Search by keyword or author

Biological Reconstruction in Musculoskeletal Oncology: Have We Reached a Turning Point?

Published: May 30, 2026 | Views: 33

Authors

Ashish Gulia

Keywords
Human action recognition, 3D skeletal data, Deep learning, Graph convolutional networks, Metaheuristic optimization, Spatiotemporal modeling, Hybrid neural networks, Transformer-based models

Abstract

In the field of musculoskeletal oncology, there has been a shift in ideology from local management of tumours with amputations to limb salvage surgery. Musculoskeletal oncology entered a new age of limb salvage due to advances in the fields of chemotherapy and radiation oncology, as well as in alloys, metals, and composites (Shojaie et al., 2023; Andrade et al., 2016). However, limb salvage is indicated only when we can achieve R0 margins and ensure that the major neurovascular structures remain uninvolved or reconstructible; salvage at all costs is a fallacy. Extensive soft tissue loss or a limb rendered insensate and ischemic is a contraindication to limb salvage surgery, where amputation would be a better functional choice.

The “void” left behind after the resection of the diseased bone was filled with a metallic prosthesis. This gave our patients almost immediate freedom of motion, a stark contrast to the older philosophy of amputation/disarticulation. However, this came at a cost; we are not gods to provide bountiful gifts that last forever. The bones we replaced with metal had an expiration date, as initial results were good but were associated with multiple complications. We were essentially placing a mechanical part into a biological system and hoping the two would coexist. Hence, we argue that we have reached a definitive turning point and are moving out of the “Age of Mechanics” and into the “Age of Biologics.” Can we consider one method as superior to the other?

References

  • Andrade, F., Teixeira, M. J. D., AraĂşjo, L. H. D. C., & Ponte, C. E. B. (2016). Knee bone tumors: Findings on conventional radiology. Radiologia Brasileira, 49(3), 182–189. https://doi.org/10.1590/0100-3984.2013.0007
  • Grimer, R. J., Aydin, B. K., Wafa, H., Carter, S. R., Jeys, L., Abudu, A., & Parry, M. (2016). Very long-term outcomes after endoprosthetic replacement for malignant tumours of bone. The Bone & Joint Journal, 98(6), 857–864. https://doi.org/10.1302/0301-620X.98B6.37417
  • Jeys, L., & Grimer, R. (2009). The long-term risks of infection and amputation with limb salvage surgery using endoprostheses. In Treatment of bone and soft tissue sarcomas (pp. 75–84). https://doi.org/10.1007/978-3-540-77960-5_7
  • Puri, A. (2021). Musculoskeletal oncology reconstructions in India–Changes in this millennium! Journal of Clinical Orthopaedics and Trauma, 20, 101473. https://doi.org/10.1016/j.jcot.2021.06.003
  • Shankhdhar, V. K., Yadav, P. S., Puri, A., Kasat, A., Dushyant, J., Raghu, R. B. N., & Gulia, A. (2018). Free fibula flap for lower limb salvage after tumour resection. Indian Journal of Plastic Surgery, 51(03), 274–282. https://doi.org/10.4103/ijps.IJPS_113_17
  • Shojaie, P., Afzali, M., Nischal, N., Iyengar, K. P., Yousef, M. M. A., & Botchu, R. (2023). Bone tumor imaging: An update on modalities and radiological findings. Journal of Arthroscopy and Joint Surgery, 10(3), 131–138. https://doi.org/10.4103/jajs.jajs_31_23
  • Tiwari, A., Mehta, S., Sharma, S. K., Chauhan, V., Rohela, H., & Arora, R. (2019). Vascularized fibula with and without extracorporeal radiotherapy for limb salvage surgery in Indian patients. Journal of Clinical Orthopaedics and Trauma, 10(1), 167–172. https://doi.org/10.1016/j.jcot.2017.09.003

How to Cite

Ashish Gulia . Biological Reconstruction in Musculoskeletal Oncology: Have We Reached a Turning Point?. J. Multidiscip. Res. Healthcare. 2025, 12, 100-102
Biological Reconstruction in Musculoskeletal Oncology: Have We Reached a Turning Point?

Current Issue

PeriodicityBiannually
Issue-1June
Issue-2December
ISSN Print2393-8536
ISSN Online2393-8544
RNI No.CHAENG/2014/57978

This work is licensed under a Creative Commons Attribution 4.0 International License.

Articles in Journal of Multidisciplinary Research in Healthcare by Chitkara University Publications are Open Access articles that are published with licensed under a Creative Commons Attribution- CC-BY 4.0 International License. Based on a work at https://jmrh.chitkara.edu.in/. This license permits one to use, remix, tweak and reproduction in any medium, even commercially provided one give credit for the original creation.

View Legal Code of the above-mentioned license, https://creativecommons.org/licenses/by/4.0/legalcode

View Licence Deed here https://creativecommons.org/licenses/by/4.0/

Creative Commons License

Journal of Multidisciplinary Research in Healthcare by Chitkara University Publications is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at https://jmrh.chitkara.edu.in/

Visibility, Memberships and Ethics