ORTHOPAEDIC SURGERY ESSENTIALS ONCOLOGY AND BASIC SCIENCE ORTHOPAEDIC SURGERY ESSENTIALS ONCOLOGY AND BASIC SCIENCE ORTHOPAEDICSURGERYESSENTIALS AdultReconstruction DanielJ.Berry,MD ScottP.Steinmann,MD FootandAnkle DavidB.Thordarson,MD HandandWrist JamesR.Doyle,MD OncologyandBasicScience TimothyA.Damron,MD Pediatrics SusanA.Scherl,MD KathrynE.Cramer,MD Spine ChristopherM.Bono,MD StevenR.Garfin,MD SportsMedicine AnthonyA.Schepsis,MD BrianD.Busconi,MD Trauma CharlesCourt-Brown,MD MargaretM.McQueen,MD PaulTornettaIII,MD ORTHOPAEDIC SURGERY ESSENTIALS ONCOLOGY AND BASIC SCIENCE Series Editors Book Editor PAUL TORNETTA III, MD TIMOTHY A. DAMRON, MD Professor DavidG.MurrayEndowedProfessorofOrthopedicSurgery DepartmentofOrthopaedicSurgery ViceChairman,DepartmentofOrthopedicSurgery BostonUniversitySchoolofMedicine StateUniversityofNewYorkUpstateMedicalUniversity DirectorofOrthopaedicTrauma AdjunctProfessor,DepartmentofBiomedicaland BostonUniversityMedicalCenter ChemicalEngineering Boston,Massachusetts SyracuseUniversity Syracuse,NewYork THOMAS A. EINHORN, MD ProfessorandChairman DepartmentofOrthopaedicSurgery BostonUniversitySchoolofMedicine Boston,Massachusetts AcquisitionsEditor:RobertHurley ManagingEditor:DavidMurphy DevelopmentalEditor:GraceR.Caputo,DovetailContentSolutions MarketingDirector:SharonZinner ProjectManager:NicoleWalz ManufacturingManager:KathyBrown CreativeDirector:DougSmock Compositor:MarylandComposition Printer:Gopsons Copyright(cid:1)2008LippincottWilliams&Wilkins,aWoltersKluwerbusiness 530WalnutStreet Philadelphia,PA19106 Allrightsreserved.Thisbookisprotectedbycopyright.Nopartofthisbookmaybereproduced inanyformorbyanymeans,includingphotocopying,orutilizedbyanyinformationstorageand retrievalsystemwithoutwrittenpermissionfromthecopyrightowner. Thepublisherisnotresponsible(asamatterofproductliability,negligence,orotherwise)for anyinjuryresultingfromanymaterialcontainedherein.Thispublicationcontainsinformation relatingtogeneralprinciplesofmedicalcarethatshouldnotbeconstruedasspecific instructionsforindividualpatients.Manufacturers’productinformationandpackageinserts shouldbereviewedforcurrentinformation,includingcontraindications,dosages,and precautions. LibraryofCongressCataloging-in-PublicationData Oncologyandbasicscience/[editedby]TimothyA.Damron. p.;cm. — (Orthopaedicsurgeryessentials) Includesbibliographicalreferencesandindex. ISBN-13:978-0-7817-8045-2 ISBN-10:0-7817-8045-4 1.Musculoskeletalsystem—Tumors.2.Orthopedics.3.Orthopedicsurgery.I.Damron, TimothyA.II.Series. [DNLM:1.BoneNeoplasms.2.OrthopedicProcedures—methods.3.SoftTissueNeoplasms. 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CONTENTS ContributingAuthors xi Preface xvii SeriesPreface xv Acknowledgment xix SECTION I: EVALUATION AND MANAGEMENT OF MUSCULOSKELETAL ONCOLOGY PROBLEMS 1 Evaluation of Bone Tumors 3 4.2 BenignTumorsofBone 54 TimothyA.Damron CynthiaM.Kelly 2 Evaluation of Soft Tissue Tumors 28 4.3 MalignantBoneLesions 60 CarolD.Morris FrancisR.Patterson,TimothyA.Damron,and CarolD.Morris 3 Biopsy of Musculoskeletal Tumors 37 4.4 SoftTissueTumors 87 EdwardA.Athanasian JohnHeinerandJeremyWhite 4 Treatment Principles 50 4.5 PathologicFractures 92 4.1 SurgicalMargins 50 TimothyA.Damron RobertQuinn SECTION II: SPECIFIC BONE NEOPLASMS AND SIMULATORS 5 Benign Bone Tumors 117 5.6 GiantCellTumorofBone 159 SeanV.McGarryandC.ParkerGibbs 5.1 BoneLesions 117 FelasfaM.Wodajo 5.7 VascularLesions 164 5.2 CartilageLesions 126 SeanV.McGarryandC.ParkerGibbs FelasfaM.Wodajo 5.8 OtherTumorsofUndefinedNeoplasticNature 170 5.3 CysticLesions 140 SeanV.McGarryandC.ParkerGibbs SungWookSeo,YoungLaeMoon,and 6 Bone Sarcomas 177 FrancisYoung-InLee 5.4 Myogenic,Lipogenic,andNeuralTumors 147 6.1 Osteosarcoma 177 SeanV.McGarryandC.ParkerGibbs FrancisR.Patterson 5.5 FibrousLesionsofBone 149 6.2 EwingSarcomaandPrimitiveNeuroectodermalTumor SungWookSeo,YoungLaeMoon,and ofBone 187 FrancisYoung-InLee BruceRougraff vii viii Contents 6.3 Chondrosarcoma 192 7.3 SkeletalDysplasias 215 R.LorRandallandKennethJ.Hunt DanielleA.Katz 6.4 Fibrous,Fibrohistiocytic,andGiantCellTumor 7.4 RetinoblastomaSyndrome 224 Malignancies 201 TimothyA.Damron HannahD.Morgan 7.5 Rothmund-ThomsonSyndrome 226 6.5 NotochordalTumors 204 KathrynPalomino HannahD.Morgan 7.6 WernerSyndrome 227 6.6 VascularSarcomasofBone 206 KathrynPalomino HannahD.Morgan 6.7 Myogenic,Lipogenic,andEpithelialBoneSarcomas 8 Metastatic Disease 229 209 TimothyA.Damron HannahD.Morgan 9 Hematologic Malignancies 244 7 Congenital and Inherited Bone Conditions 212 ValeraeO.Lewis 7.1 FamilialAdenomatousPolyposis 212 10 Metabolic Bone Diseases 251 KathrynPalomino SusanV.Bukata 7.2 Beckwith-WiedemannSyndrome 214 DanielleA.Katz SECTION III: SPECIFIC SOFT TISSUE NEOPLASMS AND SIMULATORS 11 Benign Soft Tissue Tumors 263 12 Soft Tissue Sarcomas 294 TimothyA.DamronandGustavodelaRoza CarolD.Morris SECTION IV: BASIC SCIENCE 18 Principles of Orthopaedic Pharmacology 387 13 Cellular and Molecular Biology 309 CarolD.Morris MatthewJ.Allen 19 Bone Form, Function, Injury, Regeneration, and 14 Growth and Development of the Musculoskeletal Repair 393 System 321 AlexiaHernandez-SoriaandMathiasBostrom DonaldE.SweetandThomasV.Smallman 20 Articular Cartilage Structure, Composition, and 15 Genetic Basis of Musculoskeletal Disorders 347 Repair 405 SathappanS.Sathappan,KirillIlalov,and PeterJ.RoughleyandThomasV.Smallman PaulE.DiCesare 21 Diarthrodial Joints 418 16 Biomechanics 367 ThomasV.Smallman,KrisShekitka,and FrederickW.WernerandJosephA.Spadaro DonaldFlemming 17 Biomaterials 373 22 Meniscal Structure, Function, Repair, and JosephA.Spadaro,MichaelT.Clarke,and Replacement 443 JulieM.Hasenwinkel MarkC.DrakosandAnsworthA.Allen Contents ix 23 Intervertebral Disk Structure, Composition, and 27.1 BacterialInfection 496 Mechanical Function 452 SamuelA.Joseph,Jr.,andPatrickBoland 27.2 GranulomatousInfection 508 24 Tendon and Ligament Anatomy, Biology, and Biomechanics 463 BrianJ.HarleyandJosephW.Bergman 27.3 InfectionAssociatedwithNeuropathy 521 25 Peripheral Nerve Physiology, Anatomy, and Pathology 474 27.4 ViralDisorders 524 ShikhaSethi,BrianJ.Harley,ChristianCustodio,and MichaelStubblefield 26 Skeletal Muscle Anatomy, Physiology, and 28 Neoplasia 525 Mechanics 484 MatthewJ.Allen BryanT.KellyandWilliamJ.Robertson 27 Infectious Disorders of Bone and Joint 495 ThomasV.Smallman,KrisShekitka,DonaldFlemming, andBrianJ.Harley Index 533