggested to undergo further thorough examination for the underlying cause of hyperparathyroidism. But unfortunately, a couple months after surgery, patient passed away. Discussion Based on the history, clinical, laboratory, and radiograph findings, we thought about multiple myeloma or metastatic bone disease at first. After histopathology report said that it was most consistent to GCT of the bone. We thought about multifocal GCT of the bone then. Since the incidence of multifocal GCT was considered very rare, the lesions were multiple, and the clinical condition was not suitable for GCT, we thought about possibility of metabolic condition. Further laboratory examination of serum calcium and phosphate turned out to be hypercalcemia and hypophosphatemia. Thus we thought about brown tumor of hyperparathyroidism. Parathyroid hormone level was checked later and turned out to be high. Conclusion Brown tumor of hyperparathyroidism should be considered when we found a case of multifocal osteolytic bone lesions. Normally, we would thought about multiple myeloma or metastatic bone disease at first. But when the laboratory, radiographic and histopathological examination results did not correlate to those diagnosis, we should order serum calcium, phosphate and parathyroid hormone level evaluation for patients with multiple osteolytic lesions. Any misdiagnosis and further harmful mistreatment for patients should be avoided.
Iwan Setyadi, Aldo Fransiskus Marsetio, Achmad Fauzi Kamal, Rahyussalim, Sugeng Supriadi, and Bambang Suharno
Materials Research Express, eISSN: 20531591, Published: May 2020 IOP Publishing
Achmad Fauzi Kamal and Dina Aprilya
Radiology Case Reports, eISSN: 19300433, Pages: 167-173, Published: March 2020 Elsevier BV
Fibrodysplasia ossificans progressiva is a very rare autosomal dominant genetic connective tissue disease with a progressive ectopic ossification of muscle (intramuscular) or perimuscular connective tissue such as tendons or joint capsules. The osseous masses produced will form bridges that abnormally connect sections of the skeleton, causing disfiguration and normal motor function inhibition. We reported a 5-year-old girl with multiple hard nodules on the back region which initially present as a painful soft mass on the posterior neck region. As the pain subsided, the mass hardened and also appeared in other parts of her back. We decided not to do a biopsy or excisional surgery to prevent flaring up of the disease. Early diagnosis prevents catastrophic diagnostic and treatment procedures. The progressive nature of this disease is difficult to stop but we should delay it as much as possible by preventing muscle trauma, giving disease modifying agent and long-term physiotherapy to counter further disabilities which will eventually develop.
Achmad Fauzi Kamal, Wahyu Widodo, Mohamad Walid Kuncoro, I. Wayan Arya Mahendra Karda, Yogi Prabowo, Hadiki Habib, Lies Dina Liastuti, Trimartani, Errol Untung Hutagalung, Ifran Saleh, Singkat Dohar A.L. Tobing, Bambang Gunawan, Ismail Hadisoebroto Dilogo, Andri MT Lubis, Aryadi Kurniawan, Ahmad Jabir Rahyussalim, Ihsan Oesman, Nadia NPPS Ifran, Wildan Latief, Mohammad Triadi Wijaya, Muhammad Deryl Ivansyah, Muhammad Rizqi Adhi Primaputra, Adisa Yusuf Reksoprodjo, Andra Hendriarto, K.M. Azka Novriandi, Ziad Alaztha, Anissa Feby Canintika, and Anita Happy Rahayu Sitanggang
International Journal of Surgery Case Reports, ISSN: 22102612, Pages: 870-874, Published: January 2020 Elsevier BV
Introduction Every emergency surgery performed is aimed at saving lives; however, during COVID-19 pandemic, surgeries are often postponed. Many existing recommendations take into account postponing surgery during a pandemic. How these surgeries can lead to increasing infection rates has not been widely published. This study aims to investigate the relationship of emergency orthopaedic surgery and the incidence rate of COVID-19. Presentation of case : This was a case series of 14 patients. The study was performed at the emergency department unit at a national tertiary hospital in Jakarta, Indonesia. A total of 14 patients underwent orthopaedic surgery in the emergency room of our institution. The mean age of the subjects was 40.07 ± 20.5 years. Twelve (85.7%) were male patients and 2 (14.3%) were female patients. The average duration of surgery was 125 minutes. The most used type of anaesthesia was general anaesthesia for 6 operations (50%). Patients were hospitalized for an average length of 4 days. Three patients had infiltrates found on plain x-ray examination, which required further examination to determine whether the cause was COVID-19 infection or not. There was no ground glass appearance (GGO) in the three patients in further follow-up examination. Conclusions We found that emergency orthopaedic surgery was not associated with increasing number of COVID-19 cases. Factors including duration of surgery, length of stay, types of anaesthesia and comorbidities were also not associated with COVID-19 cases in this study.
Achmad Fauzi Kamal, Akbar Rizki Beni Asdi, Ahmad Jabir Rahyussalim, Rio Wikanjaya, Resda Akhra Syahrani, Tri Kurniawati, and Septelia Inawati Wanandi
Stem Cells International, eISSN: 16879678, Volume: 2020, Published: 2020 Hindawi Limited
Background. Various chemical agents have been used as an adjuvant treatment for giant cell tumor (GCT). However, the comparative effect of these chemicals remains unclear. Methods. Multinucleated and spindle cells from cultured GCT patients, characterized by Nanog and Oct4 expression with RT-PCR, were directly administered, in vitro, with concentrations of 1%, 3%, and 5% of H2O2 and 75%, 85%, and 95% of ethanol for 10 minutes and concentrations of 0.003%, 0.005%, 0.01%, 0.03%, 0.1%, and 0.3% of H2O2 for 5 minutes and were incubated for 24 hours. Cell morphology, cell viability, and flow cytometry after various concentrations of H2O2 and ethanol exposure were assessed. Results. H2O2 in all concentrations caused loss of cell viability. The number of viable cells after H2O2 exposure was related to the concentration-dependent effect. The initial viable spindle-shaped cell, multinucleated giant cell, and round-epithelioid cell had morphological changes into fragmented nonviable cells after exposure to H2O2. Flow cytometry using Annexin V showed cell death due to necrosis, with the highest concentration amounting to 0.3%. Conclusion. Administering local chemical adjuvants of H2O2 in vitro caused loss of viable GCT cells. The number of viable cells after H2O2 exposure was related to the concentration-dependent effect, whereas reducing concentration of H2O2 may cause loss of viability and morphology of cultured GCT cells with the apoptotic mechanism.
Yogi Prabowo, Achmad Fauzi Kamal, Evelina Kodrat, Marcel Prasetyo, Samuel Maruanaya, and Toto Suryo Efar
International Journal of Surgical Oncology, ISSN: 20901402, eISSN: 20901410, Volume: 2020, Published: 2020 Hindawi Limited
Osteosarcoma arising from cortical surface is classified into parosteal, periosteal and high-grade surface osteosarcoma. Along the spectrum, parosteal osteosarcoma occupies the well-differentiated end. It is a relatively rare disease entity, comprised only 4% of all osteosarcomas and barely reported in the literature. The objective of this study is to describe cases of parosteal osteosarcoma as well as a variety of treatment options amenable to such entity. Six cases of parosteal osteosarcoma were identified based on histopathological reports in a tertiary referral hospital in Jakarta, Indonesia between January 2001 and December 2019. The mean age was 29.8 years old; four of them (66.7%) were male. Distal end of femur was the most commonly involved bone (five cases, 83.3%). The patients were treated with wide excision followed by several different reconstruction methods: replacement with endoprosthesis, extracorporeal irradiation, knee arthrodesis, or prophylactic fixation. One of our patients presented with dedifferentiated component, and therefore was treated by limb ablation. While two cases died of pulmonary metastasis, other patients reported fair to excellent functional outcome.
Iwan Setyadi, Pancar Muhammad Pribadi, Aldo Fransiskus Marsetio, Achmad Fauzi Kamal, Ahmad Jabir Rahyussalim, Bambang Suharno, and Sugeng Supriadi
Key Engineering Materials, ISSN: 10139826, eISSN: 16629795, Volume: 833 KEM, Pages: 194-198, Published: 2020 Trans Tech Publications, Ltd.
The development of magnesium-based materials, applied for a biodegradable implant, attracted the attention of many researchers. In this research, the initial development of the Mg/carbonate apatite (CA) miniplate was carried out. The miniplate Mg/5CA is fabricated through powder metallurgy and is followed by a sintering process. Pure magnesium is also fabricated with the same process and is used as a reference. The visual form, microstructure (OM), bending test and corrosion test of miniplate were investigated. The results showed that the visual form of the Mg/5CA miniplate is still not perfect. Flexural stress, flexural strain, and elasticity modulus were obtained at 34.02 MPa, 0.9%, and 3.53 GPa, respectively. The corrosion rate is obtained at 12.64 mm/year. The compaction process of Mg/5CA powder followed by sintering is considered to be less appropriate. The addition of the extrusion process and/or the ECAP process in fabrication can be an option to improve its properties.
Achmad Fauzi Kamal and Almu Muhamad
Annals of Medicine and Surgery, ISSN: 20490801, Pages: 61-66, Published: January 2020 Elsevier BV
Introduction This study is to evaluate the outcomes of En bloc resection and reconstruction in patients with GCT of the bone around the knee and in the distal radius. Materials and methods We reviewed 41 cases of GCT of the bone that was treated by En bloc resection around the knee joint and in the distal radius from 2011 to 2018. The local recurrence, metastases, complications and functional score were evaluated for each operation technique. Results The average of MSTS score for all group was 78% (excellent). In the knee joint, the megaprostheses group had an excellent MSTS score of78.9% and good 21.1%. The MAMC group had an excellent MSTS score of40.0%, good 50.0% and fair 10.0%. One patient in the megaprostheses group had metastasis to the lung and 1 patient in the knee arthrodesis group has a recurrence. Infection occurred in 2 cases of megaprostheses while only 1 case in MAMC. Both of the groups in knee joint GCT had 1 patient with implant loosening. In the distal radius, FVFG group had an excellent MSTS score 100% and NVFG group had an excellent score 77.7%, good 11.1% and fair 11.1%. One patient in the NVFG group had an infection, 1 patient has implant loosening and another one patient had graft failure. Two patients in the NVFG group had a recurrence. No metastasis was found in both of the group types of surgery in distal radius GCT. Conclusion Functional outcome of a patient with GCT of the bone after En bloc resection and reconstruction with the above techniques had comparable results with previous studies.
Archives of Bone and Joint Surgery, ISSN: 23454644, eISSN: 2345461X, Pages: 514-522, Published: 1 November 2019
Archives of Bone and Joint Surgery, ISSN: 23454644, eISSN: 2345461X, Pages: 498-505, Published: 1 November 2019