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Biomedical subjects

D A Campanacci

Publications and source records attributed to D A Campanacci.

9 recordsLinked to original sources
PubMed2006

Soft tissue sarcomas of the popliteal fossa: outcome and risk factors.

BACKGROUND: Limb salvage surgery of popliteal soft tissue sarcomas may be hampered due to the incomplete anatomical containment of this region and the vicinity of neurovascular structures. The scope of this study was to determine outcome and to define risk factors. PATIENTS AND METHODS: 27 patients (53.3+/-15.8 y; 16/27 male) with popliteal soft tissue sarcomas were assessed. Mean follow-up was 40.9+/-33.8 months (48.5+/-36.7 months in surviving patients). 9/27 patients were included after prior treatment elsewhere (5 after intralesional resections and 4 local recurrences). The lesions were staged IB in 8/27 patients, IIB in 17/27 and III in 2/27. Immediate amputations were performed in 7/27 patients. 15/27 patients were subjected to radiation therapy (preoperative in 6/15 cases), 8/27 patients received chemotherapy (5/8 preoperatively). RESULTS: Overall survival and disease-free survival at 5 y was 63.0% and 59.5%. Local recurrence occurred in 2 patients. 8/27 patients developed metastatic disease after 28.9+/-9.8 months. Survival (p=0.397) and disease-free survival (p=0.113) did not differ in patients after amputations vs limb salvage. Application of radiation therapy was associated with a better survival (p=0.003). Complications related to the surgical intervention were recorded in 2/27 patients, complications related to radiation therapy occurred in 6/15 patients. DISCUSSION: Despite being extra-compartmental, popliteal sarcomas can be treated with a high rate of limb salvage while equal safety compared to amputations is maintained. Irradiation improved survival in our patient population. In cases with involvement of neurovascular structures, preoperative down-staging with radio or chemo-therapy may prevent amputation.

Adult↗
PubMed2001

Retrieved human allografts : a clinicopathological study.

BACKGROUND: We studied seventy-three massive preserved human allografts, retrieved from two to 156 months after implantation, to provide insight into the mechanisms of their repair. METHODS: The specimens were studied with radiographic and histological techniques that permitted time-related quantitative analysis of the reparative mechanisms of union, cortical repair, soft-tissue attachment, fracture, and characteristics of the allograft-cement interface and the articular cartilage. RESULTS: Union at cortical-cortical junctions occurred slowly (approximately twelve months) by host-derived external callus that bridged the junction and filled the gap between abutting cortices. The bone in the gap did not undergo stress-oriented remodeling even after many years, and, when the union was intentionally disrupted, failure occurred at the cement line that marked the allograft-host junction. Repair of the necrotic graft matrix was both external and internal. External repair consisted of the apposition of a thin seam of host bone on the outer surface of the graft, coating about 40% of the surface at one year and 80% at two years. Internal repair was confined to the ends and the periphery of the cortices and penetrated so slowly that only 15% to 20% of the graft was repaired by five years, after which deeper repair seldom occurred. Graft fractures in specimens retrieved soon after fracture showed only necrotic bone adjacent to the fracture site, whereas those retrieved after fracture-healing showed a marked increase in internal repair of the bone about the fracture site. When bone cement had been used to fix a prosthesis, there was no evidence of bone resorption or loosening of the device. The osteoarticular specimens showed no survival of chondrocytes in the articular cartilage. However, the architecture of the acellular cartilage was well preserved after two to three years and occasionally after as many as five years. Late degenerative changes in the articular cartilage coincided with subchondral revascularization and fragmentation, and the articulating surfaces became covered by a pannus of fibrovascular reparative tissue. Degenerative changes in articular cartilage occurred earlier and were more advanced in specimens retrieved from patients with an unstable joint than in those retrieved from patients with a stable joint. CONCLUSIONS: Repair of massive human allografts is an indolent process that follows a fairly predictable course during the first few years and is influenced by other biological activities, such as fracture repair, supplementary autografting, and tumor recurrence.

Adolescent↗
PubMed1998

Synovial chondromatosis in a lumbar apophyseal joint.

A 31-year-old woman presented with painful swelling in the right paravertebral region that had been present for 2 years. Radiography and CT revealed an area of increased density due to multiple calcifications localized at the fourth lumbar vertebra. Histological examination revealed that the lesion consisted of nodules of hyaline cartilage, with focal areas of calcification, growing within synovial tissue.

Adult↗
PubMed1996

Unicameral and aneurysmal bone cysts.

Unicameral and aneurysmal bone cysts are considered tumorlike conditions of unclear origin. The diagnosis of unicameral bone cysts is almost always based on the radiographic appearance, whereas aneurysmal bone cyst imaging may sometimes mimic a sarcomatous lesion. Several pathogenetic hypotheses [correction of hypothesis] reported in literature have been described. Classifications have been proposed to detect the activity of the cysts and to predict the prognostic behavior. The results observed with different options of treatment have been discussed.

Bone Cysts↗
PubMedDate not supplied

Bizarre parosteal osteochondromatous proliferation (Nora's lesion). Description of six cases and a review of the literature.

The authors report their experience with 6 cases of bizarre parosteal osteochondromatous proliferation (BPOP) observed in 4 patients in its typical site (distal ends of the limbs), and in 2 patients where it was instead atypically localized in the humerus and femur. The histories of the patients revealed that 50% reported previous trauma in the site of lesion. Five patients were submitted to surgical exeresis, while the remaining patient refused to undergo any type of treatment because he was asymptomatic. At a mean follow-up of 36 months 1 patient presented with recurrence (20%). BPOP is a rare pseudotumorous lesion with typical radiographic and histopathologic findings similar to to those of other benign and malignant tumor forms. A review of the small amount of literature in existence is used to analyze the elements that may lead to accurate differential diagnosis.

Adolescent↗
PubMedDate not supplied

Rotationplasty in segmental resections of the femur.

The authors report 26 cases of high-grade malignant tumors of the distal femur (23 osteosarcomas, 3 Ewing's tumors) submitted to rotation-plasty. The five-years actuarial survival rate (in the 23 cases of osteosarcoma) was 69% and there was no incidence of local recurrence. The following complications were observed: wound dehiscence (6 cases), arterial thrombosis (in 2 patients submitted to resection and vascular termino-terminal suturing), paralysis of the sciatic nerve (2 cases), delay in consolidation (2 cases), traumatic fracture of the neo-femur (3 cases). All of the complications were resolved favorably, 5 of these requiring surgical treatment (33%). Satisfactory functional results were obtained in all of the cases, except in one patient who had limitation of the ankle joint subsequent to vascular compartmental syndrome. On the basis of the oncological, functional and biomechanical results reported in this study and in the literature, the authors discuss current indications for rotation-plasty.

Adolescent↗
PubMedDate not supplied

Osteoid osteoma of the femur with a double nidus: a case report.

Osteoid osteoma is a common benign lesion, that occurs in children and young adults. The authors report the observation of a multifocal lesion which is infrequently reported in the literature. S.A., a 10-year-old female came to our observation complaining of spontaneous pain in her right hip and cruralgia radiating to the homolateral knee over the last 6 months; the symptoms, which increased during the night, were relieved by treatment with NSAIDS. Clinical examination and imaging studies confirmed a diagnosis of osteoid osteoma with a double nidus; the lesion was treated by CT-guided thermo-ablation with radiofrequency under general anaesthesia. Complete regression of symptoms was observed at 2-year follow-up.

Catheter Ablation↗
PubMedDate not supplied

A histomorphologic study of explants of massive allografts: preliminary results.

The authors report their experience in the histologic study of massive allografts, explanted as a result of oncological, mechanical or biological complications. The study was conducted according to the method of inclusion in methyl methacrylate that does not involve decalcification. A description is provided of all of the phases of fusion between graft and host bone in the site of the osteotomies, as well as distribution of revascularization and rehabilitation of the graft, attachment of the soft tissues, and finally, modifications in the joint cartilage of the osteoarticular grafts. The allograft must be considered to be osteoconductive, and is only weakly osteoinductive. Incorporation of the graft is a slow and incomplete process that follows sequential phases. The Volkmann's canals in the osteotomies constitute the preferred paths for rehabilitation of the graft that is on the order of millimeters on the surface and centimeters in the site of the osteotomies. The greatest modifications have been observed in the joint cartilage. The cartilaginous cells appear to be vital only from a morphological point of view.

Adolescent↗