Walid Ebeid - Academia.edu (original) (raw)

Papers by Walid Ebeid

Research Square (Research Square), Mar 20, 2024

Research Square (Research Square), Dec 21, 2023

Annals of Surgical Oncology

Background The aim of the study was to assess the functional and oncological outcomes of patients... more Background The aim of the study was to assess the functional and oncological outcomes of patients with distal femoral osteosarcoma managed by limb salvage using modular endoprosthesis as well as to assess related complications. Patients and Methods A total of 82 patients were included in our study. Functional outcome was assessed using MSTS score and knee range of motion. Oncological outcome was assessed regarding local recurrence, chest metastasis, and patient survivorship. Complications were classified according to Henderson et al. Results The mean MSTS score was 26.21 (87.4%) (range 8–30 points) with 70.7% of patients having more than 90° of flexion. The incidence of local recurrence was 3.7% (3 patients), while the incidence of chest metastasis was 14.6% (12 patients). Aseptic loosening (type 2 failure) was the commonest complication (19.5%), followed by infection (15.9%). The 5- and 10-year survivorships of the limb were 98.8%, while the 5- and 10-year survivorships of the pros...

The bone & joint journal, May 1, 2024

Journal of Orthopaedics and Traumatology, Apr 6, 2023

Background Giant cell tumor of bone (GCTB) is a benign locally aggressive tumor frequently treate... more Background Giant cell tumor of bone (GCTB) is a benign locally aggressive tumor frequently treated with intralesional curettage and cementation. The aim of this study was to investigate the long-term incidence of arthritic changes following curettage and cementation of GCTB around the knee. Materials and methods This study was a retrospective review of patients with GCTB around the knee treated with curettage and cementation with a minimum follow-up of 10 years. The functional results were assessed using the Musculoskeletal Tumor Society (MSTS) score. The arthritic changes were classified using the Kellgren-Lawrence (KL) classification system of osteoarthritis. Results This study included 119 patients, 54 males and 65 females, with a mean age of 29.4 ± 9.2 years. There were 35 (29.4%) patients with pathological fractures. There were 84 (70.6%) patients with de novo lesions and 35 (29.4%) with recurrent lesions. The mean follow-up period was 13.2 ± 3.16 years. The mean MSTS score was 28.5 ± 1.9. Overall, 25 (21%) patients developed variable degrees of arthritis of KL grade 1 (n = 7), KL grade 2 (n = 11), KL grade 3 (n = 4), and KL grade 4 (n = 3). Ten patients showed progression of arthritis during the follow-up period. Age at presentation, gender, presence of pathological fracture, whether the tumor was de novo or recurrent, and tumor location were not associated with arthritis incidence. Conclusions Curettage and cementation can be used safely to treat GCTB around the knee. Arthritis of the knee is a possible complication, but mild grades are expected in most cases. There was no association between arthritis incidence and age, gender, pathological fractures, tumor location, or recurrent tumors. Level of evidence Level IV.

BMC Musculoskeletal Disorders, May 21, 2022

Background: There is no agreement about the best reconstructive option following resection of pro... more Background: There is no agreement about the best reconstructive option following resection of proximal humerus tumors. The purpose of this study was to compare the functional outcomes of endoprosthesis reconstruction versus nail cement spacer reconstruction after wide resection of proximal humeral tumors. Methods: This retrospective comparative study included 58 patients with proximal humerus tumors who had undergone tumor resection and reconstruction with modular endoprosthesis (humeral hemiarthroplasties) or cement spacer. Medical records were reviewed for the epidemiological, clinical, radiological, and operative data. Lung metastasis, local recurrence, and complication were also reviewed. The functional outcome was evaluated using the Musculoskeletal Tumor Society scoring (MSTS) system. Results: Nineteen patients with a mean age of 33.4 ± 17.5 years underwent reconstruction by modular endoprosthesis, and 39 patients with a mean age of 24.6 ± 14.3 years underwent reconstruction by cement spacer. The mean MSTS score was 24.8 ± 1.1 in the endoprosthesis group and 23.9 ± 1.4 in the spacer group, P = 0.018. Complications were reported in 5 (26.3%) patients in the endoprosthesis group and 11 (28.2%) patients in the spacer group, P = 0.879. There were no statistically significant differences in the functional outcomes in both patient groups with or without axillary or deltoid resection. Conclusions: Both endoprostheses and cement spacers are durable reconstructions with almost equal functional outcomes with no added advantage of the expensive endoprosthesis.

Clinical Orthopaedics & Related Research

Background In patients who have osteosarcoma of the distal femur, there is concern that when diss... more Background In patients who have osteosarcoma of the distal femur, there is concern that when dissecting the popliteal vessels from the posterior soft tissue extent of the tumor, a less-than-wide margin of resection may be achieved depending on the extent of the posterior soft tissue mass. Surgeons have little information to guide them when deciding whether dissecting the popliteal vessels in a patient in whom the vessels are in direct contact with a posterior mass will result in an increased likelihood of local recurrence compared with patients in whom the popliteal vessels are not in contact with the tumor mass. Questions/purposes (1) Is dissecting the adherent popliteal artery and vein away from the posterior soft tissue extent of a distal femoral osteosarcoma by stripping them from their adventitia associated with an increased risk of local recurrence compared with patients in whom there is normal tissue between the tumor and vessels? (2) Is there an association with the type of ...

Journal of Orthopaedics and Traumatology

Aim To compare the functional outcome of proximal femoral reconstruction using endoprosthetic rep... more Aim To compare the functional outcome of proximal femoral reconstruction using endoprosthetic replacement and hip arthrodesis using a vascularised fibular graft Material and Methods The study included thirty-five patients who had proximal femoral reconstruction following resection of a malignant bone tumour. Patients were divided into 2 groups according to the reconstructive modality used. Group 1 (15 patients) reconstructed by hip arthrodesis using a vascularised fibular graft. Group 2 (20 patients) reconstructed by endoprosthesis. The mean age of group I was 14.9 years (range, 7-25). 8 patients had Ewing9s sarcoma, 5 osteogenic sarcoma, and 2 chondrosarcoma. In group 2, the mean age was 35 years (range, 14-61). Eight patients had osteogenic sarcoma, 2 chondrosarcoma, 2 Ewing9s sarcoma, 1 lymphoma, 1 MFH, 1 synovial sarcoma, 1 parosteal osteosarcoma, and 4 metastatic carcinomas. Results In group 1 failure of the fixation occurred in two patients, and deep infection developed in one patient. These patients were managed with revision of internal fixation and debridement respectively. The mean MSTS functional score was 87% (range 70 – 96%) at the time of the latest follow-up (mean = 64 months). The average limb length discrepancy was 2 cm (range 1 to 4). In group 2, two patients developed deep infection, one patient had a dislocation, and one had loosening of the implant with a re-operation rate of 20%. After a mean follow up of 49.1 months, the mean MSTS functional score was 79% (range 60 – 93%). Conclusion The functional outcome of hip arthrodesis using a vascularized fibular graft is comparable to endoprosthetic replacement after proximal femoral resections. It should be considered as a durable reconstructive modality in children and young active patients with long life expectancy.

Introduction and aim. Management of complicated wounds after tumor extipiration of pelvic and pro... more Introduction and aim. Management of complicated wounds after tumor extipiration of pelvic and proximal lower limb musculoskeletal sarcoma represents an essential component in the outcome of these patients. The authors present modified vertical rectus abdominis musculocutaneous (VRAM) flap techniques to reconstruct extensive defects after debridment of these complicated wounds. Material and Methods. Over a period of 4 years (2002–2005), 5 men and 2 women were managed. Median age was 21 years (range 15–49). The patients were managed for complicated lower trunk, groin, and upper thigh wounds after resection of

Journal of Clinical Orthopaedics and Trauma, 2021

Background Giant cell tumor (GCT) of bone has a rare potential for metastatic spread. This study ... more Background Giant cell tumor (GCT) of bone has a rare potential for metastatic spread. This study aimed at evaluating the incidence of chest metastases in GCT and their oncological outcome and identifying possible risk factors. Methods Medical records of 466 (313 de novo and 153 recurrent) patients with primary GCT of bone were retrospectively reviewed. Fifteen (3.2%) patients developed chest metastasis. Time from diagnosis of the primary bone lesion to the diagnosis of metastasis, treatment modalities of metastasis, and the course of treatment were revised. The functional outcome was evaluated using the Musculoskeletal Tumor Society (MSTS) scoring system, and postoperative complications were recorded. Results This study included 7 males and 8 females with a mean age of 27.3 ± 7.9 years. The most common site of the primary tumor was the distal femur. All fifteen patients were recurrent cases. The mean follow-up period was 67.7 ± 33.2 months. Chest metastasis was diagnosed after a mean time of 28.1 ± 28.9 months from the initial diagnosis of the bone lesion. One patient died of disease (DOD) 18 months after the surgical intervention. The incidence of chest metastasis in recurrent cases was 9.8%, while de novo cases did not develop chest metastasis, P < 0.001. Previous curettage was associated with a higher incidence of chest metastasis (14.6%) compared to previous resection (4.2%), P = 0.03. Conclusions Chest metastasis following GCT of bone is rare. Risk factors include recurrent cases, especially following previous curettage. Patients have a good prognosis and a low mortality rate. Level of evidence Level IV, retrospective.

Journal of Musculoskeletal Surgery and Research

Objectives: The objectives of the study was to compare the effectiveness of 1 day versus 3 days p... more Objectives: The objectives of the study was to compare the effectiveness of 1 day versus 3 days post-operative antibiotic prophylaxis in decreasing surgical site infection (SSI) rate after arthroplasty surgery. Methods: A prospective, randomized controlled trial was conducted over 1 year, in Cairo University Hospitals. The study included adult patients, who were scheduled for arthroplasty. Sixty patients were divided into two groups, 30 patients in each. The first group of patients received cefazolin for 1 day postoperatively (1-day group) and the other group for 3 days postoperatively (3-days group). Patients were randomized using the sealed opaque envelope method. Results: There were 32 females and 28 males. The mean patient age was 52 years (range 20–85 years). Wound infection developed in four cases (one case from the 1-day group and three cases from the 3-days group). All infections occurred within the early post-operative period, and completely resolved after proper management...

Fifteen patients (11 males, 4 females) with a median age of 16 years (range, 7–25) were treated i... more Fifteen patients (11 males, 4 females) with a median age of 16 years (range, 7–25) were treated in our centre by intra-articular resection of the proximal femur, and hip arthrodesis using a vascularized fibular graft. Eight patients had Ewing’s sarcoma, 5 osteogenic sarcoma, and 2 chondrosarcoma. After a mean follow up of 58.2 months, 13 patients were alive with no evidence of disease. All fibular grafts united at a mean time of 7.6 months (range, 7–9 months). Four patients had stress fractures of the vascularized fibular graft, all healed after a mean period of 6.5 weeks. Failure of the fixation system occurred in two patients. Deep infection developed in one case which necessitated plate removal. Three of these patients with complications underwent a second procedure, giving a re-operation rate of 20%. The mean MSTS functional score was 85.9% at the time of the latest follow-up. We conclude that hip arthrodesis using a vascularized fibular graft is a viable alternative to endopros...

Journal of Orthopaedic Research, 2014

Liaison: Elie Ghanem MD Leaders: Volkmar Heppert MD (International), Mark Spangehl MD, FRCSC (US)... more Liaison: Elie Ghanem MD Leaders: Volkmar Heppert MD (International), Mark Spangehl MD, FRCSC (US) Delegates: John Abraham MD, Khalid Azzam MD, Lowry Barnes MD, Federico Jose Burgo MD, Walid Ebeid MD, Nitin Goyal MD, Ernesto Guerra MD, Kirby Hitt MD, Sofiene Kallel MD, Gregg Klein MD, Yona Kosashvili MD, Brett Levine MD, Laura Matsen MD, Michael J Morris MD, James J Purtill MD, Chitranjan Ranawat MD, FRCS, FRCSC, Peter F Sharkey MD, Rafael Sierra MD, Anna Stefansdottir MD, PhD

Zagazig university medical journal, 2021

The Journal of arthroplasty, 2014

Several methods have been used for proximal humeral reconstruction following tumour resection. No... more Several methods have been used for proximal humeral reconstruction following tumour resection. None of these modalities allow the patient to regain his normal shoulder range of motion. Moreover, every modality has its advantages and disadvantages. The aim of this study was to compare the functional outcome of 2 reconstructive modalities that we are using in our institution for proximal humeral reconstruction; endoprosthesis and shoulder arthrodesis using a vascularised autograft This study included 48 patients diagnosed with malignant or benign aggressive tumours that required resection of their proximal humerus. They were divided into 2 groups according to the method of reconstruction. Group 1 included 22 patients with an average age of 20 years were reconstructed by shoulder arthrodesis using a free vascularised fibular graft (6) or a pedicled scapular crest graft (16). Group 2 included 26 patients with an average age of 26 years were reconstructed with an endoprosthesis. In group...

Current Orthopaedic Practice, 2021

Background: Several viable options have been discussed in the literature for management of bone d... more Background: Several viable options have been discussed in the literature for management of bone defects that result from resection of proximal tibial sarcomas. Pedicled vascularized fibular graft alone as a reconstructive technique can be considered as an alternative method that needs to be evaluated regarding adequacy, safety, and applicability for these situations. Methods: This is a retrospective case series study of 23 patients (14 male and nine female) aged from 7 yr to 40 yr with proximal tibial sarcomas that were managed from 1999 through 2017 by a knee-sparing limb salvage technique. Routine clinical and radiographic examinations were performed with histopathologic diagnosis that found 16 patients who had conventional osteosarcoma, three patients who had parosteal osteosarcoma, three patients who had Ewing sarcoma, and one patient who had fibrosarcoma. One patient had initial lung metastasis. Results: The average functional score from the revised Musculoskeletal Tumor Societ...

The aim of this study was to evaluate the oncologic and functional outcome after wide resection o... more The aim of this study was to evaluate the oncologic and functional outcome after wide resection of malignant tumours of the distal tibia and reconstruction of the defect by ipsilateral pedicled vascularised fibular graft and ankle arthrodesis. Thirteen patients (9 males and 4 females) with primary malignant tumours of the distal tibia were treated by wide resection. The mean age of the patients at the time of surgery was 15 years. The fibula was mobilised to fill the defect, pedicled on the peroneal vessels. The average size of the defects reconstructed was 10 cms. Patients were evaluated functionally using the Musculoskeletal Tumor Society evaluation system. The mean duration of follow-up was 27 months. Chest metastases developed in 4 patients and local recurrence in one. The mean functional score was 80% at the time of last follow-up. The average time to union of the graft both proximally and distally was 6 months. Complications were minimal and did not affect the functional outco...