Orthopedic Oncology

Orthopedic oncology is a modern branch of medicine that deals with the diagnostics and complex treatment of benign and malignant neoplasms of musculoskeletal system and surrounding soft tissues. The development of this medical area is extremely important for patients, since malignant bone tumors often require radical and disabling surgical interventions – amputations, and early diagnosis and a well-structured treatment program will allow not only to preserve the limb affected by the tumor process, but also to restore it completely.

An entire multidisciplinary team works in Orthopedic Oncology Department, because only orthopedic doctors are not enough to create comfortable conditions for patient and provide patients with the full range of necessary therapeutic and diagnostic procedures. We employ highly qualified orthopedic traumatologists, surgeons, radiologists, rehabilitation specialists, oncologists, psychologists, physical therapists and other necessary specialists to provide patient with the opportunity to receive continuous medical care in one institution, starting from the first visit and diagnosis, ending with surgical treatment, recovery after this and subsequent outpatient monitoring.

A female doctor is pointing on a bone in a spine

Directions of practice of Orthopedic Oncology Department

Patients with any benign or malignant neoplasms of musculoskeletal system and soft tissues can seek help from orthopedic oncology department. Most often we help people with the following problems:

Bone neoplasms – sarcomas, osteomas, cysts.
Neoplasms of adipose tissue – lipomas, liposarcomas.
Vascular neoplasms – angiosarcomas, hemangiomas, lymphangiomas.
New malformations of cartilage – chondromas, chondrosarcomas, fibromas.
Tumors of other soft tissues – leiomyomas, leiomyosarcoma, rhabdomyomas, rhabdomyosarcomas, histiocytomas, myxomas, giant cell tumors, fibromas, fibroblastomas.

If the disease that you have been diagnosed with is not on this list, consult a specialist in the field of oncological orthopedics at our clinic, he will tell you about all advantages and disadvantages of available diagnostic and treatment methods in your particular case.

What diseases does Orthopedic Oncology Department treat?

3D Printing Technology: Next-Generation Surgery

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Diagnostic methods in oncology orthopedics

All patients with neoplasms of bones, cartilage or soft tissues need high-quality and comprehensive modern diagnostics, because further treatment and its success will depend on this. At Tel Aviv Medical Center, patient has access to all modern diagnostic procedures that his clinical situation requires. Among these:

General clinical, hormonal and biochemical blood and urine tests.
Biopsy of bones and soft tissue tumors.
Modern medical imaging techniques – CT, MRI, PET-CT, MSCT with and without contrast, skeletal scintigraphy to determine the presence of distant metastases in the bones.
Ultrasound techniques for examining neoplasms with and without color Dopplerography.
Digital radiography and fluoroscopy.

If any procedure is painful and/or unpleasant, at the request of patient it can be performed under general or local anesthesia to relieve the person of any discomfort.

When a diagnostic program requires a biopsy, samples of obtained tissues are necessarily transferred to the best Israeli pathology laboratories for accurate diagnosis and control. Thanks to such “molecular tests” we are absolutely sure of diagnosis correctnes and the write choice of treatment methods.

The new EOS X-ray unit, unlike previous generation devices, allows us to obtain a panoramic digital image of patient’s entire musculoskeletal system in just 25 seconds. This device makes it possible to significantly reduce radiation dose to the body to perform the necessary diagnostic procedures.

Important!

Tel Aviv Medical Center has one of the best Orthopedic Oncology Departments. Our specialists have appropriate qualifications and experience in the treatment of oncopathology of the musculoskeletal system.

Modern treatment methods in Orthopedic Oncology Department

The majority of patients at Tel Aviv Medical Center Orthopedic Oncology Department retain their functionality and affected limb after treatment, and also fully recover from their illness. We achieve this success through a combination of high qualifications and training of our doctors and application of modern diagnostic equipment and advanced treatment methods.

Surgical procedures have become especially highly developed.

And if it is necessary to perform amputations, patient is sent to modern reconstructive and plastic surgeries after the main stage of treatment or to production of modern external or internal prostheses with subsequent rehabilitation.

Among innovative procedures in oncological orthopedics that we offer to our patients are:

3D printing of bone prostheses and their installation at the site of the defect;
vertebroplasty under the control of computer navigation when pathological focus is localized in spine;
osteoplasty under the control of computer navigation;
joint replacement after radical oncological surgeries;
cryoresection of bone tumors (Cryosurgery for Bone Tumors);
microsurgical reconstruction of blood vessels, bones and soft tissues;
various reconstructive plastic surgeries after primary surgical removal of pathological focus, for example, skin grafting to the site of defect after wide excision of soft tissue sarcoma, etc.;
radiofrequency thermal ablation for tumor lesions of bones and soft tissues;
endoprosthetics of pelvic bones, sternum, ribs, vertebrae;
excochleation of bone cysts.

Important!

All surgeries performed in Orthopedic Oncology Department are performed according to the basic principle – preservation of affected limb (organ-preserving) and minimally invasive intervention for rapid recovery.

Particular development has been achieved in the field of joint replacement after radical surgical interventions. Such reconstructive surgeries allow patients to restore lost functions and performance, feel like a full member of society, and lead a further healthy and active life, despite a serious illness in past.

The Stryker robotic unit is actively used to perform knee arthroplasty. The system performs medical visualization of surgical field in 3D mode, after which it ideally calculates the required location of prosthetic structures. Surgeon “guides” the robot from behind the control panel. If discrepancies arise between the prepared plan and surgeon’s manipulations, the robot immediately stops working and does not make the slightest mistake. The main advantage of using this robotic installation is the accuracy of endoprosthetics, which reduces to almost zero the need for repeated surgeries on the same patient.

Department is equipped with modern wards for chemotherapy, which is used in the complex treatment of malignant neoplasms of musculoskeletal system. Doctors use only modern chemotherapy regimens using high-quality drugs from well-known manufacturers. The dose and regimen of use, the number of courses are selected for each patient individually in such way to obtain the maximum positive effect from the treatment and at the same time prevent side effects development.

Targeted therapy is used very widely in patients at Orthopedic Oncology Department. This is a kind of modified version of chemotherapy when modern molecular genetic drugs are used. This medicine is “trained” to specifically attack tumor cells, block metabolic processes in them or their reproduction. Thanks to this action, tumor stops growing and is destroyed on its own. At the same time, surrounding healthy cells are not damaged, because targeted drugs do not affect them. An example of such modern drugs for musculoskeletal cancer treatment are T-cell therapy for sarcoma, pazopanib (Votrient®), imatinib (Gleevec®), sirolimus (Rapamune®), palbociclib (Ibrance®).

Radiation therapy in treatment of malignant diseases of bones, cartilage and soft tissues is used in complex treatment. The method is based on malignant cells destruction under the influence of ionizing radiation. Sometimes it can be used as an independent method of treatment, but more often it is used in combination with surgery and chemotherapy. Radiation therapy can be external, when the radiation source is outside of body, or contact, when radioactive material is placed directly into the tumor tissue. An example of the latter is brachytherapy. Each method has its own advantages and disadvantages. The type, scheme and duration of radiation therapy are selected by a specialist – a radiologist. There are many modern radiotherapy techniques that have minimal side effects, such as intensity modulated radiation therapy (IMRT), magnetic resonance radiation therapy (MRgRT), etc.

The main task of specialists in Orthopedic Oncology Department of Tel Aviv Medical Center is to correctly diagnose and effectively treat the patient, while avoiding amputations and disabling procedures. To do this, we are guided by such principles as a multidisciplinary and completely individualized approach to each patient, application of modern diagnostic equipment, and proven and effective treatment regimens.