Orthopaedic Oncology Research
List of Projects & Funding
Biomet ComPreSs System
Work is focusing upon development of a novel means of fixation for prostheses devices used to reconstruct skeletal defects in cases of tumor resection and failed arthroplasty. By utilizing a high compression pre-stress concept, this implant seeks to avoid the use of long intramedullary stems and cement that have been associated with stress shielding, osteolysis, and ultimate failure. In contrast, the ComPreSs system provides immediate, rigid fixation that results in bone hypertrophy in response to compression forces. This enhances the success and longevity of limb salvage procedures, especially in young, active individuals. The work is supported by a grant from the Biomet Corporation in Warsaw, Indiana.
Multimodal Neoadjuvant Treatment of Soft Tissue Sarcomas
Arising at a rate of just twenty new cases per year per million people, soft tissue sarcomas remain one the rarest forms of cancer. Fortunately, advances in radiologic imaging, surgery, radiation therapy, and chemotherapy have served to improve local control and overall survival. Work is underway to implement a Northern California regional protocol for the multimodality treatment of children and adults with soft tissue sarcoma. Wide surgical resection and external beam radiation therapy remain the mainstays of treatment. However, high dose rate brachytherapy and intraoperative radiation methods are being used increasingly to apply radiation where it is needed most— directly to the tumor bed at the time of surgery. For patients younger than 65 with large, deep, high grade tumors, pre-operative or neoadjuvant chemotherapy is also being offered in an attempt not only to treat the tumor itself, but also to decrease the risk of metastatic disease, thereby increasing overall survival.
A principal research effort is directed toward the development of an innovative custom compliant fixation system for massive skeletal reconstruction that avoids the use of bone cement and prolongs implant longevity. Another intensive area of investigation is the use of pre-operative chemotherapy and brachytherapy radiation catheters for adult soft tissue sarcomas. Benign bone lesions are being addressed with liquid nitrogen cryospray therapy, while packing is performed with bone cement or coralline hydroxyapatite, so as to minimize complications associated with traditional grafts. Immediate post-operative prostheses that optimize recovery in instances of amputation are also under study. Finally, bisphosphonate medication trials are underway to determine the potential for stopping the progression of cancer that has metastasized to bone.