Background and Objectives: Megaprostheses are the most used reconstructive approach for patients who have undergone massive resection of their distal femurs due to bone tumors. Although the literature about their outcomes has flourished in recent decades, to date, a consensus on rehabilitative treatment is yet to be established. In this study, we report on our experience with our latest standardized rehabilitation program, evaluating our results in a mid-to-long-term scenario. Materials and Methods: We evaluated the functional results of all our oncologic patients treated between 2016 and 2022 who could follow our standardized post-operative rehabilitative approach, consisting of progressive knee mobilization and early weight-bearing. Results: Sixteen cases were included in our study. The average duration of the patients’ hospitalization was 12.2 days. A standing position was reached on average 4.1 days after surgery, while assisted walking was started 4.5 days after surgery. After a mean post-operative follow-up of 46.7 months, our patients’ mean MSTS score was 23.2 (10–30). Our data suggest that the sooner patients could achieve a standing position (R = −0.609; p = 0.012) and start walking (R = −0.623; p = 0.010), the better their final functional outcomes regarding their MSTS scores. Conclusions: Rehabilitation should be considered a pivotal factor in decreeing the success of distal femur megaprosthetic implants in long-surviving oncologic patients. Correct rehabilitation, focused on early mobilization and progressive weight-bearing, is crucial to maximizing the post-operative functional outcomes of these patients.

Background: Curettage is a well-established treatment for benign bone tumors. Among the adjuvant treatments available to minimize the risk of local recurrence after curettage, cryotherapy is one of the most used and documented. Our study aims to summarize the results of curettage and intraoperative cryotherapy for the treatment of bone tumors in the modern literature. Methods: We systematically reviewed the existing literature, searching for cases treated with intraoperative cryotherapy after bone curettage in orthopedic oncology. Articles from the PubMed and MEDLINE databases, published between January 2000 and January 2025, were included. Our research was conducted in accordance with PRISMA guidelines. Case reports were excluded. For each study, we recorded the number of cases, their histological diagnosis, the curettage technique, and the cryotherapy administration strategy. Complications and recurrence rates were recorded, as well as post-operative functional performance. Results: Twenty-two studies met our inclusion criteria. A total of 1451 cases with benign and low-grade malignant bone tumors were recorded. After a mean follow-up of 55.7 months, the mean recurrence rate was 7.4% and the global complication rate was 8.7%. The mean MSTS score was 27.8. Conclusions: The combination of curettage and intra-operative cryotherapy, administered with either open or closed contact techniques, can be effective in eradicating benign and low-grade bone tumors and has low complication rates and a limited impact on patients’ functionality.

Introduction : Peripheral nerve schwannomas are rare benign tumors. The onset of a schwannoma in the sciatic nerve is uncommon and can impair the nerve’s functionality. To this date, the literature on this topic is mainly composed of case reports, lacking large case series. Aim : To overcome the limitations of previous literature, we performed a retrospective study on surgical enucleation of sciatic nerve schwannomas, evaluating surgical treatment’s clinical and functional effectiveness. Materials and methods : We examined retrospectively all cases of sciatic nerve schwannomas that underwent surgical enucleation between 2016 and 2022. For each one, we analyzed lesion size and localization. Motor and sensory deficits, Tinel sign, and lower limb functionality (assessed using MSTS and LEFS score) were evaluated before surgery and at the patients’ latest follow-up. Results : Eight cases were included in our study. All patients had pre-operative sensory deficits. The mean MRC score was 3.9 before surgery, while MSTS and LEFS scores were 21.1 and 59.5, respectively. No local recurrence or major complication were recorded. After surgery, the mean MRC score rose to 5, and both MSTS scores (29.5) and LEFS scores (78.1) significantly increased compared to pre-operative records. Conclusions : In our cohort, good functional performances and symptomatic relief were seen after the removal of sciatic nerve schwannomas. Early diagnosis and prompt surgical treatment should represent the therapeutic approach for sciatic neurinomas, considering the good postoperative outcomes.

Restoring the continuity of the anatomical layers and the musculoskeletal soft tissues is fundamental in the reconstructive phases of all surgical proceduresSynthetic surgical meshes are commonly used augments in general surgery to fill flat gaps, but can also be used in other surgical fields, including orthopedics. We evaluated the evidence in modern international literature on the use of polyethylene surgical meshes in the different fields of orthopedic surgery, including hip and knee arthroplasty, trauma surgery, shoulder surgery, and orthopedic oncology. Polyethylene surgical meshes have been used to replace or reinforce musculoskeletal soft tissues. Flat mashes can be used to reinforce flat surfaces, like the cut articular capsules or torn rotator cuffs. Folded meshes provide good longitudinal resistance, allowing the reinforcement or reconstruction of tendons and ligaments in the lower and upper limbs. Also, orthopedic oncology could benefit from using meshes to replace resected soft tissues and provide attachment sites for remaining tendons and ligaments. In conclusion, surgical meshes represent a reliable and adaptable reconstructive approach for several soft tissue lesions in orthopedics surgery. Alone or in combination with other augments, polypropylene surgical meshes should be considered when facing wide soft tissue gaps around the musculoskeletal system.