Dr. Randall on the Evolution of Orthopedic Surgery in Sarcoma

R. Lor Randall, MD, FACS, professor and The David Linn Endowed Chair for Orthopaedic Surgery and professor and chair of the Department of Orthopaedic Surgery, University of California Davis Health, discusses the evolution of orthopedic surgery in sarcoma.

Surgical intervention for patients with sarcoma requires a technical, two-step process, says Randall. The first step is to remove the cancer, and the second step is to replace the patient’s anatomy with something functional at the site of surgery. Ablative approaches, such as amputation, are reserved for rare circumstances.

The development of limb-salvage surgical techniques has eliminated the need to build custom prosthetics for patients with bone and soft tissue sarcoma, Randall says. The technology evolved to offer more off-the-shelf modular erector sets that can reconstruct patients’ limbs.

Additionally, improved imaging from radiographs to CT scans and MRIs allowed for more anatomic detail to be captured on an image. Improved imaging led to refined approaches that enabled surgeons to remove smaller amounts of tissue while sparing the joint, concludes Randall.