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Bone tumor near the articular cartilage is hard to remove sufficiently without damaging adjacent joint. The purpose of this study was to evaluate the feasibility of navigation-assisted surgery for saving joint in bone tumor resection or curettage. In this study, the investigators hypothesized that computer-assisted surgery is feasible method to get both enough margin and joint salvage. Each of them is important intermediate factor for either oncologic outcome or functional outcome respectively. The investigators designed this study to find what proportion of patients who underwent computer-assisted resection could get enough margins using some criteria obtained by overlapping preoperative and postoperative images. The investigators also evaluated whether computer-assisted surgery can be feasible for joint saving using some criteria including functional outcome.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Stryker navigation system | Other |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Navigation surgery | Procedure | In en bloc resection, the osteotomy sites were determined by navigation guidance. For curettage, we monitored curette in real-time with navigation. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Resection margin and safety | Pre-operative and post-operative CT or MRI images were fused using image fusion application of navigation software (Striker, Mahwah, NJ)in order to evaluate the resection margin. | Day 1 - During operation |
| Resection margin and safety | Pre-operative and post-operative CT or MRI images were fused using image fusion application of navigation software (Striker, Mahwah, NJ)in order to evaluate the resection margin. | 3 months - postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Oncological outcome and functional score | 1) Oncological outcome after 6 month or 12 month from surgery like patient survival or tumor recurrence (tumor recurrence was diagnosed with PET CT or MRI according to the nature of original tumor), 2) functional scores were assessed by evaluation systems of the Musculoskeletal Tumor Society (MSTS)and Toronto Extremity Salvage Score (TESS). | Postoperative 6 month and 12month |
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Inclusion criteria:
In case of malignant bone tumor, the sufficient preservation of joint anatomy should be required even with resection margin of 1.5 cm away from reactive zone of tumor. The sufficient preservation of joint is defined when at least 1 cm subchondral bone is remained after tumor resection, because 1 cm subchondral bone is required for fixation with allograft in subsequent reconstruction. The sufficient preservation of joint is also defined when articular surface is removed, but more than 50% of articular surface has to be saved.
Exclusion criteria were
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Sung Wook Seo | Contact | 02-3410-1229 | sungwook.seo@samsung.com | |
| Hee Jung Jin, bachelor's degree | Contact | 02-3410-6799 | jin8077.jin@samsung.com |
| Name | Affiliation | Role |
|---|---|---|
| Sung Wook Seo | Samsung Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Samsung Medical Center | Recruiting | Seoul | Irwon-Dong | 50 | South Korea |
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| ID | Term |
|---|---|
| D001859 | Bone Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
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| ID | Term |
|---|---|
| D025321 | Surgery, Computer-Assisted |
| D000085022 | Surgical Navigation Systems |
| ID | Term |
|---|---|
| D013514 | Surgical Procedures, Operative |
| D013523 | Surgical Equipment |
| D004864 | Equipment and Supplies |
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| Navigation system | Procedure | In en bloc resection, the osteotomy sites were determined by navigation guidance. For curettage, we monitored curette in real-time with navigation. |
|