• PEEK
• complications
• functionality
• limb sparing
• oncology
• orthopedics
• recurrence

• Biomechanics
• Bone tumor
• Femur
• Plating
• Torsional stability
• Tumor curettage

• Humans
• Femur/surgery
• Bone Plates
• Biomechanical Phenomena
• Curettage
• Female
• Middle Aged
• Male
• Aged
• Torsion, Mechanical
• Mechanical Tests

• ACT
• Fracture risk
• Orthopedic oncology

• Adult
• Female
• Humans
• Male
• Treatment Outcome
• Follow-Up Studies
• Retrospective Studies
• Bone Neoplasms/surgery
• Bone Neoplasms/pathology
• Fractures, Bone/surgery
• Curettage/adverse effects
• Curettage/methods
• Neoplasm Recurrence, Local

• ABGS
• Artificial bone graft substitutes
• Bone tumors
• Curettage

• Medical University of Graz

• Sarcoma
• elderly
• muscoloskeletal
• orthogeriatric
• score

• bone tumour
• femur
• osteoma
• parosteal osteoma
• surface osteoma

This study aims to investigate the effectivity of cement combined demineralized bone matrix (DBM) treatment on new bone formation in the cortical window as well as to evaluate the effect of new bone formation on functional outcomes.

Thirty-two benign bone tumor patients (15 males, 17 females; median age 38 years; range, 12 to 68 years), who were treated with cement combined DBM between February 2010 and December 2014, were evaluated retrospectively. Patient characteristics were recorded as age, gender, tumor localization, histological diagnosis, Enneking stage, tumor size, size of the cortical window, usage of prophylactic fixation, time to return to work, Musculoskeletal Tumor Society (MSTS) functional score, tumor relapse, and new bone formation on the cortical window in the computed tomography scans after one year of surgery.

Median tumor volume was 17.2 cm3 (range, 2.8 to 139.6 cm3), median area of the cortical window was 8.3 cm2 (range, 1.6 to 28.4 cm2), and median postoperative one-year MSTS score was 84.5 (range, 66 to 97). MSTS scores were significantly worse with the usage of prophylactic fixation (p<0.001). There was a statistically significant difference between the usage of prophylactic fixation and cortical window size (p=0.013). There was a low-level negative correlation in terms of age and bone formation on the cortical window (p=0.046, r= -0.356) and mid-level negative correlation between cortical window size and functional scores (p=0.001, r= -0.577).

Application of cement combined with DBM procedure is an effective, alternative, and biological treatment in bone tumors that provides immediate stability and stimulates new bone formation on the cortical window.

Osteofibrous dysplasia (OFD) is a developmental skeletal disorder, and cases with a giant affected area in the pelvis are rare.

In this case report, a 48-year-old man presented with a large tumor in the right iliac region that turned out to be OFD. The patient had rebound tenderness in his right hip. After radiography examination, magnetic resonance imaging examinations and some physical examination, extensive bone destruction in the right ilium was confirmed. Moreover, changes in bone mineral density and peripheral cortical bone sclerosis with surrounding soft tissue swelling were observed. Thus, this patient was considered to have giant monostotic OFD of the ilium. The tumor-related area was removed completely by surgery, and the remaining cavity was filled by artificial bones from the opposite ilium. According to the results of follow-up, the patient had normal flexion and extension activities of the right hip joint, and there was no evidence of recurrence of the tumor.

Suture of iliopsoas and gluteus medius muscle following focus curettage and bone grafting is a promising and effective method to treat giant OFD of the ilium. It is a feasible way to fill a large cavity after removing a lesion like the one is this case.

• Osteofibrous dysplasia
• Monostotic type
• Giant tumor
• Ilium
• Case report

Surgical treatment of benign and low-grade malignant intramedullary chondroid lesions at the distal femur is not well analyzed compared to higher-grade chondrosarcomas. Localization at the distal femur offers high biomechanical risks requiring sophisticated treatment strategy, but scientific guidelines are missing. We therefore wanted to analyze a series of equally treated patients with intralesional resection and bone cement filling with and without additional osteosynthesis. Twenty-two consecutive patients could be included with intralesional excision and filling with polymethylmethacrylate bone cement alone (n = 10) or with compound bone cement osteosynthesis using a locking compression plate (n = 12). Clinical and radiological outcome was retrospectively evaluated including tumor recurrences, complications, satisfaction, pain, and function. Mean follow-up was 55 months (range 7–159 months). Complication rate was generally high with lesion-associated fractures both in the osteosynthesis group (n = 2) and in the non-osteosynthesis group (n = 2). All fractures occurred in lesions that reached the diaphysis. No fractures were found in meta-epiphyseal lesions. No tumor recurrence was found until final follow-up. Clinical outcome was good to excellent for both groups, but patients with additional osteosynthesis had significantly longer surgery time, more blood loss, longer postoperative stay in the hospital, more complications, more pain, less satisfaction, and worse functional outcome. Intralesional resection strategy was oncologically safe without local recurrences but revealed high risk of biomechanical complications if the lesion reached the diaphysis with an equal fracture rate no matter whether osteosynthesis was used or not. Additional osteosynthesis significantly worsened final clinical outcome and had more overall complications. This study may help guide surgeons to avoid overtreatment with additional osteosynthesis after curettage and bone cement filling of intramedullary lesions of the distal femur. Meta-epiphyseal lesions will need additional osteosynthesis rarely, contrary to diaphyseal lesions with considerable cortical thinning.

• Atypical cartilaginous tumor
• Chondroid lesion
• Chondrosarcoma
• Compound osteosynthesis
• Enchondroma
• Femur