Our physicians have published full studies about a myriad of topics.  Feel free to read the abstracts below to gain a further understanding of the investigations that have taken place.  Full papers can be requested at the office or through the research coordinator ( This e-mail address is being protected from spam bots, you need JavaScript enabled to view it ).

A full study is one in which a large population was analyzed.  We do retrospective reviews (take data from the charts) as well as prospective studies (we conduct the study using data as it comes, not only data that has been collected in the past).

In an effort to better define the direction of the future in orthopedic oncology, we should first reflect briefly on events from the past. Reviewing the events of the past and present, we become able to better predict and guide the direction of the future. Over the past three decades, advances in our understanding of tumor behavior, radiological imaging, adjuvant therapies, surgical techniques, and implant design have all led to improved survival and durable function in patients with musculoskeletal sarcomas. As we look ahead to the twentyfirst century, there may be value in reflecting upon the developments in orthopedic oncology during the last century, including the problems encountered and recent advances, to meet the demands of a new era.

(J Orthop Sci (2005) 10:331-340 DOl 10.1007/s00776-005-0895-7)

Unicameral, or solitary, bone cysts are unusual tumors seen in the ends of long bones in skeletally immature persons.  The etiology of these lesions is poorly understood.  Various hypotheses have included dysplastic processes, synovial cysts, and abnormalities in the local circulation.  Most patients present with a nondisplaced pathologic fracture, but occasionally cysts are found incidentally.  Plain radiographs typically show a symmetric lesion with cortical thinning and expansion of the cortical boundaries.  Once diagnosed, unicameral bone cysts continue to be a treatment dilemma.  Traditional methods, such as prednisolone therapy, usually involve multiple anesthetics and injections and are associated with high recurrence rates.  Major surgical procedures, such as wide exposure, curettage, and bone grafting, may be somewhat more effective, but still carry with them significant morbidity and recurrence rates.  Newer technologies involving percutaneous grafting with allograft or bone subsitutes or a combination of the two are promising in light of their low complication rate and lower reoperation rate.

(J Am Acad Orthop Surg 2000; 8:217-224)

Giant cell tumor, a relatively rare, occasionally malignant tumor of bone, remains a difficult therapeutic problem for the orthopedic surgeon.  Various treatment options, including curettage alone, curettage with bone grafting, radiation, and curettage with acrylic cementation have been utilized and reported.  Therapeutic complications such as infection, recurrence, and loss of support of the articular surface have continued to plague the treatment of giant cell tumors.  This article reports the results of 10 consecutive cases of giant cell tumor of bone treated by curettage and methyl methacrylate cementation, followed by bone grafting of the surface of the lesion with demineralized bone matrix to reconstitute the cortex at the site of the tumor.  At an average follow up of 36 months, eight patients had an excellent functional result and two had a fair result as scored on the Musculoskeletal Tumor Society rating system.  To date, there have been no tumor recurrences or metastases, and all patients have radiographic evidence of healing of the weight bearing cortical surface.

 (Orthopedics 1992; Vol 15, No 6; 703-708)

Metastatic lesions to bone outnumber primary bone malignancies.  Osseous metastases to the tibia tend to be less common than osseous metastases to other long bones.  This study examined the treatment options of a population of patients with metastatic disease to the tibia, with surgical intervention being the cornerstone of treatment for the osseous lesion.  A multicenter study had 592 patients with metastatic disease to the bone, with 26 lesions occuring in the tibia (4.4%) during a 13-year period.  No patient had concurrent metastases distal to the elbow.  After confirmation of metastatic disease, treatment consisted of surgical intervention in all patients, including plate osteosynthesis, intramedullary rodding and cementation, endoprosthetic replacement, and in most patients, post-operative radiation therapy.  In 96% of patients, the reconstruction outlasted their life expectancy.  All patients were satisfied with their reconstruction.  Four complications were encounted in the post-operative period, all requiring addtional surgery.  Aggressive treatment of osseous metastasis is justified in patients with metastatic disease despite a limited life expectancy.  Intervention by an orthopaedic oncologist may result in fewer reconstructive failures.  Surgical intervention contributes to an improved quality of life and limb function, ease of nursing care, and may help in maintaining patient independence.

(Clin Orthop Relat Res 2003; S219-S229)

The neoadjuvant treatment of osteosarcoma using intravenous agents has resulted in survival rates of 55% to 77%. We designed a neoadjuvant chemotherapy protocol using combined intraarterial and intravenous agents to treat high-grade osteosarcoma and malignant fibrous histiocytoma of bone in an attempt to improve survival. We report the results of treating 53 adults (age 18–77 years) diagnosed with nonmetastatic extremity osteosarcoma or malignant fibrous histiocytoma.  Preoperative chemotherapy consisted of intravenous doxorubicin followed by intraarterial cisplatinum administered repetitively every 3 weeks for three to five cycles, depending on tumor response assessed by serial arteriography.  Dose and duration of cisplatin were adjusted for tumor size. After resection, good responders (90% or greater necrosis) underwent treatment with the same agents and poor responders were treated with alternative agents for longer duration. Minimum followup was 24 months (mean, 111 months; range, 24–235 months). Estimated Kaplan-Meier survival at 10 years was 82% and event-free survival was 79%. Forty-one patients (77%) had a good histologic response and 92% (49 of 53) underwent limbsparing procedures. Local recurrence occurred in two patients (4%). These results compared favorably with those reported in the current literature.

(Clin Orthop Relat Res (2008) 466:1292–1301 DOI 10.1007/s11999-008-0252-1)