Excision of Benign Bone Tumors

It is a procedure that involves removing a tumor (malignant or benign) of the bone while preserving the surrounding healthy bone and soft tissues and reconstructing the defect (space where tumor was removed).

Bone Sarcoma

What is an Excision of a Benign Bone Tumor?

There are a variety of non-cancerous bone tumors, and although benign, some cause pain, grow quickly, and act aggressively. Benign bone tumors are identified on radiographs and definitively diagnosed with biopsies. The bone tumors are further classified into stages, with stage 1 being a latent bone tumor, stage 2 being an active bone tumor that continues to grow and expand, and stage 3 being an aggressive and invasive bone tumor. Commonly, stage 1 benign bone tumors are treated through observation or excision of the lesion, dependent of its nature. Stage 2 benign bone tumors are treated with intralesional excision and reconstructed with local grafting and/or cementation. Lastly, stage 3 benign bone tumors are treated with intralesional excisions or marginal/en bloc excisions and reconstructed with grafting, cementation, endoprosthesis, and/or allograft prosthetic composite. More aggressive tumors, including those that are labeled as high grade, require more aggressive treatment, as these tumors often invade and destroy the bone and surrounding soft tissues. Higher grade bone tumors also have higher recurrence rates, and therefore need a more aggressive and effective treatment. Marginal/en bloc excisions are used to treat bone tumors and diminish recurrence rates by removing adequate tissue (margins) without destabilizing local structures. In this procedure, the surrounding tissue, nerves, and vessels are protected, and tumor is completely removed with the utilization of special tools and instruments. Margins are also taken to prevent recurrences in the future. Afterward, the surgical site is irrigated and then the bone is repaired with bone cement, grafts, or replaced with a prosthesis.

What’s involved in the technique?

What you can expect afterwards

After your surgery you may spend a few nights in the hospital depending on the type of surgery. Once discharged from the hospital, you will be recuperating at home. Various pain protocols and nerve blocks are used to minimize pain. Mostly all patients are very comfortable after the surgery. For the first few days you will ice the area and keep it elevated to reduce swelling. You will return to the office 2 weeks after surgery. Once cleared, you may subsequently start physical therapy depending on the extent of your procedure. We usually prescribe specific physical therapy protocols 3 times a week for 12 weeks after surgery to gradually strengthen muscles. Strengthening with significant resistance after sufficient range of motion is achieved as determined by Dr. Wittig. There may be an ultimate weight limit imposed upon you depending on various factors.  

You will be monitored periodically with X-Ray and MRI imaging over the course of 5 years to ensure there are no signs of recurrence. You will have follow up appointments every 4 months for the first 2 years, then every 6 months for the next 2 years, and then once a year. Since the integrity of the limb has been restored to full or almost full, recovery is anticipated provided the patient adheres to strict physical therapy.

Types Of Physical Therapy

Bone Sarcoma Removal Video

Dr. James Wittig narrates a video illustrating the surgical technique for the resection of a bone sarcoma. | WATCH VIDEO