Bone Tumor Surgery

Diagnosis begins with physical examination and imaging. An X-ray can show changes in bone structure, while MRI helps determine the local extent of a tumor and its relationship to surrounding tissues. CT scanning may be used for staging, especially when a malignant tumor is suspected. PET-CT or a bone scan may be recommended in selected cases.

A biopsy is often essential for confirming suspected bone tumors. It should be planned by specialists because the biopsy pathway may affect subsequent surgery. Biopsy tissue is examined by a pathologist to identify tumor type and grade. Molecular or genetic testing may also be useful for selected tumors.

Treatment Options

Treatment is individualized after staging. A multidisciplinary team may include orthopaedic and medical oncologists, radiologists, pathologists, radiation specialists, and rehabilitation professionals.

For certain malignant tumors, chemotherapy may be given before surgery to reduce tumor activity and treat microscopic disease. Surgery then removes the tumor with an appropriate margin of healthy tissue.

Limb-Sparing Surgery

Limb-sparing surgery removes the tumor while attempting to preserve the affected arm or leg. The surgeon carefully plans the operation to remove diseased tissue while protecting important nerves, blood vessels, and functional structures whenever possible.

After tumor removal, the resulting bone or joint defect may require reconstruction. This approach can help preserve limb function and avoid amputation in appropriately selected patients.

Bone and Joint Reconstruction

Reconstruction depends on the location and amount of bone removed. A custom or modular endoprosthesis may replace the missing bone and joint. Biological reconstruction can use bone allograft, vascularized fibula, or another suitable technique. In some children, expandable prostheses may be considered to accommodate growth.

For selected benign aggressive tumors, curettage followed by bone grafting or another filling material may restore bone strength. In metastatic disease, internal fixation or cement may be used to stabilize weakened bone and reduce pain or fracture risk.

What Happens After Surgery?