Amir Sternheim

Amir Sternheim
Tel Aviv Sourasky Medical Center | TASMC · Department of Orthopedic Oncology (National Unit- Israel)

MD

About

71
Publications
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Introduction
CT based automatic finite element bone strength in bone pathology Orthopaedic Oncology- Bone and soft tissue sarcoma, metastatic bone disease Precision surgery- 3D planning, navigation, 3D printing, radiomics
Skills and Expertise

Publications

Publications (71)
Article
Background The surgical treatment for osteoid osteoma (OO) in the foot and ankle is challenging. It is difficult to locate the lesion and the anatomy is crowded by sensitive structures. The purpose of this study was to describe the outcomes of navigated mini open-intralesional curettage (NMIC) or navigated minimally invasive radiofrequency ablation...
Article
Purpose Digital templating is an essential aspect of pre-operative planning for total joint arthroplasty procedures. For complex cases of joint reconstruction, the standard templating software is insufficient to achieve the desired accuracy. 3D printing significantly aids the pre-operative planning in complicated cases of joint reconstruction and o...
Article
BACKGROUND The main goal of treatment of soft tissue sarcomas is achieving wide negative margins to improve local control and prevent recurrence. The role of radiation therapy (RT) is well-established in sarcomas of the extremities, however its role in unplanned “Oops” operations is inconclusive. We report on the effect of RT after an unplanned sur...
Article
Background Primary bone sarcomas are associated with critically sized bone defects and require complete resection with negative margins. Recent advancements in health care have pioneered novel approaches such as the implementation of 3D surgical technologies. This study presents oncological and functional outcomes following tumor resections of long...
Article
Aims Type 2 diabetes mellitus (T2DM) impairs bone strength and is a significant risk factor for hip fracture, yet currently there is no reliable tool to assess this risk. Most risk stratification methods rely on bone mineral density, which is not impaired by diabetes, rendering current tests ineffective. CT-based finite element analysis (CTFEA) cal...
Article
Background and Objective Extra abdominal desmoid tumors are rare, highly aggressive, and invasive benign soft tissue tumors. Current treatment modalities show high levels of recurrence and comorbidities. Cryo-surgery as an alternative was subsequently investigated. Methods In this retrospective, single center study 11 patients showing symptomatic...
Article
PurposeSeveral technologies have been implemented in orthopedic surgery to improve surgical outcomes, usually focusing on more accurate execution of a surgical plan, but the development of the plan itself is also of great importance. The purpose of this study is to examine whether the use of preoperative computer planning platforms can improve the...
Article
Background : Intraoperative use of tranexamic acid (TXA) has been proven to reduce the administration of allogenic blood transfusion in total joint arthroplasty (TJA) patients. Data on TXA efficacy in reducing blood loss in trauma patients undergoing hip hemiarthroplasty are sparse, and its use is not yet well-established. The purpose of this study...
Article
Background Most benign active and latent lesions of proximal femur do not predispose a patient to a pathologic fracture. Nonetheless, there is a tendency to perform internal fixation due to the lack of accurate clinical tools that may reliably confirm low risk of pathologic fracture. As many as 30% of these surgeries may be unnecessary. A patient-s...
Article
Aims: Accurate estimations of the risk of fracture due to metastatic bone disease in the femur is essential in order to avoid both under-treatment and over-treatment of patients with an impending pathological fracture. The purpose of the current retrospective in vivo study was to use CT-based finite element analyses (CTFEA) to identify a clear qua...
Article
Full-text available
Finite element analysis (FEA), introduced more than half a century ago, requires a (qualified) analyst to generate the necessary input data, verify the output and post process the analysis results for a meaningful conclusion. The required expertise and labor efforts have precluded the use of FEA in daily medical practice by orthopedic surgeons for...
Article
Full-text available
Take home message  A retrospective in-vivo study on 41 patients with femoral MBD shows that CTFEA predicts the risk of an impending fracture by far better compared to Mirels' score (sensitivity of 100% and specificity of 67%).  CTFEA predicts well the fracture location.  The CTFEA is quick and automated and may be easily incorporated into CT sca...
Article
OBJECTIVES Previous observational research has shown that elderly patients with hip fractures who are operated early (within 48 hours from admission) benefit from less short‐ and long‐term mortality compared to those operated later. The objective of this study was to present regulatory measures aimed at promotion of early hip fracture surgery and t...
Article
Methylphenidate (MP), a widely used and abused stimulant medication for ADHD, negatively affects bone mass. However, previous epidemiological studies demonstrated that MP is not associated with increased incidence of fractures in children, and may even have a protective effect due to behavior modification. This study aimed to investigate the associ...
Poster
Objective: To investigate the effect of regulatory measures aimed at pro- moting of early hip fracture fixation on rates of operations performed within 48 hours from admission and on overall mortality. Methods: Hip fracture surgery performed within 48 h from admission has been associated with a significant decrease in short- and long-term mor- tali...
Article
Aims: Intra-articular 90Yttrium (90Y) is an adjunct to surgical treatment by synovectomy for patients with diffuse-type tenosynovial giant-cell tumour (dtTGCT) of the knee, with variable success rates. Clinical information is, however, sparse and its value remains unclear. We investigated the long-term outcome of patients who underwent synovectomy...
Article
Background: The objective of this study was to assess the accuracy and reproducibility of a novel cone-beam computed tomography (CBCT)-guided navigation system designed for osteotomies with joint-sparing bone cuts. Methods: Eighteen surgeons participated in this study. First, 3 expert tumor surgeons resected bone tumors in 3 Sawbones tumor model...
Article
Full-text available
Physician recommendation for prophylactic surgical fixation of a femur with metastatic bone disease (MBD) is usually based on Mirels' criteria and clinical experience, both of which suffer from poor specificity. This may result in a significant number of these health compromised patients undergoing unnecessary surgery. CT-based finite element analy...
Article
Full-text available
Objective Soft-tissue sarcomas are most frequently located deep within myofascial compartments. Superficial soft-tissue sarcomas (S-STS) are relatively less common and may be managed differently than deep sarcomas because generous resection margins are often possible without sacrificing critical structures. We sought to investigate the frequency an...
Article
Full-text available
Background: There are several different techniques commonly used to perform intramedullary (IM) nailing of the femur to fix femoral fractures. We sought to identify significant differences in outcomes of studies comparing 1) trochanteric and piriformis entry and 2) antegrade and retrograde entry in IM nailing of the femur. Methods: We searched M...
Article
Background: There are several different techniques commonly used to perform intramedullary (IM) nailing of the femur to fix femoral fractures. We sought to identify significant differences in outcomes of studies comparing 1) trochanteric and piriformis entry and 2) antegrade and retrograde entry in IM nailing of the femur. Methods: We searched M...
Article
Excision of the proximal femur for tumour with prosthetic reconstruction using a bipolar femoral head places a considerable load on the unreplaced acetabulum. We retrospectively reviewed the changes which occur around the affected hip joint by evaluating the post-operative radiographs of 65 consecutive patients who underwent proximal prosthetic art...
Article
This Sawbones and cadaver study was performed to assess the accuracy and reproducibility of pelvic bone cuts made with use of a novel navigation system with a navigated osteotome and oscillating saw. Using a novel navigation system and a three-dimensional planning tool, we navigated pelvic bone cuts that were representative of typical cuts made in...
Article
Background: The objectives of this study were to evaluate the risk of local recurrence and survival after soft tissue sarcoma (STS) resection with positive margins and to evaluate the safety of sparing adjacent critical structures. Methods: One hundred sixty-nine patients with localized STS who had positive resection margins were identified from...
Article
Background: POSSUM was developed to predict risk-adjusted mortality and morbidity rates for surgical procedures. We evaluated the impact of serum albumin and serum protein levels on POSSUM scores. Methods: Medical files of 2269 patients operated for proximal femur fractures were reviewed. Preoperative serum albumin levels were available for 387...
Article
In North America, two-stage revision arthroplasty is the treatment of choice for chronic periprosthetic infection of the hip and knee. Controversy exists regarding the diagnosis of persistent infection, cement spacer design, and duration of antibiotic therapy. Erythrocyte sedimentation rate and C-reactive protein tests have no clear cutoff values f...
Article
The sternoclavicular joint (SCJ) is a true diarthrodial synovial joint and therefore vulnerable to the same disease processes as in other synovial joints. We identified a group of patients with monarticular arthritis of the SCJ that had a benign process and a self-limited disease course. This retrospective study included 25 female patients who pres...
Article
The conventional method for reconstructing acetabular bone loss at revision surgery includes using structural bone allograft. The disadvantages of this technique promoted the advent of metallic but biocompatible porous implants to fill bone defects enhancing initial and long-term stability of the acetabular component. This paper presents the indica...
Article
The purpose of this study was to determine patients' survival after undergoing an early or delayed operation. We retrospectively assessed 1849 files of patients operated for proximal femoral fracture, divided into two diagnostic groups: intracapsular (n=640) and extracapsular (n=1209). 1163 (63%) were treated within 48h from hospital admission and...
Article
Purpose Acquired patella baja may result in decreased range of motion of the knee, extensor lag, and anterior knee pain. The aim of the study was to evaluate the efficacy of tibial tubercle osteotomy with proximal displacement.
Article
Full-text available
The objective of this study was to evaluate the early results of a custom non-fluted diaphyseal press-fit stem for use with the global modular replacement system (GMRS) tumour prosthesis and the early complications associated with this implant. A total of 53 patients (54 implants) were identified from a prospective database where a custom non-flute...
Article
Full-text available
We investigated the clinical outcome of internal fixation for pathological fracture of the femur after primary excision of a soft-tissue sarcoma that had been treated with adjuvant radiotherapy. A review of our database identified 22 radiation-induced fractures of the femur in 22 patients (seven men, 15 women). We noted the mechanism of injury, fra...
Article
Full-text available
A biomechanical computer-based model was developed to simulate the influence of patellar thickness on passive knee flexion after arthroplasty. Using the computer model of a single-radius, PCL-sacrificing knee prosthesis, a range of patella-implant composite thicknesses was simulated. The biomechanical model was then replicated using two cadaveric k...
Article
The early term results of 29 cases of revision total knee arthroplasty using highly porous trabecular metal cone implants for femoral and tibial major bone deficit reconstruction (Anderson Orthopedic Research Institute classification type 2B and 3) have been prospectively analyzed. Indications for revision surgery included: aseptic loosening/wear,...
Article
Full-text available
Background: It is common practice in many centers to avoid performing a clean case in a room in which an infected procedure has just taken place. No studies of which we are aware speak to the necessity of this precaution. Questions/purposes: The purposes of this study were to identify (1) the risk of infection in a group of patients who underwen...
Article
Purpose: The need for perioperative blood management measures aimed at improving patient outcomes and reducing allogenic blood transfusion (ABT) is increasingly recognised. Our study aim is to create an algorithm to predict and manage the need for blood transfusion in patients with hip fractures. Methods: We retrospectively assessed 1,484 patien...
Article
Full-text available
Trabecular metal (TM) augments are a relatively new option for reconstructing segmental bone loss during acetabular revision. We studied 34 failed hip replacements in 34 patients that were revised between October 2003 and March 2010 using a TM acetabular shell and one or two augments. The mean age of the patients at the time of surgery was 69.3 yea...
Article
Background: Both external fixation and open reduction with internal fixation (ORIF) using plates have been recommended for treatment of distal radius fractures. We conducted a systematic review and meta-analysis of randomised controlled trials comparing external fixation to ORIF. Methods: MEDLINE, EMBASE, and COCHRANE databases were searched fro...
Article
Full-text available
Well-differentiated liposarcoma represents a radiographic diagnostic dilemma. To determine the accuracy, interrater reliability, and relationship of stranding, nodularity, and size in the MRI differentiation of lipoma and well-differentiated liposarcoma, MRI scans of 60 patients with large (>5 cm), deep, pathologically proven lipomas or well-differ...
Article
Purpose: Acquired patella baja may result in decreased range of motion of the knee, extensor lag, and anterior knee pain. The aim of the study was to evaluate the efficacy of tibial tubercle osteotomy with proximal displacement. Methods: Between 1998 and 2011, a proximalization of the tibial tuberosity was performed in 15 patients (15 knees) wit...
Article
Full-text available
Achieving coronal balance during arthroplasty of a valgus knee presents a challenge for the surgeon. Various techniques for lateral release had been described with no consensus among surgeons. We retrospectively reviewed 42 consecutive patients (38 women, mean age 72.7 years, follow-up 42 ± 23 months) with a valgus deformity who were operated while...
Article
In this study we present our experience with four generations of uncemented total knee arthroplasty (TKA) from Smith & Nephew: Tricon M, Tricon LS, Tricon II and Profix, focusing on the failure rates correlating with each design change. Beginning in 1984, 380 Tricon M, 435 Tricon LS, 305 Tricon 2 and 588 Profix were implanted by the senior author....
Article
Purpose: Revision surgery for component malrotation in the painful TKA is a relatively novel indication. The purpose of this study was to assess the benefit of revision TKA for component malrotation with regard to the clinical and functional outcomes. Methods: Our retrospective case-control study included 51 patients who underwent revision surge...
Article
Long-term outcomes of cemented and uncemented cups were compared in patients with hip dysplasia who had undergone revision hip arthroplasty. Patients had uncontained superolateral acetabular defects reconstructed with a structural allograft. This retrospective study compared 18 cemented acetabular cups to 27 uncemented acetabular cups. Average foll...
Article
The treatment of substantial proximal femoral bone loss in young patients with developmental dysplasia of the hip (DDH) is challenging. We retrospectively analysed the outcome of 28 patients (30 hips) with DDH who underwent revision total hip replacement (THR) in the presence of a deficient proximal femur, which was reconstructed with an allograft...
Article
We report the use of porous metal acetabular revision shells in the treatment of contained bone loss. The outcomes of 53 patients with ≤ 50% acetabular bleeding host bone contact were compared with a control group of 49 patients with > 50% to 85% bleeding host bone contact. All patients were treated with the same type of trabecular metal acetabular...
Article
This study provides an objective appraisal of available evidence regarding the outcome of proximal femoral allograft for reconstruction of massive proximal femoral bone loss. The primary outcomes were rates of success, structural failure, and infection. A systematic literature review identified 16 studies with a minimum 2-year follow-up. Estimated...
Article
Distal femoral medial closing wedge osteotomy is useful for mechanical axis realignment to unload the lateral compartment of the valgus knee. The primary indication for unloading the lateral compartment is lateral unicompartmental osteoarthritis. Alternative treatment options include lateral unicompartment or total knee arthroplasty (TKA). Prerequi...
Article
It is important to avoid underestimating the significance of wound complications following total knee arthroplasty (TKA). Expedient and aggressive care is recommended. Understanding the blood supply to the skin around the knee and measures to prevent wound complications are fundamental to preventing wound problems. A detailed patient history and ph...
Article
Full-text available
Background: Pleomorphic Sarcoma is the most common histologic subtype of high grade soft tissue sarcoma involving the extremities. Methods: This retrospective study analyzed 135 patients presenting with primary Pleomorphic Sarcomas which were treated at a single referral institute between 1980 and 2006. Data was collected from an institutional data...
Article
Full-text available
As the indications for total hip arthroplasty increase, the prevalence of extensive proximal femoral bone loss will increase as a consequence of massive osteolysis, stress shielding and multiple revisions. Proximal femoral bone stock deficiency provides a major challenge for revision hip arthroplasty and is likely to account for a significant futur...
Article
Computed tomography (CT) is currently considered to be an accurate method for evaluating bone density. We evaluated the CT measurements of bone density using the Hounsfield units (HUs) in 23 patients who had been operated in the past for an extra-capsular hip fracture. Twelve patients were treated with a dynamic hip screw and 11 with a proximal fem...
Article
Background: Extracompartmental soft-tissue sarcomas of the sartorial canal grow in a virtual space in close proximity to the superficial femoral artery and vein and thus require a complex resection. This study was designed to assess the presentation pattern, preoperative evaluation and oncologic and functional outcomes. Methods: We retrospectively...
Article
Extra-compartmental soft tissue sarcomas may grow in virtual spaces in close proximity to major neurovascular structures and thus, require a complex resection. We analyzed the general principles by which these resections are planned. We retrospectively analyzed 53 patients with sarcomas located in the femoral triangle (15), sartorial canal (16), an...
Article
We evaluated the efficacy of the expandable nailing system for treating femur and tibia shaft nonunions. Records of 24 patients (25 fractures) were retrospectively reviewed: 16 with femur and 8 with tibia nonunions. The bones underwent reaming, and the largest possible nail sizes were inserted during re-operation. Bone debris obtained from the ream...
Article
Bladder exstrophy-epispadias complex is a rare spectrum of congenital anomalies that includes a midline abdominal wall defect and a widened pelvis with an anterior diastasis. Our patient was involved in a motorcycle accident with severe multiple injuries and concomitant bladder extrophy. In a unique and urgent clinical setting, his congenital pubic...
Article
'Telangiectatic' change, which contains a large fluid hemorrhagic component, occurs in a variety of high-grade soft tissue sarcomas. In a retrospective database review, we identified 20 consecutive patients (3%) with 'telangiectatic' change in soft tissue sarcomas. Tumors were located in the thigh (55%), shoulder (15%), calf (15%), upper arm (10%),...
Article
Recently, a method for transcranial magnetic stimulation (TMS) of the brain has been developed. Thus, it is possible to explore neurochemical and behavioral effects of TMS in rats. Repeated TMS (9 days) reduced beta-adrenergic receptor binding in cortex, as does electroconvulsive shock (ECS) and other antidepressant treatments. Thus TMS appears to...

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