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  1. Article ; Online: Is there still a role for osteoarticular allograft reconstruction in musculoskeletal tumour surgery? a long-term follow-up study of 38 patients and systematic review of the literature.

    Bus, M P A / van de Sande, M A J / Taminiau, A H M / Dijkstra, P D S

    The bone & joint journal

    2017  Volume 99-B, Issue 4, Page(s) 522–530

    Abstract: Aims: To assess complications and failure mechanisms of osteoarticular allograft reconstructions for primary bone tumours.: Patients and methods: We retrospectively evaluated 38 patients (28 men, 74%) who were treated at our institution with ... ...

    Abstract Aims: To assess complications and failure mechanisms of osteoarticular allograft reconstructions for primary bone tumours.
    Patients and methods: We retrospectively evaluated 38 patients (28 men, 74%) who were treated at our institution with osteoarticular allograft reconstruction between 1989 and 2010. Median age was 19 years (interquartile range 14 to 32). Median follow-up was 19.5 years (95% confidence interval (CI) 13.0 to 26.1) when 26 patients (68%) were alive. In addition, we systematically searched the literature for clinical studies on osteoarticular allografts, finding 31 studies suitable for analysis. Results of papers that reported on one site exclusively were pooled for comparison.
    Results: A total of 20 patients (53%) experienced graft failure, including 15 due to mechanical complications (39%) and three (9%) due to infection. In the systematic review, 514 reconstructions were analysed (distal femur, n = 184, 36%; proximal tibia, n = 136, 26%; distal radius, n = 99, 19%; proximal humerus, n = 95, 18%). Overall rates of failure, fracture and infection were 27%, 20%, and 10% respectively. With the distal femur as the reference, fractures were more common in the humerus (odds ratio (OR) 4.1, 95% CI 2.2 to 7.7) and tibia (OR 2.2, 95% CI 1.3 to 4.4); infections occurred more often in the tibia (OR 2.2, 95% CI 1.3 to 4.4) and less often in the radius (OR 0.1, 95% CI 0.0 to 0.8).
    Conclusion: Osteoarticular allograft reconstructions are associated with high rates of mechanical complications. Although comparative studies with alternative techniques are scarce, the risk of mechanical failure in our opinion does not justify routine employment of osteoarticular allografts for reconstruction of large joints after tumour resection. Cite this article:
    MeSH term(s) Adolescent ; Adult ; Bone Neoplasms/diagnostic imaging ; Bone Neoplasms/surgery ; Bone Transplantation/adverse effects ; Bone Transplantation/methods ; Cartilage/transplantation ; Female ; Femoral Neoplasms/diagnostic imaging ; Femoral Neoplasms/surgery ; Follow-Up Studies ; Graft Rejection ; Humans ; Humerus/diagnostic imaging ; Humerus/surgery ; Kaplan-Meier Estimate ; Male ; Osteosarcoma/diagnostic imaging ; Osteosarcoma/surgery ; Radiography ; Reoperation/statistics & numerical data ; Retrospective Studies ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2017-04
    Publishing country England
    Document type Evaluation Studies ; Journal Article ; Review
    ZDB-ID 2697156-2
    ISSN 2049-4408 ; 2049-4394
    ISSN (online) 2049-4408
    ISSN 2049-4394
    DOI 10.1302/0301-620X.99B4.BJJ-2016-0443.R2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: What is the Preferred Screening Tool for COVID-19 in Asymptomatic Patients Undergoing a Surgical or Diagnostic Procedure?

    Huybens, E M / Bus, M P A / Massaad, R A / Wijers, L / van der Voet, J A / Delfos, N M / van der Feltz, M / Heemstra, K A / Koch, S M P

    World journal of surgery

    2020  Volume 44, Issue 10, Page(s) 3199–3206

    Abstract: Introduction: Since the outbreak of COVID-19, measures were taken to protect healthcare staff from infection, to prevent infection of patients admitted to the hospital and to distribute PPE according to need. To assure the proper protection without ... ...

    Abstract Introduction: Since the outbreak of COVID-19, measures were taken to protect healthcare staff from infection, to prevent infection of patients admitted to the hospital and to distribute PPE according to need. To assure the proper protection without overuse of limited supply of these equipments, screening of patients before surgical or diagnostic procedure was implemented. This study evaluates the results of this screening.
    Method: All patients screened for COVID-19 before procedure warranting either general, locoregional anaesthesia or sedation were included. Screening included a symptom questionnaire by phone, PCR and HRCT chest testing. Surgical or procedural details were registered together with actions taken based on screening results.
    Results: Three hundred ninety-eight screenings were performed on 386 patients. The symptom questionnaire was completed in 72% of screenings. In 371 screenings, PCR testing was performed and negative. HRCT chest found 18 cases where COVID-19 could not be excluded, with negative PCR testing. Three patients had their surgery postponed due to inconclusive screening, and additional measures were taken in three other patients. There were incidental findings in 14% of HRCT chest scans.
    Discussion: Pre-operative screening will differentiate if PPE is needed for procedures and which patients can safely have elective surgery during this COVID-19 pandemic and in the times to come. HRCT chest has no additional value in the pre-operative screening of asymptomatic patients. Screening can be performed with a symptom questionnaire, and additional screening with PCR testing in high-risk patient groups should be considered.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asymptomatic Infections ; Betacoronavirus/isolation & purification ; COVID-19 ; COVID-19 Testing ; Child ; Child, Preschool ; Clinical Laboratory Techniques/methods ; Coronavirus Infections/diagnosis ; Coronavirus Infections/prevention & control ; Coronavirus Infections/transmission ; Diagnostic Tests, Routine ; Elective Surgical Procedures ; Female ; Humans ; Infection Control/instrumentation ; Infection Control/methods ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Male ; Mass Screening/methods ; Middle Aged ; Pandemics/prevention & control ; Personal Protective Equipment ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/transmission ; SARS-CoV-2 ; Young Adult
    Keywords covid19
    Language English
    Publishing date 2020-08-13
    Publishing country United States
    Document type Evaluation Study ; Journal Article
    ZDB-ID 224043-9
    ISSN 1432-2323 ; 0364-2313
    ISSN (online) 1432-2323
    ISSN 0364-2313
    DOI 10.1007/s00268-020-05722-9
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  3. Article ; Online: Long-Term Clinical Outcomes of Intercalary Allograft Reconstruction for Lower-Extremity Bone Tumors.

    Sanders, P T J / Spierings, J F / Albergo, J I / Bus, M P A / Fiocco, M / Farfalli, G L / van de Sande, M A J / Aponte-Tinao, L A / Dijkstra, P D S

    The Journal of bone and joint surgery. American volume

    2020  Volume 102, Issue 12, Page(s) 1042–1049

    Abstract: Background: Improved survival rates for patients with primary bone tumors of the extremities have increased the demand for reliable and durable reconstruction techniques. Some authors have stated that, after successful ingrowth, allografts are a durable ...

    Abstract Background: Improved survival rates for patients with primary bone tumors of the extremities have increased the demand for reliable and durable reconstruction techniques. Some authors have stated that, after successful ingrowth, allografts are a durable long-term solution. This hypothesis is largely based on small studies with short-to-midterm follow-up. In order to determine the durability of intercalary allograft reconstructions in the lower extremities, we evaluated the long-term clinical outcomes at a minimum of 10 years.
    Methods: All patients who received an intercalary allograft reconstruction in a lower extremity between 1980 and 2006 were included in this retrospective multicenter cohort study. One hundred and thirty-one patients with a median age of 19 years were included. Eighty-nine (68%) had a femoral reconstruction, and 42 (32%) had a tibial reconstruction. The most prevalent diagnoses were osteosarcoma (55%), Ewing sarcoma (17%), and chondrosarcoma (12%). The median follow-up was 14 years. A competing risk model was employed to estimate the cumulative incidences of mechanical failure and infection. Patient mortality or progression of the disease was used as a competing event.
    Results: Nonunion occurred in 21 reconstructions (16%), after a median of 16 months, and was associated with intramedullary nail-only fixation (p < 0.01) and fixation with nonbridging plate(s) (p = 0.03). Allograft fracture occurred in 25 reconstructions (19%) after a median of 42 months (range, 4 days to 21.9 years). Thirteen (52%) of the allograft fractures occurred within 5 years; 8 (32%), between 5 and 10 years; and 4 (16%), at >10 years. With failure for mechanical reasons as the end point, the cumulative incidences of reconstruction failure at 5, 10, and 15 years were 9%, 14%, and 21%, respectively.
    Conclusions: Intercalary allograft reconstruction is an acceptable reconstructive option, mainly because of the absence of superior alternatives with a known track record. However, a considerable and continuing risk of mechanical complications should be taken into account.
    Level of evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
    MeSH term(s) Adolescent ; Adult ; Aged ; Bone Neoplasms/diagnostic imaging ; Bone Neoplasms/pathology ; Bone Neoplasms/surgery ; Bone Plates ; Bone Transplantation/adverse effects ; Child ; Child, Preschool ; Female ; Femur ; Humans ; Male ; Middle Aged ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/epidemiology ; Reconstructive Surgical Procedures/adverse effects ; Retrospective Studies ; Sarcoma/diagnostic imaging ; Sarcoma/pathology ; Sarcoma/surgery ; Tibia ; Time Factors ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2020-04-04
    Publishing country United States
    Document type Journal Article ; Multicenter Study
    ZDB-ID 220625-0
    ISSN 1535-1386 ; 0021-9355
    ISSN (online) 1535-1386
    ISSN 0021-9355
    DOI 10.2106/JBJS.18.00893
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Screening with HRCT chest and PCR testing for COVID-19 in asymptomatic patients undergoing a surgical or diagnostic procedure.

    Huybens, E M / Bus, M P A / Massaad, R A / Wijers, L / van der Voet, J A / Delfos, N M / van der Feltz, M / Heemstra, K A / Koch, S M P

    The British journal of surgery

    2020  Volume 107, Issue 10, Page(s) e384–e385

    MeSH term(s) Anesthesia ; Asymptomatic Infections ; COVID-19/diagnosis ; COVID-19/transmission ; COVID-19 Nucleic Acid Testing ; COVID-19 Testing ; Humans ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Medical History Taking ; Preoperative Care/methods ; Radiography, Thoracic/methods ; Tomography, X-Ray Computed/methods
    Keywords covid19
    Language English
    Publishing date 2020-07-23
    Publishing country England
    Document type Letter
    ZDB-ID 2985-3
    ISSN 1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
    ISSN (online) 1365-2168
    ISSN 0263-1202 ; 0007-1323 ; 1355-7688
    DOI 10.1002/bjs.11822
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  5. Article ; Online: Clinical outcome of pedestal cup endoprosthetic reconstruction after resection of a peri-acetabular tumour.

    Bus, M P A / Boerhout, E J / Bramer, J A M / Dijkstra, P D S

    The bone & joint journal

    2014  Volume 96-B, Issue 12, Page(s) 1706–1712

    Abstract: Peri-acetabular tumour resections and their subsequent reconstruction are among the most challenging procedures in orthopaedic oncology. Despite the fact that a number of different pelvic endoprostheses have been introduced, rates of complication remain ... ...

    Abstract Peri-acetabular tumour resections and their subsequent reconstruction are among the most challenging procedures in orthopaedic oncology. Despite the fact that a number of different pelvic endoprostheses have been introduced, rates of complication remain high and long-term results are mostly lacking. In this retrospective study, we aimed to evaluate the outcome of reconstructing a peri-acetabular defect with a pedestal cup endoprosthesis after a type 2 or type 2/3 internal hemipelvectomy. A total of 19 patients (11M:8F) with a mean age of 48 years (14 to 72) were included, most of whom had been treated for a primary bone tumour (n = 16) between 2003 and 2009. After a mean follow-up of 39 months (28 days to 8.7 years) seven patients had died. After a mean follow-up of 7.9 years (4.3 to 10.5), 12 patients were alive, of whom 11 were disease-free. Complications occurred in 15 patients. Three had recurrent dislocations and three experienced aseptic loosening. There were no mechanical failures. Infection occurred in nine patients, six of whom required removal of the prosthesis. Two patients underwent hindquarter amputation for local recurrence. The implant survival rate at five years was 50% for all reasons, and 61% for non-oncological reasons. The mean Musculoskeletal Tumor Society score at final follow-up was 49% (13 to 87). Based on these poor results, we advise caution if using the pedestal cup for reconstruction of a peri-acetabular tumour resection.
    MeSH term(s) Acetabulum ; Adolescent ; Adult ; Aged ; Bone Neoplasms/surgery ; Carcinoma/surgery ; Female ; Hemipelvectomy ; Humans ; Male ; Middle Aged ; Pelvis ; Prosthesis Design ; Retrospective Studies ; Sarcoma/surgery ; Treatment Outcome
    Language English
    Publishing date 2014-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 2697156-2
    ISSN 2049-4408 ; 2049-4394
    ISSN (online) 2049-4408
    ISSN 2049-4394
    DOI 10.1302/0301-620X.96B12.34622
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Multiflora and Gram-Negative Microorganisms Predominate in Infections Affecting Pelvic Endoprostheses Following Tumor Resection.

    Sanders, P T J / Bus, M P A / Scheper, H / van der Wal, R J P / van de Sande, M A J / Bramer, J A M / Schaap, G R / de Boer, M G J / Dijkstra, P D S

    The Journal of bone and joint surgery. American volume

    2019  Volume 101, Issue 9, Page(s) 797–803

    Abstract: Background: Periprosthetic infections after pelvic reconstruction are common, with reported rates ranging from 11% to 53%. Management of these infections is troublesome, as they commonly necessitate multiple surgical interventions and implant removal. ... ...

    Abstract Background: Periprosthetic infections after pelvic reconstruction are common, with reported rates ranging from 11% to 53%. Management of these infections is troublesome, as they commonly necessitate multiple surgical interventions and implant removal. The epidemiology and outcomes of these infections are largely unknown. The aim of this study was to analyze the causative microorganisms and the clinical outcome of treatment in a series of patients with pelvic endoprostheses affected by infection following tumor resection.
    Methods: In this retrospective, multicenter cohort study, we identified all patients who developed an infection after endoprosthetic reconstruction in periacetabular tumor resection, between 2003 and 2017. The microorganisms that were isolated during the first debridement were recorded, as were the number of reoperations for ongoing infection, the antimicrobial treatment strategy, and the outcome of treatment.
    Results: In a series of 70 patients who underwent pelvic endoprosthetic reconstruction, 18 (26%) developed an infection. The type of pelvic resection according to the Enneking-Dunham classification was type P2-3 in 14 (78%) of these patients and type P2 in 4 (22%). Median follow-up was 66 months. Fourteen (78%) of the 18 patients with infection had a polymicrobial infection. Enterobacteriaceae were identified on culture for 12 (67%). Of a total 42 times that a microorganism was isolated, the identified pathogen was gram-negative in 26 instances (62%). Microorganisms associated with intestinal flora were identified 32 times (76%). At the time of latest follow-up, 9 (50%) of the patients had the original implant in situ. Of these, 2 had a fistula and another 2 were receiving suppressive antibiotic therapy. In the remaining 9 (50%) of the patients, the original implant had been removed. At the time of final follow-up, 3 of these had a second implant in situ. The remaining 6 patients had undergone no secondary reconstruction.
    Conclusions: Infections that affect pelvic endoprostheses are predominantly polymicrobial and caused by gram-negative microorganisms, and may be associated with intestinal flora. This differs fundamentally from mono-bacterial gram-positive causes of conventional periprosthetic joint infections and may indicate a different pathogenesis. Our results suggest that prophylaxis and empiric treatment may need to be re-evaluated.
    Level of evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
    MeSH term(s) Adult ; Aged ; Arthroplasty, Replacement, Hip/adverse effects ; Bone Neoplasms/surgery ; Debridement ; Female ; Gram-Negative Bacteria/isolation & purification ; Gram-Negative Bacterial Infections/diagnosis ; Gram-Negative Bacterial Infections/etiology ; Hip Prosthesis/adverse effects ; Humans ; Male ; Middle Aged ; Pelvic Bones ; Prosthesis-Related Infections/microbiology ; Reoperation ; Retrospective Studies ; Young Adult
    Language English
    Publishing date 2019-05-02
    Publishing country United States
    Document type Journal Article ; Multicenter Study
    ZDB-ID 220625-0
    ISSN 1535-1386 ; 0021-9355
    ISSN (online) 1535-1386
    ISSN 0021-9355
    DOI 10.2106/JBJS.18.00836
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Screening with HRCT chest and PCR testing for COVID-19 in asymptomatic patients undergoing a surgical or diagnostic procedure

    Huybens, E M / Bus, M P A / Massaad, R A / Wijers, L / van der Voet, J A / Delfos, N M / van der Feltz, M / Heemstra, K A / Koch, S M P

    Br. j. surg

    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #670614
    Database COVID19

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  8. Article: What is the Preferred Screening Tool for COVID-19 in Asymptomatic Patients Undergoing a Surgical or Diagnostic Procedure?

    Huybens, E M / Bus, M P A / Massaad, R A / Wijers, L / van der Voet, J A / Delfos, N M / van der Feltz, M / Heemstra, K A / Koch, S M P

    World J Surg

    Abstract: INTRODUCTION: Since the outbreak of COVID-19, measures were taken to protect healthcare staff from infection, to prevent infection of patients admitted to the hospital and to distribute PPE according to need. To assure the proper protection without ... ...

    Abstract INTRODUCTION: Since the outbreak of COVID-19, measures were taken to protect healthcare staff from infection, to prevent infection of patients admitted to the hospital and to distribute PPE according to need. To assure the proper protection without overuse of limited supply of these equipments, screening of patients before surgical or diagnostic procedure was implemented. This study evaluates the results of this screening. METHOD: All patients screened for COVID-19 before procedure warranting either general, locoregional anaesthesia or sedation were included. Screening included a symptom questionnaire by phone, PCR and HRCT chest testing. Surgical or procedural details were registered together with actions taken based on screening results. RESULTS: Three hundred ninety-eight screenings were performed on 386 patients. The symptom questionnaire was completed in 72% of screenings. In 371 screenings, PCR testing was performed and negative. HRCT chest found 18 cases where COVID-19 could not be excluded, with negative PCR testing. Three patients had their surgery postponed due to inconclusive screening, and additional measures were taken in three other patients. There were incidental findings in 14% of HRCT chest scans. DISCUSSION: Pre-operative screening will differentiate if PPE is needed for procedures and which patients can safely have elective surgery during this COVID-19 pandemic and in the times to come. HRCT chest has no additional value in the pre-operative screening of asymptomatic patients. Screening can be performed with a symptom questionnaire, and additional screening with PCR testing in high-risk patient groups should be considered.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #713528
    Database COVID19

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  9. Article ; Online: Screening with HRCT chest and PCR testing for COVID-19 in asymptomatic patients undergoing a surgical or diagnostic procedure ; COVID-19 Screening

    Huybens, E. M. / Bus, M. P. A. / Massaad, R. A. / Wijers, L. / van der Voet, J. A. / Delfos, N. M. / van der Feltz, M. / Heemstra, K. A. / Koch, S. M. P.

    British Journal of Surgery ; ISSN 0007-1323

    2020  

    Keywords Surgery ; covid19
    Language English
    Publisher Wiley
    Publishing country us
    Document type Article ; Online
    DOI 10.1002/bjs.11822
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: What is the Preferred Screening Tool for COVID-19 in Asymptomatic Patients Undergoing a Surgical or Diagnostic Procedure?

    Huybens, E. M. / Bus, M. P. A. / Massaad, R. A. / Wijers, L. / van der Voet, J. A. / Delfos, N. M. / van der Feltz, M. / Heemstra, K. A. / Koch, S. M. P.

    World Journal of Surgery

    2020  Volume 44, Issue 10, Page(s) 3199–3206

    Keywords Surgery ; covid19
    Language English
    Publisher Springer Science and Business Media LLC
    Publishing country us
    Document type Article ; Online
    ZDB-ID 224043-9
    ISSN 1432-2323 ; 0364-2313
    ISSN (online) 1432-2323
    ISSN 0364-2313
    DOI 10.1007/s00268-020-05722-9
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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