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ONE OF THE MOST COMPREHENSIVE ORTHOPAEDIC ONCOLOGY PROGRAMS IN THE REGION FOR BOTH ADULTS AND CHILDREN

Our Orthopaedic Oncology Program is comprised of experts from both Montefiore and Children's Hospital at Montefiore, dedicated to the diagnosis and treatment of both benign and malignant tumors. We use a team approach that leverages our experience caring for patients of all ages in our efforts to produce the best treatment outcomes possible.

Our experts collaborate to provide proactive and multidisciplinary care that is thorough, comprehensive and easily accessible.

Together with Montefiore Einstein Center for Cancer Care and its research partner, Albert Einstein Cancer Center, our program represents one of the most comprehensive of its kind in the region.

A MULTIDISCIPLINARY, TEAM APPROACH

When evaluating a new patient, we work to gain a complete understanding of the patient’s main complaint, medical history and treatment to date, so we can assemble the best team. That team will often interview and evaluate new patients together, maintaining a close collaboration through treatment and follow-up care.

This approach offers tremendous advantages to our patients, including:

  • Eliminating traditional boundaries between specialists
  • Minimizing the number of visits and examinations
  • Ensuring clear communication among all clinicians
  • Streamlining the coordination of subsequent diagnostic studies, treatments and follow-up visits

Our team formally discusses diagnoses and treatment plans on a weekly basis. We collectively review all relevant patient information, imaging studies, test results and biopsy findings. We then design individualized treatment strategies that are driven by evidence-based medicine, national guidelines, ongoing clinical trials and the group’s combined clinical expertise.


CONDITIONS WE TREAT

We diagnose and manage both benign and malignant tumors, treating primary tumors, such as bone and soft-tissue sarcomas, as well as secondary tumors, such as metastatic carcinomas.

MALIGNANT BONE TUMORS  

Adamantinoma
Angiosarcoma of bone
Chondrosarcoma
Chordoma
Ewing's Sarcoma
Hemangioendothelioma
Lymphoma of bone
Malignant fibrohistiocytoma of bone (MFH)
Multiple Myeloma
Osteosarcoma (Osteogenic Sarcoma)
Treatment-associated sarcomas
Metastatic tumor to bone

MALIGNANT SOFT-TISSUE TUMORS  

Angiosarcoma of soft tissues
Dermatofibrosarcoma protuberans
Epithelioid sarcoma
Fibrosarcoma
Leiomyosarcoma
Liposarcoma
Malignant tumors of peripheral nerves (MPNST)
Rhabdomyosarcoma
Synovial sarcoma
Undifferentiated Pleomorphic Sarcoma

BENIGN BONE TUMORS (NON-CANCEROUS)  

Aneurysmal bone cyst
Chondroblastoma
Chondromyxoid fibroma
Enchondroma
Fibrous cortical defect
Fibrous dysplasia
Giant cell tumor of bone
Hemangioma of bone
Langerhans cell histiocytosis (Eosinophilic Granuloma)
Non-ossifying fibroma
Osteoblastoma
Osteochondroma
Osteofibrous dysplasia
Osteoid osteoma
Periosteal chondroma
Unicameral bone cysts

BENIGN SOFT-TISSUE TUMORS (NON-CANCEROUS)  

Fibroma
Fibromatosis
Giant cell tumor of tendon sheath
Hemangioma
Lipoma
Myositis ossificans
Myxoma
Neurofibroma
Pigmented villonodular synovitis (PVNS)
Schwannoma
Synovial chondromatosis
Tumoral calcinosis

TREATMENT OPTIONS

We provide a full range of innovative treatments, supported by the research we conduct with our university partner, Albert Einstein College of Medicine. In all cases, we implement the least invasive solution. 

SURGICAL AND RECONSTRUCTIVE OPTIONS  

Allograft Bone Reconstruction

This reconstruction involves the use of cadaver bones, which are selected from accredited and reputable bone banks and have been carefully screened. Our surgeons use allograft bone to rebuild or reconstruct a patient’s limb joint following surgical resection of a tumor.

Allograft-Prosthetic Composite Reconstruction (APC)

A sophisticated technique that utilizes both allograft bone and artificial joint replacement technology in an effort to maximize a patient’s functional outcome. APC reconstruction is typically used to rebuild either the upper arm and shoulder joint or the upper leg and knee joint.

Custom Joint Replacement Implants

These implants are used by our surgeons to rebuild or reconstruct a patient’s joint following surgical resection of a tumor in or adjacent to a major joint. While standard joint replacement implants can often be used successfully, they are not always ideal due to tumor size, tumor location, remaining bone stock or other patient-specific considerations.

Growing Implants

Tumor removal in or around a major joint is particularly challenging in a young child because the procedure frequently requires removing one or more growth plates. In the past, children needed to undergo multiple major surgeries to revise and extend the implant as they continued to grow. Today, however, our surgeons can utilize a growing implant, which lengthens over time, allowing the child’s limb length to keep up with the opposite side and maintain anatomic symmetry. This is important for function, comfort and aesthetics.

Limb-Salvage Surgery

This technique allows our surgeons to remove an extremity tumor while sparing the involved arm or leg, thereby avoiding amputation. We employ this highly specialized approach in most cases of bone and soft-tissue tumors.

Navigation-Guided Surgery

This procedure is also referred to as image-guided surgery and computer-assisted surgery. These techniques use imaging modalities, such as CT scans, to increase the accuracy of the surgery. When our surgeons position and move their instruments, they can see the where the instrument is being positioned and directed on the imaging study display. This allows for very small and specific surgical corrections. In select patients with tumors located in the pelvis or the spine, navigation guidance can serve as an extremely valuable tool.

Radiofrequency Ablation

This minimally invasive technique is used to treat a variety of benign and malignant tumors. It offers very accurate and reliable outcomes in the vast majority of patients. Our team frequently conducts this procedure to treat noncancerous bone tumors, termed osteoid osteomas. In many cases, the procedure has removed the need for major orthopaedic surgery and has become the standard of care.


ADDING TO THE SCIENCE OF TUMOR TREATMENT

As a leading academic medical center, Montefiore continually advances tumor treatment through groundbreaking research. Our Musculoskeletal Oncology Lab investigates bone and soft tissue sarcomas to develop insights into the genetic mechanisms driving tumor invasion and metastasis (spreading), and to decrease the cancer burden by developing molecular-based therapies that target underlying cancer mechanisms of sarcoma. We participate in national and international clinical trials and routinely present our research findings at national and international conferences. Our study results are frequently published in the most highly regarded peer-review publications.

RESEARCH HIGHLIGHTS  

DOSI (Diffuse Optical Spectroscopic Imaging)

A clinical trial investigating a new infrared imaging device in bone sarcoma to evaluate the effectiveness of chemotherapy. We are the only U.S. institution to use the device to study bone sarcoma in children.

Parity

We’re comparing the effectiveness of postoperative antibiotics in patients receiving a megaprosthesis, an implanted leg device that includes the hip joint, femur, and knee joints and can adjust to a person’s leg length.

Tumor Banking

This project is focused on developing a study protocol, or blueprint, for storing orthopaedic oncology tumor tissue and cell lines for research.

Bayesian Study

In this clinical trial we’re studying serum biomarkers in patients with metastatic bone disease. Cancer biomarkers are usually proteins detected in the blood, urine, or other body fluids that are either produced by the tumor itself or in response to the presence of cancer. This research can be used to develop new ways to detect metastatic bone cancer.

Hip Randomization

A clinical trial to compare different types of fixation for patients with pathologic fractures. Pathologic bone fractures are caused by diseases leading to the weakness of the bone structure. Osteoporosis is often the cause, but fractures may also be due to cancer, infection, inherited bone disorders, or a bone cyst of the proximal femur, the area of the femur that forms the hip joint with the pelvis.

 


THE ONCOLOGY TEAM