Introduction for Dr. Richard A. Brand, Jr.
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Biomedical subjects
Publications and source records attributed to Gary E Friedlaender.
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Femurs of Sprague-Dawley rats were subjected to in vitro 3-Mrad irradiation and/or freeze-drying to investigate whether these processes have an order-dependent effect on the biomechanical properties of bone. Four experimental groups were designated-irradiated (RAD); freeze-dried (FD); irradiated, then freeze-dried (RAD/FD); and freeze-dried, then irradiated (FD/RAD). After the various treatments, the bones were inspected for microfractures and then torsion-tested. Microfractures were seen in more than 90% of the specimens that had undergone freeze-drying alone or with irradiation. Regarding the normalized relative ratios of torque, there was a statistically significant difference (P < .05) between the RAD group (1.0) and the 3 other groups (FD, .32; RAD/FD, .40; FD/RAD, .14). Differences among the FD, RAD/FD, and FD/RAD groups were not significant. However, a trend was bones were weaker than FD and noted: FD/RAD RAD/FD bones.
Amputation, once the mainstay of treatment of malignant bone tumors, now is used selectively and infrequently. Most patients are candidates for limb-sparing procedures because of effective chemotherapeutic agents and regimens, improved imaging modalities, and advances in reconstructive surgery. Patient age as well as tumor location and extent of disease help define the most appropriate surgical alternatives. Options for skeletal reconstruction include modular endoprostheses, osteoarticular or bulk allografts, allograft-prosthetic composites, vascularized bone grafts, arthrodesis, expandable prostheses, rotationplasty, and limb-lengthening techniques. Two key factors must be considered: survival rates should be no worse than those associated with amputation, and the reconstructed limb must provide satisfactory function. Functional outcome studies comparing limb-sparing procedures and amputation have inherent limitations, including the inability to randomize treatment and the subjective nature of important outcome measures.