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Biomedical subjects

P Ritschl

Publications and source records attributed to P Ritschl.

At least 19 recordsLinked to original sources
PubMed1992

[Therapy of bone metastases of the lower extremity with the KMFTR modular tumor endoprosthesis system].

During the years 1975 through 1989, 189 patients have been operated because of metastases within bones of the lower extremity. Thereof, 34 patients received an endoprosthesis of the KMFTR (Kotz Modular Femur-Tibia reconstruction system) type. In detail, the following reconstruction elements had been used: proximal femur (n = 20), distal femur (n = 7), complete femur (n = 2), proximal tibia (n = 5). At the time of follow-up examination 30 patients had died. Mean survival time after resection of metastases was 18.6 months (range 8-44 months). According to histologic judgement, in 23 cases wide or marginal resections had been performed whereas 11 patients had been operated intralesionally. In no case local recurrence as relevant to therapy was observed. At the same time-point, survival periods after detection of secondary manifestations of the malignant diseases within the remaining 4 patients were 29, 61, 73 and 125 months, respectively. The following complications were observed: luxation of the prosthesis (n = 6), transient paresis of the peroneus (n = 3), deep vein thrombosis (n = 2), pulmonary infarction (n = 1), wound healing disturbances (n = 2) and hematoma (n = 3).

Acetabulum↗
PubMed1991

Parosteal osteosarcoma. 2-23-year follow-up of 33 patients.

In a study of the working group for bone tumors of the German Orthopedic Society, 33 patients with a histologically confirmed parosteal osteosarcoma at reexamination underwent clinical and radiographic follow-up. Local recurrence occurred in all the cases after intralesional surgery and in 4 of 8 cases after marginal excision. The grade of differentiation was decisive for the prognosis. Despite intralesional surgery, the prognosis for Grade 1 tumors was good. Metastases developed in 1 of 23 patients with a Grade 1 tumor and in 4 of 9 patients with a Grade 2 tumor. The single patient with a Grade 3 tumor was treated with adjuvant chemotherapy and was free of disease after 5 years.

Adolescent↗
PubMed1991

The management of IIB osteosarcoma. Experience from 1976 to 1985.

From 1976 to 1985, 75 IIB osteosarcomas have been treated out of a total of 98 osteosarcomas at the authors' institution. Because of the effective chemotherapy including high-dose methotrexate administered during this time period, the surgical management changed, and only ten patients out of the 75 IIB osteosarcomas required an amputation. The overall result of 76.7% of disease-free, three-year survival was equally distributed regardless of the surgical procedure. Endoprosthesis, resection with or without grafts, and rotationplasties, as well as amputations, revealed similar results. No negative influence from the limb-sparing surgery could be observed.

Adolescent↗
PubMed1991

Rotationplasty for limb salvage in the treatment of malignant tumors at the knee. A follow-up study of seventy patients.

Seventy patients who had a rotationplasty for treatment of a malignant tumor in the region of the knee (the femur or the tibia) between 1974 and 1987 were followed for two to thirteen years (mean duration of follow-up, four years). Forty-seven patients had a stage-IIB osteosarcoma; the remaining twenty-three patients had a malignant fibrous histiocytoma, a chondrosarcoma, a Ewing sarcoma, or a giant-cell tumor. The most severe postoperative complication was occlusion of the reanastomosed vessels (seven patients), leading to amputation proximal to the knee in three patients. Other complications were problems with wound-healing (eight patients), transient nerve palsy (five patients), irreversible nerve palsy (two patients), pseudarthrosis (four patients), and rotational malalignment (one patient). Late complications included eight fractures, two infections, two delayed unions, and one lymphatic fistula. More than half of the patients were free of complications related to the operative procedure. Forty-four of the patients who had a stage-IIB osteosarcoma could be followed, and their data were analyzed for survival statistics. These patients had a 58 percent rate of disease-free survival and a 70 per cent rate of over-all survival. One patient had a local recurrence five years after the operation.

Adolescent↗
PubMed1990

Fibrous metaphyseal defect.

The tendon and ligaments inserted into the perichondrium of the epiphyseal plate were examined in 152 autopsy specimens of tubular long bones. In the region of two areas where tendons were inserted (Ranvier's nodes), the normal medullary tissue is replaced by fibroblastic tissue. A retrospective radiological examination of 155 fibrous metaphyseal defects shows that they are situated at characteristic sites on the circumference of the metaphysis of long tubular bones. This can be related to the insertion of a tendon or ligament near the epiphyseal growth plate which corresponds to areas found in the morphological study and is the site of origin of fibrous metaphyseal defects.

Bone Diseases, Developmental↗
PubMed1990

[MRT in the follow-up of the healing process of spongy bone transplants--initial experiences].

We present our first experience with MR in bone grafts in 23 patients. Graft implantation followed curettage of benign bone lesions. The locations were, rather exclusively, the long tubular bones. T1-and T2-weighted spin echo-sequences including intravenous application of Gadolinium-DTPA were performed (Magnetom 63, 1,5 T). A total of 29 examinations (1 follow-up control in 6 pat.) was divided into 5 groups, with regard to different stages after surgery, which varied from 1 week to more than 3 years postoperatively. The MR results were related to the respective groups. The results show typical stages of bone graft incorporation, but also greater individual variations in the duration of incorporation. Our first results, however, represent only "snapshots" of different patients at different stages after bone graft surgery. Therefore some important questions are still unanswered but may perhaps be explained with the help of subsequent prospective studies.

Adult↗
PubMed1989

Fibrous metaphyseal defects. Magnetic resonance imaging appearances.

Sixteen patients with fibrous metaphyseal defects were examined with both plain radiography and magnetic resonance (MR) imaging. Depending on the age of the fibrous metaphyseal defects, characteristic radiomorphologic changes were found which correlated well with MR images. Following intravenous Gadolinium-DTPA injection, fibrous metaphyseal defects invariably exhibited a hyperintense border and signal enhancement. Healed lesions exhibited a transition to normal bone marrow. A line through the maximum longitudinal diameter of a fibrous metaphyseal defect invariably led to a point of tendinous or ligamentous insertion. Coronal MR images demonstrated the maximum longitudinal extension and the respective inserting tendon or ligamentous structure at the epiphyseal line.

Adolescent↗
PubMed1989

Refixation of muscular insertions after endoprosthetic replacement of the proximal humerus.

We describe the refixation of muscle insertions after resection of the proximal humerus in tumor patients. The prosthesis specially designed for this purpose carries large drill holes in the places corresponding to the anatomical sites of the muscle insertions. The muscles are attached to the prosthesis by means of tendon strips from the fascia lata. This can be expected to produce better functional results and to prevent subluxation.

Biomechanical Phenomena↗
PubMed1989

[Fibrous dysplasia: its appearance in the magnetic resonance tomogram].

Eleven patients with proven fibrous dysplasia of the skeleton (FD) were examined using magnetic resonance imaging (MRI). Almost constantly T1-weighted hypointense, T2-weighted hyperintense (cystic) as well as T1- and T2-weighted hypointense (fibrous) areas within the lesion could be demonstrated, the latter of which always exhibited either moderate or marked enhancement following intravenous application of Gd-DTPA, resulting in a typical appearance. Furthermore, T1- and T2-weighted hyperintense areas within the lesion were seen in many patients due to focal hemorrhage. No linear time correlation between the clinical symptom pain and focal areas of hemorrhage as shown by MRI, could be established.

Adult↗
PubMed1989

[Management of the administration of leucovorin calcium in high-dose methotrexate therapy].

At the Orthopaedic University Hospital Vienna, neoadjuvant chemotherapy with high-dose methotrexate (MTX) has been applied since 1975 in patients with osteosarcoma. Since 1977 the hospital has been a participant in the Cooperative German-Austrian Study on Osteosarcoma (COSS, 77, 80, 82, 85, 86). Therapeutic results and incidence of side effects are reviewed at regular intervals. Over a 2-year period (1/86 to 12/87), a total of 1999 g MTX were given to 15 patients in 102 therapeutic cycles. In patients treated with MTX in our hospital, only minor intolerance phenomena occurred, owing to careful leucovorin monitoring. Intoxications of up to grade III (modified WHO-score) have been seen in only a few patients. The management of the administration of leucovorin (leucovorin calcium, calcium folinate, INN; citrovorum factor) which is directly dependent on the serum level of MTX, is exactly shown in the discussion.

Adult↗
PubMed1988

Fibrous metaphyseal defects--determination of their origin and natural history using a radiomorphological study.

The radiomorphological appearance of fibrous metaphyseal defects (FMDs) is demonstrated by long-term follow-up studies. A characteristic radiomorphological course rather than a typical single appearance can be established. These findings correlate well with the duration of these tumor-like lesions; therefore, the radiological findings allow conclusions to be made about the age of a fibrous metaphyseal defect. In addition, the characteristic locations of FMDs will be explained in respect of their origins at insertions of tendons and ligaments.

Adolescent↗
PubMed1988

[Vascular surgical reconstructions in orthopedic tumor operations].

The surgical treatment of bone tumors today results more and more in a radical resection therapy. The major vessels are often included in the tumor mass and therefore they have to be resected and reconstructed. Between 1981-1986 30 patients of the Orthopaedic University Clinic in Vienna were treated with tumor resection. The arterial and/or venous reconstruction was done in cooperation with the I. Department of Surgery of the University of Vienna. In 73% of the cases rotation plasty of the knee was performed, in 10% a local tumor resection and in 7% a tumor resection and reconstruction by a tumor endoprosthesis (KMFTR-system). Three patients underwent partial pelvic resection, hemipelvectomy and rotation plasty of the hip respectively.

Adolescent↗
PubMed1987

[Compatibility and toxicity of methotrexate in the treatment of bone tumors].

Chemotherapeutical treatment with high dose methotrexate (HD-MTX) of osteogenic sarcoma has been performed at the Orthopaedic University Clinic of Vienna since 1975. In accordance with the cooperative study for osteosarcoma (Coss) which has been in use in Germany and Austria since 1977, HD-MTX has been used in larger quantity beside other cytostatic drugs. The total of 4259 g MTX has been applied to 36 patients who were suffering from malignant bone tumors. We report about the toxicity and compatibility of MTX. Within 231 cycles of treatment in 8 cases a high toxicity (grade IV after modified WHO-Score) was found. One patient died in consequence of the chemotherapy by fungal infection.

Bone Neoplasms↗