Orthopaedic Oncology and Bone Pathology
Onco-orthopedics – it is a science on the junction between traumatology, orthopedics and oncology. The sphere of professional interest of onco-orthopedists are tumors and tumor – like affections of bones, joints and soft tissues of musculoskeletal system. Even though in the total structure of oncological diseases this type of diseases don’t exceed 3,5-4 %, nevertheless, as a rule, this pathology affects young and middle age people, because of which this particular group of diseases is a serious social and economic problem.
The treatment of soft tissues tumor is one of the more difficult problems in contemporary oncosurgery Hidden clinical course of tumor, aggressive local growth and early metastasis deteriorate the prognosis of treatment for this particular patients’ group. In diagnostics of this pathology is used the whole complex of modern radiological technologies to discover topographic characteristic of tumor and affection of regional lymphatic apparatus, and also their involvement into the remote targeted organs. By all means we perform all types of biopsy (FNA, core-biopsy, incision and excision biopsy) to determine the tactic of patient’s treatment, which must be discussed on the meetings of functioning in our Clinic Tumor Board. During detection of surgical intervention’s character are considered oncological as well as orthopedic indications to perform reconstructive interventions during relapsing and locally spreading forms of soft tissue sarcomas, depending on localization and morph – functional characteristics of defect. If soft tissue tumor grows into the neighboring anatomical structures, we use wide and combined operations to ensure radicality of treatment’s surgical component.
The treatment of bones malignant tumors is a relatively new chapter in modern oncology. The progress in this field was connected to the achievements in orthopedics and was a consequence of the success in replacement of traumatological etymology’s bone – joint defects. At the present time the indications to organ – safe surgical interventions are significantly increased, even during far gone tumors. Mutilating surgeries (amputations and exarticulations) are performed only in those cases, when the radical amputation of the tumor is not possible during resection stage.
Principal activities of the Clinic
At the present in the Service of Oncoorthopedics and Bone Pathology we implement practically all types of surgeries that must be performed to this sort of patients:
- organ – safe surgical treatment of extremities’ soft tissues tumors,
- Extensive and combined interventions during soft tissues tumors with the same moment plastic replacement of occurring defects,
- Surgical treatment of benign tumors and tumor – like affections of bones using methods of auto-, alloplastic of occurring defects and plastic by bio composing tissues,
- Organ – safe surgical treatment of bone malignant tumors with resection of tumor affected bone segments and same moment replacement of developed bone-joint defects by individual joint and diaphyseal mega - endoprosthesis,
- Mega – endoprosthesis of knee joint by automatic endoprosthesis of knee joint with internal rotation of CMS model (first time in Armenia),
- mega - endoprosthesis of shoulder joint and shoulder bone,
- mega - endoprosthesis of hip joint and hip bone,
- individual endoprosthesis of diaphyseal bone defects.
Also, in the Department we perform surgeries regarding elective orthopedic pathology (endoprosthesis during deforming coxarthrosis and gonarthrosis), correcting osteotomy during displacement of big toe entoectad (hallux valgus).
Members of the Service actively participate at conferences in republic of Armenia as well as in the foreign countries. During replacement of bone-joint defects there are used endoprosthesis of Zimmer (USA), Beznoska (Czech Republic), Bioimpianti (Italy) and other famous firm – manufacturer.