Honderd jaar orthopedie in Nederland. III. Bottumoren

In the fifties, patients with a malignant bone tumour were treated with radiotherapy, sometimes supplemented by resection, as recommended by the Bone Tumour Committee established in 1953. In the seventies, improvement of imaging techniques and chemotherapy made limb-saving surgery possible.

Currently, 70 of patients with a malignant tumour of the locomotor apparatus are treated by limb saving, oncologically justified surgery. The surgical defects can be repaired with the aid of an endoprosthesis, or bone homografting or autografting. Children are often treated with an operation involving 180 rotation of the ankle to function as the knee, combined with a prosthesis. Adults are sometimes treated with this technique, but also with internal (‘standard’) prostheses and donor bone.

The future will have to make clear which technique is to be preferred in which situation. Probably, typing and prognosis of various tumours may improve, leading to better insight into the treatment. Centralization of the treatment of rare tumours may also contribute to improvement of the treatment and its scientific research.