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Surgical Management of Metastatic Bone Disease
Jacob Bickels, MD1; Shlomo Dadia, MD1; Zvi Lidar, MD1
1 National Unit of Orthopedic Oncology (J.B. and S.D.) and Spine Care Unit (Z.L.), Tel-Aviv Sourasky Medical Center, 6 Weizmann Street, Tel-Aviv 64239, Israel. E-mail address for J. Bickels: jbickels@012.net.il
The Journal of Bone & Joint Surgery.  2009; 91:1503-1516  doi:10.2106/JBJS.H.00175
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Abstract

Metastatic bone disease is a major contributor to the deterioration of the quality of life of patients with cancer; it causes pain, impending and actual pathological fractures, and loss of function and may also be associated with considerable metabolic alterations.

Operative treatment may be required for an impending or existing fracture and intractable pain. The goals of surgery are to provide local tumor control and allow immediate weight-bearing and function. Radiation therapy is often indicated postoperatively.

Detailed preoperative evaluation is required to assess the local extent of bone destruction and soft-tissue involvement, involvement of other skeletal sites, and the overall medical and oncological status.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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