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Ortho Onco Surgery (Bone Cancer)
Ortho onco surgery, also known as orthopaedic oncology surgery, is a specialised field of medicine that focuses on the diagnosis and treatment of benign and malignant bone and soft tissue tumours. It combines orthopaedic surgery principles and techniques with oncology techniques to provide comprehensive care to patients with musculoskeletal tumours.
Ortho-onco surgery, sometimes referred to as orthopedic oncology surgery, is a specialty of medicine that focuses on the identification and management of soft tissue and bone tumors, both benign and malignant. It provides patients with bone tumors with complete care by fusing oncology procedures and orthopedic surgery concepts.
Ortho-onco surgery is used to remove tumors that damage the bones, muscles, tendons, ligaments, and other soft tissues of the body. These tumors are classified as bone cancer. Metastatic tumors are those that begin in the musculoskeletal system and spread to other areas of the body.
Tumours affecting the bones, muscles, tendons, ligaments, and other soft tissues of the body are categorised under Bone Cancer are removed during ortho onco surgery. These tumours can start in the musculoskeletal system and spread to other parts of the body (metastatic tumours).
The objectives of orthooncology surgery are as follows:
The removal of the tumor: The main objective of ortho-onco surgery is to remove tumors while maintaining the healthy structure and function of the affected limb. To minimize the chance of recurrence, surgeons aim for wide or marginal resections, which guarantee the removal of the tumor together with a margin of healthy tissue surrounding it.
Limb Salvage: Orthooncologists try to avoid amputations wherever possible by performing limb-salvaging procedures. By employing cutting-edge reconstructive methods like bone transplants, prostheses, or tissue transfers, they aim to maintain the patient's quality of life and the functionality of the affected limb.
Pain Reduction: Ortho oncosurgical procedures have the potential to reduce pain resulting from musculoskeletal tumors. Surgeons can greatly minimize pain and enhance patient comfort by excising the tumor and rebuilding the afflicted area.
Restoring Function: Ortho onco surgery aims to remove the tumor while also restoring the damaged limb or body part's mobility and function. Physical therapy and rehabilitation are essential components of the recovery process that assist patients in regaining their strength, flexibility, and independence.
Bone Cyst: A bone cyst is a fluid-filled sac that forms inside a bone. Although it can affect any bone in the body, including the long bones of the arms and legs, particularly the area around the knee joint, it is a non-cancerous (benign) disorder. Bone cysts can also form in other bones, including the pelvis, shoulder, and hip.
Most often, bone cysts are unintentionally found during standard imaging procedures like MRIs or X-rays that are being done for other purposes. Most of the time, they don't cause any symptoms or discomfort and are asymptomatic. Bone cysts, however, can occasionally hurt, weaken the bone, and raise the risk of fractures.
Simple bone cysts sometimes referred to as unicameral bone cysts, and aneurysmal bone cysts are the two different forms of bone cysts. Simple bone cysts usually have thin walls and are filled with clear fluid; aneurysmal bone cysts, on the other hand, might have blood-filled gaps and more complex structures.
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The following are the objectives of ortho oncology surgery:
Tumour Removal: The primary goal of ortho onco surgery is to remove tumours completely while preserving the normal function and structure of the affected limb or body part. Surgeons strive for wide or marginal resections, which ensure the removal of the tumour as well as a margin of healthy tissue around it to reduce the risk of recurrence.
Limb Salvage: Ortho oncologists strive to perform limb-saving surgeries rather than amputations whenever possible. They strive to preserve the limb's functionality and maintain the patient's quality of life by using advanced reconstructive techniques such as bone grafts, prostheses, or tissue transfers.
Pain Relief: Ortho onco surgery can help alleviate pain caused by tumors in the musculoskeletal system. By removing the tumor and reconstructing the affected area, surgeons can significantly reduce pain and improve the patient's overall comfort.
Restoring Function: In addition to tumor removal, ortho onco surgery focuses on restoring the function and mobility of the affected limb or body part. Rehabilitation and physical therapy play crucial roles in the recovery process to help patients regain strength, flexibility, and independence.
Bone Cyst: A fluid-filled sac that develops within a bone is known as a bone cyst. It is a non-cancerous (benign) condition that can occur in any bone in the body but is most commonly found in the long bones of the arms and legs, especially around the knee joint. Other bones, such as the hip, shoulder, and pelvis, can also develop bone cysts.
Bone cysts are typically discovered by chance during routine imaging tests such as X-rays or MRI scans that are being performed for other reasons. They are frequently asymptomatic, causing no symptoms or discomfort. However, bone cysts can cause pain, weaken the bone, and increase the risk of fractures in some cases.
There are two types of bone cysts: simple bone cysts (also known as unicameral bone cysts) and aneurysmal bone cysts. Aneurysmal bone cysts have more complex structures and may contain blood-filled spaces, whereas simple bone cysts are typically filled with clear fluid and have thin walls.
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Soft Tissue Sarcomas
Soft tissue sarcomas are cancers that develop in soft tissues such as muscles, bones, deep layers of skin, or fat. They can also develop on blood vessels, nerves, or connective tissues that support organs and other tissues. A painless lump or growth is the most common symptom of soft tissue sarcoma. However, some may go undetected until they are large enough to press on nearby muscles or nerves.
Myeloma Bone Disease
Myeloma bone disease can cause bones to thin and weaken (osteoporosis), as well as holes to form in the bone (lytic lesions). Under minor pressure or injury, the weakened bone is more likely to break (pathologic fracture). Not only can myeloma bone disease cause fractures, but it can also cause pressure on the spinal cord (spinal cord compression), the need for surgery to prevent or repair broken bones,
Metastatic Epidural Spinal Cord Compression
Metastatic epidural spinal cord compression (MESCC) is a condition that occurs when cancer spreads (metastasizes) to the spine and compresses the spinal cord or the nerves within the spinal canal. It is a serious complication of cancer that can lead to neurological deficits and functional impairment. Back pain is the most common symptom.
Rotationplasty
Rotationplasty is a procedure used to treat bone cancer near the knee. The middle section of your leg, including the tumour, is removed by a surgeon. Your lower leg has been reattached at the thigh but has been rotated 180 degrees. Your ankle joint serves as your replacement knee joint. You wear a prosthesis, also known as an artificial limb. A rotationality is a more functional alternative to a full leg amputation above the knee.
Management of Pathological Fracture
A pathologic fracture is a broken bone caused by a disease rather than due to an injury. Some conditions weaken your bones, making them more prone to breaking. Coughing, stepping out of a car, or bending over can all fracture a bone that has been weakened by illness. Osteomalacia is a bone softening condition. It is frequently caused by a lack of vitamin D, which aids your body's absorption of calcium.
Pelvic Resection
Pelvic resection is a surgical procedure that involves removing portions of the pelvic girdle. This procedure was previously known as internal hemipelvectomy. A hemipelvectomy is a resection of the ipsilateral limb. Tumours and cysts that are not cancerous Paget's disease of bone is a rare condition that results in an abnormal bone structure called osteogenesis imperfecta.
Computer Navigation Assisted Cancer Surgery
In orthopaedic oncology, computer navigation assisted cancer surgery refers to the use of advanced computer technology and imaging systems to aid surgeons in the planning and execution of surgical procedures for the treatment of bone and soft tissue tumours. Here are some examples of computer navigation's applications and benefits in orthopaedic oncology: Preoperative planning: Using various imaging techniques such as CT scans, MRI scans, and PET scans, surgeons can accurately assess the tumor's location, size, and extent using computer navigation.
Biological Reconstruction
Reconstruction surgery following musculoskeletal tumour excision has advanced significantly in the last few decades. New chemotherapy protocols and imaging techniques have enabled surgeons to surgically remove previously unresectable tumours, curing disease and preserving limb function1. There are now many long-term survivors of limb salvage procedures, and as a result, there is more follow-up data on the outcomes of the reconstruction techniques used. There are several methods for reconstructing a limb. After resection of a large piece of bone.
What is an amputation?
Amputation is the surgical removal of all or a portion of a limb or extremity (outer limbs). The following are examples of common amputations: Amputation above the knee involves removing a portion of the thigh, knee, shin, foot, and toes. Amputation of the lower leg, foot, and toes below the knee. Amputation of an arm. Amputation of the hand. Amputation of a finger. Foot amputation is the removal of a portion of the foot. Amputation of the big toe. Amputation may be required to prevent an infection from spreading through your limbs and to alleviate pain. A wound that does not heal is the most common reason for an amputation. This is frequently caused by insufficient blood flow to that limb.
Endoprosthetic Reconstruction
Endoprosthetic reconstruction is a surgical procedure that involves replacing a segment of a bone or joint with an artificial implant known as an endoprosthesis. This procedure is typically performed when a portion of a bone or joint is damaged or diseased and cannot be effectively repaired through traditional means. Endoprosthetic reconstruction is commonly used in the treatment of bone cancers, such as osteosarcoma, where the affected bone needs to be removed to eliminate the tumor.