Primary malignant fibrous histiocytoma of bone: report of six cases with ultrastructural study and analysis of the literature

Six cases of malignant fibrous histiocytoma (MFH) primary in bone were studied clinicopathologically with ultrastructural study of three. The histologic differentiation of MFH from osteosarcoma and from fibrosarcoma is discussed. Two of the six cases had highly malignant tumors histologically designated as Grade III and IV; one died with diffuse metastatic disease eight months after diagnosis and the second developed pulmonary metastases within ten months. Review of the literature revealed that 45 of the total 119 reported cases had been followed for less than five years; these cases were considered unevaluable for assessing biologic behavior. The remaining 74 cases, followed for more than five years or until death, showed a 36.5% five-year survival rate. All but one of the cases which developed metastasis within five years did so within the first two years. It is therefore concluded that MFH of bone is a rapidly metastasizing tumor with a relatively low five-year survival rate. Paradoxically, 13 of these 74 cases (17.6%) survived between five and 38 years with no evidence of disease. This is comparable to the long-term survival rate in osteosarcoma. The five-year survival rate is also comparable to that of fibrosarcoma of bone

Massive Allografts in Non-tumorous Orthopaedic Conditions

Encouraged by our favourable results with the use of massive allografts in reconstructive surgery of bone tumors [1], we started a prospective clinical study in September 1982 to use massive osseous and osteo-articular allografts to replace destroyed, injured or diseased segments of the skeleton in non-tumorous orthopaedic conditions [2]. The purpose of this paper is to evaluate the results of this study

Preliminary Clinical Analysis of Mechanical Performance of the STH Titanium Alloy Total Hip Replacement

Total hip replacement has been performed with the STH titanium alloy femoral stem at the University of Miami School of Medicine consistently since 1976. During the period of 1976 through 1980, eight different staff surgeons and many residents operated on 154 patients and performed 178 total hip replacements utilizing this device. A retrospective analysis of hip replacements in 52 patients from this group who could be adequately followed is reported, utilizing subjective and objective measures of early results. The prosthesis was designed to prevent fracture of femoral component stems, decrease proximal lysis of the femur, decrease femoral component loosening, and provide a prosthesis that could be easily implantable while maintaining good reconstructive procedure about the hip. Since the implementation of the first prosthesis questions about the use of such a design have been raised regarding the vulnerability of titanium to wear and the vulnerability of the proximal cement around the titanium stem to premature failure. The short-term clinical and radiographic results were comparable to those of other series of more conventional total hip replacements. The mechanical reconstruction of the hip and cement failure were comparable, and lysis of the proximal bone was favorably comparable to early results of previous series. Concerns about abnormal wear cannot be supported by the in vivo data in this study