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Biomedical subjects

Bruce T Rougraff

Publications and source records attributed to Bruce T Rougraff.

7 recordsLinked to original sources
PubMed2005

The impact of previous surgical manipulation of subcutaneous sarcoma on oncologic outcome.

UNLABELLED: We prospectively followed 106 consecutive patients referred for surgical treatment of nonmetastatic subcutaneous soft tissue sarcoma to assess whether prior surgical manipulation had an impact on local control and/or disease-free survival. 10 patients had no previous surgical treatment; 11 had only a previous biopsy, 75 had a previous attempted excision, and 10 were referred after the tumor had recurred locally. Histologic grade was inversely associated with overall survival and disease-free survival. Of the 75 patients with previous attempted excision, 22 (29%) had gross residual disease, 27 (36%) had microscopic residual disease, and 26 (35%) had no identifiable residual disease. The 5-year metastasis-free survival was 88%. Local control was obtained in 100% of patients without previous surgical manipulation, 89% of those with previous surgery, and 60% of those who were referred after a local relapse had been recognized. Cox proportional hazards analysis revealed that larger tumor size negatively impacted disease-free survival in those patients who were treated with previous attempted excision. Of those patients with tumors 4 cm or larger and a previous unplanned sarcoma excision, disease-free survival was lower than in those patients referred without previous attempted excision. LEVEL OF EVIDENCE: Prognostic study, Level I-2 (prospective study). See the Guidelines for Authors for a complete description of levels of evidence.

Adolescent↗
PubMed2005

Bone graft alternatives in the treatment of benign bone tumors.

Most bone grafting procedures are done during spinal fusion and to treat patients with skeletal trauma. Very few studies have addressed the bone grafting of skeletal defects after benign bone tumor excision. Contained defects have been treated with autogenous bone grafts, fresh-frozen allografts, freeze-dried allografts, demineralized bone matrix, and ceramic materials. Additionally, bone morphogenetic proteins may provide a future treatment option for bone tumor reconstruction.

Bone Neoplasms↗
PubMed2004

Soft-tissue lumps and bumps.

Soft-tissue masses of the extremities and torso are a common problem encountered by the orthopaedic surgeon. Although these soft-tissue masses are often benign, the orthopaedic surgeon must be able to recognize the features key to differentiating benign and malignant masses. An understanding of the epidemiology and clinical presentation of soft-tissue masses is needed in order to outline a practical approach to evaluation and surgical management.

Biopsy↗
PubMed2003

Evaluation of the patient with carcinoma of unknown origin metastatic to bone.

Metastatic carcinoma to bone of uncertain primary origin is a common clinical diagnostic scenario. I present a simple and effective staging system to identify primary malignancies. The role of clinical history, physical examination, laboratory studies, and limited radiographic studies are critical to the success of this diagnostic strategy. Needle or open biopsy frequently is needed yet usually is more effective as a confirmatory study for carcinoma or to rule out primary bone sarcomas. Patients who present with a displaced pathologic fracture require an urgent diagnostic and treatment plan that does not compromise future treatment options and provides durable skeletal reconstruction.

Bone Neoplasms↗
PubMed2002

Treatment of active unicameral bone cysts with percutaneous injection of demineralized bone matrix and autogenous bone marrow.

BACKGROUND: The treatment of unicameral bone cysts varies from open bone-grafting procedures to percutaneous injection of corticosteroids or bone marrow. The purpose of this study was to evaluate the feasibility and effectiveness of percutaneous injection of a mixture of demineralized bone matrix and autogenous bone marrow for the treatment of simple bone cysts. METHODS: Twenty-three patients with an active unicameral bone cyst were treated with trephination and injection of allogeneic demineralized bone matrix and autogenous bone marrow. The patients were followed for an average of fifty months (range, thirty to eighty-one months), at which time pain, function, and radiographic signs of resolution of the cyst were assessed. RESULTS: The average time until the patients had pain relief was five weeks, and the average time until the patients returned to full, unrestricted activities was six weeks. Bone-healing at the site of the injection was first seen radiographically at three to six months. No patient had a pathologic fracture during this early bone-healing stage. Cortical remodeling was seen radiographically by six to nine months, and after one year the response was usually complete, changing very little from then on. Five patients required a second injection because of recurrence of the cyst, and all five had a clinically and radiographically quiescent cyst after an average of thirty-six additional months of follow-up. Seven of the twenty-three patients had incomplete healing manifested by small, persistent radiolucent areas within the original cyst. None of these cysts increased in size or resulted in pain or fracture. CONCLUSIONS: Percutaneous injection of allogeneic demineralized bone matrix and autogenous bone marrow is an effective treatment for unicameral bone cysts.

Adolescent↗